Tini from Edmonton asks: I am a lupus patient and the pharmacist and my insurance company said that my prescription drug Mycophenolate, which is quite expensive, may not be covered.  What should I do?

Mycophenolate is a commonly used medication in the treatment of lupus and other connective tissue diseases.  In rheumatology, many medications are used “off label”, meaning they do not have formal Health Canada (or FDA, etc.) approval for a particular use.  However, through many studies and years of experience, we know these medications bring significant benefit to the management of rheumatic conditions and are appropriate to use.  Despite this, companies have not asked health authorities for more formal approval and without it, insurance companies may not always reimburse the cost.  If this is the case, we strongly encourage you to discuss this with your rheumatologist.  This is not an unusual situation for your rheumatologist and they often have access to other means of ensuring you can take the best medication for your condition.

Posted: August 29, 2023

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