See below for the full quote from the canadian website, but CAD$24,057 per year is the canadian cost threshold so yeah, it'd be just barely disallowed. The $120k number you may be thinking of is a five-year average.
Plus side, "spouse" is explicitly listed as an exception, so I guess it's somewhat less disgusting now that they're at least not using disability as the reason to keep people's spouses and children from reuniting with their family in Canada.
Which drug is the leading/where'd you find the info? I believe you, now I'm just curious about the Canadian health systems' treatment philosophy + how it differs (if at all) by province.
Wow. In the US the list price/general price is ~68k annually or ~17k per infusion. (Of course this isn't what people pay, but for 'cost to the system' metrics, it would be the apples to apples comparison).
Nothing near my number, which is encouraging. My numbers are clearly somewhat out of date. But I do wonder where that extra 40k+ cost (depending on currency values) in the US comes from.
Yeah, the whole thing where the drug manufacturer pays for your copay is a bit infuriating in how it sets up such horrific incentives in terms of price-to-insurance. Tecfidera was just dimethyl fumarate, which you can buy in gallon quantities for pretty cheap.
That is why it is more expensive in the US. The patient rarely pays for it, so the insurance companies make it comically expensive and then the insurance pays for it up to a deductable and then the MANUFACTURER pays the copay for you. It's really, really stupid incentives.
Literally with Tecfidera I would burn through my annual deductible so fast that I didn't have to pay for any other medical procedures after the first three months of a year. But out of pocket it was free because of these incentive plans. It was freaking dimethyl furmarate, and I'll grant them manufacturing and formulary costs, and trial costs, but clearly there's more than just that going on.
But yes, Ocrevus and Kesimpta (both are monoclonal antibodies that reduce B-cells, and leave you immunosupressed -- I got 5 covid vaccine boosters, two rounds of monoclonal antibodies to boost my immune system, and still got COVID last month) are as far as I am aware the state of the art for drugs.
Personally I think the idea of somehow treating an underlying EB infection while also doing other treatments is the most actually encouraging news I heard out of MS research since Ocrevus.
In any case, FWIW I did more research on that site and it does actually list "spouse" as excluded. Since other people may also have rather panicked after hearing about this I have copied it below wholesale.
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Excessive demand cost threshold
2022 cost threshold (under the temporary public policy)
$120,285 over 5 years (or $24,057 per year)
This is an amount that we use to decide if the cost of your condition places an excessive demand on Canada’s health and social services.
In June 2018, the Government of Canada announced changes to the excessive demand policy. Under the new policy, the cost threshold amount is increased. The new amount is now three times the Canadian average cost for health and social services. We’ll update this amount every year, based on the latest Canadian average.
Exceptions
Medical inadmissibility rules for excessive demand reasons don’t apply to:
* refugees and their dependants
* protected persons
* certain people being sponsored by their family, such as dependant children, spouses and common-law partners
There's ways around medical inadmissibility, you can absolutely get around the cost threshold by proving your ability to cover the cost- so long as it isn't a personal guarantee. It's sort of a nightmare, you have to apply for PR, be denied, and then there's a one time appeal process. Talk to a lawyer about it if this is your actual plan, because they know more than I ever will.
