I am a pharmacist in Canada, and I see how Fair PharmaCare deductible costs can create a major financial burden for patients in British Columbia, especially those living with multiple sclerosis (MS). Even when a medication is eligible for coverage, patients must first pay a significant deductible out of pocket before any coverage begins. For those with conditions such as MS, this can be especially challenging given that many MS treatments are considered high cost specialty medications.

Details of BC's Fair PharmaCare

In BC, prescription drug coverage falls under Fair PharmaCare, a program that helps families pay for eligible medication costs. However, before coverage begins, patients must first pay a deductible based on their household income. Only after meeting that deductible does Fair PharmaCare begin covering 70% of eligible costs, and once the family maximum is reached, coverage rises to 100%.

These deductible amounts are substantial, and they apply the same way whether you are a single person or a family, since Fair PharmaCare is based on net household income, not family size.

According to BC’s official Fair PharmaCare income bands:

• Income $45,000 to $48,333: deductible $1,400 before Fair PharmaCare begins covering 70% of eligible costs, with 100% coverage after $2,000 in total spending
• Income $65,000 to $70,833: deductible $2,000 before 70% coverage begins, with 100% coverage after $3,000
• Income $100,000 to $108,000: deductible $3,000 before 70% coverage begins, with 100% coverage after $4,500
• Income $120,000 to $125,000: deductible $3,500 before 70% coverage begins, with 100% coverage after $5,250
• Income $170,000 to $180,000: deductible $6,000 before 70% coverage begins, with 100% coverage after $9,000
• Income above $250,000: deductible $10,000 before 70% coverage begins, with 100% coverage also after $10,000 in total spending

Fair PharmaCare Assistance Levels

Once a patient finally reaches their maximum and qualifies for full coverage, the cycle resets every January 1. Each year, people living with MS must start over and pay the full deductible again before Fair PharmaCare contributes, creating a repeating financial shock that adds stress to an already difficult condition.

Within the first month of starting some treatments, many patients can reach their entire annual deductible. For example:
• Rituximab, commonly used for relapsing remitting MS, costs about $3,269 per 1 g dose. A commonly used schedule includes two 1 g infusions two weeks apart (about $6,540 total), followed by another 1 g every 6 months, for approximately $9,800 in the first year. Some patients may receive other doses depending on their treatment plan.
• Ocrelizumab (Ocrevus), only covered by PharmaCare for primary progressive MS, costs about $8,588 per 300 mg vial. The standard dosing includes two 300 mg infusions two weeks apart (about $17,000 total) and another 600 mg every 6 months, for approximately $34,000 in the first year.

While Fair PharmaCare does offer an option to spread deductible payments monthly, this only eliminates the upfront payment, not the total financial burden. Most people with MS still meet their full deductible each year, and that ongoing cost can cause significant financial and emotional stress. On top of this, living with MS involves many other expenses beyond medication, such as travel to infusion clinics, mobility aids, time off work, home adaptations, and managing symptoms like fatigue and pain.

MS Canada reports that “medications, specifically DMTs, represented 65% of the annual excess cost of MS,” and that “the annual cost of MS to Canada is significant, totalling more than $3.4 billion in direct health costs, productivity losses and other costs.” MS Canada also notes that “early diagnosis and timely intervention with the most effective treatment is key to protecting brain health, preserving function, and minimizing the impact on our healthcare system.” Let's eliminate this deductible burden!

People living with MS already face uncertainty about their health. They should not also face a financial crisis each year just to access evidence based treatment that helps them remain active, employed, and independent.

I am calling on the BC Ministry of Health to eliminate the Fair PharmaCare deductible for all British Columbians living with multiple sclerosis, a life long chronic illness. Please add your name and help ensure that access to treatment depends on medical need, not financial means.

Please share your experience in the comments. Do you reach your deductible every year? Does it create financial stress for you or your family? Have you had to delay or struggle to afford treatment? Your stories matter and will help show why change is urgently needed in BC.

References:

MS Canada. Health Care Costs Associated with MS. “Medications, specifically DMTs, represented 65% of the annual excess cost of MS.”

https://mscanada.ca/ms-research/latest-research/health-care-costs-with-multiple-sclerosis#:~:text=Medications%2C%20specifically%20DMTs%20represented%2065,such%20as%20physician%20visits%20costs.
MS Canada. Costly Disease… Costly Delays / The Cost of MS to Canada. “The annual cost of MS to Canada is significant, totalling more than $3.4 billion in direct health costs, productivity losses and other costs.” 

https://mscanada.ca/cost-of-ms
MS Canada. COVID Disruptions to Cost Multiple Sclerosis Community $600 Million. Quote by Dr. Pamela Valentine, President and CEO, MS Canada. 

https://mscanada.ca/about-us/news-and-publications/covid-disruptions-to-cost-multiple-sclerosis-community-600-million
BC Ministry of Health. Fair PharmaCare Assistance Levels – Regular. Income Band Table. https://www2.gov.bc.ca/assets/gov/health/forms/5405fair_pharmacare_income_bands_regular.pdf