B.C. woman petitions province to cover cost of 'life-changing' migraine medication

A Surrey woman who suffers from chronic migraines is calling on the province to cover the cost of an expensive drug she says is necessary for her to live a normal life.

Christina Sall, 28, started having migraines when she was five years old. By the time she was in her early 20s, they were happening every two or three days. The debilitating pounding headaches could last for days and caused nausea, vomiting, light sensitivity and trouble speaking.

She tried numerous medications, including triptans, antidepressants and beta blockers, but they either didn't work or resulted in side effects that led to hospital visits. She eventually had to drop out of her program at University of the Fraser Valley in Chilliwack, B.C.

"It really affected my life as someone who is in their early 20s trying to get their career going and trying to get my life started," Sall said.

"It was pretty heartbreaking for me."

Immediate effects from new drug

In March 2019, she started a clinical trial for a new migraine medication called erenumab, also known as Aimovig.

The effect was almost immediate, she said. She went from having a migraine every two or three days to one every couple of months.

The drug was free for a year with the clinical trial, but since it ended last March, Sall says she's had to pay $505 each month for the injection, after a 20 per cent discount from the company.

The drug is not covered under B.C. PharmaCare and she says Pacific Blue Cross denied her coverage request.

It's a financial burden for Sall, who has returned to school to study nursing and is paying for the medication with student loans. She has started an online petition to urge the government to include the drug in provincial coverage, and has emailed Health Minister Adrian Dix numerous times but says she has not received a response.

"I literally can't do this program unless I'm on this medication. If I don't have this medication, I'm not a functional human being," Sall said. 

"It has been life changing."

'These are real game changers'

In a statement to CBC News, the B.C. Ministry of Health said The Pan-Canadian Pharmaceutical Alliance (pCPA) is currently involved in price negotiations with Novartis Pharmaceuticals Canada Inc., which manufactures the drug. Once that process is completed, the ministry will make a decision about coverage.

Typical review timelines for drugs are 12 months, and the pandemic did not cause significant delays in the drug review process, the ministry added. 

Alan Low, a pharmacist and executive director at Medicines Access Coalition B.C. (MedAccessBC), says biologic drugs like Aimovig can typically be expensive and go through multiple review processes before being approved in B.C. and other provinces.

Sometimes these processes go smoothly but a province's budget does not allow for a new drug and it ends up being delayed, Low said.

"So it will just kind of sit on a shelf until the province is able to essentially afford it," he said. 

A manufacturer might provide support to keep patients on these expensive medications, he said, but this can be rare. Low encourages patients to advocate for themselves by reaching out to their political representatives and MedAccessBC.

According to Migraine Canada, 4.5 million Canadians suffer from migraines. In B.C., more than 600,000 people suffer from migraines, and 50,000 people live with chronic migraines, like Sall.

Newer medications like Aimovig are a sign of hope for many because there have been so few medications approved for treating migraines in the past decade, said Wendy Gerhart, executive director of Migraine Canada.

Sall's story is not uncommon, Gerhart said. Migraine Canada is working with drug manufacturers and governments to move approvals forward and ensure drugs are more accessible for patients.

She encourages patients to advocate for themselves and share their stories so the impact of migraines is better understood.

"It is very challenging for patients right now, especially knowing that these medications have been approved by Health Canada and yet they can't access them," Gerhart said. 

"These are real game changers and they are making a difference in patients' lives ... so we need to try to work together and tighten that gap up and get medications to patients more quickly."