Reference Drug Program

The RDP encourages prescribers to prescribe less costly, equally effective drugs that PharmaCare fully covers.

On this page: About the Reference Drug Program (RDP) I  RDP drug groups I  April 1, 2021 RDP changes I History of changes to the RDP

The RDP groups drugs in the same drug family that treat the same medical conditions. The drugs are equally safe and effective. Each group has one or more “reference” drugs. The rest are “non-reference”.

• Fully covered: the reference drugs in a group
• Partially covered: the non-reference drugs in a group

The cost of the reference drug determines how much is covered of a non-reference drug. For example, if the reference drug is $5/dose, and the non-reference drug is $8/dose, then PharmaCare covers $5 of the non-reference drug.

If you cannot take a reference drug for a medical reason, your prescriber can submit a Special Authority request for full coverage of a non-reference drug. Patients are expected to try reference drugs first or have a medical reason for taking a non-reference drug. Talk to your prescriber or pharmacist if you would prefer a non-reference product.

*Actual coverage depends on the rules of your PharmaCare plan, including any annual deductible. Note: The maximum amount that PharmaCare reimburses for partially covered RDP drugs changes regularly.

RDP drug groups:

• Angiotensin-converting enzyme inhibitors (ACEIs) — for high blood pressure and heart disease
• Dihydropyridine calcium channel blockers (CCBs) — for high blood pressure and heart disease
• Histamine 2 receptor blockers (H2 blockers) — for significant stomach acid issues, such as acid reflux or ulcers
• Angiotensin receptor blockers (ARBs) — for high blood pressure and heart disease
• Proton pump inhibitors (PPIs) — for significant stomach acid issues, such as acid reflux or ulcers
• HMG-CoA reductase inhibitors (statins) — for high cholesterol. 
• Nonsteroidal anti-inflammatory drugs (NSAIDs) — for inflammation and pain

>> See the full list of RDP drugs.

Replacing one drug with another that treats the same condition is called therapeutic substitution. Pharmacists can help with this type of substitution, if it is appropriate.

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April 1, 2021 RDP changes

In April 2021, changes were made to the RDP:

• Nitrates category removed. All drugs made regular PharmaCare benefits
• Several drugs in the nonsteroidal anti-inflammatory drugs (NSAIDs) category became Limited Coverage:
  • diclofenac with misoprostol
  • diflunisal
  • flurbiprofen
  • indomethacin
  • ketoprofen regular and sustained release
• Ibuprofen 200 mg removed. Now covered only through Plan B and Plan W

If you were taking one of the drugs affected and had filled a prescription within 6 months of April 1, 2021, your coverage should not have been affected. PharmaCare would have pre-approved you for ongoing full coverage.

Patients who were taking specific nitrates (isosorbide dinitrate or isosorbide mononitrate extended release) should have seen no changes in coverage, because the drugs became regular benefits.

If you had Special Authority for a drug in an RDP category, you would have continued to be eligible for full PharmaCare coverage if you filled your prescription within the 6 months before April 1, 2021. Please speak to your pharmacist to make sure you are covered.

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History of changes to the RDP

The RDP has gone through several changes over the years as new drugs and generic versions become available, and as efficacy and safety information  is updated. The price of many generic drugs has also been lowered, thanks to B.C.’s Drug Price Regulation and the work of the pan-Canadian Pharmaceutical Alliance. 1995: Three RDP categories were introduced (NSAID, H2 Blockers and Nitrates)

• 1997: Two RDP categories added (ACEI and CCB)
• 2016: The RDP grows to 8 groups and PharmaCare changes the coverage level for drugs in 3 groups
• April 1, 2021: The RDP is re-arranged as 7 groups:
  • The nitrates group is removed. All drugs are made regular PharmaCare benefits
  • In the nonsteroidal anti-inflammatory drugs (NSAIDs) category, the list of fully covered and partially covered drugs is changed. Patients don’t lose coverage for any drugs removed from the NSAIDs group

Whenever the RDP changes, PharmaCare informs prescribers and pharmacists across B.C. PharmaCare provides tools to help these health care professionals support patients who rely on PharmaCare coverage and, if needed, transition those patients to an equally safe and effective alternative drug.

The Ministry of Health reviews available research, coverage recommendations, and clinical evidence for each RDP category. See the RDP Review Reports.