Making an exception

A man with a rare condition that causes muscle weakness was prescribed a medication that wasn’t covered by the Ontario Drug Benefit program. He had been on the medication for 20 years and couldn’t get out of bed without it, but could no longer afford it after the manufacturer discontinued its compassionate funding program.

He told us his application to the Exceptional Access Program (EAP) was denied because he was required to try a different medication first. However, he said that medication was not available in Canada.

RESULT: We escalated the man’s case to EAP staff, who assessed the file and agreed to provide funding for his existing longtime medication through the program’s compassionate review policy.