Regulation - LGIC
Regulation Number(s): O. Reg. 201/96
Bill or Act: Ontario Drug Benefit Act
Summary of Proposal: As part of the 2017 Budget and the government's ongoing commitment to provide better and faster access to high-quality health services, Ontario is proposing to create OHIP+: Children and Youth Pharmacare Program.
Under the program, the province would, as of January 1, 2018, provide drug coverage for children and youth who are covered by OHIP and aged 24 or under, regardless of family income. Enrollment in OHIP+ would be automatic based on age and OHIP coverage, and eligible drug products would be available at no cost. There would be no applications necessary to join the program and no upfront costs to acquire eligible medications at a pharmacy. Those who are eligible for the program would only need to have their health card number and a valid prescription starting January 1st, 2018.
The program would cover all drugs currently covered through the Ontario Drug Benefit (ODB) program. This includes more than 4,400 drug products listed on the ODB Formulary/Comparative Drug Index and additional drugs eligible for funding through the Exceptional Access Program (EAP).
Covering the cost of eligible prescription medication for children and youth is part of Ontario's Patients First: Action Plan for Health Care, which is increasing access to care, reducing wait times and improving the patient experience.
Amendments to O. Reg. 201/96 made under the Ontario Drug Benefit Act (ODBA) are required to create and implement the program. The proposed regulatory amendments would:
- prescribe persons who have OHIP coverage and are aged 24 or under as a class of "eligible persons" for the purposes of the ODB Program;
- specify that no co-payment may be charged to ODB-eligible persons who are under 25; and
- prescribe the implementation of OHIP+: Children and Youth Pharmacare Program as a purpose for which the Ministry of Health and Long-Term Care may collect, use and disclose personal information under section 13 of the ODBA.
Proposal Number: 17-HLTC032