title: Access to biologic therapies in Canada for children with juvenile idiopathic arthritis.
abstract: OBJECTIVE
  To compare access to biologic therapies for children with juvenile idiopathic arthritis (JIA) across Canada, and to identify differences in provincial regulations and criteria for access.
  
  
  METHODS
  Between June and August 2010, we compiled the provincial guidelines for reimbursement of biologic drugs for children with JIA and conducted a multicenter Canada-wide survey of pediatric rheumatologists to determine their experience with accessing biologic therapies for their patients.
  
  
  RESULTS
  There were significant difficulties accessing biologic treatments other than etanercept and abatacept for children. There were large discrepancies in the access criteria and coverage of biologic agents across provinces, notably with age restrictions for younger children.
  
  
  CONCLUSIONS
  Canadian children with JIA may not receive optimal internationally recognized "standard" care because pediatric coverage for biologic drugs through provincial formularies is limited and inconsistent across the country. There is urgent need for public policy to improve access to biologic therapies for these children to ensure optimal short-term and longterm health outcomes.
authors.affiliation: McGill University, and Department of Pediatrics, Montreal Children's Hospital, 2300 Rue Tupper, Montreal, Quebec H3H 1P3, Canada. claire.leblanc@muhc.mcgill.ca
authors.forename: Claire M A
authors.initials: CM
authors.lastname: Leblanc
authors.forename: Bianca
authors.initials: B
authors.lastname: Lang
authors.forename: Alma
authors.initials: A
authors.lastname: Bencivenga
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Chetaille
authors.forename: Paul
authors.initials: P
authors.lastname: Dancey
authors.forename: Peter
authors.initials: P
authors.lastname: Dent
authors.forename: Paivi
authors.initials: P
authors.lastname: Miettunen
authors.forename: Kiem
authors.initials: K
authors.lastname: Oen
authors.forename: Alan
authors.initials: A
authors.lastname: Rosenberg
authors.forename: Johannes
authors.initials: J
authors.lastname: Roth
authors.forename: Rosie
authors.initials: R
authors.lastname: Scuccimarri
authors.forename: Shirley M L
authors.initials: SM
authors.lastname: Tse
authors.forename: Susanne
authors.initials: S
authors.lastname: Benseler
authors.forename: David A
authors.initials: DA
authors.lastname: Cabral
authors.forename: Sarah
authors.initials: S
authors.lastname: Campillo
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Chédeville
authors.forename: Ciaran M
authors.initials: CM
authors.lastname: Duffy
authors.forename: Karen Watanabe
authors.initials: KW
authors.lastname: Duffy
authors.forename: Elie
authors.initials: E
authors.lastname: Haddad
authors.forename: Adam M
authors.initials: AM
authors.lastname: Huber
authors.forename: Ronald
authors.initials: R
authors.lastname: Laxer
authors.forename: Deborah
authors.initials: D
authors.lastname: Levy
authors.forename: Nicole
authors.initials: N
authors.lastname: Johnson
authors.forename: Suzanne
authors.initials: S
authors.lastname: Ramsey
authors.forename: Natalie
authors.initials: N
authors.lastname: Shiff
authors.forename: Heinrike
authors.initials: H
authors.lastname: Schmeling
authors.forename: Rayfel
authors.initials: R
authors.lastname: Schneider
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Stringer
authors.forename: Rae S M
authors.initials: RS
authors.lastname: Yeung
authors.forename: Lori B
authors.initials: LB
authors.lastname: Tucker
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000188:drug therapy*; D001688:Biological Products / Q000627:therapeutic use*; D002170:Canada; D002648:Child; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D012720:Severity of Illness Index
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products