PharmaCare Special Authority

About PharmaCare Special Authority

PharmaCare Special Authority grants full benefit status to a drug, medical supply or medical device that otherwise would not be covered or would be only partially covered. Coverage is provided for patients with specific medical circumstances and actual reimbursement depends on the patient’s PharmaCare plan rules, including any annual deductible requirements.

To receive coverage, Special Authority approval must be in place before the patient purchases the prescription. Coverage cannot be provided retroactively.

Special Authority approval may be granted for:

Drug type Description More information
Limited Coverage drugs Medications that generally are not considered to be first line therapies or that have more cost-effective alternatives. See list below to access the criteria and forms for these drugs.
Non-reference drugs For patients who experience an adverse reaction or treatment failure on the reference drug. See list below to access the criteria and forms for these drugs.
Alternate products For patients unable to use the low-cost alternative drug due to allergy. For more information, see Low Cost Alternative Program.
Drugs not marketed in Canada For instance, Health Canada "Special Access Programme Drugs." Covered in exceptional circumstances only. For more information, see the PharmaCare Policy Manual Section 6.2.

Items Not Normally Covered

Other Useful Information

Special Authority Request Forms | Submitting a Special Authority Request | Special Authority Patient Information Sheet | PharmaCare Formulary Search | PharmaCare Drug Coverage Decisions | PharmaCare Drug Review Results & Process

List of Limited Coverage and Non-Reference Drugs requiring Special Authority Approval

The list below includes all drugs that require Special Authority approval, with the exception of Alzheimer's Drug Therapy Initiative drugs (see ADTI—Information for clinicians) and Insulin Pumps for Children and Adolescents.

To access the criteria for Special Authority coverage and form(s) for each drug, click on the drug name. To access a description of the reimbursement category under which the drug is covered, click on the category name.

This table can be sorted by brand or generic name or Special Authority Category.

Generic Drug Name Brand Drug Name Special Authority Category
abatacept for juvenile idiopathic arthritis Orencia® LCD
abatacept for rheumatoid arthritis Orencia® LCD
acamprosate Campral® LCD
acetaminophen 500 mg Tylenol 500 mg® LCD
adalimumab for ankylosing spondylitis Humira® LCD
adalimumab for Chrohn's disease Humira® LCD
adalimumab for rheumatoid arthritis Humira® LCD
adalimumab for polyarticular Juvenile Idiopathic Arthritis Humira® LCD
adalimumab for psoriatic arthritis Humira® LCD
adalimumab for psoriasis Humira® LCD
adefovir Hepsera® LCD
alendronate 10/70 mg Fosamax® 10 mg / 70 mg LCD
alendronate 10/70 mg Fosavance® 70 mg / 5600 IU LCD
alendronate 40 mg Fosamax® 40 mg LCD
alitretinoin Toctino® LCD
ambrisentan Volibris® LCD
amlodipine Norvasc® RDP - Calcium Channel Blockers
apixaban for atrial fibrillation Eliquis® LCD
apixaban for venous thromboembolism Eliquis® LCD
aprepitant Emend® LCD
aripiprazole Abilify ® LCD - No-Charge Psychiatric Medication Plan (Plan G)
asenapine Saphris™ LCD
aztreonam Cayston™ LCD
baclofen intrathecal Lioresal® Intrathecal LCD
benazepril Lotensin® RDP - ACE Inhibitor Drugs
benzydamine Tantum® LCD
boceprevir Victrelis™ LCD
boceprevir Victrelis Triple™ LCD
bosentan Tracleer® LCD
botulinum neurotoxin type A, free from complexing proteins, also known as incobotulinumtoxinA Xeomin® LCD
botulinum neurotoxin type A, with complexing proteins, also known as onabotulinumtoxinA Botox® LCD
budesonide capsules Entocort Capsules® LCD
budesonide enema Entocort Enema® LCD
budesonide nebules Pulmicort® LCD
buprenorphine plus naloxone Suboxone® LCD
bupropion Wellbutrin® SR and XL LCD - No-Charge Psychiatric Medication Plan (Plan G)
bupropion Zyban® LCD - No-Charge Psychiatric Medication Plan (Plan G)
buserelin Suprefact® LCD
candesartan Atacand® LCD
candesartan Atacand Plus® LCD
carvedilol Coreg® LCD
celecoxib Celebrex® LCD
certolizumab Cimzia® LCD
chlorambucil Leukeran® LCD
chloroquine Aralen ® LCD
ciclopirox 1% Loprox® LCD
ciprofloxacin / dexamethasone Ciprodex® LCD
ciprofloxacin ophthalmic Ciloxan® LCD
clioquinol topical Vioform Cream® LCD
clobazam (Plan G) Frisium ® LCD - No-Charge Psychiatric Medication Plan (Plan G)
clopidogrel Plavix® LCD
clotrimazole Canesten Topical® LCD
codeine sustained release Codeine Contin® LCD
cyclosporine Neoral® LCD
cyproterone Androcur® LCD - No-Charge Psychiatric Medication Plan (Plan G)
dabigatran Pradaxa® LCD
dalteparin Fragmin® LCD
deferasirox Exjade® LCD
denosumab Prolia® LCD
desmopressin oral DDAVP Tablets® LCD
desmopressin oral DDAVP Melt® LCD
diclofenac regular release Voltaren® RDP - Non Steroidal Anti Inflammatory Drugs: Group 2
diclofenac with misoprostol Arthrotec® RDP - Non Steroidal Anti Inflammatory Drugs: Group 2
dienogest Visanne® LCD
diflunisal Dolobid® RDP - Non Steroidal Anti Inflammatory Drugs: Group 2
dimethyl fumarate Tecfidera™ LCD
diphenoxylate Lomotil® LCD
dipyridamole-acetylsalicylic acid Aggrenox®  LCD
dorzolamide-timolol preservative free Cosopt non-preserved® LCD
dronedarone Multaq® LCD
dutasteride Avodart® LCD
econazole topical Ecostatin Cream® LCD
enalapril Vasotec® RDP - ACE Inhibitor Drugs
enoxaparin Lovenox® LCD
entacapone Comtan® LCD
entacapone / levodopa / carbidopa combination tablet Stalevo® LCD
entecavir Baraclude® LCD
epoprostenol Flolan® LCD
eprosartan 600 mg Teveten® 600 mg LCD
eprosartan 60 mg Teveten Plus® LCD
esomeprazole 40 mg Nexium® 40 mg LCD
estradiol patches Climara® LCD
estradiol patches Estalis® LCD
estradiol patches Estalis-Sequi® LCD
estradiol patches Estracomb® LCD
estradiol patches Estraderm® LCD
estradiol patches Estradot® LCD
estradiol patches Oesclim® LCD
estradiol patches Vivelle® LCD
estradiol transdermal gel Divigel® LCD
estradiol transdermal gel Estrogel® LCD
etanercept Enbrel® LCD
famotidine 20 / 40 mg Pepcid® 20 / 40 mg RDP - H2 Blocker Drugs
febuxostat Uloric® LCD
fenoprofen Nalfon® RDP - Non Steroidal Anti Inflammatory Drugs: Group 2
fenoterol nebules Berotec® LCD
fentanyl patch Duragesic® LCD
fidaxomicin Dificid® LCD
finasteride Proscar® LCD
fingolimod Gilenya® LCD
fluconazole oral solids Diflucan® LCD
flurbiprofen regular release Ansaid® RDP - Non Steroidal Anti Inflammatory Drugs: Group 2
flurbiprofen regular release Froben® RDP - Non Steroidal Anti Inflammatory Drugs: Group 2
formoterol or formoterol in combination with budesonide or mometasone Foradil® LCD
formoterol or formoterol in combination with budesonide or mometasone Oxeze® Turbuhaler® LCD
formoterol or formoterol in combination with budesonide or mometasone Symbicort® LCD
fosinopril Monopril® RDP - ACE Inhibitor Drugs
gabapentin (Plan G) Neurontin® LCD - No-Charge Psychiatric Medication Plan (Plan G)
glatiramer acetate Copaxone® LCD
gliclazide Diamicron® LCD
glycopyrronium Seebri® Breezehaler® LCD
golimumab Simponi® LCD
goserelin Zoladex® LCD
granisetron Kytril® LCD
hydromorphone controlled release Hydromorph Contin® LCD
hydromorphone prolonged release Jurnista® LCD
hydroxyzine (Plan G) Atarax ® LCD - No-Charge Psychiatric Medication Plan (Plan G)
hydroxyurea Hydrea® LCD
indapamide Lozide® LCD
indacaterol maleate Onbrez® Breezehaler® LCD
indomethacin Indocid® RDP - Non Steroidal Anti Inflammatory Drugs: Group 2
infliximab Remicade® LCD
insulin detemir Levemir® LCD
insulin glargine Lantus® LCD
interferon alfa Intron A® LCD
interferon beta-1a Avonex® LCD
interferon beta-1a Rebif® LCD
interferon beta-1b Betaseron® LCD
interferon beta-1b Extavia® LCD
ipratropium nebules Atrovent® LCD
irbesartan Avapro® LCD
irbesartan Avalide® LCD
isosorbide 5 mononitrate extended release 60 mg Imdur® 60 mg RDP - Nitrate Drugs
itraconazole capsules Sporanox® LCD
ketoconazole 2% cream Nizoral® LCD
ketoprofen - regular release and enteric coated forms Orudis® RDP - Non Steroidal Anti Inflammatory Drugs: Group 2
ketoprofen - regular release and enteric coated forms Orudis E® RDP - Non Steroidal Anti Inflammatory Drugs: Group 2
lacosamide tablets Vimpat® LCD
lactulose Laxilose® LCD
lamivudine Heptovir® LCD
lamotrigine (Plan G) Lamictal ®
LCD - No-Charge Psychiatric Medication Plan (Plan G)
lansoprazole 30 mg Prevacid® 30 mg LCD
leflunomide Arava® LCD
leuprolide Lupron® LCD - No-Charge Psychiatric Medication Plan (Plan G)
levetiracetam Keppra® LCD
linagliptin Trajenta™ LCD
linezolid 600 mg tablet Zyvoxam® LCD
lisinopril Prinivil® RDP - ACE Inhibitor Drugs
lisinopril Zestril® RDP - ACE Inhibitor Drugs
loperamide Imodium® LCD
losartan Cozaar® LCD
losartan Hyzaar® LCD
meloxicam 7.5 / 15 mg Mobicox® LCD
mercaptopurine Purinethol® LCD
methotrexate injection Methotrexate® Injection LCD
methylphenidate long-acting Concerta® LCD - No-Charge Psychiatric Medication Plan (Plan G)
miconazole 2% topical Micatin Cream® LCD
miconazole topical Monistat Derm Cream® LCD
modafinil Alertec® LCD
formoterol or formoterol in combination with budesonide or mometasone Zenhale™ LCD
mometasone nasal spray Nasonex® LCD
morphine sulfate sustained release suppositories MS Contin® Suppositories LCD
nabumetone Relafen® LCD
nadroparin Fraxiparine® LCD
naltrexone ReVia® LCD
naproxen enteric coated 250 mg Naprosyn EC® 250 mg RDP - Non Steroidal Anti Inflammatory Drugs: Group 2
naproxen enteric coated 375 mg Naprosyn EC® 375 mg RDP - Non Steroidal Anti Inflammatory Drugs: Group 2
naproxen enteric coated 500 mg Naprosyn EC® 500 mg RDP - Non Steroidal Anti Inflammatory Drugs: Group 2
natalizumab Tysabri® LCD
nicardipine Cardene® RDP - Calcium Channel Blockers
nifedipine Adalat® RDP - Calcium Channel Blockers
nizatidine Axid® RDP - H2 Blocker Drugs
ofloxacin ophthalmic drops Ocuflox® LCD
olanzapine Zyprexa® LCD - No-Charge Psychiatric Medication Plan (Plan G)
olanzapine Zyprexa Zydis® LCD
olmesartan Olmetec® LCD
olmesartan Olmetec Plus® LCD
olsetamivir Tamiflu® LCD
omeprazole 10 mg Losec® 10 mg LCD
omeprazole 20 mg Losec® 20 mg LCD
ondansetron Zofran® LCD
paliperidone palmitate injection Invega® Sustenna® LCD - No-Charge Psychiatric Medication Plan (Plan G)
pamidronate Aredia® LCD
pantoprazole magnesium 40 mg Tecta® LCD
pantoprazole sodium 40 mg Pantoloc® 40 mg LCD
pegylated interferon + ribavirin Pegasys® RBV LCD
pegylated interferon + ribavirin Pegetron® LCD
pegylated interferon + ribavirin Pegetron Redipen® LCD
pentazocine Talwin® LCD
perindopril Coversyl® RDP - ACE Inhibitor Drugs
pimecrolimus cream Elidel® Cream LCD
pioglitazone Actos® LCD
piroxicam 10 / 20 mg capsules Feldene® LCD
piroxicam 10 / 20 mg suppositories Feldene® LCD
pramipexole Mirapex® LCD
prasugrel Effient® LCD
prostaglandin compounded injection Prostaglandin® LCD
quinagolide 0.075 / 0.150 mg tablets Norprolac® LCD
rabeprazole 10 / 20 mg Pariet® 10 / 20 mg LCD
raloxifene Evista® LCD
risedronate 30 mg Actonel® 30 mg LCD
risedronate 5 / 35 mg Actonel® 5 / 35 mg LCD
risperidone microspheres Risperdal Consta® LCD - No-Charge Psychiatric Medication Plan (Plan G)
rituximab Rituxan® LCD
rivaroxaban for prophylaxis of venous thromboembolism Xarelto® LCD
rivaroxaban for atrial fibrillation Xarelto® LCD
rivaroxaban for deep vein thrombosis treatment Xarelto® LCD
ropinirole ReQuip® LCD
rufinamide Banzel® LCD
salbutamol nebules Ventolin® LCD
salmeterol OR salmeterol in combination with fluticasone Advair®  LCD
salmeterol Serevent® LCD
salsalate Disalcid® RDP - Non Steroidal Anti Inflammatory Drugs: Group 2
sildenafil sildenafil 25 mg for PAH LCD
sitagliptin Januvia® LCD
sitagliptin plus metformin Janumet® LCD
sodium cromoglycate nebules Intal® Nebules LCD
somatropin Humatrope® LCD
somatropin Nutropin® LCD
somatropin Saizen® LCD
sulindac Clinoril® LCD
sumatriptan injection Imitrex® Injection LCD
tacrolimus ointment Protopic® Ointment LCD
tadalafil 20 mg Adcirca® LCD
telaprevir Incivek™ LCD
telmisartan Micardis® LCD
telmisartan Micardis Plus® LCD
telmisartan + amlodipine combination Twynsta® LCD
tenofovir Viread® LCD
tenoxicam Mobiflex® LCD
terbinafine tablets Lamisil® Tablets LCD
testosterone enanthate Delatestryl® LCD
testosterone cypionate Depo-testosterone® LCD
tiaprofenic acid regular release Surgam® LCD
ticagrelor Brilinta® LCD
ticlopidine Ticlid® LCD
tinzaparin Innohep® LCD
tiotropium Spiriva® LCD
tizanidine Zanaflex® LCD
tobramycin Tobi® LCD
tobramycin Tobi® Podhaler® LCD
tocilizumab for the treatment of Rheumatoid Arthritis Actemra ® LCD
tocilizumab for the treatment of systemic Juvenile Idiopathic Arthritis Actemra ® LCD
tolmetin Tolectin® LCD
treprostinil Remodulin® LCD
tretinoin topical Rejuva-A Cream® LCD
tretinoin topical Retin-A Cream® LCD
tretinoin topical Stieva-A Cream® LCD
tretinoin topical Vitamin A Acid Cream® LCD
ustekinumab Stelara® LCD
valganciclovir Valcyte® LCD
valsartan Diovan® LCD
valsartan Diovan HCT® LCD
vancomycin oral Vancocin® LCD
varenicline Champix® LCD - No-Charge Psychiatric Medication Plan (Plan G)
verapamil (Plan G) Isoptin® LCD - No-Charge Psychiatric Medication Plan (Plan G)
voriconazole Vfend® LCD
zanamivir Relenza® LCD
ziprasidone Zeldox® LCD - No-Charge Psychiatric Medication Plan (Plan G)
zoledronic acid Aclasta™ LCD
zopiclone Imovane® LCD - No-Charge Psychiatric Medication Plan (Plan G)

Contact PharmaCare

Prescribers with questions about the Special Authority process may contact Health Insurance BC and ask to be transferred to the Special Authority team.