5.14 Insulin

General Policy Description

PharmaCare covers insulin, including biosimilars, for clients with insulin-dependent diabetes.

Policy Details

Regular insulin is reimbursed at the regular retail price with no dispensing fee.

Short-acting (rapid acting) insulin analogues, such as insulin aspart (Trurapi^®), insulin lispro (Admelog^®), and insulin glulisine (Apidra^®), are reimbursed at the regular retail price with no dispensing fee. 

Long-acting insulin analogues such as insulin glargine (Basaglar™) and insulin detemir are reimbursed at the regular retail price, with no dispensing fee. These insulins require Special Authority approval for coverage. Refer to the Special Authority drug list.

Insulin can be dispensed to a client with or without a prescription from a prescriber.

For client safety and PharmaCare coverage, pharmacists should record the insulin provided in the client's PharmaNet profile. For out-of-province/country clients, the claim does not need to be entered in PharmaNet.

If there is no prescription, the pharmacist should enter their Pharmacist ID in place of the Practitioner ID. If the pharmacist wants to enter a Prescriber ID, the pharmacist must get permission from the prescriber for the insulin to be dispensed under their Prescriber ID.