Limited Coverage Drugs - Special Authority Criteria

Generic Name / Strength / Form
leuprolide

Criteria Approval Period
1. Diagnosis of precocious puberty.1. First approval: One year

Renewals: One year

OR

2. Diagnosis of endometriosis. 2. First approval: Six months

Renewal: Six months

OR

3. Diagnosis indicating need to reduce sexual drive. 3. Indefinite

Practitioner Exemptions

  • Paediatric endocrinologists

Special Notes

  • For (1) & (2) criteria applicable for all plans excluding Plan G.
  • For (3) criteria applicable for all plans including Plan G.
  • For any cancer related condition, please contact the British Columbia Cancer Agency at (604) 877-6098 ext. 4610.

Online Forms (PDF)
Click on the link to complete a special authority request form.