126x Filetype PDF File size 3.01 MB Source: www.princeedwardisland.ca
P.E.I. Pharmacare Formulary PEI Pharmacare Formulary …………………………………………………Page - 1 - Inquiries should be directed to: PEI Pharmacare Health PEI P.O. Box 2000, 20 Fitzroy St. Charlottetown, PEI C1A 7N8 Telephone inquiries should be directed to: Client Eligibility 1-902-368-4947 Charlottetown Prescriber Eligibility 1-877-577-3737 Toll Free in PEI Medication Eligibility 1-902-368-4905 Fax Pharmacy Eligibility Pharmacist Eligibility Claim Inquiries Special Authorization Drug Status Formulary Inquiries Pharmacy Information Program (PhIP) 628-3772 Charlottetown Inquiries and Technical Support Help Desk 1-877-201-6771 Toll Free in PEI 7:00 am to 12:00 midnight 7 days per week PEI Insulin Pump Program 1-902-213-4825 Phone Diabetes Glucose Sensor Program 1-833-335-0538 Toll Free in PEI Montague Health Center diabetesadminofficer@ihis.org Email 407 MacIntyre Avenue Montague, PE C0A 1R0 Statements within this document are not intended to override or modify the provisions within an enactment or Minister authority. Published by the authority of the Minister of Health and Wellness, Province of Prince Edward Island for the exclusive use of PEI Pharmacare Updated: December 2022 PEI Pharmacare Formulary …………………………………………………Page - 2 - THE FORMULARY The Prince Edward Island Pharmacare Formulary is a listing of therapeutically effective medications approved for coverage through the following programs: HIV Drug Program High Cost Drug Program Catastrophic Drug Program Institutional Pharmacy Program Community Mental Health Drug Program Nursing Home Drug Program Children in Care Program Nutrition Services Program Cystic Fibrosis Drug Program Substance Use Harm Reduction Drug Diabetes Drug Program Program Erythropoietin Program Phenylketonuria (PKU) Program Family Health Benefit Drug Program Smoking Cessation Drug Program Financial Assistance Drug Program Seniors Drug Program Generic Drug Program Sexually Transmitted Diseases Program Growth Hormone Drug Program Transplant Drug Program Hepatitis Drug Program Tuberculosis Drug Program It is compiled on behalf of the Minister of Health and Wellness based upon recommendations from either the Atlantic or Canadian Expert Drug Advisory Committees, or the Joint Oncology Drug Review Committee. Medications in the Formulary are listed by Therapeutic Categories developed by the American Society of Hospital Pharmacists. The PEI Pharmacare Formulary is not to be used to determine interchangeability of therapeutic products. The PEI Pharmacare Formulary may be downloaded from the Health PEI website at – www.healthpei.ca/formulary PEI Pharmacare Formulary …………………………………………………Page - 3 - PRINCE EDWARD ISLAND DRUG PROGRAMS Program Beneficiaries Benefits Fee (Formulary Code) (Note: A prescription is required for all benefits unless otherwise indicated.) Programs Delivered Through Community Retail Pharmacies Children-In-Care Persons in temporary All prescription No fee. Program or permanent medications. (W) custody of the Non-prescription Director of Child medications Welfare approved under the Financial Assistance Program Generic Drug Persons less than 65 Maximum of $19.95 Program (G) years of age with no Approved generic per prescription. private drug prescription insurance medications. Diabetes Drug Persons eligible for Approved insulin $10.00 per 10 mL vial Program PEI Medicare, products of insulin. (D) diagnosed with $20.00 per box of diabetes, and insulin cartridges. registered with the program. Approved oral $11.00 per diabetes prescription medications Approved urine $11.00 per testing materials prescription (Diastix and Ketostix – no prescription required) Blood Glucose test $11.00 per dispense. strips. Patients must Maximum of 100 have used insulin strips per 25 days. within 150 days (no prescription required). Approved glucagon $20.00 per unit devices. Patients must have used insulin within 150 days (no prescription required for up to 2 units in PEI Pharmacare Formulary …………………………………………………Page - 4 -
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