Limited coverage criteria – pioglitazone

Last updated on March 21, 2025

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Generic name	pioglitazone
Strength & form	15 mg/30 mg/45 mg, tablet

Special Authority criteria	Approval period
To be administered as part of a combination treatment for type 2 diabetes mellitus: After inadequate glycemic control on maximum tolerated doses of dual therapy of metformin and a sulfonylurea OR After dual therapy of metformin and an insulin	Indefinite

Special Authority criteria

Approval period

To be administered as part of a combination treatment for type 2 diabetes mellitus:

After inadequate glycemic control on maximum tolerated doses of dual therapy of metformin and a sulfonylurea

After dual therapy of metformin and an insulin

Indefinite

Practitioner exemptions

None

Special notes

PharmaCare coverage for pioglitazone is intended for combination treatment of type 2 diabetes (e.g., not as monotherapy)
Patients intolerant to a sulfonylurea may be considered for coverage. Patients intolerant to glyburide may try another sulfonylurea (e.g., gliclazide, which is available through Special Authority)
Clinical judgment is warranted to assess the increased risk of adverse outcomes in patients with concurrent cardiovascular conditions, including heart failure
Pioglitazone is contraindicated for patients with New York Heart Association (NYHA) heart failure Classes I to IV

Special Authority request form(s)

Log in to eForms
HLTH 5481 – Third-Line Anti-Diabetic Drugs (PDF, 672KB)

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