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c/glp1canada·posted 11 months ago by u/matias_salgado

special authorization is the most under-discussed thing on this board

Private Plan Slow Clap ×5 Sourced ×1

special authorization is the most under-discussed thing on this board. I have gone back and forth on this for months.

Quantity limits restrict how much may be dispensed in a period even where coverage exists. They are a distinct barrier and require a distinct request.

National regulatory approval establishes that a product may be sold. Whether any plan pays for it is a separate decision, and public drug plans are administered provincially.

Special authorization is a documented exception process with published criteria. Applications that answer those criteria explicitly, point by point, fare better than general clinical narratives.

Sceptical readings welcome. The confident ones are the ones I distrust.

1,193 up / 246 down83% upvoted39 commentsid du6yf427 Aug 2025

39 comments

24 in this archive, depth 5

best — the order this archive was captured in

u/formulary_fighterappeals155 points·11 months ago

Formulary criteria are revised, and plan renewal is a natural point at which a previously refused request may succeed without anything about the applicant changing.

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u/piotr_nascimento45 points·11 months ago

Careful, that criterion was updated at renewal and the version you are quoting is superseded.

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u/elin_varga14 points·11 months ago

Health Canada approval is not coverage

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u/pavel_kravchenko7 points·11 months ago

private plans and provincial plans are different fights entirely

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u/ayesha_radich0 points·11 months ago

Health Canada approval is not coverage

elin_varga is right that a rejected claim and a denied authorization are different animals.

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u/marit_coelho1 point·11 months ago

Employer-sponsored plans have their own criteria and appeal processes, independent of the provincial formulary. Which one applies determines everything about the route.

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[deleted]1 point·11 months ago

[deleted]

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u/niels_norgaard114 points·11 months ago

Is there a quantity limit involved rather than a coverage refusal?

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u/matias_salgadoOP61 points·11 months ago

Small fix — that formulary position is another province’s and does not apply here.

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u/matias_salgadoOP24 points·11 months ago

Those criteria were revised at renewal, so the version quoted upthread is out of date.

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u/kian_ekstrom17 points·11 months ago

Read the special authorization criteria and wrote the application against them line by line. Approved first time after a previous refusal.

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u/santiago_szabo69 points·11 months ago

A rejected claim at the pharmacy counter and a denied authorization are different events with different remedies. The first can be an administrative or quantity issue; the second is a determination you can appeal.

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u/dario_vermeulen19 points·11 months ago

Kept every form and reference number. When they had no record of a submission, I did.

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u/constipation_clubside effects78 points·11 months ago

the same product can be covered in one province and not the next

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u/kian_ekstrom43 points·11 months ago

A rejected claim at the pharmacy counter and a denied authorization are different events with different remedies.

Disagreeing with this line: that is an employer plan process and the provincial one differs.

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u/canada_coverageMOD39 points·11 months ago

Plan and policy numbers redacted from the screenshot above.

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u/kian_ekstrom0 points·11 months ago

Plan and policy numbers redacted from the screenshot above.

Adding the fastest step — ask the pharmacist. They can usually check in minutes.

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u/matias_salgadoOP1 point·11 months ago

Which province?

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u/kian_ekstrom1 point·11 months ago

I would not read one pharmacy’s cash price as the going rate. The spread is real.

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u/food_noise_gonemaintenance1 point·11 months ago·edited

Which province?

This is why every thread here needs a province in it.

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u/milos_vestergaard0 points·11 months ago·edited

Correction: that is regulatory approval, not coverage. They are separate decisions by separate bodies.

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u/zaid_grimaldi1 point·11 months ago

Not convinced. A rejected claim at the counter is not a denied authorization and the next step differs.

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u/ayesha_erdogan-13 points·11 months ago

The pharmacist sorted in five minutes what the phone line had not managed in a fortnight.

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u/ahmed_abubakar1 point·11 months ago

Right, and the pharmacist can usually give a definite answer faster than a week of forum speculation.

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Canadian access: provincial formulary differences, private plan coverage, the special-authorisation process, cross-border pricing arbitrage and why the Ontario answer is not the Alberta answer.

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