Step-by-Step Guide to Accessing TKIs for CML
Patients in Nova Scotia
This guide provides step-by-step instructions for Chronic Myeloid Leukemia (CML) patients in Nova Scotia, to access Tyrosine Kinase Inhibitors (TKIs). It includes details on navigating provincial drug programs, private insurance, and additional resources.
1. General Overview
Accessing TKIs in Nova Scotia involves a combination of private insurance, provincial drug programs, and patient assistance programs. These steps ensure that patients receive life- saving medications without financial barriers.
2. Step-by-Step Instructions
Step 1: Consult with Your Oncologist
Your oncologist will determine the most appropriate TKI for your treatment and provide the prescription. They may also initiate the application process for provincial drug plans or private insurance.
Step 2: Submit to Private Insurance
If you have private insurance, submit your TKI prescription to your insurer. Private insurance will typically cover a portion of the drug cost. Obtain an Explanation of Benefits (EOB) document from your insurer for any remaining costs.
Step 3: Apply to Provincial Drug Programs
Accessing TKIs Through Pharmaceutical Company Programs In some case, employer sponsored, or private drug plans may have high co-pays. Co-Pays are the amount you pay after the deduction. In that case, pharmaceutical companies often sponsor patient support programs, administered by third parties such as Innomar, Bayshore, or McKesson, to help patients access TKIs.
The steps to access the programs are essentially the same as obtaining coverage from your private plan/ employer drug plan:
1. Consult with your oncologist or hematologist for a prescription and necessary
documentation/referral. Submit a Special Authorization request to your insurance provider, along with supporting medical documents. For non-generic TKI’s there are patient support programs:
1. Asciminib (Scemblix): Mfg. Novartis
Patient support program Sentia – PSP contact information:
Phone: 1-855-736-8421
Fax: 1-866-636-8421
Email: psp@sentia-exp.ca
2. Nilotinib (Tasigna): Mfg. Novartis
Patient support program Sentia – PSP contact information:
Phone: 1-855-736-8421
Fax: 1-866-636-8421
Email: psp@sentia-exp.ca
3. Bosutinib (Bosulif): Pfizer Liaison (1-844-616-6888)
4. Ponatinib (Iclusig): Paladin Labs Distribution Program for patients. Contact 1.877.318.4462 or Email: PalSupport@bayshore.ca for support Generic TKIs and Cost-Saving Options
With the availability of generic TKIs like dasatinib, patients may find these alternatives more affordable.
Consult your healthcare provider about switching to a generic medication if cost is a concern.
Key Resources for Support:
Here are some organizations and programs that can assist with accessing TKIs:
1. CML Society of Canada: Provides guidance on medication access. Provincial Cancer Societies: Provide support and guidance for patients navigating access to treatments.
2. Pharmacists: Assist with insurance claims and provide information on co-pay programs.
3. Healthcare Providers: Work closely with your oncologist and care team to ensure timely access to medications.
Conclusion:
Accessing TKIs for CML treatment in Atlantic Canada involves coordination between private insurance, provincial drug programs, and patient assistance programs. By following these steps, patients can navigate the system effectively and ensure access to life-saving treatments.