5.14 Insulin

General Policy Description

PharmaCare covers insulin, including biosimilar insulins, for patients with insulin-dependent diabetes.

Policy Details

Insulin claims are reimbursed in the following ways:

• Regular insulin is reimbursed at the regular retail price with no dispensing fee
• Short-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. These products are also referred to as rapid-acting insulin analogues.
• 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 are Limited Coverage products and therefore require Special Authority approval for coverage

>> See Special Authority's list of Limited Coverage Drugs for more information.

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

For patient safety, pharmacists should record insulin provided to B.C. residents in their PharmaNet profile. This also ensures that PharmaCare will provide for coverage or count the claim towards the patient’s family deductible or family maximum co-payment.

For out-of-province/country patients, 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 obtain authorization from the patient’s prescriber for the insulin to be dispensed under their Prescriber ID.