Where to get your prescription medications
The transplant pharmacist will also meet with you after your transplant to get contact information for your local pharmacy. This way we can find out if your pharmacy carries (or can order) the medications you will need, as not all pharmacies carry every medication. Some liquid medications are difficult to make up, so we will also find out if your pharmacy can prepare these.
Cyclosporine (an immunosuppressant) is covered for transplant patients living in Ontario only if the prescription is filled at a transplant hospital. So if you are prescribed cyclosporine, you will need to fill the prescription at the hospital where you got your organ transplant. If you move, you can fill the prescription at a transplant hospital pharmacy closer to home.
Refilling prescriptions
- Right after transplant, you will get a limited supply (usually one month) of each medication from the hospital pharmacy. Dose changes may cause you to run out a little sooner.
- Keep an eye on your bottles or pill containers so you can see when your supply is getting low. It is critical that you do not run out of immunosuppressant (anti-rejection) medications! Keep an eye on expiry dates. Any liquid that has to be specially made will have an expiry label on the bottle.
- Call your pharmacy three to five working days before you run out. This is really important if the medicine is a liquid that the pharmacy must make up especially for you.
- Check your prescription label regularly to make sure that you still have refills on the medication. Call the transplant team if you notice that you have no refills left. Again, please do this three to five working days before your supply runs out. The transplant team can call in a prescription to your pharmacy.
Once your condition is more stable, you can request up to three months’ supply of medications that have long expiry dates. The amount will also depend on your drug plan coverage.
Medications and clinic appointments
It is important to bring the following to your clinic appointment:
- a list of your medications (with doses and times that you take them)
- names of medications for which you need refills at the pharmacy
- your medications (bring a supply for the whole day in case you need to stay for tests or other appointments)
- a list of any questions that you would like to ask.
Paying for your medications
If your family has private medical insurance
Most medical insurance plans cover prescription medications. Most over-the-counter medicines, for example acetylsalicylic acid (ASA) or magnesium or phosphate supplements, are not covered. This means you will need to pay for them.
The transplant pharmacist will give you a list of the drug identification numbers (DINs) for the medications you need after your transplant. Your parent or guardian then calls your family’s insurance provider and gives them the DINs to find out if the provider covers the medications.
When calling the insurance provider, it’s important to get answers to these three questions.
- What portion of the cost of the medications does the plan cover (for example 100%, 80% or 60%)? This will help your family budget for the remaining cost, if any.
- How do you pay for the medications? For example, do you pay up front and then submit receipts to the insurance provider or do you pay a deductible (a portion of the cost), while the pharmacy bills the insurance provider for the rest of the cost directly?
- Is there a cap (a limit) on the amount of coverage and, if so, how is this calculated? For example, is there a maximum amount each year or over a person’s lifetime?
If you have Ontario Drug Benefits (ODB) coverage
Ontario Drugs Benefits coverage is available through:
- Home Care Program or Community Care Access Centre (CCAC)
- Ontario Works or Ontario Disability Support Program (ODSP)
- Assistance for Children with Severe Disabilities (ACSD)
- Trillium
- OHIP+ (see below).
ODB covers most prescription medications. Sometimes a special code needs to be added to the prescription. There are a few medicines that can only be covered with special permission from the government. The transplant team will arrange this for you as needed.
Most over-the-counter medications are not covered by ODB. Your family will have to pay for these medications.
For more information, contact the Ministry of Health & Long-Term Care Info Line at 1-866-532-3161 (toll free in Ontario only) or visit their website.
OHIP+
Under OHIP+, the government of Ontario now covers the costs of certain medications up to age 25 if you have a valid OHIP card. You will be enrolled in the program automatically if your OHIP card is valid.
To find out if your transplant medication is covered, visit the Government of Ontario website. If your medication is designated as "may be covered" or "not covered", check if your family's private medical insurance might cover the cost. If the medication is not covered by OHIP+ or private insurance, ask your transplant team about other possible sources of funding.
If you are from outside Ontario and have no private insurance
Provinces have different rules for medication coverage. The transplant team will help you find out how much coverage is available in your home province and help organize any paperwork that you need before you leave hospital.
