Every year, dozens of new drug products come on the market in Canada. For many of the new drugs made available to the public, we have to decide if the medication should be added to the Pharmacare drug benefit program.
Before a new drug is considered for Pharmacare coverage, the manufacturer must send a drug submission to the Manitoba Drug Standards and Therapeutics Committee. This information includes reviews of scientific literature, comparable drug therapies, anticipated drug costs, and therapeutic benefits.
The Manitoba Drug Benefits Formulary lists therapeutically effective drugs of proven high quality that are approved for coverage under the Pharmacare drug benefit program. It is compiled with the advice of the Manitoba Drug Standards and Therapeutics Committee and the Common Drug Review, assisted by Manitoba Health staff and outside consultants.
Updates to the Manitoba Formulary are provided to health professionals every three or four months--either by bulletin or on the Internet.
Doctors and pharmacists all receive a copy of the Formulary. Ask your pharmacist, physician, or the Pharmacare office if a drug is covered, before you purchase your medication.
Pharmacare may be reached at (204) 786-7141 or toll-free in Manitoba at 1-800-297-8099.
No. It depends on the recommendation of the Manitoba Drug Standards and Therapeutics Committee. The goal of the Committee is to list a variety of drugs that doctors can choose as an effective course of therapy for most patients. Sometimes a new drug simply doesn't offer enough benefits compared to other drugs or treatments and services in the health system.
The Pharmacare drug benefits list is divided into three parts. Part I includes drug products that are eligible for Pharmacare benefits under all prescribed circumstances. Part II includes drug products that are eligible for Pharmacare benefits only when prescribed for the terms and conditions indicated.
When a drug is not listed in Part I or part II, a request for Exception Drug Status coverage will be considered under Part III for each individual's specific circumstance. Your doctor can apply to the Pharmacare Exception Drug Status program, at 300 Carlton Street, Winnipeg, Manitoba R3B 3M9.
Under this program physicians are able to apply to obtain drug coverage (for each person) for medication not normally covered. The approval is generally given for a one-year period, after which time the person's doctor must reapply. A one-time notification indicating drug coverage dates are sent to individuals at time of approval.
The following flowchart shows the steps in the process when a new drug is considered for coverage under the Pharmacare drug benefit program.
The Manitoba Drug Standards and Therapeutics Committee is independent of government. It includes three physicians and three pharmacists. Committee members provide recommendations on drug interchangeability and on the therapeutic and economic value of drug benefits. Nominations for committee membership are provided by the College of Physicians and Surgeons of Manitoba, Manitoba Medical Association, Manitoba Pharmaceutical Association, and the University of Manitoba.
Based on the Committee's recommendations, the Minister of Health gives the final approval for benefits under the Pharmacare Drug Benefit program.
Yes. An individual or doctor can request a review of any decision that has been rejected by the exception Drug Status Program through the Manitoba Drug Standards and Therapeutics Committee by writing to the address below.
Manitoba Health - Provincial Drug Programs
300 Carlton Street
Winnipeg MB R3B 3M9
In Winnipeg, call (204) 786-7141
Outside of Winnipeg 1-800-297-8099 (toll-free)