Slow Trikafta Coverage Expands in Canada

TRIKAFTA® (elexacaftor/tezacaftor/ivacaftor and ivacaftor), Vertex’s newest CFTR modulator, has been available in the U.S. for those 6 and up with one F508del mutation for some time now. This astounding medication has undoubtedly changed the lives of many Americans living with CF.

While the U.S. has continued to approve Trikafta to include more individuals based on their age and rare mutations, our neighbors in Canada have struggled to grant authorization and make it publicly available.

CF in Canada

In 2019 according to the “Canadian CF Registry Data Report”, there are 4,344 Canadians living with CF.¹ Unlike the U.S and the historically quick FDA approval of Trikafta we experienced, the Canadian approval of CFTR modulators has been painfully slow and frustrating for many CF patients and the 42 accredited CF Centers.¹

Health Canada grants authorization

In June of 2021, Health Canada approved the sale of Trikafta for people 12 and up with one F508del mutation as a first step in a long and complicated drug approval process.¹

The “Notice of Compliance” means that doctors can prescribe Trikafta for the approved groups but it doesn’t necessarily mean it would be covered by public or private insurance.

In order to  be covered by insurance, Trikafta was then assessed by Canada’s health technology assessment bodies and finally the price negotiated by pan-Canadian Pharmaceutical Alliance (pCPA) before provinces would cover the medication.¹

Under these bodies, the annual price of Trikafta was determined to be roughly 300k. There were also specific draft coverage recommendations that limited coverage to those patients with fev1 lower than 90%.

Coverage in various provinces

In late September, four Canadian provinces--Ontario, Alberta, Quebec, and Saskatchewan-- announced they would pay to provide Trikafta to patients that meet the criteria.³

This was a big win for many Canadians living with CF and hoping to gain access to this life-changing medication under their publicly funded drug programs. More provinces are expected to follow suit and approve to pay for Trikafta in the future.

Public pressure

In response to the slow approval of CFTR modulators, Canadians have banded together to put public pressure on the governmental bodies involved in the approval process. Through social media and viral campaigns patients have called to action the importance of bringing Trikafta to Canada as a means of saving the lives of people with CF.

Thankfully, public pressure has seemed to a momentous force to begin a string of approvals in late Summer and Fall of this year.

Are you a Canadian living with CF? Share you thoughts and experiences with Trikafta!