Because it's not in the Ontario Drug Formulary yet, the manufacturer is running a patient-access programme here in Ontario, which covers the full cost if your oncologist enrolls you (mine had a bunch of enrollment cards, and just handed me one). Once Orgovyx is in the formulary, both the government programmes and private insurance will pay for it.

It costs almost exactly the same as Firmagon here (about US $220/month), so there's no reason for the government and insurers not to cover it.