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Received Fairness Letter......Seeking guidance for reply

chimetex2002

Star Member
Mar 31, 2015
83
0
N4 58' 15.3084" E8 19" 44.9832"
Category........
Visa Office......
Accra/London
NOC Code......
0213
Job Offer........
Pre-Assessed..
App. Filed.......
20-07-2016
Nomination.....
23-08-2016
AOR Received.
10-09-2016
IELTS Request
N/A
File Transfer...
22/09/2016, 16/02/2017
Med's Request
24-08-2016
Med's Done....
30-08-2016; Passed 12-04-2017
Interview........
N/A
Passport Req..
26/04/2017
Please is Hepstart available for people not yet in canada?

anlindsey said:
We're on the same boat though I have not received a fairness letter because I'm still on medical furtherance.I need to submit again my laboratory results after oct.7. I emailed GILEAD and they have a program in Canada it is called HEPSTART.they provide financial aid for VIREAD user.They give 1200cad/year.You just have to call to enroll (1-866-949-9920) if you are in Canada. Tenofovir will expire on July 25,2017. Please keep me posted about your case.Thanks.

Your inbox is full.
 

anlindsey

Full Member
Feb 26, 2012
31
1
123
Category........
NOC Code......
0714
Job Offer........
Pre-Assessed..
App. Filed.......
July 25,2016
Nomination.....
March 8, 2016
AOR Received.
July 25, 2016
Med's Request
Upfront Medical: March 28,2016
Med's Done....
Medical Passed: November 1, 2016
No HEPSTART is ONLY available for people residing in CANADA.GILEAD (manifacturer of VIREAD) they have other programs in other countries like USA (COPAY PROGRAM,financial assistance) , in my country GILEAD has a special access program wherein the cost of VIREAD is around 75cad/30 tabs.while in CANADA viread costs 520cad/30 tabs.
 

chimetex2002

Star Member
Mar 31, 2015
83
0
N4 58' 15.3084" E8 19" 44.9832"
Category........
Visa Office......
Accra/London
NOC Code......
0213
Job Offer........
Pre-Assessed..
App. Filed.......
20-07-2016
Nomination.....
23-08-2016
AOR Received.
10-09-2016
IELTS Request
N/A
File Transfer...
22/09/2016, 16/02/2017
Med's Request
24-08-2016
Med's Done....
30-08-2016; Passed 12-04-2017
Interview........
N/A
Passport Req..
26/04/2017
ok thanks. I spoke to the lady and asked if I could get some form of documentation stating that I would be under the hepstart program before entering Canada but she said no and advised me to speak directly with Gilead if anything is possible. can the Hepstart program serve as a mitigation plan to CIC medical/immigration officers? please advise

anlindsey said:
No HEPSTART is ONLY available for people residing in CANADA.GILEAD (manifacturer of VIREAD) they have other programs in other countries like USA (COPAY PROGRAM,financial assistance) , in my country GILEAD has a special access program wherein the cost of VIREAD is around 75cad/30 tabs.while in CANADA viread costs 520cad/30 tabs.
 

anlindsey

Full Member
Feb 26, 2012
31
1
123
Category........
NOC Code......
0714
Job Offer........
Pre-Assessed..
App. Filed.......
July 25,2016
Nomination.....
March 8, 2016
AOR Received.
July 25, 2016
Med's Request
Upfront Medical: March 28,2016
Med's Done....
Medical Passed: November 1, 2016
I think we should include it in our mitigation plan since it will help reduce the cost of the drug.i hope the medical officer would really consider it since hepstart has its patent/license in canada.what province were you nominated?my husband is the PA under NBPNP.did you receive medical furtherance?
 

chimetex2002

Star Member
Mar 31, 2015
83
0
N4 58' 15.3084" E8 19" 44.9832"
Category........
Visa Office......
Accra/London
NOC Code......
0213
Job Offer........
Pre-Assessed..
App. Filed.......
20-07-2016
Nomination.....
23-08-2016
AOR Received.
10-09-2016
IELTS Request
N/A
File Transfer...
22/09/2016, 16/02/2017
Med's Request
24-08-2016
Med's Done....
30-08-2016; Passed 12-04-2017
Interview........
N/A
Passport Req..
26/04/2017
I think we should include it in our mitigation plan since it will help reduce the cost of the drug.i hope the medical officer would really consider it since hepstart has its patent/license in canada.

"I sincerely hope so too, I am just taking precaution as my medical passed update is kind of delaying - havent heard from cic and my status reads medical review in progress"


what province were you nominated?my husband is the PA under NBPNP.did you receive medical furtherance?
I was nominated by Saskatchewan
 

anlindsey

Full Member
Feb 26, 2012
31
1
123
Category........
NOC Code......
0714
Job Offer........
Pre-Assessed..
App. Filed.......
July 25,2016
Nomination.....
March 8, 2016
AOR Received.
July 25, 2016
Med's Request
Upfront Medical: March 28,2016
Med's Done....
Medical Passed: November 1, 2016
In quebec formulary the cost of viread is 518 cad or 18cad per pc.if we use that we will not exceed the threshold 6450cad.i wonder if they have a clear rule for this?why did they refer to bc pharmacare?
 

anlindsey

Full Member
Feb 26, 2012
31
1
123
Category........
NOC Code......
0714
Job Offer........
Pre-Assessed..
App. Filed.......
July 25,2016
Nomination.....
March 8, 2016
AOR Received.
July 25, 2016
Med's Request
Upfront Medical: March 28,2016
Med's Done....
Medical Passed: November 1, 2016
http://www.ic.gc.ca/app/opic-cipo/trdmrks/srch/vwTrdmrk.do?lang=eng&fileNumber=13513

Above is the link for the trademark of HEPSTART program in Canada.

Should I get international insurance already??
 

chimetex2002

Star Member
Mar 31, 2015
83
0
N4 58' 15.3084" E8 19" 44.9832"
Category........
Visa Office......
Accra/London
NOC Code......
0213
Job Offer........
Pre-Assessed..
App. Filed.......
20-07-2016
Nomination.....
23-08-2016
AOR Received.
10-09-2016
IELTS Request
N/A
File Transfer...
22/09/2016, 16/02/2017
Med's Request
24-08-2016
Med's Done....
30-08-2016; Passed 12-04-2017
Interview........
N/A
Passport Req..
26/04/2017
is it possible to use the quebec formulary while you are in another province? is that allowed?


anlindsey said:
In quebec formulary the cost of viread is 518 cad or 18cad per pc.if we use that we will not exceed the threshold 6450cad.i wonder if they have a clear rule for this?why did they refer to bc pharmacare?
 

anlindsey

Full Member
Feb 26, 2012
31
1
123
Category........
NOC Code......
0714
Job Offer........
Pre-Assessed..
App. Filed.......
July 25,2016
Nomination.....
March 8, 2016
AOR Received.
July 25, 2016
Med's Request
Upfront Medical: March 28,2016
Med's Done....
Medical Passed: November 1, 2016
chimetex2002 said:
is it possible to use the quebec formulary while you are in another province? is that allowed?
Im not sure but with their fairness letter to MXIA they used bc pharmacare when the applicant was from OINP. The chepeast version of viread in canada is from gilead UK.
 

chimetex2002

Star Member
Mar 31, 2015
83
0
N4 58' 15.3084" E8 19" 44.9832"
Category........
Visa Office......
Accra/London
NOC Code......
0213
Job Offer........
Pre-Assessed..
App. Filed.......
20-07-2016
Nomination.....
23-08-2016
AOR Received.
10-09-2016
IELTS Request
N/A
File Transfer...
22/09/2016, 16/02/2017
Med's Request
24-08-2016
Med's Done....
30-08-2016; Passed 12-04-2017
Interview........
N/A
Passport Req..
26/04/2017
Please seniors in the house kindly advise and throw more light. @computergeek et al, kindly assist.


anlindsey said:
Im not sure but with their fairness letter to MXIA they used bc pharmacare when the applicant was from OINP. The chepeast version of viread in canada is from gilead UK.
 

MXIA

Newbie
Sep 13, 2016
6
1
anlindsey said:
We're on the same boat though I have not received a fairness letter because I'm still on medical furtherance.I need to submit again my laboratory results after oct.7. I emailed GILEAD and they have a program in Canada it is called HEPSTART.they provide financial aid for VIREAD user.They give 1200cad/year.You just have to call to enroll (1-866-949-9920) if you are in Canada. Tenofovir will expire on July 25,2017. Please keep me posted about your case.Thanks.

Your inbox is full.
Hi anlindsey,

Thank you for the information:)

The funny thing is, after I look at my prescription, I realized that my doctor never prescribed me Tenofovir, but Entecavir...I have no clue why the MO thinks my medication is Tenofovir. My doctor clearly indicated that I will be taking Entecavir in his Medical Furtherance notes.

So that makes things simple for me - Entecavir is not covered by Ontario Drug Benefit Program nor Trillium Benefit Program. I am also not eligible for Exceptional Access Program (I asked doctor to write a note to back me up), which means I'm not gonna get a penny from government for the drug I'm taking.

I'm about to submit the letter now, thank you everyone for the support, I will keep you posted shall I hear back from IRCC! Wish everyone good luck on your case!

Special thanks to Computergeek, you are the best!
 

roman_emperor08

Hero Member
Apr 18, 2013
572
13
computergeek said:
In the Companioni decision, the court said that IRCC must consider insurance in doing their calculation. Because you have an in-place policy that is already covering some portion of the cost, IRCC must consider that.

In your response you should point to the insurance, provide evidence (e.g., via an explanation of benefits, often found on their web portal, sometimes mailed to you via mail, depending upon the insurance company) that it is already paying part of the cost. Also include the Trillium drug evidence that you cited. The cost evidence you provided as a basis for the cost of generic tenofovir should also be included. The combination should be more than enough to overcome this objection. If they refuse you still, then you would have a good case in Federal Court.

Good luck!
Please check your inbox. Thanks
 

roman_emperor08

Hero Member
Apr 18, 2013
572
13
computergeek said:
Welcome to the nightmare of A38(1)(c) - "excessive demand medical inadmissibility". You have three options at this point:

(1) You can ignore the fairness letter; they will refuse your application.
(2) You can hire an attorney to help you compose a response and lay the groundwork for a legal challenge should they refuse you. This option will cost between $3-5k most likely.
(3) You can educate yourself on the process and prepare a response to the fairness letter. If so, you should expect to spend 50-100 hours reading, learning how the process works, and preparing your response. There may still be some costs associated with this.

As I recall, the threshold is $6285, though it is due to be revised (that value is rather old). You are fortunate that they provided you with a cost estimate.

First, you should confirm that this is the actual cost of the medication. I've found that CIC often does not have accurate cost information. The best source of this I've found is actually the Quebec formulary, which lists the prices that Quebec pays for such drugs.

A fairness response can take several approaches:

* You can challenge the medical diagnosis. This could include their claim you have the condition as well as their estimate of the treatment and/or costs required.
* You can present a mitigation plan. This would be where you present evidence of insurance. Of course, it is far more convincing if you show that your insurance is already actively paying for the drugs rather than them being provided by the province. As part of a mitigation plan you should include a declaration of ability and intent. There is a sample of this in OP 15 (from the CIC website) as I recall.
* You can set up arguments that would provide fodder for challenging a refusal. For example, it is best practice to request a TRP to overcome the inadmissibility (there's a $200 per person fee for that application and there's no formal form for it - you have to explain why you should be granted a TRP). While a TRP won't give you PR, after three years you can apply for PR in the "permit holder's class" and they cannot refuse you on the grounds for which the TRP was granted. Other arguments relate to the violation of Charter rights (you have a disability) and the obligations that Canada has undertaken as a signatory to the UN Convention on the rights of people with disabilities. There's an argument that the entire section is itself ultra vires (which means the Canadian Federal Government has no right to make such decisions) because health care belongs to the provinces exclusively. I've also argued that the very mathematical basis is suspect: they use the average Canadian costs, but they use the maximum costs in your group - because you will BOTH be deemed inadmissible. Thus, the argument is that the excessive demand threshold is really $6285 times the number of people in the application. In your case that isn't sufficient anyway, but these are the kinds of arguments that can be included.

Most important: don't panic. If you aren't comfortable doing this on you own get an attorney. This is a HIGHLY specialized area though and there are only two that I can directly recommend because both have won significant decisions in Federal Court in this area (CIC doesn't do so well in Federal Court on cases similar to yours).
Can you recommend immigration lawyer to help me to response on fairness letter? I sent you pm.
 

srikamesh

Star Member
Aug 31, 2015
67
7
Canada
Category........
PNP
Visa Office......
NDVO
NOC Code......
6235 - Outland FSW
App. Filed.......
27-02-2017
Nomination.....
27-04-2017
AOR Received.
21-06-2017
Med's Done....
16-06-2017
LANDED..........
01-02-2018
Hi computergreek,

This is Kamesh from India. I have a medical condition - Ankylosing spondylitis - An autoimmune disorder which will affects the spine and fuse it which will restrict movements at the later stage. In addition i undergone both hip replacement surgeries on 2010 and 2016 respectively. Now I have a fused SI joint, but otherwise completely active in my daily work life. I am an outland applicant.

Actually as per canada health care system this condition will be treated usually with the drug Inflectra ($650/injection). Dosage is based on patient weight, for my weight it will be 3 injections every 2 months. ((650*3)*6=$11700 per annum).

I am a PNP applicant from Nova Scotia province. As per Nova scotia drug plan, we should co-pay the drug cost based on the family household income. Lets say if me and my spouse have a combined salary of $75000 per annum then our out of pocket expense will be around $10000 before we get 100% coverage from province plan.

Also in my home country this drug cost only $250/injection and free of cost in Government owned hospitals. Is it possible to get medicine from home country once I move to Canada and Can I give this as reason in reply to medical fairness leeter saying I can fly back to home country every 3 months and get infused.

But as of now I am not taking this drug in my home country and taking general medication prescribed by my doctor.

My concern is if I receive a medical fairness letter, how should I proceed with my reply. Can I mention prospective reply saying that me and my spouse will get a job with salary $75000 per annum approx since our NOC are in demand.

Could you please advise me?

Thanks a lot in advance
 

chimetex2002

Star Member
Mar 31, 2015
83
0
N4 58' 15.3084" E8 19" 44.9832"
Category........
Visa Office......
Accra/London
NOC Code......
0213
Job Offer........
Pre-Assessed..
App. Filed.......
20-07-2016
Nomination.....
23-08-2016
AOR Received.
10-09-2016
IELTS Request
N/A
File Transfer...
22/09/2016, 16/02/2017
Med's Request
24-08-2016
Med's Done....
30-08-2016; Passed 12-04-2017
Interview........
N/A
Passport Req..
26/04/2017
Hello All,

You could join our whatsapp group via this link: https://chat.whatsapp.com/1GpanOiHqvm9N7vxGL4asj where we deliberate on how to tackle medical issues for PR applicants that are considered excessive demand in canada. Its a new group and so we decided to share ideas as it is much faster there.