I understand. Since I did not get it, I would ask the question again which is bugging me,sorry; Did you get this case report from your own specialist or the designated specialist of CIC?
Thanks a lot.
Help with the medical test...IBD
- Thread starter ahmedhere
- Start date
Thanks a lot.
Hi,
I submitted my EE profile about two weeks ago and received an ITA last week. I went for my medical exam yesterday and only realized afterwards that my medical condition could result in a rejection of my PR application.
I have had 2 optic neuritis attacks close together in early 2009, when I was 18 years old. The first attack was assessed as a clinically isolated syndrome but after the second one my doctor prescribed Rebif 44 (interferon beta 1a), used to treat MS. I've been using Rebif for over 8 years and have not had any attacks ever since. I go for a neurological assessment every 6 months and an MRI every year. Other than the medication I have to use, I lead a normal life with no work restrictions. The panel physician told me my condition wouldn't be a problem but she would need a prognosis report from my neurologist to upload with my file.
After the medical exam, I read the information about medical inadmissibility once again. Having looked through many threads about medical inadmissibility in this forum, I'm convinced Rebif 44 would be considered as an excessive demand on the public health system and result in me getting a procedural fairness letter after I submit my application.
It's been a boost of morale to see some people here who have succeeded in challenging such a letter. I'm wondering if any of you could help me about how to overcome this problem. What should be my strategy? Do I need to try to find an employer and discuss private insurance benefits with them? By the way, I'm applying from outside Canada and Rebif is 100% financed by my home country's public health insurance. Would I be able to get Canada to accept me getting my medication from abroad (I believe a user mentioned having medication shipped to the US and getting it from there)?
Thanks in advance to anyone who can help!
I submitted my EE profile about two weeks ago and received an ITA last week. I went for my medical exam yesterday and only realized afterwards that my medical condition could result in a rejection of my PR application.
I have had 2 optic neuritis attacks close together in early 2009, when I was 18 years old. The first attack was assessed as a clinically isolated syndrome but after the second one my doctor prescribed Rebif 44 (interferon beta 1a), used to treat MS. I've been using Rebif for over 8 years and have not had any attacks ever since. I go for a neurological assessment every 6 months and an MRI every year. Other than the medication I have to use, I lead a normal life with no work restrictions. The panel physician told me my condition wouldn't be a problem but she would need a prognosis report from my neurologist to upload with my file.
After the medical exam, I read the information about medical inadmissibility once again. Having looked through many threads about medical inadmissibility in this forum, I'm convinced Rebif 44 would be considered as an excessive demand on the public health system and result in me getting a procedural fairness letter after I submit my application.
It's been a boost of morale to see some people here who have succeeded in challenging such a letter. I'm wondering if any of you could help me about how to overcome this problem. What should be my strategy? Do I need to try to find an employer and discuss private insurance benefits with them? By the way, I'm applying from outside Canada and Rebif is 100% financed by my home country's public health insurance. Would I be able to get Canada to accept me getting my medication from abroad (I believe a user mentioned having medication shipped to the US and getting it from there)?
Thanks in advance to anyone who can help!
I did a quick search and found that Rebif is not covered under Ontario's insurance, and will only be covered on a case-by-case basis. I am not sure which province is your intended destination, but I doubt Rebif is covered by other provinces. Since Rebif is not routinely covered, and if you promise that you won't apply for case-by-case coverage, you can argue that usage of the drug shouldn't count against the annual $6,655 quota.
On the other hand, I am a bit concerned about how much an MRI will cost, as well as specialists visits. In the States, MRI could easily cost 10k dollars. Probably ask your doctor if annual MRI is really necessary, or if there are less costly alternatives (e.g., CT).
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Thanks for your reply. Ontario is my intended destination. I also checked the formulary after a little more research here and yes, it looks like Ontario doesn't pay for Rebif unless you apply for Exceptional Access Program and you're found eligible. So I can probably make a case that my medication isn't publicly funded and my employer health plan benefits will cover the cost. Showing such an employer health plan would be best, I guess, but I don't have an employer or a job offer. I'd thought I would have a better chance of finding a job after getting PR.
I'll also have to do some research about the cost of MRIs and neurologist visits...
As far as I understand, Rebif is covered by Exceptional access program if you have EDSS of less than or equal to 6...I'm pretty sure your score is less than 6, this is a weakness point cause it means (to the officer) that you might be eligible for that coverage,
However, a very good point you should expand on is the fact that it is not covered automatically, it is assessed case by case as mentioned here:
http://www.health.gov.on.ca/en/pro/programs/drugs/pdf/frequently_requested_drugs.pdf
Therefore, the officer cannot make a certain assumption that your drug will be covered, because he doesn't know if your application will be approved in case you apply, not like other drugs which are automatically funded, you should definitely explain that..especially that the assessment takes into consideration your last neurological exam and your recent clinical history, and since you are in a very good status, your application for coverage does not have a high chance of being approved...
Make sure you explain that very well..don't assume that the officer will just understand and conclude on his own, you have to explain your point very clearly...
Also try to see if there are other cheaper biosimilars as other options? and of course having a private insurance through employer is a huge point that will definitely help you...
Another important point, from my experience, the longer your response letter is the better your chances are as long as you write meaningful points not just spamming, so do your research and write about 10-15 page response letter and DON'T FORGET to add references and governmental website links for every information you mention, like the link I provided above...
Dude, This is amazing!! Im really glad things worked out for you. I have Crohns as well and im in the process of applying for PR. I've been following your posts for a while last year when i was interrupted by a flare up and eventually a surgery. But now i came back to see some positive news that you received. Congrats!
I'm already in Canada on a work permit and was diagnosed in Feb2017. Had to take humira for 3 months before i had my surgery. But since then everything has been great and im no longer on any medicines for the moment. Im at the stage of building my EE profile right now and i was wondering at what stage do i need to get a case report from my Specialist and who do i need to submit to? Do i give it to the panel physician who does my medical exam or do i upload it on the CIC website during the application process?
When you have received ITA and you have applied to CIC and your application has been accepted, you will be asked to conduct medical exam. Then you will be asked to declera your pre-existing healt conditions and to obtain a current case report from your Specialist. At that moment you will be able to submit the case report from your Specialist to the designated medical practitionar. After that, the designated medical practitionar will send this case report along with your laboratuary results to the health center, Ottawa, Canada. In there, the commission will decide whether you pass the medical exam or not. That is what is going to happen to you regarding your health issue.
Hello all, I applied PR from SK on Saskatchewan Experience Category.I have Ulcerative colitis ( on Remicade) and received procedural fairness letter in December 2017. Remicade is covered mostly by province and partly by my private insurance. I have explained them clearly that if needed, my private insurance can cover the cost or pharma company can cover if i lose provincial coverage. I haven't heard anything since December, 2017. Any one of you in similar situation??
Not sure if this applies to applications made before but do you know how much Remicade costs you per year? The new rule changes announced today would mean that you might be eligible for PR now. I just dont know if you have to reapply or not to become eligible to be considered under the new rule.
https://www.newswire.ca/news-releases/government-of-canada-brings-medical-inadmissibility-policy-in-line-with-inclusivity-for-persons-with-disabilities-679872763.html
Thanks for the info. But cost of remicade is 35,000/year which is more than the updated threshold. But I have provided detail plan on how I can offset the provincial coverage cost. I was hoping that changes would bring medical inadmissibility exempt for applicants already residing in Canada. But no luck.
Ohh i didnt realize Remicade costs that much. I was under the impression that it was less than Humira. I was on Humira for a while so i didnt apply and was hoping for the same.. that they would exclude people who are already here. But looks like that didnt happen.
You mentioned being able to cover all your Remicade through private insurance. Is that private insurance through your employer or private insurance youve applied for yourself?
I have my employer's plan which can cover upto 80% of cost, separate my wife's employer plan and even drug company is also ready to sponsor if needed. I have provided significant bank balance as well. I do not know what explanation they need if want to reject anyway.
Thanks for the info. I have my employers coverage that covers 80% as well. But they require me to have provincial coverage first and they will only pay 80% of whatever amount is left after provincial coverage pays their share for it. Without provincial coverage, i do not get the 80%. So thats unfortunate.
But glad to hear there are private insurance companies out there that covers you 80% even if you dont have provincial coverage. Please do update here when you get a decision back from CIC. I'm definitely interested in knowing how this went for you.