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 (partially covered) 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 Reference Drug Program 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 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

aripiprazole

Abilify ®

LCD - Psychiatric Medications Plan (Plan G)

aripiprazole monohydrate

Abilfy Maintena®

LCD

quinapril without HCTZ

Accupril®

RDP - ACE Inhibitor Drugs

quinapril with HCTZ

Accuretic®

RDP - ACE Inhibitor Drugs

zoledronic acid

Aclasta™

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

risedronate 30 mg

Actonel® 30 mg

LCD

risedronate 5 / 35 mg

Actonel® 5 / 35 mg

LCD

pioglitazone

Actos®

LCD

nifedipine

Adalat®

RDP - Calcium Channel Blockers

tadalafil 20 mg

Adcirca®

LCD

dextroamphetamine-amphetamine

Adderall XR®

LCD

salmeterol OR salmeterol in combination with fluticasone

Advair®

LCD

dipyridamole-acetylsalicylic acid

Aggrenox®

LCD

modafinil

Alertec®

LCD

cyproterone

Androcur®

LCD - Psychiatric Medications Plan (Plan G)

umeclidinium in combination with vilanterol

Anoro® Elipta®

LCD

flurbiprofen regular release

Ansaid®

RDP - Non Steroidal Anti Inflammatory Drugs

eslicarbazepine acetate

Aptiom™

LCD

chloroquine

Aralen ®

LCD

leflunomide

Arava®

LCD

pamidronate

Aredia®

LCD

donepezil

Aricept®

LCD

diclofenac with misoprostol

Arthrotec®

RDP - Non Steroidal Anti Inflammatory Drugs

candesartan with HCTZ

Atacand Plus®

LCD

candesartan without HCTZ

Atacand®

LCD

hydroxyzine

Atarax ®

LCD - Psychiatric Medications Plan (Plan G)

ipratropium nebules

Atrovent®

LCD

teriflunomide

Aubagio™

LCD

irbesartan without HCTZ

Avapro®

RDP (Modernized) - ARB Drugs + LCD

irbesartan with HCTZ

Avalide®

RDP (Modernized) - ARB Drugs + LCD

dutasteride

Avodart®

LCD

interferon beta-1a

Avonex®

LCD

nizatidine

Axid®

RDP - H2 Blocker Drugs

rufinamide

Banzel®

LCD

entecavir

Baraclude®

LCD

interferon beta-1b

Betaseron®

LCD

botulinum neurotoxin type A, with complexing proteins, also known as onabotulinumtoxinA

Botox®

LCD

vilanterol - fluticasone furoate

Breo® Ellipta®

LCD

ticagrelor

Brilinta®

LCD

etanercept BrenzysTM LCD

acamprosate

Campral®

LCD

clotrimazole

Canesten Topical®

LCD

captopril

Capoten®

RDP - ACE Inhibitor Drugs

epoprostenol

Caripul®

LCD

aztreonam

Cayston™

LCD

celecoxib

Celebrex®

LCD

varenicline

Champix®

LCD - Psychiatric Medications Plan (Plan G)

ciprofloxacin ophthalmic

Ciloxan®

LCD

certolizumab for the treatment of Ankylosing Spondylitis

Cimzia®

LCD

certolizumab for the treatment of Psoriatic Arthritis

Cimzia®

LCD

certolizumab for the treatment of Rheumatoid Arthritis

Cimzia®

LCD

ciprofloxacin / dexamethasone

Ciprodex®

LCD

estradiol patches

Climara®

LCD

sulindac

Clinoril®

LCD

codeine sustained release

Codeine Contin®

LCD

entacapone

Comtan®

LCD

methylphenidate extended-release

Concerta®

LCD

methylphenidate long-acting

Concerta®

LCD - Psychiatric Medications Plan (Plan G)

glatiramer acetate

Copaxone®

LCD

carvedilol

Coreg®

LCD

secukinumab 

Cosentyx®

LCD

dorzolamide-timolol preservative free

Cosopt non-preserved®

LCD

perindopril

Coversyl®

RDP - ACE Inhibitor Drugs

losartan

Cozaar®

LCD

daclatasvir

Daklinza™

LCD

desmopressin oral

DDAVP Melt®

LCD

desmopressin oral

DDAVP Tablets®

LCD

testosterone enanthate

Delatestryl®

LCD

testosterone cypionate

Depo-testosterone®

LCD

stiripentol

Diacomit™

LCD

gliclazide

Diamicron®

LCD

fidaxomicin

Dificid®

LCD

fluconazole oral solids

Diflucan®

LCD

valsartan with HCTZ

Diovan HCT®

RDP (Modernized) - ARB Drugs + LCD

valsartan without HCTZ

Diovan®

RDP (Modernized) - ARB Drugs + LCD

salsalate

Disalcid®

LCD

estradiol transdermal gel

Divigel®

LCD

diflunisal

Dolobid®

RDP - Non Steroidal Anti Inflammatory Drugs

aclidinium-formoterol

Duaklir™ Genuair®

LCD

fentanyl patch

Duragesic®

LCD

econazole topical

Ecostatin Cream®

LCD

prasugrel

Effient®

LCD

pimecrolimus cream

Elidel® Cream

LCD

apixaban for atrial fibrillation

Eliquis®

LCD

apixaban for venous thromboembolism

Eliquis®

LCD

apixaban for the treatment of deep vein thrombosis (DVT) or pulmonary embolism (PE)

Eliquis® LCD

aprepitant

Emend®

LCD

etanercept Enbrel® LCD

budesonide capsules

Entocort Capsules®

LCD

budesonide enema

Entocort Enema®

LCD

vedolizumab

Entyvio®

LCD

sofosbuvir-velpatasvir

Epclusa®

LCD

estradiol patches

Estalis®

LCD

estradiol patches

Estalis-Sequi®

LCD

estradiol patches

Estracomb®

LCD

estradiol patches

Estraderm®

LCD

estradiol patches

Estradot®

LCD

estradiol transdermal gel

Estrogel®

LCD

raloxifene

Evista®

LCD

deferasirox

Exjade®

LCD

rivastigmine

Exelon®

LCD

interferon beta-1b

Extavia®

LCD

piroxicam 10 / 20 mg capsules

Feldene®

LCD

piroxicam 10 / 20 mg suppositories

Feldene®

LCD

deferiprone

Ferriprox®

LCD

epoprostenol

Flolan®

LCD

formoterol or formoterol in combination with budesonide or mometasone

Foradil®

LCD

alendronate with vitamin D 10/70 mg

Fosamax® 10 mg / 70 mg

LCD

alendronate 40 mg

Fosamax® 40 mg

LCD

alendronate 10/70 mg

Fosavance® 70 mg / 5600 IU

LCD

dalteparin

Fragmin®

LCD

nadroparin

Fraxiparine®

LCD

clobazam

Frisium ®

LCD - Psychiatric Medications Plan (Plan G)

flurbiprofen regular release

Froben®

RDP - Non Steroidal Anti Inflammatory Drugs

perampanel

Fycompa™

LCD

simeprevir

Galaxeos™

LCD

somatropin

Genotropin®

LCD

fingolimod

Gilenya®

LCD

filgrastim

Grastofil®

LCD

ledipasvir-sofosbuvir

Harvoni™

LCD

adefovir

Hepsera®

LCD

lamivudine

Heptovir®

LCD

ombitasvir-paritaprevir-ritonavir and dasabuvir

Holkira™ Pak

LCD

somatropin

Humatrope®

LCD

adalimumab

Humira®

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

hydroxyurea

Hydrea®

LCD

hydromorphone controlled release

Hydromorph Contin®

LCD

losartan with HCTZ

Hyzaar®

LCD

losartan without HCTZ

Cozaar®

LCD

ribavirin

Ibavyr™

LCD

isosorbide 5 mononitrate extended release

Imdur®

RDP - Nitrate Drugs

sumatriptan injection

Imitrex® Injection

LCD

loperamide

Imodium®

LCD

zopiclone

Imovane®

LCD - Psychiatric Medications Plan (Plan G)

umeclidinium

Incruse™ Ellipta®

LCD

indomethacin

Indocid®

RDP - Non Steroidal Anti Inflammatory Drugs

infliximab

Inflectra™

LCD

cilazapril without HCTZ

Inhibace®

RDP - ACE Inhibitor Drugs

cilazapril with HCTZ

Inhibace Plus®

RDP - ACE Inhibitor Drugs

tinzaparin

Innohep®

LCD

tiotropium-olodaterol

Inspiolto® Respimat®

LCD

sodium cromoglycate nebules

Intal® Nebules

LCD

interferon alfa

Intron A®

LCD

paliperidone palmitate injection

Invega® Sustenna®

LCD - Psychiatric Medications Plan (Plan G)

deferasirox Jadenu® LCD

linagliptin-metformin

Jentadueto™

LCD

ocriplasmin

Jetrea®

LCD

hydromorphone prolonged release

Jurnista®

LCD

levetiracetam

Keppra®

LCD

saxagliptin-metformin

Komboglyze™

LCD

granisetron

Kytril®

LCD

lamotrigine

Lamictal ®

LCD - Psychiatric Medications Plan (Plan G)

terbinafine tablets

Lamisil® Tablets

LCD

insulin glargine

Lantus®

LCD

lactulose

Laxilose®

LCD

fluvastatin

Lescol®

RDP (Modernized) - Statin Drugs

chlorambucil

Leukeran®

LCD

insulin detemir

Levemir®

LCD

insulin detemir

Levemir® FlexTouch®

LCD

baclofen intrathecal

Lioresal® Intrathecal

LCD

diphenoxylate

Lomotil®

LCD

ciclopirox 1%

Loprox®

LCD

omeprazole 20 mg

Losec® 20 mg

RDP (Modernized) - PPI Drugs + LCD

benazepril

Lotensin®

RDP - ACE Inhibitor Drugs

enoxaparin

Lovenox®

LCD

indapamide

Lozide®

LCD

leuprolide

Lupron®

LCD - Psychiatric Medications Plan (Plan G)

trandolapril

Mavik®

RDP - ACE Inhibitor Drugs

methotrexate injection

Methotrexate® Injection

LCD

lovastatin

Mevacor®

RDP (Modernized) - Statin Drugs

telmisartan with HCTZ

Micardis Plus®

RDP (Modernized) - ARB Drugs + LCD

telmisartan without HCTZ

Micardis®

RDP (Modernized) - ARB Drugs + LCD

miconazole 2% topical

Micatin Cream®

LCD

pramipexole

Mirapex®

LCD

meloxicam

Mobicox®

LCD

tenoxicam

Mobiflex®

LCD

ribavirin

Moderiba™

LCD

miconazole topical

Monistat Derm Cream®

LCD

fosinopril

Monopril®

RDP - ACE Inhibitor Drugs

morphine sulfate sustained release suppositories

MS Contin® Suppositories

LCD

dronedarone

Multaq®

LCD

fenoprofen

Nalfon®

LCD

naproxen enteric coated 250 mg, 375 mg and 500 mg

Naprosyn EC®

RDP - Non Steroidal Anti Inflammatory Drugs

mometasone nasal spray

Nasonex®

LCD

cyclosporine

Neoral®

LCD

gabapentin

Neurontin®

LCD - Psychiatric Medications Plan (Plan G)

esomeprazole

Nexium®

RDP (Modernized) - PPI Drugs + LCD

ketoconazole 2% cream

Nizoral®

LCD

somatropin

Norditriopin Nordiflex®

LCD

quinagolide 0.075 / 0.150 mg tablets

Norprolac®

LCD

somatropin

Nutropin AQ®

LCD

ofloxacin ophthalmic drops

Ocuflox®

LCD

estradiol patches

Oesclim®

LCD

olmesartan with HCTZ

Olmetec Plus®

LCD

olmesartan without HCTZ

Olmetec®

LCD

somatropin

Omnitrope®

LCD

indacaterol maleate

Onbrez® Breezhaler®

LCD

saxagliptin

Onglyza®

LCD

abatacept for polyarticular Juvenile Idiopathic Arthritis

Orencia®

LCD

abatacept for rheumatoid arthritis

Orencia®

LCD

ketoprofen - enteric coated

Orudis E®

RDP - Non Steroidal Anti Inflammatory Drugs

ketoprofen - regular release

Orudis®

RDP - Non Steroidal Anti Inflammatory Drugs

formoterol or formoterol in combination with budesonide or mometasone

Oxeze® Turbuhaler®

LCD

pantoprazole sodium 40 mg

Pantoloc® 40 mg

RDP (Modernized) - PPI Drugs + LCD

rabeprazole

Pariet®

RDP (Modernized) - PPI Drugs + LCD

pegylated interferon + ribavirin

Pegasys® RBV

LCD

pegylated interferon + ribavirin

Pegasys® RBV ProClick™ Autoinjector

LCD

pegylated interferon + ribavirin

Pegetron Redipen®

LCD

pegylated interferon + ribavirin

Pegetron®

LCD

famotidine

Pepcid®

RDP - H2 Blocker Drugs

clopidogrel

Plavix®

LCD

felodipine

Plendil®

RDP - Calcium Channel Blockers

dabigatran

Pradaxa®

LCD

pravastatin

Pravachol®

RDP (Modernized) - Statin Drugs

lansoprazole 15 or 30 mg

Prevacid®

RDP (Modernized) - PPI Drugs + LCD

lisinopril without HCTZ

Prinivil®

RDP - ACE Inhibitor Drugs

denosumab

Prolia®

LCD

finasteride

Proscar®

LCD

prostaglandin compounded injection

Prostaglandin®

LCD

tacrolimus ointment

Protopic® Ointment

LCD

budesonide nebules

Pulmicort®

LCD

mercaptopurine

Purinethol®

LCD

interferon beta-1a

Rebif®

LCD

tretinoin topical

Rejuva-A Cream®

LCD

nabumetone

Relafen®

LCD

zanamivir

Relenza®

LCD

infliximab

Remicade®

LCD

galantamine

Reminyl®

LCD

treprostinil

Remodulin®

LCD

felodipine

Renedil®

RDP - Calcium Channel Blockers

ropinirole

ReQuip®

LCD

tretinoin topical

Retin-A Cream®

LCD

naltrexone

ReVia®

LCD

risperidone microspheres

Risperdal Consta®

LCD

rituximab

Rituxan®

LCD

somatropin

Saizen®

LCD

asenapine

Saphris™

LCD

glycopyrronium

Seebri® Breezhaler®

LCD

salmeterol

Serevent®

LCD

golimumab

Simponi®

LCD

sofosbuvir

Sovaldi®

LCD

tiotropium

Spiriva®

LCD

tiotropium

Spiriva® Respimat®

LCD

itraconazole capsules

Sporanox®

LCD

entacapone / levodopa / carbidopa combination tablet

Stalevo®

LCD

ustekinumab

Stelara®

LCD

tretinoin topical

Stieva-A Cream®

LCD

tiaprofenic acid regular release

Surgam®

LCD

atomoxetine

Strattera®

LCD

asunaprevir

Sunpreva™

LCD

formoterol or formoterol in combination with budesonide or mometasone

Symbicort®

LCD

cimetidine - prescription strength

Tagamet®

RDP - H2 Blocker Drugs

pentazocine

Talwin®

LCD

oseltamivir

Tamiflu®

LCD

benzydamine

Tantum®

LCD

dimethyl fumarate

Tecfidera™

LCD

pantoprazole magnesium

Tecta®

RDP (Modernized) - PPI Drugs + LCD

eprosartan without HCTZ

Teveten®

RDP (Modernized) - ARB Drugs + LCD

eprosartan with HCTZ

Teveten Plus®

RDP (Modernized) - ARB Drugs + LCD

ticlopidine

Ticlid®

LCD

tobramycin

Tobi®

LCD

tobramycin

Tobi® Podhaler®

LCD

alitretinoin

Toctino®

LCD

tolmetin

Tolectin®

LCD

bosentan

Tracleer®

LCD

linagliptin

Trajenta™

LCD

aclidinium

Tudorza™ Genuair™

LCD

telmisartan + amlodipine combination

Twynsta®

RDP (Modernized) - ARB Drugs + LCD

acetaminophen 500 mg

Tylenol 500 mg®

LCD

natalizumab

Tysabri®

LCD

febuxostat

Uloric®

LCD

indacaterol in combination with glycopyrronium

Ultibro® Breezhaler®

LCD

valganciclovir

Valcyte®

LCD

vancomycin oral

Vancocin®

LCD

enalapril without HCTZ

Vasotec®

RDP - ACE Inhibitor Drugs

enalapril with HCTZ

Vasotec Plus®

RDP - ACE Inhibitor Drugs

salbutamol nebules

Ventolin®

LCD

solifenacin

Vesicare®

LCD

voriconazole

Vfend®

LCD

sildenafil

Viagra® LCD

lacosamide tablets

Vimpat®

LCD

clioquinol topical

Vioform Cream®

LCD

tenofovir

Viread®

LCD

dienogest

Visanne®

LCD

tretinoin topical

Vitamin A Acid Cream®

LCD

estradiol patches

Vivelle®

LCD

ambrisentan

Volibris®

LCD

diclofenac regular release

Voltaren®

RDP - Non Steroidal Anti Inflammatory Drugs

lisdexamfetamine

Vyvanse ®

LCD

bupropion

Wellbutrin® SR and XL

LCD - Psychiatric Medications Plan (Plan G)

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

tofacitinib

Xeljanz®

LCD

botulinum neurotoxin type A, free from complexing proteins, also known as incobotulinumtoxinA

Xeomin®

LCD

tizanidine

Zanaflex®

LCD

ziprasidone

Zeldox®

LCD - Psychiatric Medications Plan (Plan G)

formoterol or formoterol in combination with budesonide or mometasone

Zenhale™

LCD

elbasvir-grazoprevir

Zepatier™

LCD

lisinopril without HCTZ

Zestril®

RDP - ACE Inhibitor Drugs

lisinopril with HCTZ

Zestorectic®

RDP - ACE Inhibitor Drugs

simvastatin

Zocor®

RDP (Modernized) - Statin Drugs

ondansetron

Zofran®

LCD

goserelin

Zoladex®

LCD

bupropion

Zyban®

LCD - Psychiatric Medications Plan (Plan G)

olanzapine

Zyprexa Zydis®

LCD

olanzapine

Zyprexa®

LCD - Psychiatric Medications Plan (Plan G)

linezolid 600 mg tablet

Zyvoxam®

LCD

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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.