Patients potentially covered
Indicates the number of potential patients by type of coverage (public, private, not covered/cash) if all drug plans reimbursed the product.
Patients coverage estimate / Estimation de la couverture des patients
Product : Qalizumab
Indication: Rheumatoid arthritis / Polyarthrite rheumatoide
1. Patients potentially covered
Number of patients
Province
Provincial plan
NIHB
Private plan
No coverage (Cash)
Total
BC
8,857
0
4,392
0
13,250
AB
5,566
183
4,248
0
9,997
SK
1,854
223
886
0
2,963
MB
1,683
236
1,498
0
3,416
ON
19,233
440
17,112
0
36,785
QC
14,210
156
8,026
0
22,392
NB
1,095
42
1,052
0
2,189
PE
230
8
178
2
419
NS
1,650
52
975
20
2,697
NL
713
29
742
0
1,485
TERR
142
112
100
0
353
Canada
55,234
1,480
39,209
22
95,945
Description: The table shows the the number of potential patients by type of coverage (public, private, not covered/cash) if all drug plans reimbursed the product.
2. Patients effectively covered
Number of patients
Province
Provincial plan
NIHB
Private plan
No coverage (Cash)
Total
BC
0
0
1,251
11,999
13,250
AB
0
183
2,099
7,716
9,997
SK
1,854
223
886
0
2,963
MB
0
236
333
2,847
3,416
ON
19,233
440
17,112
0
36,785
QC
14,210
156
8,026
0
22,392
NB
0
42
269
1,877
2,189
PE
0
8
65
346
419
NS
1,650
52
975
20
2,697
NL
0
29
249
1,206
1,485
TERR
0
112
34
207
353
Canada
36,947
1,480
31,300
26,218
95,945
Description: The table shows the number of patients by type of coverage (public, private, not covered/cash) based on the drug plans that reimburse the product as specified in the questionnaire.
1.1 Patients potentially covered
Patients percent breakdown
Province
Provincial plan
NIHB
Private plan
No coverage (Cash)
Total
BC
9.2%
0.0%
4.6%
0.0%
13.8%
AB
5.8%
0.2%
4.4%
0.0%
10.4%
SK
1.9%
0.2%
0.9%
0.0%
3.1%
MB
1.8%
0.2%
1.6%
0.0%
3.6%
ON
20.0%
0.5%
17.8%
0.0%
38.3%
QC
14.8%
0.2%
8.4%
0.0%
23.3%
NB
1.1%
0.0%
1.1%
0.0%
2.3%
PE
0.2%
0.0%
0.2%
0.0%
0.4%
NS
1.7%
0.1%
1.0%
0.0%
2.8%
NL
0.7%
0.0%
0.8%
0.0%
1.5%
TERR
0.1%
0.1%
0.1%
0.0%
0.4%
Canada
57.6%
1.5%
40.9%
0.0%
100.0%
Description: The table shows the break down of patients potentially covered by type of coverage.
2.1 Patients effectively covered
Patients percent breakdown
Province
Provincial plan
NIHB
Private plan
No coverage (Cash)
Total
BC
0.0%
0.0%
1.3%
12.5%
13.8%
AB
0.0%
0.2%
2.2%
8.0%
10.4%
SK
1.9%
0.2%
0.9%
0.0%
3.1%
MB
0.0%
0.2%
0.3%
3.0%
3.6%
ON
20.0%
0.5%
17.8%
0.0%
38.3%
QC
14.8%
0.2%
8.4%
0.0%
23.3%
NB
0.0%
0.0%
0.3%
2.0%
2.3%
PE
0.0%
0.0%
0.1%
0.4%
0.4%
NS
1.7%
0.1%
1.0%
0.0%
2.8%
NL
0.0%
0.0%
0.3%
1.3%
1.5%
TERR
0.0%
0.1%
0.0%
0.2%
0.4%
Canada
38.5%
1.5%
32.6%
27.3%
100.0%
Description: The table shows the break down of patients effectively covered by type of coverage.
1.2 Patients potentially covered
Potential coverage of patients, Canada
Description: The graph shows the break down of patients potentially covered at the canadian level by type of coverage.
2.2 Patients effectively covered
Effective coverage of patients, Canada
Description: The graph shows the break down of patients effectively covered at the canadian level by type of coverage.
2.3 Patients effectively covered
Patients breakdown by province
Description: The graph shows the break down of patients effectively covered by province and by type of coverage.
2.4 Patients effectively covered
Coverage rate by province
Description: The graph shows the percentage of patients for whom the product is effectively reimbursed, by province and type of coverage. Patients who are not covered/cash are excluded from the graph.
3. Drug coverage within the private plan segment
Coverage rate by plan type
Province
Open plans
Managed plans
Mimicking province
Total private
BC
27.8%
11.0%
0.0%
21.4%
AB
48.4%
30.4%
0.0%
42.4%
SK
100.0%
100.0%
100.0%
100.0%
MB
36.1%
23.4%
0.0%
22.2%
ON
100.0%
100.0%
100.0%
100.0%
QC
100.0%
100.0%
100.0%
100.0%
NB
36.8%
11.7%
0.0%
25.6%
PE
35.7%
4.6%
0.0%
25.2%
NS
100.0%
100.0%
100.0%
100.0%
NL
31.1%
28.8%
0.0%
30.1%
TERR
31.5%
24.3%
0.0%
29.2%
Canada
78.9%
74.1%
31.3%
75.3%
Description: The table presents the coverage rate of the drug within private drug plans only.
Private plans coverage rate, Canada
4. Main opportunities to increase reimbursement
Description: The graph shows the main market segments where the product is not yet reimbursed. It represents the main oppotunities for increasing coverage for the product.
Summary of responses used in calculations
Product basic information
| Questions | Answer |
|---|---|
| Report name | Patients coverage estimate / Estimation de la couverture des patients |
| Product name | Qalizumab |
| Disease or indication | Rheumatoid arthritis / Polyarthrite rheumatoide |
| Is the product used to treat cancer (oncology)? | No |
| Specify the annual cost of the product. | Annual cost between $10,000 and $24,999. |
Information on disease prevalence/incidence
| Age group | Male | Female |
|---|---|---|
| 0-14 years old | 0% | 0% |
| 15-24 years old | 0.05% | 0.05% |
| 25-34 years old | 0.15% | 0.15% |
| 35-44 years old | 0.2% | 0.2% |
| 45-54 years old | 0.3% | 0.3% |
| 55-64 years old | 0.4% | 0.4% |
| 65-74 years old | 0.5% | 0.5% |
| 75-84 years old | 0.7% | 0.7% |
| 85+ | 0.7% | 0.7% |
| Segment of the total market | 100% | |
Information on public coverage
| Provinces | Public plans covering product |
|---|---|
| British Columbia | |
| Alberta | |
| Saskatchewan | Yes |
| Manitoba | |
| Ontario | Yes |
| Quebec | Yes |
| New Brunswick | |
| Prince Edward Island | |
| Nova Scotia | Yes |
| Newfoundland | |
| Territories | |
| NIHB | Yes |
Information on private coverage
| Insurers | Open plans | Managed plans |
|---|---|---|
| Sunlife | Yes | Yes |
| Manulife | ||
| Canada Life (GWL) | ||
| Green Shield | ||
| Desjardins | Yes | Yes |
| Beneva | ||
| Industrial Alliance | Yes | Yes |
| Pacific Blue Cross | ||
| Alberta Blue Cross | Yes | |
| Manitoba Blue Cross | Yes | |
| Saskatchewan Blue Cross | Yes | Yes |
| Medavie | ||
| ClaimSecure | ||
| Other |
Appendix 1: Number of covered patients by age group
A1-1. Patients potentially covered
Age 0-24
Province
Provincial plan
NIHB
Private plan
No coverage (Cash)
Total
BC
122
0
186
0
308
AB
60
13
206
0
279
SK
32
16
41
0
89
MB
38
16
54
0
108
ON
215
18
734
0
967
QC
150
6
314
0
470
NB
12
2
30
0
44
PE
2
0
7
0
10
NS
18
2
38
1
59
NL
11
1
17
0
29
TERR
5
7
4
0
15
Canada
666
82
1,631
1
2,379
A1-2. Patients effectively covered
Age 0-24
Province
Provincial plan
NIHB
Private plan
No coverage (Cash)
Total
BC
0
0
40
268
308
AB
0
13
87
179
279
SK
32
16
41
0
89
MB
0
16
12
80
108
ON
215
18
734
0
967
QC
150
6
314
0
470
NB
0
2
8
34
44
PE
0
0
2
8
10
NS
18
2
38
1
59
NL
0
1
6
22
29
TERR
0
7
1
7
15
Canada
415
82
1,282
600
2,379
Age 25-64
Province
Provincial plan
NIHB
Private plan
No coverage (Cash)
Total
BC
3,192
0
4,206
0
7,398
AB
2,136
134
4,042
0
6,312
SK
735
166
845
0
1,747
MB
712
172
1,123
0
2,007
ON
4,295
291
16,378
0
20,965
QC
4,498
100
7,712
0
12,310
NB
420
29
724
0
1,173
PE
49
6
171
2
227
NS
459
36
937
20
1,452
NL
301
20
484
0
805
TERR
79
81
96
0
255
Canada
16,876
1,036
36,718
21
54,651
Age 25-64
Province
Provincial plan
NIHB
Private plan
No coverage (Cash)
Total
BC
0
0
903
6,495
7,398
AB
0
134
1,712
4,466
6,312
SK
735
166
845
0
1,747
MB
0
172
250
1,584
2,007
ON
4,295
291
16,378
0
20,965
QC
4,498
100
7,712
0
12,310
NB
0
29
185
959
1,173
PE
0
6
43
178
227
NS
459
36
937
20
1,452
NL
0
20
171
614
805
TERR
0
81
28
147
255
Canada
9,987
1,036
29,165
14,463
54,651
Age 65 and over
Province
Provincial plan
NIHB
Private plan
No coverage (Cash)
Total
BC
5,543
0
0
0
5,543
AB
3,370
36
0
0
3,406
SK
1,086
41
0
0
1,127
MB
933
48
321
0
1,302
ON
14,724
130
0
0
14,854
QC
9,563
49
0
0
9,613
NB
662
11
298
0
971
PE
179
2
0
0
181
NS
1,173
13
0
0
1,186
NL
401
8
241
0
650
TERR
58
24
0
0
83
Canada
37,692
362
861
0
38,915
Age 65 and over
Province
Provincial plan
NIHB
Private plan
No coverage (Cash)
Total
BC
0
0
308
5,235
5,543
AB
0
36
300
3,070
3,406
SK
1,086
41
0
0
1,127
MB
0
48
72
1,183
1,302
ON
14,724
130
0
0
14,854
QC
9,563
49
0
0
9,613
NB
0
11
76
884
971
PE
0
2
20
160
181
NS
1,173
13
0
0
1,186
NL
0
8
73
570
650
TERR
0
24
5
53
83
Canada
26,545
362
853
11,155
38,915
Appendix 2: Breakdown of covered patients by age group
A2-1. Patients potentially covered
Age 0-24
Province
Provincial plan
NIHB
Private plan
No coverage (Cash)
Total
BC
5.1%
0.0%
7.8%
0.0%
13.0%
AB
2.5%
0.5%
8.7%
0.0%
11.7%
SK
1.4%
0.7%
1.7%
0.0%
3.8%
MB
1.6%
0.7%
2.3%
0.0%
4.5%
ON
9.0%
0.8%
30.8%
0.0%
40.6%
QC
6.3%
0.2%
13.2%
0.0%
19.7%
NB
0.5%
0.1%
1.3%
0.0%
1.8%
PE
0.1%
0.0%
0.3%
0.0%
0.4%
NS
0.7%
0.1%
1.6%
0.0%
2.5%
NL
0.5%
0.1%
0.7%
0.0%
1.2%
TERR
0.2%
0.3%
0.2%
0.0%
0.6%
Canada
28.0%
3.4%
68.6%
0.0%
100.0%
A2-2. Patients effectively covered
Age 0-24
Province
Provincial plan
NIHB
Private plan
No coverage (Cash)
Total
BC
0.0%
0.0%
1.7%
11.3%
13.0%
AB
0.0%
0.5%
3.7%
7.5%
11.7%
SK
1.4%
0.7%
1.7%
0.0%
3.8%
MB
0.0%
0.7%
0.5%
3.4%
4.5%
ON
9.0%
0.8%
30.8%
0.0%
40.6%
QC
6.3%
0.2%
13.2%
0.0%
19.7%
NB
0.0%
0.1%
0.3%
1.4%
1.8%
PE
0.0%
0.0%
0.1%
0.3%
0.4%
NS
0.7%
0.1%
1.6%
0.0%
2.5%
NL
0.0%
0.1%
0.2%
0.9%
1.2%
TERR
0.0%
0.3%
0.0%
0.3%
0.6%
Canada
17.4%
3.4%
53.9%
25.2%
100.0%
Age 25-64
Province
Provincial plan
NIHB
Private plan
No coverage (Cash)
Total
BC
5.8%
0.0%
7.7%
0.0%
13.5%
AB
3.9%
0.2%
7.4%
0.0%
11.5%
SK
1.3%
0.3%
1.5%
0.0%
3.2%
MB
1.3%
0.3%
2.1%
0.0%
3.7%
ON
7.9%
0.5%
30.0%
0.0%
38.4%
QC
8.2%
0.2%
14.1%
0.0%
22.5%
NB
0.8%
0.1%
1.3%
0.0%
2.1%
PE
0.1%
0.0%
0.3%
0.0%
0.4%
NS
0.8%
0.1%
1.7%
0.0%
2.7%
NL
0.6%
0.0%
0.9%
0.0%
1.5%
TERR
0.1%
0.1%
0.2%
0.0%
0.5%
Canada
30.9%
1.9%
67.2%
0.0%
100.0%
Age 25-64
Province
Provincial plan
NIHB
Private plan
No coverage (Cash)
Total
BC
0.0%
0.0%
1.7%
11.9%
13.5%
AB
0.0%
0.2%
3.1%
8.2%
11.5%
SK
1.3%
0.3%
1.5%
0.0%
3.2%
MB
0.0%
0.3%
0.5%
2.9%
3.7%
ON
7.9%
0.5%
30.0%
0.0%
38.4%
QC
8.2%
0.2%
14.1%
0.0%
22.5%
NB
0.0%
0.1%
0.3%
1.8%
2.1%
PE
0.0%
0.0%
0.1%
0.3%
0.4%
NS
0.8%
0.1%
1.7%
0.0%
2.7%
NL
0.0%
0.0%
0.3%
1.1%
1.5%
TERR
0.0%
0.1%
0.1%
0.3%
0.5%
Canada
18.3%
1.9%
53.4%
26.5%
100.0%
Age 65 and over
Province
Provincial plan
NIHB
Private plan
No coverage (Cash)
Total
BC
14.2%
0.0%
0.0%
0.0%
14.2%
AB
8.7%
0.1%
0.0%
0.0%
8.8%
SK
2.8%
0.1%
0.0%
0.0%
2.9%
MB
2.4%
0.1%
0.8%
0.0%
3.3%
ON
37.8%
0.3%
0.0%
0.0%
38.2%
QC
24.6%
0.1%
0.0%
0.0%
24.7%
NB
1.7%
0.0%
0.8%
0.0%
2.5%
PE
0.5%
0.0%
0.0%
0.0%
0.5%
NS
3.0%
0.0%
0.0%
0.0%
3.0%
NL
1.0%
0.0%
0.6%
0.0%
1.7%
TERR
0.1%
0.1%
0.0%
0.0%
0.2%
Canada
96.9%
0.9%
2.2%
0.0%
100.0%
Age 65 and over
Province
Provincial plan
NIHB
Private plan
No coverage (Cash)
Total
BC
0.0%
0.0%
0.8%
13.5%
14.2%
AB
0.0%
0.1%
0.8%
7.9%
8.8%
SK
2.8%
0.1%
0.0%
0.0%
2.9%
MB
0.0%
0.1%
0.2%
3.0%
3.3%
ON
37.8%
0.3%
0.0%
0.0%
38.2%
QC
24.6%
0.1%
0.0%
0.0%
24.7%
NB
0.0%
0.0%
0.2%
2.3%
2.5%
PE
0.0%
0.0%
0.1%
0.4%
0.5%
NS
3.0%
0.0%
0.0%
0.0%
3.0%
NL
0.0%
0.0%
0.2%
1.5%
1.7%
TERR
0.0%
0.1%
0.0%
0.1%
0.2%
Canada
68.2%
0.9%
2.2%
28.7%
100.0%