As N.W.T. mulls health coverage changes, petition calls for preventative HIV drug to be free

A Yellowknife resident is calling on the Northwest Territories government to offer an HIV preventative drug at no cost to residents without health insurance. 

William Gagnon said HIV pre-exposure prophylaxis (PrEP), a daily pill taken by those at high risk of contracting HIV, isn't covered by the N.W.T. government for those without health insurance.

Meaning residents in need would have to pay out of pocket. 

"If you don't [have insurance] then it could be a big financial barrier," Gagnon told CBC News. 

"So I just think it should be universal coverage."

The drug is found be effective at preventing HIV when taken as prescribed and is covered for residents in several other jurisdictions including the Yukon, Manitoba, B.C., Saskatchewan and Alberta. 

Jeremy Bird, a spokesperson for the Health Department, said in an email the current policy doesn't offer the drug because the N.W.T.'s Specified Disease Conditions Extended Health Benefits program coverage requires a diagnosis of a specified condition. He said it costs around $1,000 a month for those not covered to pay for it. Gagnon said in the petition for those without health insurance PrEP costs around $250 a month. 

However, most employer insurance plans cover PrEP, as well as non-insured health benefits programs for First Nations, Inuit and Métis.

Feedback on proposed changes

Gagnon started a petition that encourages residents to fill out a feedback form the territorial government is collecting on proposed changes to the extended health benefits policy.  

The territory is proposing extending coverage for those who don't have health insurance and make under a certain amount annually. 

The changes would make PrEP free for those who fit into that category.

The feedback form said the N.W.T. hasn't updated its health benefits policy in 34 years and is doing so to ensure it meets the objectives of fairness and equity. 

Chelsea Thacker, the executive director of the Northern Mosaic Network, said it's good the N.W.T. is taking feedback, but that PrEP should have been offered to residents long before this. 

"We shouldn't even be debating preventative health care measures and the access to it," they said. 

"So many people need access to this medication in order to safely engage in physical contact with their partner." 

Thacker added PrEP should be available to all, no matter their income. 

"Basing it off people's income isn't necessarily something that we have the right to do," they said. 

"A lot of people have different expenses that we don't know about. And so really with so many things still needing to be paid in our health-care system, I think that this medication should just be free for everyone."

N.W.T. dealing with syphilis outbreak

The territory has only had five cases of HIV diagnosed in the past five years, according to data provided by the Health Department. 

However, sexually transmitted infections (STIs) rates as a whole are among the highest in the country and the territory is in the midst of an unprecedented syphilis outbreak. 

Sean Hosein is a science and medicine editor with Catie.ca, a Canadian information website on HIV and other STIs. 

He said a syphilis infection makes it easier for HIV to be transmitted due to genital inflammation or lesions.

"So when you've got inflammation inside your genitals or on them, or tiny holes or lesions, then not only can you spread syphilis to other people, but you can get other germs, including HIV," Hosein said. 

He said in the long run, preventative drugs like PrEP are far more cost effective than treatment. 

"It's always cheaper and easier and simpler to prevent something rather than wait until it gets more complicated down the road," he said.

"So the costs of PrEP are really low compared to the lifetime cost for treating chronic HIV infection." 

As of Friday afternoon, nearly 2,000 people had signed Gagnon's petition which was started on Tuesday. 

Residents interested in sharing feedback on the proposed changes to the N.W.T. extended health benefits have until Oct. 14 to do so.