Frequently Asked Questions

A Drug Access Navigator, or DAN, is a healthcare professional who’s focus is to connect a patient with a drug / treatment. This can include assisting with applications for public / private insurance, enrolling patients into various programs to help with cost as well other tasks like genomic testing. The DAN takes the burden of paperwork, applications and appeals away from the patient as much as possible so they can focus on their treatment.

DANs are mostly found in cancer clinics but are increasingly found in other diseases like Multiple Sclerosis and Cystic Fibrosis. There are over 200 DANs in various clinics across Canada.

The Drug Access Navigator can also be known by other titles like Drug Access Facilitator, Drug Access Coordinator and Medication Reimbursement Specialist.

A pharmaceutical manufacturer's patient support program, or PSP, is a service to provide features for patients on specific medications. They can offer things like bridging medication where a drug is provided free until there is public or private coverage. They may provide financial assistance to cover extra costs of a medication, like an insurance copayment or deductible. They may also assist patients by coodinating private infusion of a drug given intravenously, home delivery of an oral drug and other services like nursing drug adherance call reminders.

If you have specific inquiries about accessing a medication, you should:

1. For cancer related medications, see if your cancer clinic has a Drug Access Navigator that can assess your situation and see what opportunities exist to help. They may go by another title.
   1. For Ontario cancer patients, you can also use www.odano.ca for helpful information.
   2. For Quebec cancer patients, you can also use www.aqcamo.ca for helpful information.
   3. For Atlantic cancer patients, you can also use www.acodana.ca for helpful information
2. For non-cancer patients, check with your prescriber or pharmacist for guidance on what options may be available to assist you.

This process is much more complex than outlined here but the basic steps are:

Health Canada will review the drug effect and safety. If approved, the drug will be marketable in Canada and given a Drug Identifical Number (DIN).

Then, a Health Technology Assessment (HTA) will take place. This is done by Canada's Drug Agency or the Institut national d'excellence en santé et services sociaux (INESSS) for Quebec. They will assess value of the treatment.

Canada's Drug Agency | CDA-AMC (cadth.ca)
INESSS: Home

If approved, pricing negotiations will take place. This is done through the pan-Canadian Pharmaceutical Alliance (pCPA). Pricing is negotiated between the drug manufacturer and government. 

Brand Name Drug Negotiations Status | pCPA (pcpacanada.ca)

With pricing complete, the drug will be approved by the provinces next and become a public benefit.

Drugs in Canada are funded through a patchwork of different methods. 

• Drugs provided in hospital are paid for by the hospital at no cost to the patient. 
• Drugs taken outside of hospital are often the responsibility of the patient. This can include public drug coverage through provincial or federal plans or through private health insurance. Provinces have their own systems for covering patients. Private health insurance is often obtained through an employer or can be purchased on its own by a patient like travel insurance. 
• Sometimes drugs are paid for out-of-pocket. This is where a patient pays out the cost of the drug themselves and may be due to not having public / private drug insurance or for a drug not paid for by the government such as off label use.

While government health insurance plans give you access to basic medical services, you may also have private insurance to pay for things that government plans don’t fully cover.

These extended health plans may cover costs for:

• prescription medications
• dental care
• physiotherapy
• ambulance services
• prescription eyeglasses

Often this extended coverage is often provided through an employer but can also be purchases on its own like travel insurance. You may pay a monthly fee through your employer to obtain these private health benefits.

The Special Access Programme (SAP) provides access to drugs that have not been approved for use by Health Canada. These are drugs for treating patients with serious or life-threatening conditions when conventional therapies have failed, are unsuitable, or unavailable. The SAP authorizes a manufacturer to sell a drug that cannot otherwise be sold or distributed in Canada. Drugs considered for release by the SAP include pharmaceutical, biologic, and radio-pharmaceutical products not approved for sale in Canada.

To see if a drug is available through the Special Access Program, you may want to reach out to the drug manufacturer directly.

You can learn more about SAP here: 

https://www.canada.ca/en/health-canada/services/drugs-health-products/special-access/drugs.html

Drug Access Canada provides access to the OKRX platform for healthcare providers to enroll patients into Patient Support Programs. OKRX cuts down on paperwork, faxing and phone calls by providing electronic forms for all Patient Support Program forms in a single cloud based solution.

You can learn more about their digital platform at: Health Care Providers | OkRx