Drugs, Health Technologies, Health Systems
Key Messages
What Is the Issue?
Oncology medications can be broadly classified into treatments that are administered in a hospital and treatments that can be taken in the home setting.
In Canada, public drug plan reimbursement for oncology medication varies between federal, provincial, and territorial (FPT) jurisdictions, and depending on the setting of administration.
What Did We Do?
We conducted a literature search of key resources, including the websites of health care agencies in Canada and FPT public drug programs as well as a focused internet search. This information was validated and supplemented with details gathered from surveying FPT public drug plans.
What Did We Find?
Most public drug programs provide coverage for hospital-administered oncology medications listed on their formulary, with no cost to patients.
Between jurisdictions, there is variability in terms of public reimbursement of take-home oncology medications:
Some jurisdictions provide full coverage for take-home oncology medications if the medication is listed on their formulary and the patient meets prespecified clinical criteria, while other jurisdictions limit coverage to patients eligible for a specific drug plan.
In some cases, patients may receive varying levels of reimbursement depending on the drug plan they are enrolled in, and some may incur additional out-of-pocket costs.
Nearly all jurisdictions provide alternative pathways for the reimbursement of oncology medications not listed on their formulary.
Key differences between jurisdictions include how supportive medications are defined, the availability of programs covering high-cost treatments, and if and how CAR T-cell therapy is reimbursed.
What Does It Mean?
While most jurisdictions provide access to oncology medications delivered in hospital settings at no cost to patients, coverage for take-home medications is often dependent on specific eligibility criteria, income thresholds, patient age, and the availability of private insurance.
There may be opportunities for future alignment of oncology medication funding policies across public drug plans in Canada, including alignment of definitions for hospital-administered, take-home, and supportive care medications.
AHS
Alberta Health Services
CAF
Canadian Armed Forces
CSC
Correctional Service Canada
EAP
Exceptional Access Program
FPT
federal, provincial, and territorial
NIHB
Non-Insured Health Benefits
NLPDP
Newfoundland and Labrador Prescription Drug Program
ODB
Ontario Drug Benefit
OHIP
Ontario Health Insurance Plan
SCA
Saskatchewan Cancer Agency
VAC
Veterans Affairs Canada
Advances in oncology, including the development of new drugs, have improved survival for people living with cancer.1 More than 60% of people living in Canada diagnosed with cancer now live at least 5 years after their diagnosis compared to approximately 25% in the 1940s.1 The availability of innovative oncology medications has cost and access implications for publicly funded drug programs.1,2 With the increased use of newer and potentially higher-cost drugs, expenditures associated with public reimbursement of oncology drugs continue to rise at a significant rate.2,3
In Canada, FPT governments administer publicly funded drug programs (i.e., government programs). Each publicly funded drug program has a different funding scope, process, and formulary that identifies which drugs are eligible for coverage and under what clinical criteria. Consequently, the coverage of oncology medications may vary among FPT jurisdictions.1,4-6
Oncology medications can be categorized into hospital-administered medications and take-home oncology medications. Hospital-administered oncology medications are defined as drugs used for active treatment administered on hospital premises, such as those given in inpatient units, outpatient clinics located in hospitals, and outpatient cancer centres. Most hospital-administered oncology drugs are administered by IV infusion or through other forms of infusions or injections (e.g., subcutaneous, intrathecal, intramuscular). Take-home oncology medications are drugs used for active cancer treatment that are typically administered orally and are sometimes administered by injection in community settings (e.g., at home, long-term care homes).
Take-home oncology drugs are a standard treatment option for many types of cancer, offering several benefits for patients and health systems.1,7 Take-home oncology medications can be taken at patients’ homes, which is more convenient8 and require less travel to hospital.1 They may also provide an option for more convenient cancer care delivery in rural and remote communities,9 improve treatment satisfaction and patient-centredness,10 and potentially reduce indirect financial costs for patients,9 demands on hospital resources, and costs to the health systems.8
Some jurisdictions may classify supportive therapies as take-home cancer drugs. Supportive therapies refer to treatments that prevent or treat the symptoms or side effects associated with cancer treatment. Examples of supportive therapies include antiemetics (to prevent and treat nausea and vomiting) and colony-stimulating factors (medications that increase the number of certain blood cells).7
The Canada Health Act legislates that publicly funded hospital services are required to be fully covered for eligible people living in Canada, including the cost of eligible medications administered to patients who are admitted to the hospital (i.e., inpatients), with no out-of-pocket costs.6 However, the Act does not stipulate coverage for drugs prescribed for use in the outpatient setting.6 As such, each jurisdiction may take a different approach to funding take-home oncology medications.11
With the growing reliance on take-home oncology drugs,1,7 it is important to understand the current landscape of public funding of oncology drugs in Canada. Further insight into take-home oncology medication and hospital-administered oncology medication funding across jurisdictions in Canada may add to existing knowledge and inform FPT drug programs in future planning and policy discussions.
The objective of this Environmental Scan is to provide a summary of the public reimbursement policies for take-home and hospital-administered oncology medications across FPT drug programs in Canada.
The following research questions are addressed in the Environmental Scan:
What are the similarities and differences in take-home (oral and injectable) and hospital-administered oncology medication funding across FPT drug programs?
What are the FPT drug funding programs and policies for take-home and hospital-administered oncology medications?
An information specialist conducted a literature search on key resources including MEDLINE via Ovid, the websites of health care agencies in Canada, as well as a focused internet search. The search approach was customized to retrieve a limited set of results, balancing comprehensiveness with relevancy. The search strategy comprised both controlled vocabularies, such as the National Library of Medicine’s MeSH (Medical Subject Headings), and keywords. Search concepts were developed based on the elements of the research questions and selection criteria. The main search concepts focused on take-home oncology medications in Canada. Search filters were applied to limit retrieval to health technology assessments, systematic reviews, and guidelines. The search was completed on February 5, 2026, and limited to English-language documents. The search strategy is available on request. Additional searches of FPT public drug programs and formularies in Canada, excluding Quebec, were conducted between February 12 and February 27, 2026. Table 1 presents the inclusion criteria used for the literature screening and selection of information included in this Environmental Scan.
Criteria | Description |
|---|---|
Population | People of any age living with a cancer diagnosis |
Concept | Information on funding mechanisms for take-home (oral and injectable) and hospital-administered oncology medications.a Include special funding pathways, if available. |
Context | Federal, provincial, and territorial jurisdictional drug programs in Canada |
Study design | All study designs |
aCosts related to the administration of drugs are out of scope for this Environmental Scan.
We surveyed FPT public drug plans in Canada to gather additional information on how take-home and hospital-administered oncology medications are funded across jurisdictions. A copy of the survey questions can be found in Appendix 1.
Information about public coverage of take-home and hospital-administered medicines and the relevant policies for each jurisdiction are presented subsequently. Table 2 provides an overview of the type of public drug funding programs, program scope, key eligibility criteria to qualify for coverage, and access-related information for each jurisdiction for take-home oncology medications. This information was collected from drug program websites and each jurisdiction through a survey (refer to Appendix 1). Unless otherwise indicated by a citation, information and quotations presented in this report are derived from survey responses provided by jurisdictions.
The provincial government fully funds injectable oncology drugs administered in hospitals through its publicly administered health insurance plan.11 For take-home oncology medications, patients can seek coverage through their public drug plan or private insurance and pay any applicable deductibles.11
The Newfoundland and Labrador Prescription Drug Program (NLPDP) is the publicly funded drug program that provides financial support for people living in the province to purchase eligible prescription medications, which includes medications for oncology.12 There are 5 main plans under the program: the Foundation Plan, 65Plus Plan, Access Plan, Assurance Plan, and the Select Needs Plan. As the payer of last resort, the NLPDP covers prescription expenses only when they are not reimbursed by another insurer or program.12 If the patient has coverage through another drug plan(s), prescription costs must first be billed to that drug plan(s). NLPDP will cover eligible prescription costs for the amount that is not paid by the other drug plan(s).
To be eligible for the NLPDP, individuals must meet the criteria for 1 of the 5 plans under the program. Drugs that are not listed on the NLPDP formulary13 may be requested by a physician through an exceptional review process. For take-home oncology medications, the amount covered depends on the type of public drug plan the patient qualifies for.
CAR T-cell therapies are assessed and funded through the Department of Health and Community Services.
Prince Edward Island has 2 funding models for oncology medications listed on the Health PEI Formulary Drugs for Oncology: the Cancer Treatment Centre formulary for injectable medications and PEI Pharmacare for oral cancer medications.14,15 The Cancer Treatment Centre formulary typically covers injectable cancer drugs dispensed and administered at oncology centres or other approved hospital sites in Prince Edward Island.14,15 All patients with a valid Prince Edward Island Health Card are automatically eligible to receive medications listed under this program at no cost to them and do not need to apply for coverage.
Several PEI Pharmacare plans exist to provide coverage or cost assistance of approved prescription medications including take-home oncology medications or supportive care medications. These plans include the Family Health Benefit Drug Program, Generic Drug Program, High Cost Drug Program, Nursing Home or Institutional Pharmacy Program, Catastrophic Drug Program, Seniors Drug Program, and Financial Assistance Drug Program. Specific oral cancer medications may be covered under different PEI Pharmacare drug programs.15 To be eligible for coverage, patients must be a Prince Edward Island resident, have a valid Prince Edward Island Health Card, qualify and be enrolled in one of the previously listed Prince Edward Island drug plans.14,15 Coverage of listed medications only applies if a patient meets the funded eligibility criteria specified for each medication and if the medications are dispensed at a participating community pharmacy in Prince Edward Island.14,15
Prince Edward Island also has a nonformulary request process whereby a physician can request coverage of medications that are not listed in the Health PEI Formulary Drugs for Oncology. CAR T-cell therapy is assessed and funded through Health PEI Medical Affairs.
Oncology drug coverage in Nova Scotia differs for hospital-administered and take-home oncology medications. The provincial government’s New Cancer Drug Fund funds the cost of parenteral oncology medications administered in hospitals or clinics at no cost to patients. Take-home oncology drugs and supportive care medications listed on the Nova Scotia Pharmacare formulary16 are publicly funded under various Nova Scotia Pharmacare programs.
There are several Nova Scotia Pharmacare programs including Seniors’ Pharmacare Program,17 Family Pharmacare Program,18 Drug Assistance for Cancer Patients19 and the Take-Home Cancer Drug Fund.20 The Senior Pharmacare Program is available to individuals aged 65 years and older.17 The Family Pharmacare Program18 provides drug coverage for anyone with a valid Nova Scotia Health Card. The Drug Assistance for Cancer Patients Program19 is an income-based assistance program covering medications for cancer treatment available to those who earn less than $35,000 per year. Most patients are covered under the Seniors’ Pharmacare and Drug Assistance for Cancer Patients programs.
Take-home oncology cancer medications are subject to copays and deductibles depending on the drug coverage plan. The Take-Home Cancer Drug Fund is a supplemental program for patients who are enrolled in the Family Pharmacare Program and have high out-of-pocket expenses.20 This fund covers a range of take-home drugs that are used to treat cancer, including chemotherapy, hormonal therapies, and immunotherapies. Only drugs that are publicly insured by the Nova Scotia Pharmacare programs are covered by this fund. Patients must meet the established funding criteria to be eligible for the Take-Home Cancer Drug Fund: individuals must be a resident of Nova Scotia with a valid Nova Scotia Health Card and be taking cancer medications at home and have exhausted all other sources of financial assistance programs, including private, public, and manufacturer assistance programs. Patients must also have out-of-pocket expenses for eligible drugs that are greater than 4% of their net family income. Coverage of medications outside of the approved formulary may be considered through an exceptional case-by-case review program for patients with rare diseases or unique circumstances.
CAR T-cell therapy is publicly funded in Nova Scotia and funded through the Department of Health and Wellness.
Oncology drug coverage in New Brunswick differs for hospital-administered and take-home oncology medications. Injectable oncology drugs administered in hospitals and outpatient cancer treatment facilities are funded by the Government of New Brunswick at no cost to patients.11
For take-home oncology drugs and supportive care medications, the Government of New Brunswick provides drug coverage for eligible residents of New Brunswick through the New Brunswick Prescription Drug Program (NBPDP) and the New Brunswick Drug Plan (collectively referred to as the New Brunswick Drug Plans). The drugs covered by the New Brunswick Drug Plans are listed on the New Brunswick Drug Plans Formulary.21 Eligible beneficiaries of the NBPDP include “seniors, those living in nursing homes, adult residential facilities, correctional facilities, those with specific medical conditions and Social Development clients” [from original source].11,21 There are copayments with both the Seniors and Social Development plans. The New Brunswick Drug Plan is an income-based drug plan that provides drug coverage to eligible uninsured residents of New Brunswick who have a valid New Brunswick Medicare card.22 Beneficiaries of the New Brunswick Drug Plan are required to pay a monthly premium and copayment per prescription.22 Medications that are not listed in the New Brunswick Drug Plans Formulary are not publicly covered.
New Brunswick does not provide CAR T-cell therapy. Eligible patients are referred out of province for treatment.
Oncology and supportive care medications are covered, in general, for patients who reside in Ontario, hold a valid Ontario Health Card, and meet eligibility criteria for the specific medication and program to qualify for coverage.23
Take-home and supportive oncology medications may be covered by the Ontario Drug Benefit (ODB) program for eligible program recipients.23 The ODB program also provides funding through the Exceptional Access Program (EAP) for select additional prescribed take-home oncology and supportive care medications not listed on the ODB Formulary. Patients must be eligible to receive benefits under the ODB program and must meet drug-specific reimbursement criteria for EAP coverage. Deductibles and copayments may apply for take-home oncology and supportive care medications through the ODB program.23
Newer, high-cost injectable oncology medications (e.g., immunotherapy, chemotherapy) administered to outpatients in hospitals and cancer centres are funded through the New Drug Funding Program. Applicants must be residents of Ontario and have a valid Ontario Health Card to be considered eligible for the New Drug Funding Program for NDFP. Patients must meet drug-specific reimbursement criteria for coverage.
The Systemic Treatment–Quality Based Procedure program funds certain systemic therapies administered in outpatient settings of the hospital (e.g., cancer clinic, chemotherapy suite) for adult residents of Ontario with a valid Ontario Health Card. Patients must meet regimen-specific criteria for coverage.
Hospital-administered outpatient or take-home oncology medications that are not otherwise publicly funded may be considered on a case-by-case basis through the Case-By-Case Review Program.23 This program is intended for patients with rare clinical circumstances where there is a lack of suitable treatment options, no alternative funded options available, and an urgent need for treatment. Eligibility requires a valid Ontario Health Card for hospital-administered outpatient oncology medications, and patients must qualify for the ODB program if they require take-home oncology medications.
In certain circumstances, oncology medications that are administered in hospital to inpatients are insured hospital services under the Health Insurance Act and paid for by the hospitals’ own operational funding.
The High-Cost Therapy Funding Program may fund certain high-cost oral or injectable cancer drugs that are administered in a hospital inpatient unit. Applications are considered for residents of Ontario who are admitted as inpatients and have a valid Ontario Health Card. For eligible patients who meet drug-specific reimbursement criteria for coverage, 100% of the drug costs are funded.
Ontario’s CAR T-cell Therapy Program provides eligible patients with access to CAR T-cell therapies that are approved for funding in the inpatient setting.23 Due to limited capacity in Canada to deliver CAR T-cell therapy, the program may also consider treating patients from other provinces or territories, if funding is approved by their government. Ontario residents must have a valid Ontario Health Card and meet the eligibility criteria listed on the enrolment form. For patients who meet the eligibility criteria, 100% of costs are covered.
The provincial cancer agency, CancerCare Manitoba, provides inpatient and outpatient medications at no cost to eligible patients if they are on the formulary and prescribed within the specified criteria.11 Two different publicly funded provincial programs are available for hospital-administered and take-home oral medications. The Provincial Oncology Drug Program fully covers the cost of IV cancer drugs administered in hospitals and outpatient cancer centres.24 The Home Cancer Drug Program is a Pharmacare program that fully covers the cost of approved take-home oral cancer medications and select supportive care medications (e.g., antiemetics, steroids) dispensed at outpatient pharmacies in Manitoba.25 Funding for medications not listed on the provincial formulary may be considered on a case-by-case basis.
For supportive care medications, such as antivirals, antibiotics, and anticoagulants, patients pay applicable deductibles or use private insurance. To be eligible for cancer drug coverage through the Home Cancer Drug Program,25 individuals must be registered with the Manitoba Pharmacare Program and not be eligible for coverage of their prescriptions through federal or other provincial or territorial drug programs.24 Patients not eligible for Manitoba Pharmacare may be eligible for coverage through other provincial or federal programs.
CAR T-cell therapy is covered through the Provincial Oncology Drug Program.
The Saskatchewan Cancer Agency (SCA) funds cancer drugs on the SCA drug formulary for eligible patients through funding from the Government of Saskatchewan Ministry of Health.26,27 IV drugs administered in cancer centres and hospitals and oral cancer treatments taken at home are covered if listed on the SCA drug formulary.26,27 Special funding approval for a drug or indication not listed on the formulary or used outside approved criteria may be considered in exceptional clinical circumstances through the Case-by-Case Review Program.
Some supportive care drugs are covered at no cost to patients if listed on the SCA drug formulary and used within defined eligibility criteria, including antinauseants, bone-directed therapy to prevent skeletal-related events, and white blood cell growth factors. Coverage for other supportive therapies (e.g., anti-infectives, antithrombotic agents, medications for pain management) are not funded by SCA.26,27 Supportive drugs that are not covered through the SCA may be covered by the Saskatchewan Drug Plan, which is a separate provincially-funded drug plan for noncancer and supportive medications administered by the Government of Saskatchewan Drug Plan and Extended Benefits Branch.26,27 Patients may also use private insurance.
In Saskatchewan, CAR T-cell therapy is funded by the SCA.
Cancer Care Alberta is the provincial organization responsible for overseeing, planning, and delivering cancer care services for individuals living with cancer in Alberta.28 Alberta Health Services funds IV and take-home oncology medications specified in the Alberta Health Services Outpatient Cancer Drug Benefit Program List at no cost to eligible patients.29 Patients may receive medications at major cancer centres, designated regional cancer centres, community cancer centres, or may self-administer take-home medications (i.e., oral and subcutaneous medications).29
Individuals qualify for cancer drug coverage if they are Alberta residents, have a valid Alberta health card, are registered in the provincial cancer registry with a cancer diagnosis, and require drugs for the treatment of cancer.29 Cancer medications must be prescribed by a licensed and authorized physician to qualify for public reimbursement.29 An approval process is available for prescribers to request medications not listed on the oncology formulary or outside the approved criteria. Supportive care medications are not publicly covered in Alberta.
CAR T-cell therapy is funded in Alberta.
Cancer care in British Columbia is managed by BC Cancer, the provincial cancer agency of the Provincial Health Services Authority.30 BC Cancer provides comprehensive cancer control program for the residents of British Columbia and Yukon, and funding for cancer therapies for active treatment of cancer.30 All patients with a cancer diagnosis enrolled in British Columbia’s Medical Services Plan, including First Nations people receiving services through the First Nation Health Authority, are eligible for coverage.30 Prescriptions for funded oncology medications are dispensed by BC Cancer or community oncology network hospitals only.30 Coverage for oncology drugs classified as a restricted benefit or drugs that are not on the Benefit Drug List may be available on a case-by-case basis through the BC Cancer Compassionate Access Program.30
Supportive care medications, such as antiemetics, antibiotics, and analgesics, are not covered by BC Cancer.30 Potential sources of funding for cancer medications or supportive medications not covered by BC Cancer include the BC Pharmacare Plan, Manufacturer Patient Assistance Programs, BC Palliative Care Benefits Program, Health Canada Special Access Program, or private drug plans.30 For example, some supportive care medications may be funded if they are covered on the BC Pharmacare Plan.
CAR T-cell therapy is funded by the British Columbia Ministry of Health through BC Cancer.
Hospital-administered oncology medications are covered by the Yukon Hospital Corporation using the BC Cancer Benefit Drug List. Take-home oncology medications and supportive care medications are covered through the Chronic Disease and Disability Benefits program for individuals younger than 65 years or the Seniors Pharmacare program for people aged 65 years and older using the BC Cancer Benefit Drug List. Requests for oncology medications that are not listed on the formulary are evaluated for funding on a case-by-case basis through the BC Cancer Compassionate Access Program.
CAR T-cell therapy is covered by reciprocal billing agreements through the hospital claims system on a case-by-case basis.
In the Northwest Territories, hospital-administered oncology medications are covered by their respective health authorities using the Alberta Outpatient Cancer Drug Benefit Program List as a reference. Take-home oncology medications and supportive care medications are covered under the Extended Health Benefits and Métis Health Benefits programs if listed on the Northwest Territories Pharmacare Formulary. Funding for medications not listed on the formulary may be considered on a case-by-case basis. For individuals eligible for the Non-Insured Health Benefits (NIHB) program, NIHB provides coverage through their program for take-home oncology medications and supportive care medications.
CAR T-cell therapy is covered by reciprocal billing agreements through the hospital claims system and is funded on a case-by-case basis.
Oncology drug coverage in Nunavut differs for hospital-administered oncology medications and take-home oncology medications. Hospital-administered oncology medications are covered for all patients in Nunavut through the Government of Nunavut’s operational budget for drugs administered within the territory or through reciprocal billing for drugs administered out of territory. Typically, the costs of inpatient oncology drugs administered out of territory are included in per diem payments for insured hospital services to the province providing treatment. High-cost inpatient oncology drugs exceeding $5,000 require separate review and prior approval. Funding requests for these high-cost inpatient therapies are submitted to the Government of Nunavut through the Interprovincial Health Insurance Agreements Coordinating Committee (IHIACC) process. The prior approval process applies to all oncology drugs exceeding $5,000, including CAR T-cell therapy.
Take-home oncology medications may be funded through NIHB, the Extended Health Benefits program, or private insurance. Prior approval is required for take-home oncology drugs exceeding $5,000 in cost. This policy applies to patients who are Nunavut Inuit (eligible for NIHB) and other patients. For individuals eligible for coverage through NIHB, NIHB covers the cost of take-home oncology medications listed on the NIHB Drug Benefit Listf. Patients with private insurance are covered through their private insurance plan. Patients who are not eligible for NIHB and who do not have private insurance may be eligible for coverage through the Extended Health Benefits program for drugs listed on the NIHB Drug Benefit List. Similar to high-cost inpatient oncology medications, take-home oncology drugs costing more than $5,000 that are not covered by private plans, NIHB, or the Extended Health Benefits program require prior approval and are considered for funding by the Government of Nunavut on a case-by-case basis. Prior approval is also required for supportive therapies costing more than $5,000.
Funding requests for CAR-T-cell therapy are made through the IHIACC process. Approval is based on the home province’s funding decision for the clinical indication.
The Canadian Armed Forces (CAF) does not have a separate oncology program for coverage of oncology medications. Funding of hospital-administered medications is in line with civilian standards guaranteed to all eligible residents of Canada under the Canada Health Act.31 Take-home oncology and supportive care medications are covered by CAF if listed on the CAF Drug Benefit List.32 Patients must meet eligibility criteria for the drug and indication to receive coverage for medications listed on the CAF formulary.
For medications that are not listed on the CAF formulary and CAR T-cell therapy, funding requests are evaluated by the drug plan on a case-by-case basis.
Correctional Service Canada (CSC) funds hospital-administered oncology medications, take-home oncology medications, and supportive care medications coverage for federally incarcerated individuals in Canada. Patients must meet drug-specific funding criteria for coverage of medications listed in the CSC National Formulary. All requests for medications not listed in the CSC National Formulary or outside of approved CSC National Formulary criteria are evaluated on a case-by-case-basis.
CSC does not currently fund CAR T-cell therapy; however, funding may be considered on an exceptional case-by-case basis.
The NIHB program provides eligible clients with coverage for a range of medically necessary health benefits when these benefits are not otherwise covered through private, provincial, or territorial health insurance plans or social programs.33 NIHB drug benefits are not specific to oncology medications. The NIHB program covers prescription and select over-the-counter medications primarily used in the home or ambulatory setting that are included on the NIHB Drug Benefit List and prescribed by a licensed health professional within their scope of practice. As such, supportive therapies are covered by NIHB when they meet the plan’s criteria for eligible benefits.
To be eligible for drug coverage through the NIHB program, an individual must be a resident of Canada and be one of the following: a First Nations person who is registered under the Indian Act (commonly referred to as a person with Indian status), an Inuk recognized by an Inuit land claim organization as outlined in Inuit client eligibility for the NIHB program, or a child younger than 2 years whose parent is eligible for NIHB.33 Individuals eligible for the NIHB program have the right to appeal the denial of medication coverage for case-by-case consideration.
NIHB does not fund hospital-administered oncology medications or CAR T-cell therapy.
The Veterans Affairs Canada (VAC) Prescription Drug Program provides eligible clients with coverage for approved treatment benefits. The VAC drug formulary is comprehensive in scope, containing non-oncology, oncology (both take-home and hospital-administered), and supportive care medications. Two types of health coverage for VAC clients are available based on the disability entitlement: A-line and B-line coverage.
A-line coverage includes health care benefits and services provided under the Veterans Health Care Regulations to eligible clients for conditions that have been approved for disability benefits entitlement.34 For clients with A-line coverage, medications are fully funded if they are listed on the VAC drug formulary and the medication is related to the condition for which disability benefits entitlement has been granted.
B-line coverage includes health care benefits and services to eligible clients who are not receiving disability benefits and do not have coverage through other publicly funded programs or private insurance.34 For clients with B-line coverage, medications are fully funded if they are listed on the VAC drug formulary and not available under a publicly funded or private plan. Medications that are not listed on the VAC drug formulary can be considered on an individual basis based on the specific needs of the client.
CAR T-cell therapy is not currently funded by VAC; however, requests can be considered on an exceptional case-by-case basis.
Table 2: Overview of FPT Drug Coverage Programs and Policies for Take-Home Oncology Medications
Drug coverage program | Eligible population (beneficiaries) | Other access-related details (enrolment, costs, premiums, copayments) |
|---|---|---|
Provincial and territorial programs | ||
Newfoundland and Labrador | ||
Foundation Plan12 | Persons and families receiving income support benefits, supervised care, or services through the regional health authorities, including children in the care of Child, Youth and Family Services. | Individuals are automatically enrolled when the health authority is notified that the individual or family is receiving other government benefits. No application is required. |
65Plus Plan12 | Residents aged ≥ 65 years receiving Old Age Security benefits and the Guaranteed Income Supplement. | Individuals are automatically enrolled when the health authority is notified that the individual is receiving other government benefits. No application is required. Dispensing fee up to a maximum of $6. |
Access Plan12 | Individuals and families with low incomes. Total net annual incomes of ≤ $27,151 for individuals, ≤ $30,009 for couples without children, and ≤ $42,870 for families with children and single parents. | Individuals must apply for the plan and submit necessary documentation (e.g., income). Copayment between 20% and 70% of total prescription costs, depending on their income levels. |
Assurance Plan12 | Individuals and families for whom eligible drug costs exceed 5% of net income for earnings < $40,000 a year; 7.5% of net income for earnings of $40,000 to $75,000 a year; and 10% of net income for earnings of $75,000 to < $150,000 a year. | Beneficiaries pay a copayment depending on their income levels and drug costs. Eligibility and copayment rate are reassessed every 6 months using the most recent income and drug cost data available. |
Prince Edward Island | ||
Family Health Benefit Drug Program14 | Families with at least 1 child aged < 19 years or aged < 25 years and still attending school and net annual family income < $24,800, increased by $3,000 for each additional child. | Individuals must apply for the plan on an annual basis and submit income information. Pharmacy dispensing fee applies for each prescription. |
Generic Drug Program14 | Persons aged < 65 years with no private drug insurance. | Maximum of $19.95 per prescription. |
High Cost Drug program14 | Persons eligible for Prince Edward Island Medicare and approved for coverage for 1 or more of the medications included in the program. | Must apply for the plan on an annual basis and submit income information. Beneficiaries pay an income-based portion of the medication cost plus the pharmacy professional fee for each prescription obtained. |
Nursing Home Program or Institutional Pharmacy Program14 | Persons living in government-funded long-term care facilities or private nursing homes eligible for coverage under the Social Assistance Act. | No out-of-pocket costs. |
Catastrophic Drug Program14 | Individuals who have high prescription drug costs relative to their income. Annual prescription drug costs are capped at an amount that does not exceed a set percentage of household annual income.
| Out-of-pocket eligible drug expenses must exceed the annual household limit before the program will cover any further eligible drug expenses in the program year. |
Seniors Drug Program14 | Persons eligible for PEI Medicare and aged ≥ 65 years. | Maximum of $15.94 per prescription. |
Financial Assistance Program14 | Persons eligible under the Social Assistance Act and Regulations. | No out-of-pocket costs. |
Nova Scotia | ||
Seniors’ Pharmacare17 | People aged ≥ 65 years with a valid Nova Scotia Health Card who do not have other forms of coverage. | Annual premium based on income up to a yearly maximum of $424. Premium may be reduced or waived depending on income. A late-fee penalty and a waiting period of 90 days may apply if enrolling after age 65 years. Beneficiaries pay a 30% copayment on each prescription, with a yearly maximum of $382. |
Family Pharmacare18 | Individual of any age with a valid Nova Scotia Health Card who does not have other forms of coverage. | No joining fee or premiums. Annual family deductible and a 20% copayment on each medication until maximum annual deductible and copayments are reached depending on family income and size. |
Drug Assistance for Cancer Patients19,a | People diagnosed with cancer who have a valid Nova Scotia Health Card but do not have private insurance. Must have a gross family income < $35,000 per year. | No out-of-pocket costs (joining fee, premiums, deductibles, copayments). |
Take-Home Cancer Drug Fund20,a | Individual must be a resident of Nova Scotia with a valid Nova Scotia Health Card, be taking cancer medications at home, and must have exhausted all other sources of financial assistance programs, including private, public, and manufacturer assistance programs. Patients must have out-of-pocket expenses for eligible drugs > 4% of their net family income. Only drugs that are publicly funded by Nova Scotia Pharmacare Programs are covered by this fund. Patients must register with the Nova Scotia Family Pharmacare Program. | Individuals must apply for the fund and submit income and other information. |
New Brunswick | ||
NBPDP Seniors21 | Individuals in New Brunswick are eligible to apply for drug coverage if they:
| NBPDP has no premiums. Copayment of $9.05 per prescription. Maximum copayment of $500 per year. |
NBPDP Nursing Home Residents21 | Individuals who live in a registered nursing home. Eligibility for drug coverage through this plan is determined by the Department of Social Development. | No copayments or fees. |
NBPDP Adult Residential Facilities21 | Individuals who live in an adult residential facility. Eligibility for drug coverage through this plan is determined by the Department of Social Development. | No copayments or fees. |
NBPDP Correctional Services21 | Individuals in provincial correctional facilities who do not have existing drug coverage. | No copayments or fees. |
NBPDP for Social Development Clients21 | Individuals who hold a valid health card issued by the Department of Social Development. Eligibility for drug coverage through this plan is determined by the Department of Social Development. | Copayment of $4 for each prescription for adults (aged ≥ 18 years) and $2 for children (aged < 18 years) up to a maximum of $250 per family in a year. |
NBPDP Children in the Care of the Minister of Social Development and Special Needs Children21 | Children in care of the Minister of Social Development and special needs children. Eligibility for drug coverage through this plan is determined by the Department of Social Development. | No copayments or fees. |
New Brunswick Drug Plan22 | Individual must be a resident of New Brunswick with an active Medicare Card and meet one of the following requirements:
| If no other drug coverage is available, individuals must apply for the plan. Beneficiaries pay annual premiums based on income, and a 30% copay to a maximum per prescription, ranging from $5.25 to $36.00. |
Ontario | ||
Ontario Drug Benefit Program23 |
Eligible recipients include the following individuals: 1. Individuals entitled to receive drug benefits under the Ontario Disability Support Program Act, 1997 and the Ontario Works Act, 1997; 2. Individuals who are insured persons under the Health Insurance Act and who are: ○ ≥ 65 years ○ ≤ 24 years and do not have a private plan ○ residents of long-term care homes ○ residents of homes for special care or community Homes for opportunity ○ enrolled in the Trillium Drug Program 3. Individuals who are receiving one of the following: ○ professional service within the meaning of Ontario Regulation 187/22 (Home and Community Care Services) made under the Connecting Care Act, 2019 that is provided by a health service provider or an Ontario Health Team, other than training ○ substantially equivalent service that is provided by an Indigenous organization that has entered into an agreement with the Ministry of Health. For eligibility details, refer to Ontario Drug Programs Reference Manual |
Copayments and deductibles vary depending on eligibility stream (e.g., individuals aged ≥ 65 years, Trillium Drug Program). |
Manitoba | ||
Home Cancer Drug Program25,a | Individuals must have a valid Manitoba Health Card, be registered in the Manitoba Pharmacare Program, and not be eligible for coverage of their prescriptions through federal or other provincial drug programs. | No out-of-pocket costs. Individuals are fully covered for take-home oncology medications listed on formulary. |
Saskatchewan | ||
Eligible patients are those who have a valid Saskatchewan Health Card, are registered with the SCA and meet the clinical eligibility criteria for coverage. | No out-of-pocket costs. Individuals are fully covered for take-home oncology medications listed on formulary. | |
Alberta | ||
Alberta Health Services Outpatient Cancer Drug Benefit Program29,a | Individuals qualify for cancer drug coverage if they are Alberta residents, have a valid Alberta Health Card, are registered in the provincial cancer registry with a cancer diagnosis, and require drugs for the treatment of cancer. | No out-of-pocket costs. Individuals are fully covered for take-home oncology medications listed on Alberta Health Services Outpatient Cancer Drug Benefit List. |
British Columbia | ||
British Columbia Cancer Benefit Drug program30,a | All patients with a cancer diagnosis enrolled in British Columbia’s Medical Services Plan, including those eligible for First Nations Health Authority benefits, are eligible for coverage of oral cancer medications on the BC Cancer Benefit Drug List. | No out-of-pocket costs. Individuals are fully covered for take-home oncology medications listed on the BC Cancer Benefit Drug List. |
Yukon | ||
CDDB and Pharmacare or Seniors Pharmacare programs | Patients are covered through the CDDB program (aged < 65 years) or the Seniors’ Pharmacare program (aged > 65 years) using the BC Cancer Benefit Drug List. | — |
Northwest Territories | ||
Extended Health Benefits and Métis Health Benefits programs | Patients who are enrolled in the Extended Health Benefits program or Métis Health Benefits program are covered. | Copayments and deductibles vary depending on income level, patient age, and region. |
Federal programs | ||
Canadian Armed Forces | ||
CAF Drug Benefit Plan32 | The Constitution Act places responsibility upon the Federal Government for providing medical care to members of the CAF. This is because the Canada Health Act and the provincial health insurance acts exclude members of the CAF from the list of “insured persons” for the purpose of provincial health care coverage. Therefore, the CAF provides its members with comprehensive health care comparable to that guaranteed to all eligible residents of Canada under the Canada Health Act. The Canada Health Act of April 1, 1984, states that: “...the primary objective of Canadian health care policy is to protect and restore the physical and mental well-being of the residents of Canada and to facilitate reasonable access to health services without financial or other barriers.”31 The Act further states that insured person means: “...a resident of the province other than a member of the Canadian Forces.”31 All Regular Force personnel are covered by the CAF Spectrum of Care from the time of enrolment to the effective date of release from the CAF. Reserve Force personnel are covered only during specified periods of eligibility based on their duty status and the relatedness of their illness or injury to military service. From time to time, other persons may be authorized for specific services or for specified periods of time. Some examples are visiting military forces, foreign military exchange personnel and their dependents, CAF recruit applicants, and civilian food handlers. | No out-of-pocket costs. Individuals are fully covered for eligible take-home oncology medications. |
Correctional Service Canada | ||
CSC National Formulary | CSC is responsible for providing essential health care, including medically necessary medications, to individuals who federally incarcerated under the Corrections and Conditional Release Act. | — |
Non-Insured Health Benefits | ||
NIHB program33 | To be eligible for drug coverage through the NIHB program, an individual must be a resident of Canada and be one of the following:33
Individuals eligible for the NIHB program have the right to appeal the denial of medication coverage for case-by-case consideration. | — |
Veteran Affairs Canada | ||
VAC Prescription Drug Program34 | Clients have one of the following types of coverage:
| — |
CAF = Canadian Armed Forces; CDDB = Chronic Disease and Disability Benefits; CSC = Correctional Service Canada; NBPDP = New Brunswick Prescription Drug Program; NIHB = Non-Insured Health Benefits; ODB = Ontario Drug Benefit; SCA = Saskatchewan Cancer Agency; VAC = Veteran Affairs Canada.
aPublic drug reimbursement program is specific for oncology medications.
While most jurisdictions provide no-cost access to oncology medications delivered in hospital settings listed on their formulary, coverage for take-home medications is not covered through a consistent approach.
Several factors contribute to variability between jurisdictions, which may include eligibility for the specific FPT drug plan, income threshold, patient age, or access to private insurance. Additionally, in some jurisdictions, some patients eligible for public funding may still incur out-of-pocket costs, copayments, and premiums. While formulary-based coverage is the general approach to covering oncology medications, nearly all jurisdictions offer mechanisms for exceptional or case-by-case review for medications not listed on their formulary or used outside of the approved reimbursement criteria.
The definitions of hospital-administered, take-home, and supportive care medications may vary based on the FPT drug plan. In particular, coverage of supportive care medications is less consistent between jurisdictions, where definitions of supportive care and coverage policies differ. Across drug plans, access to CAR T-cell therapy varies from no coverage to coverage through publicly funded programs, with some jurisdictions relying on interprovincial arrangements or exceptional approvals.
Overall, there is broad public coverage for oncology medications in Canada. However, disparities in funding policies exist, particularly for take-home and supportive therapies, presenting future opportunities for FPT drug programs to work toward common definitions of hospital-administered, take-home, and supportive care medications for oncology medicines.
1.Canadian Cancer Society. Access to cancer drugs and diagnostics. Accessed 2026 February 27. https://cancer.ca/en/get-involved/advocacy/what-we-are-doing/drug-access
2.Patented Medicine Prices Review Board. CompassRx, 10th edition: Annual Public Drug Plan Expenditure Report, 2022/23. Patented Medicine Prices Review Board; 2025. https://www.canada.ca/en/patented-medicine-prices-review/services/npduis/analytical-studies/compassrx-10th-edition.html
3.Del Paggio JC, Naipaul R, Gavura S, et al. Cost and value of cancer medicines in a single-payer public health system in Ontario, Canada: a cross-sectional study. The Lancet Oncology. 2024;25(4):431-438. doi:10.1016/S1470-2045(24)00072-X PubMed
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8.PDCI Market Access. Uncovering the Hidden Costs of Take-Home Cancer Drug. 2021.
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10.Ayto R, Annibali O, Biedermann P, Roset M, Sanchez E, Kotb R. The EASEMENT study: A multicentre, observational, cross-sectional study to evaluate patient preferences, treatment satisfaction, quality of life, and healthcare resource use in patients with multiple myeloma receiving injectable-containing or fully oral therapies. Eur J Haematol. 2024;112(6):889-899. doi:10.1111/ejh.14180 PubMed
11.Patented Medicine Prices Review Board. Alignment among Public Formularies in Canada. Part 2: Oncology Medicines. Patented Medicine Prices Review Board; 2021. https://www.canada.ca/content/dam/pmprb-cepmb/documents/npduis/analytical-studies/formularies/PMPRB-P2-Formularies-en.pdf
12.Newfoundland and Labrador Department of Health and Community Services. Prescription Drug Program (NLPDP). 2026. Accessed 2026 February 27. https://www.gov.nl.ca/hcs/prescription/
13.Newfoundland and Labrador Department of Health and Community Services. NLPDP Coverage Status Table. 2026. Accessed 2026 February 27. https://www.health.gov.nl.ca/health/prescription/coverage_status_table.pdf
14.Government of Prince Edward Island. Health PEI Formulary Drugs for Oncology. 2026. Accessed 2026 February 13. https://www.princeedwardisland.ca/sites/default/files/publications/oncologyformulary.pdf
15.PEI Department of Health and Wellness. Medication Coverage – PEI Pharmacare Formulary. 2026. Accessed 2026 February 13. https://www.princeedwardisland.ca/en/information/health-and-wellness/medication-coverage-pei-pharmacare-formulary
16.Nova Scotia Department of Health and Wellness. Formulary. 2026. Accessed 2026 February 17. https://novascotia.ca/dhw/pharmacare/documents/formulary.pdf
17.Nova Scotia Department of Health and Wellness. Nova Scotia Seniors’ Pharmacare Program. 2025. Accessed 2026 May 12. https://www.novascotia.ca/sites/default/files/documents/1-3844/seniors-pharmacare-program-guide-en.pdf
18.Nova Scotia Department of Health and Wellness. Nova Scotia Family Pharmacare Program. 2024. Accessed 2026 May 12. https://www.novascotia.ca/sites/default/files/documents/1-3845/family-pharmacare-program-guide-en.pdf
19.Nova Scotia Department of Health and Wellness. Drug Assistance for Cancer Patients Program. 2026. Accessed 2026 May 12. https://www.novascotia.ca/apply-funding-cancer-related-drugs-and-supplies-drug-assistance-cancer-patients-program
20.Nova Scotia Health Cancer Care Program. Take-Home Cancer Drug Fund. 2025. Accessed 2026 February 17. https://www.nshealth.ca/clinics-programs-and-services/take-home-cancer-drug-fund
21.Government of New Brunswick. Eligibility for the New Brunswick Prescription Drug Program. Accessed February 5, 2026. https://www.gnb.ca/en/topic/health-wellness/nb-drug-plans/eligibility-prescription.html
22.Government of New Brunswick. New Brunswick Drug Plan. 2026. Accessed February 5.https://www.gnb.ca/en/topic/health-wellness/nb-drug-plans/eligibility-prescription.html
23.Cancer Care Ontario. Cancer Drug Coverage, Funding and Reimbursement. 2026. Accessed 2026 February 25. https://www.cancercareontario.ca/en/cancer-treatments/chemotherapy/funding-reimbursement
24.Government of Manitoba. Increased Funding for Intravenous Cancer Drugs will Support Manitobans Fighting Cancer: Premier. 2016. Accessed February 23. https://news.gov.mb.ca/news/?item=38170
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34.Veterans Affairs Canada. Definitions for Health Care Benefits, Veterans Independence Program, and Long Term Care. 2019. Accessed August 31, 2026. https://www.veterans.gc.ca/en/about-vac/reports-policies-and-legislation/policies/definitions-health-care-benefits-veterans-independence-program-and-long-term-care
Please note that this appendix has not been copy-edited.
In your jurisdiction, how are take-home oncology medications covered? Please describe any additional FPT programs that also fund oncology medications for special circumstances.
In your jurisdiction, how are hospital-administered oncology medications covered? Please describe any additional FPT programs that also fund oncology medications for special circumstances.
Are there differences in funding between drugs for active cancer treatment and those for supportive care? Please describe.
For drugs that are not found on your jurisdictional formulary, is a special or compassionate access program available?
How is CAR T-cell therapy funded in your jurisdiction?
Please provide any additional feedback.
ISSN: 2563-6596
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