Limited Coverage Drugs - Limited Coverage drugs are not generally considered 'first line' therapies or have more cost-effective alternatives. For these drugs, PharmaCare Special Authority approval is required before the patient fills their prescription.
Reference Drug Program - Under this program, full PharmaCare coverage is provided only to the identified reference drug. Other drugs within each category are eligible for partial coverage. If a patient has a medical condition preventing use of the reference drug, Special Authority can be requested for full coverage of another drug in the category.
Low Cost Alternative Program - If several drugs have identical active ingredients, PharmaCare set a maximum price ("LCA Price") it will cover for that category of drug(s). Patients can obtain a fully covered low cost alternative or a drug that will be only partially covered. If a patient cannot take the low cost alternative(s), Special Authority can be requested for full coverage of another drug.