When a 20-year-old man living with complex seizure disorder was recently denied funding for new medication from the Ministry of Health and Long-Term Care’s Exceptional Access Program (EAP), after having a severe reaction to EAP-approved medication, he and his family lodged a complaint with Ontario’s ombudsman’s office.
Once investigated by the ombudsman, it was discovered the man’s neurologist should have been notified that alternative medication would have been funded if a “severe adverse reaction” form had been completed.
The situation was eventually rectified but this is an example of a lack of understanding that exists when it comes to accessing medication funding for people living with seizure disorders, says epilepsy expert Suzanne Nurse.
For people wanting to learn more about how to receive funding for seizure-control medication, Nurse says the Ministry of Health and Long-Term Care’s website is a good starting point because it offers information about drug programs they can access, as well as medication funding application forms that can be downloaded.
Nurse adds that people can also call the Ministry of Health and Long-Term Care for information, as well as their local epilepsy support agency.
“Epilepsy agencies and Epilepsy Ontario are available to help people navigate the system,” says Epilepsy Ontario executive director Rozalyn Werner-Arcé.
Nurse notes that requests for medication funding are sometimes denied but when this happens people should not be discouraged — this happens frequently and persistence is key to having a medication funding application approved.
“It’s not uncommon for us to hear that somebody has applied for funding under programs and have been denied, so generally what we tell people is that if their application has been denied it’s a good idea for them to talk with their local agency and get some input about reapplying and what might be necessary for them to do to get approved,” says Nurse.
“Don’t give up if you’re denied.”
People looking for information about medication funding for seizure control can visit the following links for more information:
Ontario Public Drug Program: http://www.health.gov.on.ca/en/public/programs/drugs/programs/odb/odb.aspx
Trillium Drug Program: http://www.health.gov.on.ca/en/public/programs/drugs/programs/odb/opdp_trillium.aspx
Exceptional Access Program: http://health.gov.on.ca/en/public/programs/drugs/programs/odb/opdp_eap.aspx
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Writer: Deron Hamel