Each province has a list of prescription drugs that they cover on their different plans (called a “formulary”). By searching these lists, you can find out:
- If a prescription drug has been reviewed and listed by the province
- If that prescription drug is covered on YOUR specific provincial drug plan (e.g. Seniors, Low Income, General, or High Cost plan)
- If there is a Prior Authorization form required for that drug
The following are links to each provincial plan formulary. You will need the drug name and the DIN to use in your search of the formulary. Each formulary is updated monthly.
This formulary appears as a pdf document. To search for a specific drug, use the “Find” feature in your options menu. Click “Find” and then enter the drug name or DIN.
If the drug appears, highlighted, look to 4th column to the right of the drug name. If there is nothing in that column, the drug is a “non-benefit”. If there are letters, they each represent the following coverage information:
S=Covered under the Seniors Pharmacare Program
F=Covered under the Family Pharmacare and Community Services Programs
C=Covered under the Drug Assistance for Cancer Patients Program
E=Drug required Prior Authorization (called “Exception Status” in NS Pharmacare programs)
To access the criteria for each Prior Authorization, go to the end of the document.
The Nova Scotia Cancer Care Program produces Prior Authorization forms for each cancer treatment drug on the NS Pharmacare programs. They are not available on-line and should be completed by your oncologist or hematologist automatically at the time of prescription.
The NS Pharmacare formulary is updated monthly.
This formulary also appears as a pdf document. To search for a specific drug, use the “Find” feature in your options menu. Click “Find” and then enter the drug name or DIN.
If the drug appears, highlighted, look to last column on the right of the page. The letters that appear in that last column each represent the following coverage information:
A=Covered under the Seniors Drug Plans
D=Covered under the NB Drug Plan
F=Covered under the Social Development Program
R=Specific drugs covered under the Organ Transplant Program
W=Covered under the Extra Mural Program for eligible home care clients
SA=Drug requiring Prior Authorization (called “Special Authorization” in NB Drug Plans)
The government of Prince Edward Island lists all the drugs it covers for cancer care in one drug list – both the drugs administered in hospital AND the take at home cancer treatment drugs listed on its provincial drug plans. The list includes treatment drugs and those commonly use to treat symptoms or side effects from treatments.
This formulary appears as a pdf document and can be searched easily simply by scanning through the drug names. You can also use the “Find” feature in your options menu. Click “Find” and then enter the drug name or DIN.
If the drug appears, highlighted, look to column entitled “Funding Program”. In that space it will tell you if the drug is covered through a PEI Pharmacare Plans. If it is, the letter code will tell you on which program it is covered:
S=Seniors Drug Plan
F=Family Health Benefit Drug Plan
G=Generic Drug Plan
M=High Cost Drug Plan
Q=Catastrophic Drug Plan
W=Financial Assistance Drug Plan
If you are not on the provincial drug plan specified for that drug – don’t panic. In Prince Edward Island a person may be on several different programs at once. For example, if you are already on the Seniors Drug Plan, you may also need to apply to the Catastrophic Drug Plan for coverage of a specific drug. Talk to your oncology drug access navigator for more information.
To check if the drug requires Prior Authorization (called “Special Authorization” in PEI), look to the column on the far right of the document, entitled “Funded Eligibility Criteria”. If under that heading it states “Open Benefit” then no Prior Authorization is required. If there is criteria listed, the drug requires pre-approval and a Prior Authorization form must be submitted.
There is also a Generic Special Authorization request form for all other drugs that require prior authorization:
Generic SA Form PEI
This formulary is provided to the public in a searchable on-line database. Simply type in the drug name or DIN in the appropriate boxes and click “Search”. If the drug is listed on any of the Newfoundland Labrador provincial drug plans, it will appear in a new window. Each formulation and/or dose of the drug will be listed. Click on the dosage you have been prescribed (or any, if you aren’t sure) and a chart will appear.
This chart will specify if the drug is an “Open Benefit” (meaning it is covered on all the drug plans) or if the drug requires “Special Authorization” (which is the same as Prior Authorization). If you see “Special Authorization”, click on it and a separate window will appear outlining the criteria for coverage.
Special Authorization Request form for NL Drug Plans:
Generic SA Form NL