@bepeacefulall - financially, when I signed on the numbers being tossed around were something like US$89000 per year. I have no idea about how valid those numbers were except to say that it would have been out of my reach at 1/8 of that, so I understand your concern. I'm in Alberta, so it wouldn't have been OHIP/Trillium, but I really don't know how they handled it. The REMS program (I hope it still exists for you) came with a nurse-case-manager who navigated all of this for me. I *believe* (but could be wrong) that the manufacturer still has a program that can assist with the costs beyond what provincial/private can cover. Your cardiologist will be well connected with how it all works. Good luck with the whole thing.