Drug coverage for opioid use disorder

PharmaCare pays the full cost of most opioid agonist treatment (OAT) for B.C. residents.

• No forms to fill out
• Present your prescription at a pharmacy
• The pharmacy will need your Personal Health Number. Your Personal Health Number is on your driver’s licence, BC Services Card, or CareCard

If you are not enrolled in MSP, a pharmacist or prescriber can help you get temporary coverage of OAT.

PharmaCare covers the treatments below.

Regular benefit opioid agonist treatment (OAT)

These treatments are fully covered:

• Several formulations of methadone (Methadose^® (cherry) and Metadol-D^® (unflavoured))
• Buprenorphine/naloxone 2 mg and 8 mg sublingual tablets*
  • generic products are fully covered
• 24-hour slow-release oral morphine (Kadian^®)
• Long-acting injectable buprenorphine (brand name Sublocade^®)

*Brand-name buprenorphine/naloxone (Suboxone^®) 2 mg and 8 mg sublingual tablets are partially covered. They are covered up to the price of the matching generic product, as per the Low Cost Alternative program.

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Treatments that need a Special Authority request from your prescriber

For some treatments, your prescriber needs to submit a special request for coverage. This would be as a last resort if you have not benefited from other forms of oral OAT. This is called exceptional Special Authority coverage and is available for:

• High-dose buprenorphine/naloxone tablets
• Compounded methadone
• Full coverage of a brand name version of a covered generic drug, for example in case of an allergy to the generic version

If PharmaCare approves the request, you will be fully covered for the drug. Special Authority coverage may be for a limited time. Your prescriber will have to submit a new request when it ends.