Criteria for reimbursement of chronic hepatitis B medications in Canada*
| Province/territory or federal plan | Lamivudine | Adefovir | Emtrictiabine–tenofovir | Tenofovir disoproxil fumarate† | Entecavir | Interferon |
|---|---|---|---|---|---|---|
| CDEC | NA | Take with lamivudine for lamivudine failure | NA | Cirrhosis with HBV DNA level > 2000 IU/mL | Cirrhosis with HBV DNA level > 2000 IU/mL | NA |
| British Columbia | ALT and viral load requirement OR cirrhosis | Lamivudine resistance | NA | Cirrhosis and viral load ± ALT requirement OR lamivudine resistance | Cirrhosis and viral load ± ALT requirement | Alfa-2b HBeAg+ with ALT and viral load requirement |
| Alberta | No restrictions for specialists | No restrictions for specialists | NA | No restrictions for specialists | No restrictions for specialists | Pegylated interferon alfa-2a No restrictions for specialists |
| Saskatchewan | No restrictions for specialists | As per CDEC with specialist consultation | NA | As per CDEC with specialist consultation | As per CDEC with specialist consultation | Alfa-2b Up to 6 mo with specialist consultation |
| Manitoba | No restrictions | NA | NA | As per CDEC OR cirrhosis with lamivudine resistance | No restrictions | NA |
| Ontario | HBV DNA level ≥ 1000 IU/mL with ALT level > ULN or fibrosis/cirrhosis | NA | NA | HBV DNA level ≥ 1000 IU/mL with ALT level > ULN or fibrosis/cirrhosis | HBV DNA level ≥ 1000 IU/mL with ALT level > ULN or fibrosis/cirrhosis | Alfa-2b Age < 50 yr, ≤ stage F3 fibrosis with ALT and DNA requirements |
| Quebec | No restrictions | As per CDEC OR > Child–Pugh class A6 OR after liver transplantation with DNA requirement | No restrictions | No restrictions | No restrictions | Pegylated interferon alfa-2a No restrictions |
| New Brunswick | No restrictions for specialists | NA | No restrictions | No restrictions for specialists | No restrictions for specialists | Pegylated interferon alfa-2a HBeAg–, liver inflammation, failed lamivudine |
| Nova Scotia | No restrictions with specialist request | As per CDEC | NA | As per CDEC | As per CDEC | NA |
| Prince Edward Island | No restrictions | As per CDEC | NA | No restrictions | As per CDEC | NA |
| Newfoundland and Labrador | No restrictions | As per CDEC | NA | As per CDEC | As per CDEC | Alfa-1a/-2b HBeAg–, liver inflammation, lamivudine failure with specialist consultation |
| Yukon Territory | No restrictions | As per CDEC with specialist recommendation | Case by case with specialist recommendation | Case by case with specialist recommendation | Case by case with specialist recommendation | NA |
| Non-Insured Health Benefits Program | No restrictions | As per CDEC | No restrictions | As per CDEC | As per CDEC | Pegylated interferon alfa-2a No cirrhosis, with DNA requirements and specialist request |
| Correctional Services Canada | No restrictions | No restrictions | No restrictions | No restrictions | No restrictions | Pegylated interferon alfa-2a/-2b No restrictions |
| Veterans Affairs | No restrictions | NA | No restrictions | No restrictions | NA | Interferon alfa-2b |
Note: ALT = alanine aminotransferase, CDEC = Canadian Drug Expert Committee, HBeAg= hepatitis B e-antigen, HBV = hepatitis B virus, NA = no recommendation or not listed, ULN = upper limit of normal.
↵* No public health plans reimburse telbivudine.
↵† No public health plans reimburse tenofovir alafenamide fumarate.