Vancouver woman with MS asks why B.C.’s the only province that doesn’t cover her medication

B.C. is the only province that doesn't cover the cost of a powerful and pricey medication for people with multiple sclerosis.

Teresa Alfeld is a documentary film director from Vancouver who was diagnosed with relapsing-remitting multiple sclerosis in September 2024.

As a Type 1 diabetic, the 37-year-old can’t take steroid medications regularly prescribed for MS.

“In conversation with my doctor, we both agreed I needed a really strong drug to make sure that the lesions didn’t continue progressing, and so our choice was Kesimpta,” said Alfeld.

Kesimpta is a once-a-month injectable that costs $26,000 a year.

“Sadly, that’s not something that myself and my family can cover,” Alfeld said. She secured six doses of the medication from the manufacturer while she looked into long-term coverage.

“I have two private plans, my own and my husbands, which we went through first and then found out that neither plan covered it. And so then it was on to PharmaCare. And that was when we found out, shockingly, that they were not going to cover it,” said Alfeld.

She learned British Columbia is the only province in Canada that doesn’t cover the cost of Kesimpta for MS patients.

“We call it the postal code lottery at MS Canada because your access to medication really depends on where you live,” said Alanah Duffy with MS Canada.

“I would have thought that OK, I’m a special case because I can’t use the steroids. Surely they’ll cover just me in this case. But I’ve been rejected multiple times,” Alfeld said.

Duffy said MS Canada has been petitioning the B.C. government to cover the medication for years, with no success.

“What we’ve continuously heard from the B.C. government is that these treatments are not cost effective. But our argument is that funding these treatments would save other health-care costs because Kesimpta is a highly efficacious treatment,” Duffy said.

In an email, the Ministry of Health said it engaged in price negotiations with the company that makes Kesimpta, but the manufacturer was unable to address the province’s concerns with regards to cost-effectiveness and value for money.

The statement went on to say: “B.C. covers many drugs that other provinces do not. Numerous treatment options for relapsing-remitting multiple sclerosis (RRMS), with the same clinical effectiveness as ofatumumab (Kesimpta) and ocrelizumab (Ocrevus), are covered by PharmaCare. We encourage patients to discuss treatment options with their physician.”

Alfeld said she can’t take the alternative drugs the ministry is suggesting because they require taking steroids alongside the medication, which are not advisable for people with Type 1 diabetes. Older drugs that are covered are also far less effective, she said.

“The drug that I have been taking is rated at about 90 per cent efficacy at stopping the progression of lesions, which is why my neurologist and I chose it for myself. The legacy drugs that I’ve been offered are rated 50 per cent,” said Alfeld. “So this is a huge gamble that I’m not comfortable taking.”

The doses of Kesimpta that Alfeld got from the drug manufacturer have now run out. “I am due for my next shot on June 30th, and I don’t have that shot,” she said, adding she has been working with her MLA and petitioning PharmaCare and the Health Ministry to provide the medication.

But as the days tick down until she’s due for her next shot, Alfeld is worried. “I just focus on taking action, because I can’t really allow myself to think about what’s going to happen.”