Special Authority

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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 only partially covered. Coverage is provided for patients with specific medical circumstances and the 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 an allergy. For more information, see Low Cost Alternative Program.
Drugs not marketed in Canada

For instance, Health Canada "Special Access Programme Drugs" are covered in exceptional circumstances only.

For more information, see the PharmaCare Policy Manual—Section 6.2 (PDF, 294KB)

 

Items Not Normally Covered

See What is not covered through PharmaCare.

Other Useful Information

Special Authority Request Forms | Submitting a Special Authority Request | Special Authority Patient Information Sheet (PDF, 230KB) | PharmaCare Formulary Search | PharmaCare Drug Review Process & Results

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 polyarticular Juvenile Idiopathic Arthritis

Orencia®

LCD

abatacept for rheumatoid arthritis

Orencia®

LCD

acamprosate

Campral®

LCD

acetaminophen 500 mg

Tylenol 500 mg®

LCD

aclidinium

Tudorza™ Genuair™

LCD

adalimumab for ankylosing spondylitis

Humira®

LCD

adalimumab for Crohn's disease

Humira®

LCD

adalimumab for polyarticular Juvenile Idiopathic Arthritis

Humira®

LCD

adalimumab for psoriasis

Humira®

LCD

adalimumab for psoriatic arthritis

Humira®

LCD

adalimumab for rheumatoid arthritis

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)

aripiprazole monohydrate Abilfy Maintena® LCD

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

Caripul®

LCD

epoprostenol

Flolan®

LCD

eprosartan 60 mg

Teveten Plus®

LCD

eprosartan 600 mg

Teveten® 600 mg

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

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

fluticasone vilanterol Breo® Ellipta® LCD

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

formoterol or formoterol in combination with budesonide or mometasone

Zenhale™

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® Breezhaler®

LCD

golimumab

Simponi®

LCD

goserelin

Zoladex®

LCD

granisetron

Kytril®

LCD

hydromorphone controlled release

Hydromorph Contin®

LCD

hydromorphone prolonged release

Jurnista®

LCD

hydroxyurea

Hydrea®

LCD

hydroxyzine (Plan G)

Atarax ®

LCD - No-Charge Psychiatric Medication Plan (Plan G)

indacaterol in combination with glycopyrronium Ultibro® Breezhaler® LCD

indacaterol maleate

Onbrez® Breezhaler®

LCD

indapamide

Lozide®

LCD

indomethacin

Indocid®

RDP - Non Steroidal Anti Inflammatory Drugs: Group 2

infliximab

Remicade®

LCD

insulin detemir

Levemir®

LCD

insulin detemir

Levemir® FlexTouch®

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

ledipasvir-sofosbuvir

Harvoni™

LCD

leflunomide

Arava®

LCD

leuprolide

Lupron®

LCD - No-Charge Psychiatric Medication Plan (Plan G)

levetiracetam

Keppra®

LCD

linagliptin

Trajenta™

LCD

linagliptin-metformin

Jentadueto™

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

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

nifedipine

Adalat®

RDP - Calcium Channel Blockers

nizatidine

Axid®

RDP - H2 Blocker Drugs

ocriplasmin

Jetrea®

LCD

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

ombitasvir-paritaprevir-ritonavir and dasabuvir

Holkira™ Pak

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

Pegasys® RBV ProClick™ Autoinjector

LCD

pegylated interferon + ribavirin

Pegetron®

LCD

pegylated interferon + ribavirin

Pegetron Redipen®

LCD

pentazocine

Talwin®

LCD

perampanel

Fycompa™

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

ribavirin

Ibavyr™

LCD

risedronate 30 mg

Actonel® 30 mg

LCD

risedronate 5 / 35 mg

Actonel® 5 / 35 mg

LCD

risperidone microspheres

Risperdal Consta®

LCD

rituximab

Rituxan®

LCD

rivaroxaban for atrial fibrillation

Xarelto®

LCD

rivaroxaban for prophylaxis of venous thromboembolism

Xarelto®

LCD

rivaroxaban for the treatment of venous thromboembolic events (DVT or PE)

Xarelto®

LCD

ropinirole

ReQuip®

LCD

rufinamide

Banzel®

LCD

salbutamol nebules

Ventolin®

LCD

salmeterol

Serevent®

LCD

salmeterol OR salmeterol in combination with fluticasone

Advair® 

LCD

salsalate

Disalcid®

RDP - Non Steroidal Anti Inflammatory Drugs: Group 2

saxagliptin

Onglyza®

LCD

saxagliptin-metformin

Komboglyze™

LCD

sildenafil

sildenafil 25 mg for PAH

LCD

simeprevir

Galaxeos™

LCD

sodium cromoglycate nebules

Intal® Nebules

LCD

sofosbuvir

Sovaldi®

LCD

somatropin

Genotropin®

LCD

somatropin

Humatrope®

LCD

somatropin

Nutropin AQ®

LCD

somatropin

Omnitrope®

LCD

somatropin

Saizen®

LCD

stiripentol Diacomit LCD

sulindac

Clinoril®

LCD

sumatriptan injection

Imitrex® Injection

LCD

tacrolimus ointment

Protopic® Ointment

LCD

tadalafil 20 mg

Adcirca®

LCD

telmisartan

Micardis®

LCD

telmisartan

Micardis Plus®

LCD

telmisartan + amlodipine combination

Twynsta®

LCD

tenofovir

Viread®

LCD

tenoxicam

Mobiflex®

LCD

terbinafine tablets

Lamisil® Tablets

LCD

teriflunomide

Aubagio™

LCD

testosterone cypionate

Depo-testosterone®

LCD

testosterone enanthate

Delatestryl®

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 polyarticular Juvenile Idiopathic Arthritis

Actemra ®

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

umeclidinium in combination with vilanterol Anoro® Elipta® 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)

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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.