New BC PharmaCare Coverage Discriminatory to Adults with ADHD

On April 18th BC PharmaCare announced that it was expanding its existing coverage of medications for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in the paediatric population.

Three long acting ADHD medications (Adderall XR, Vyvanse and Strattera) will be added under the Special Authority (SA) program.

  • The SA program covers medications for patients under special medical circumstances.
  • The SA program will still require a physician’s written request and documentation of failure on cheaper short acting medications (either Ritalin or Dexedrine).

During the fall of 2015, CADDRA, B.C physicians and CADDAC, called on the B.C. government to provide coverage for all long-acting medications for all age groups diagnosed with ADHD. So, CADDRA and CADDAC along with BC medical practitioners welcome these expanded medication options for children. However, British Columbia continues to lag significantly behind other provinces by denying coverage to individuals over 19, thereby discriminating against adults with ADHD.

The GOOD NEWS

Since treatment through medication is not a “one size-fits-all” scenario, adding more choice improves the ability “to get a better treatment fit.” And clinical experience tells us that long-acting medications are better tolerated, have fewer side effects, greater effectiveness, less abuse potential, and improved adherence.

The BAD NEWS

On turning 19, children who have had access to these medications through Limited Coverage will now be refused treatment under PharmaCare. To qualify for access to these newer medications as a child, they had to fail on a trial on the short acting medications. Therefore, reverting back to these medications is not an option.

This is the wrong time to remove treatment. Moving into post-secondary education, the workplace and adult life is one of the most vulnerable times. We will be setting them up to fail.

The only way that adults with ADHD, might access these newer medications is for their doctor to spend hours mining years of medical data from numerous sources, and writing lengthy reports describing symptoms and past failed medication trials.

IN SUMMARY

Increasing treatment choices for children and adolescents with ADHD using Pharmacare is good. Barring adult patients’ access to these treatment options is discriminatory. This will result in increased post-secondary school failure, more job loss and unemployment and greater overall costs to health care.

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