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c/glp1canada·submitted 1 year ago by u/sigrid_kaufmann

[Meta] the province rule is doing its job and people should stop complaining

Questionbranch of 6 comments

Putting this to the board: the province rule is doing its job and people should stop complaining. The pharmacist sorted in five minutes what the phone line had not managed in a fortnight. Spent three weeks on what turned out to be a quantity limit rather than a coverage question. Moved provinces and the coverage…

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6 comments, started 1 year ago
u/mei_cardoso4 points·1 year ago

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.

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u/formulary_fighterappeals2 points·1 year ago

Have you asked the pharmacist to check?

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u/santiago_szabo1 point·1 year ago

Nothing here is medical or legal advice. The pharmacist and the prescriber are the people who can act, and both are faster than a forum.

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u/sigrid_kaufmannOP1 point·1 year ago·edited

employer plans have their own criteria and their own appeals

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u/rina_nascimento1 point·1 year ago

employer plans have their own criteria and their own appeals

Agreed — write the application against the published criteria rather than around them.

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u/sigrid_kaufmannOP0 points·1 year ago

Has your plan renewed since the last time you applied?

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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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