Vyvanse Now Covered on Ontario Drug Plan

By Dr. Kenny Handelman

Vyvanse (lisdexamfetamine) is one of the newer medications for ADHD. It has been in Canada since February 2010. However, the provincial insurance plans did not cover it.

I’m pleased to announce that as of June 8, 2011, Vyvanse will be covered by the Ontario Drug Plan. This means that if a family has an Ontario drug card (from being on OW, or ODSP, or a child disability, or even the Trillium Drug Plan), then Vyvanse will be covered.

The rules for Vyvanse coverage are written as follows:

Notes: Patients > 6 years of age diagnosed with ADHD according to DSM-IV criteria and where symptoms are not due to
other medical conditions which affect concentration, and who require 12-hour continuous coverage due to academic and/or
psychosocial needs, and who meet the following:
1) Patients who demonstrate significant and problematic disruptive behaviour or who have problems with
inattention that interfere with learning; AND
2) Prescribed by or in consultation with a specialist in pediatric psychiatry, pediatrics or a general practitioner
with expertise in ADHD; AND
3) Have been tried on methylphenidate immediate release (IR) or methylphenidate slow release (SR) or
Dexedrine IR or Dexedrine SR (Spansules), and have experienced unsatisfactory results due to poor
symptom control, side effects, administrative barriers, or societal barriers.
Administrative barriers include:
. inability of a school to dose the child at lunch;
. the school lunch hour does not coincide with the dosing schedule;
. poor compliance with noon or afternoon doses;
. the patient is unable to swallow tablets.
Societal barriers include:
. the patient or patient’s caregiver(s) has(have) a history of substance abuse or diversion of listed
immediate-release alternatives;
. the patient or patient’s caregiver(s) is/are at risk of substance abuse or diversion of listed
immediate-release alternatives.

From a practical perspective, the doctor does not have to complete a form, or get formal approval, so it will be up to your doctor to decide when he or she will begin using Vyvanse with you.

This is very good news for ADHD patients in Ontario. I know that a lot of advocacy work went on, spearheaded by CADDAC. I know that I spoke to my MPP and got him to write a letter of support, and many other doctors and patients did the same. I hope that this precedent will help to get coverage in the other provinces too.

Best,

Dr. Kenny

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Comments

  1. Jamie Ginter says:

    I’m moving to ON! My only options are Ritalin or Dexedrine. Not that Dexedrine isn’t working for me, but i want to be able to go to school and work without popping med’s all day. Once a day in the morning just sounds better.

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