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

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

aclidinium-formoterol

Duaklir™ 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

adalimumab for ulcerative colitis Humira® LCD

adefovir

Hepsera®

LCD

alendronate with vitamin D 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

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

aripiprazole monohydrate

Abilfy Maintena®

LCD

asenapine

Saphris™

LCD

asunaprevir

Sunpreva™

LCD

atomoxetine

Strattera®

LCD

aztreonam

Cayston™

LCD

baclofen intrathecal

Lioresal® Intrathecal

LCD

benzydamine

Tantum®

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

carvedilol

Coreg®

LCD

celecoxib

Celebrex®

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

chlorambucil

Leukeran®

LCD

chloroquine

Aralen ®

LCD

ciclopirox 1%

Loprox®

LCD

ciprofloxacin/dexamethasone

Ciprodex®

LCD

ciprofloxacin ophthalmic

Ciloxan®

LCD

clioquinol topical

Vioform Cream®

LCD

clopidogrel

Plavix®

LCD

clotrimazole

Canesten Topical®

LCD

codeine sustained release

Codeine Contin®

LCD

cyclosporine

Neoral®

LCD

dabigatran

Pradaxa®

LCD

daclatasvir

Daklinza™

LCD

dalteparin

Fragmin®

LCD

deferasirox

Exjade®

LCD

deferiprone

Ferriprox®

LCD

denosumab

Prolia®

LCD

desmopressin oral

DDAVP Tablets®

LCD

desmopressin oral

DDAVP Melt®

LCD

dextroamphetamine-amphetamine

Adderall XR®

LCD

dienogest

Visanne®

LCD

dimethyl fumarate

Tecfidera™

LCD

diphenoxylate

Lomotil®

LCD

dipyridamole-acetylsalicylic acid

Aggrenox® 

LCD

donepezil

Aricept®

LCD

dorzolamide-timolol preservative free

Cosopt non-preserved®

LCD

dronedarone

Multaq®

LCD

dutasteride

Avodart®

LCD

econazole topical

Ecostatin Cream®

LCD

elbasvir-grazoprevir

Zepatier™

LCD

enoxaparin

Lovenox®

LCD

entacapone

Comtan®

LCD

entacapone/levodopa/carbidopa combination tablet

Stalevo®

LCD

entecavir

Baraclude®

LCD

epoprostenol

Caripul®

LCD

epoprostenol

Flolan®

LCD

eslicarbazepine acetate

Aptiom™

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

etanercept

Brenzys™


LCD

febuxostat

Uloric®

LCD

fenoprofen

Nalfon®

LCD

fentanyl patch

Duragesic®

LCD

fidaxomicin

Dificid®

LCD

filgrastim

Grastofil®

LCD

finasteride

Proscar®

LCD

fingolimod

Gilenya®

LCD

fluconazole oral solids

Diflucan®

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

galantamine

Reminyl®

LCD

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

indacaterol in combination with glycopyrronium

Ultibro® Breezhaler®

LCD

indacaterol maleate

Onbrez® Breezhaler®

LCD

indapamide

Lozide®

LCD

infliximab

Inflectra™, 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

itraconazole capsules

Sporanox®

LCD

ketoconazole 2% cream

Nizoral®

LCD

lacosamide tablets

Vimpat®

LCD

lactulose

Laxilose®

LCD

lamivudine

Heptovir®

LCD

ledipasvir-sofosbuvir

Harvoni™

LCD

leflunomide

Arava®

LCD

levetiracetam

Keppra®

LCD

linagliptin

Trajenta™

LCD

linagliptin-metformin

Jentadueto™

LCD

linezolid 600 mg tablet

Zyvoxam®

LCD

lisdexamfetamine

Vyvanse ®

LCD

loperamide

Imodium®

LCD

meloxicam

Mobicox®

LCD

mercaptopurine

Purinethol®

LCD

methotrexate injection

Methotrexate® Injection

LCD

methylphenidate extended-release

Concerta®

LCD

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

natalizumab

Tysabri®

LCD

ocriplasmin

Jetrea®

LCD

ofloxacin ophthalmic drops

Ocuflox®

LCD

olanzapine

Zyprexa Zydis®

LCD

olmesartan

Olmetec®

LCD

olsetamivir

Tamiflu®

LCD

ombitasvir-paritaprevir-ritonavir and dasabuvir

Holkira™ Pak

LCD

omeprazole 20 mg

Losec® 20 mg

LCD

ondansetron

Zofran®

LCD

pamidronate

Aredia®

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

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

raloxifene

Evista®

LCD

ribavirin

Ibavyr™

LCD

ribavirin

Moderiba™

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

rivastigmine

Exelon®

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®

LCD

saxagliptin

Onglyza®

LCD

saxagliptin-metformin

Komboglyze™

LCD

secukinumab

Cosentyx®

LCD

sildenafil

Viagra®

LCD

simeprevir

Galaxeos™

LCD

sodium cromoglycate nebules

Intal® Nebules

LCD

sofosbuvir

Sovaldi®

LCD

sofosbuvir-velpatasvir

Epclusa®

LCD

solifenacin

Available generics only

LCD

somatropin

Genotropin®

LCD

somatropin

Humatrope®

LCD

somatropin

Norditriopin Nordiflex®

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

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

tiotropium

Spiriva® Respimat®

LCD

tiotropium-olodaterol

Inspiolto® Respimat®

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

tofacitinib

Xeljanz®

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

umeclidinium

Incruse™ Ellipta®

LCD

umeclidinium in combination with vilanterol

Anoro® Elipta®

LCD

valganciclovir

Valcyte®

LCD

vancomycin oral

Vancocin®

LCD

vedolizumab

Entyvio®

LCD

vilanterol - fluticasone furoate

Breo® Ellipta®

LCD

voriconazole

Vfend®

LCD

zanamivir

Relenza®

LCD

zoledronic acid

Aclasta™

LCD

aripiprazole

Abilify ®

LCD - Psychiatric Medications Plan (Plan G)

bupropion

Wellbutrin® SR and XL

LCD - Psychiatric Medications Plan (Plan G)

bupropion

Zyban®

LCD - Psychiatric Medications Plan (Plan G)

clobazam

Frisium ®

LCD - Psychiatric Medications Plan (Plan G)

cyproterone

Androcur®

LCD - Psychiatric Medications Plan (Plan G)

gabapentin

Neurontin®

LCD - Psychiatric Medications Plan (Plan G)

hydroxyzine

Atarax ®

LCD - Psychiatric Medications Plan (Plan G)

lamotrigine

Lamictal ®

LCD - Psychiatric Medications Plan (Plan G)

leuprolide

Lupron®

LCD - Psychiatric Medications Plan (Plan G)

olanzapine

Zyprexa®

LCD - Psychiatric Medications Plan (Plan G)

paliperidone palmitate injection

Invega® Sustenna®

LCD - Psychiatric Medications Plan (Plan G)

varenicline

Champix®

LCD - Psychiatric Medications Plan (Plan G)

verapamil

Isoptin®

LCD - Psychiatric Medications Plan (Plan G)

ziprasidone

Zeldox®

LCD - Psychiatric Medications Plan (Plan G)

zopiclone

Imovane®

LCD - Psychiatric Medications Plan (Plan G)

benazepril

Lotensin®

RDP - ACE Inhibitor Drugs

captopril

Capoten®

RDP - ACE Inhibitor Drugs

cilazapril with or without HCTZ

Inhibace®, Inhibace Plus®

RDP - ACE Inhibitor Drugs

enalapril with or without HCTZ

Vasotec®, Vasotec Plus ®

RDP - ACE Inhibitor Drugs

fosinopril

Monopril®

RDP - ACE Inhibitor Drugs

lisinopril with or without HCTZ

Prinivil®, Zestril®, Zestoretic®

RDP - ACE Inhibitor Drugs

perindopril

Coversyl®

RDP - ACE Inhibitor Drugs

quinapril with or without HCTZ

Accupril®, Accuretic®

RDP - ACE Inhibitor Drugs

trandolapril

Mavik®

RDP - ACE Inhibitor Drugs

candesartan

Atacand®, Atacand Plus®

RDP (Modernized) - ARB Drugs + LCD

eprosartan with or without HCTZ

Teventen®, Teveten Plus®

RDP (Modernized) - ARB Drugs + LCD

irbesartan with or without HCTZ

Avapro®, Avalide®

RDP (Modernized) - ARB Drugs + LCD

losartan

Cozaar®, Hyzaar®

RDP (Modernized) - ARB Drugs + LCD

olmesartan

Olmetec®, Olmetec Plus®

RDP (Modernized) - ARB Drugs + LCD

telmisartan with or without HCTZ or amlodipine Micardis®, Micardis Plus®, Twynsta® RDP (Modernized) - ARB Drugs + LCD

valsartan with or without HCTZ

Diovan®,  Diovan HCT®

RDP (Modernized) - ARB Drugs + LCD

felodipine

Plendil®, Renedil®

RDP - Calcium Channel Blockers

nifedipine

Adalat®

RDP - Calcium Channel Blockers

cimetidine - prescription strength

Tagamet®

RDP - H2 Blocker Drugs

famotidine

Pepcid®

RDP - H2 Blocker Drugs

nizatidine

Axid®

RDP - H2 Blocker Drugs

isosorbide 5 mononitrate extended release 60 mg

Imdur®

RDP - Nitrate Drugs

diclofenac with or without misoprostol

Voltaren®, Arthrotec®

RDP - Non Steroidal Anti Inflammatory Drugs

diflunisal

Dolobid®

RDP - Non Steroidal Anti Inflammatory Drugs

flurbiprofen regular release

Ansaid®, Froben®

RDP - Non Steroidal Anti Inflammatory Drugs

indomethacin

Indocid®

RDP - Non Steroidal Anti Inflammatory Drugs

ketoprofen

Orudis®, Orudis E®

RDP - Non Steroidal Anti Inflammatory Drugs

naproxen enteric coated 250 mg, 375 mg and 500 mg

Naprosyn EC®

RDP - Non Steroidal Anti Inflammatory Drugs

esomeprazole

Nexium® RDP (Modernized) - PPI Drugs + LCD

lansoprazole 15 mg or 30 mg

Prevacid® RDP (Modernized) - PPI Drugs + LCD

omeprazole 20 mg

Losec® 20 mg RDP (Modernized) - PPI Drugs + LCD

pantoprazole magnesium

Tecta® RDP (Modernized) - PPI Drugs + LCD

pantoprazole sodium 40 mg

Pantoloc® 40 mg RDP (Modernized) - PPI Drugs + LCD

rabeprazole

Pariet® RDP (Modernized) - PPI Drugs + LCD

fluvastatin

Lescol® RDP (Modernized) - Statin Drugs

lovastatin

Mevacor® RDP (Modernized) - Statin Drugs

pravastatin

Pravachol® RDP (Modernized) - Statin Drugs

simvastatin

Zocor® RDP (Modernized) - Statin Drugs

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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.