Your Voice - PharmaCare
Drug Coverage Decisions

Page 1 of 12

Welcome to B.C. PharmaCare's Public Input Questionnaire
for drugs being reviewed under the B.C. Drug Review Process.

This patient group questionnaire is for tocilizumab (Actemra®).

You may submit a questionnaire only once. If you do not complete the questionnaire or navigate away from the page while entering your responses, you can return to the last unsaved page and complete the questionnaire. To ensure privacy, you will not be able to go back to review or change your answers on a page once it is saved.

To protect your privacy, please do not include in your response the names of individuals or companies, locations, or any other information that might identify them or anyone else.

Completing the questionnaire

Mandatory questions are flagged with a red asterisk (*).

You do not need to answer all the optional questions. You need only answer those that you think apply to you.

To protect your privacy, please close this browser window after you complete this questionnaire.


Respondent information

To have your input accepted, you must complete the Confirmation of Eligibility, Contact Information and Conflict of Interest Declaration sections of this questionnaire.