Several multiple sclerosis drugs covered by Pharmacare in every province except B.C.

When Deborah Stefanek was 38 years old, the mother of four from Kimberley, B.C. was diagnosed with relapsing remitting multiple sclerosis.

That was in 2018, and she hoped a healthy lifestyle would enable her to stay off medication. She changed her diet and started an exercise routine. But after an MRI last fall showed her disease is progressing, Stefanek’s neurologist recommended she begin taking a new medication called Kisempta.

The drug’s manufacturer agreed to temporarily provide the medication free of charge while Stefanek looked into coverage through Pharmacare and private insurance.

“And it came back that my husband’s insurance would only cover 45 per cent of the cost of Kesimpta, which would mean we would have to pay $19,000 out of pocket, because B.C. Pharmacare doesn’t cover it,” said Stefanek.

She was shocked to learn every province in Canada covers Kisempta under their Pharmacare plans except B.C. It’s the same situation for a similar drug called Ocrevus. Stefanek’s friend Andrea Rollheiser, who also has RRMS, was told by her neurologist that Ocrevus is the best drug for her, but it too isn’t covered by B.C. Pharmacare.

The province’s health critic Shirley Bond says that’s unacceptable.

“As patients in British Columbians look across the country, British Columbia is an island on this issue unto itself. And it very hard for people to understand why other jurisdictions, including the one next door to us, can figure out how to cover these drugs,” said Bond, who believes it’s all about cost.

Roche Canada, the maker of Ocrevus, is hoping the B.C. government will reverse course and cover both drugs, which are approved by Health Canada and have been proven to reduce the number and severity of MS relapses.

“All of the other provincial governments have made the decision to make this medicine available, they felt it was a valuable medicine for those living with MS in thier province. And we are equally hopeful that we can have a discussion with the government of British Columbia so that a similar decision can be made,” said Roche Canada president and CEO Brigitte Nolet.

Bond says the opposition will continue to push the government to reconsider its decision on Kesimpta and Ocrevus. And she hopes patients keep speaking out.

“I think it is important for people to speak up and remind the government, and certainly we are doing that as well, that other jurisdictions have figured this out, have approved it. And MS patients, particularly those that suffer from relapse, are being treated differently in B.C. than the rest of the country,” said Bond.

Stefanek says with the bridge financing from the drug company now over, she can only remain on Kestimpa if it’s covered by Pharmacare.

“As it stands right now, we cannot afford that $19,000. So currently, I’m not on the medication,” she said.

And that has her worried she’s at risk for relapse, which could leave her bedridden and unable to care for her kids.

“I need to keep moving, being able to support them and provide for them,” Stefanek said. “If I’m sick, I’m no good to anybody.”