If you qualify, you can get full coverage for some drug treatments not covered by other drug programs.

These include:

Injectable cancer drugs

Ontario Health (Cancer Care Ontario)’s New Drug Funding Program covers the cost of many newer, and often very expensive, injectable cancer drugs given in hospitals and cancer centres. If you qualify, the program reimburses the hospital directly on your behalf.

How to qualify

To qualify for the New Drug Funding Program, you must:

  • be a resident of Ontario
  • have a valid Ontario health card
  • meet the specified criteria for one of the funded injectable cancer drugs

For more information about the eligibility criteria, speak with your doctor or health care team. Any forms that need to be filled out during the process will be completed by your doctor and submitted on your behalf.

Learn more about the New Drug Funding Program.

Where you’ll receive the drug

Your doctor will arrange for your treatment at an outpatient clinic in a local hospital or regional cancer centre.

Drugs for certain serious conditions

Through the Special Drugs Program, we cover the full cost of certain drugs used to treat specific serious conditions.

These include:

Cystic fibrosis (a lung disease)Anti-infectives, vitamins, nutritional and other products
Thalassemia (a blood disease)Deferoxamine, hydrocortisone injections and other drugs
HIV infection (an immune system disease)Zidovudine
Anemia (low red blood cell count) due to end- stage kidney diseaseErythropoietin
After organ or bone marrow transplantCyclosporine
Children with a lack or shortage of growth hormoneBiosynthetic human growth hormone
Treatment-resistant schizophreniaClozapine
Gaucher’s disease (a genetic disorder)Imiglucerase

How to qualify

To qualify for the Special Drugs Program, you must:

Filling the prescription

You will need to fill your prescription at a designated hospital. If you qualify, you won’t have to pay for these drugs. The program pays for them directly on your behalf.

Metabolic disease drugs

Inherited metabolic disease refers to a number of disorders that disrupt a person’s normal metabolism and can damage organs, or lead to organ failure.

Through the Inherited Metabolic Diseases Program, we cover the full cost of some treatments, such as:

  • drugs (for example, L-carnitine)
  • supplements (for example, vitamins, antioxidants)
  • low-protein foods (for example, pasta, buns)
  • modified L-amino acid mixtures or medical foods (for example, essential amino acid mix)
  • infant formula (for example, Nutramigen A+)
  • nutritional products (for example, Boost, Ensure) used in enteral, or tube feeding

How to qualify

To qualify for the Inherited Metabolic Diseases Program, you must:

  • live in Ontario
  • have a valid Ontario health card
  • be diagnosed with one of the disorders that the program covers (for example, cobalamin (B12) defect, biopterin deficiency, mitochondrial myopathy)
  • be under the care of a doctor from a designated treatment

You do not qualify if you already receive coverage for these drugs, supplements or products through private insurance or employee benefits.

How to apply

Your doctor must fill out and submit this form for you. Once approved, you will be registered in the Inherited Metabolic Disease Program.

Filling the prescription

Once you’re in the program, you can pick up drugs, supplements or products at:

  • Hotel Dieu (Kingston)
  • London Health Sciences Centre
  • Hamilton Health Science Centre
  • a member of the University Health Network (Toronto)
  • The Children’s Hospital of Eastern Ontario (Ottawa)
  • The Hospital for Sick Children (Toronto)

If you qualify, you won’t have to pay for these drugs. The program pays for them directly on your behalf.

Drug for eye conditions

The drug Visudyne® is the brand name for verteporfin. It is used during laser eye treatment:

  • to slow age-related macular degeneration (an eye condition)
  • for pathologic myopia (a rare condition where the eye continues to elongate after reaching adult size)
  • for presumed ocular histoplasmosis (a rare fungal infection of the eye)

All of these conditions can result in vision loss.

You can get the full cost of this drug covered when you qualify for the Visudyne® Program.

How to qualify

To qualify, you must:

  • live in Ontario
  • have a valid health card
  • be examined by an ophthalmologist participating in the program to confirm you need the treatment

How to apply

The ophthalmologist will fill out and submit this form to enroll you in the Visudyne® Program.

Receiving the drug

Once you are enrolled in the program, a pharmacy in a participating hospital will provide the Visudyne® to your ophthalmologist.

Preventative drug for high-risk babies

If your baby was born prematurely, or has a heart or lung disease, ask your doctor about using Synagis® (generic name: palivizumab) to prevent respiratory syncytial virus (RSV).

RSV causes infections of the lungs and respiratory system and can be severe, especially for premature babies and infants with underlying health conditions.

If your baby qualifies, the Respiratory Syncytial Virus Prophylaxis for High-Risk Infants Program covers the full cost of up to five shots of Synagis®.

How to qualify

To qualify, your baby must:

  • live in Ontario
  • have a valid health card
  • meet the treatment guidelines set by the Ministry of Health and Long-Term Care at the beginning of each RSV season (usually from November to April, but can vary depending on where you live)

Receiving the shots

Your doctor will fill out and submit this form to enroll your baby in the program.

Once approved, your baby will begin to receive shots for the current/upcoming RSV season.