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Scenario 4: Ontario Trillium Drug Program Profile: 61-year-old on fixed income, BMI 34, diabetes, qualifies for Trillium Coverage: Trillium covers medications after household pays 4% of after-tax income as deductible Calculation: Household income: $35,000 Trillium deductible: $1,400 (4% of income) After deductible met, Trillium pays medication costs up to formulary maximum Trillium annual cap for obesity medications: $3,000-4,500 Patient cost: $1,400 deductible + $16,500-18,000 for non-covered months Total patient cost: $17,900-19,400 annually Verdict: Provincial coverage helps but doesnt come close to making treatment affordable for low-income Ontarians
10.1002/med.20142 21 MohsinS.BaniyasM
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