Ontario spells out when it will fund drug treatment abroad

Ontario amended Regulation 552 of the Health Insurance Act to clarify when out-of-country drug treatment may receive public funding, aligning the regulation with a policy in place since 2011.

The release lists these conditions for funding:

• The treatment is performed in Ontario.
• The drug and its administration are publicly funded in Ontario.
• The drug is temporarily unavailable in Ontario.
• The delay makes travel outside Canada necessary to avoid death or medically significant, irreversible tissue damage.

Drug funding decisions will continue to use Ontario’s review process, including regulatory approval, health technology assessment, negotiation and a final funding decision. The government says the change could avoid up to $5.2 billion in additional costs each year. It is also exploring options following a recent Divisional Court decision, including an appeal or a resolution with the court applicant.