how much of what we believe about private plan actually comes from special authorization threads

Asking properly rather than in a comment on somebody else’s thread: how much of what we believe about private plan actually comes from special authorization threads.

How to write a special authorization request that gets approved.

Get the published criteria for your province. Answer them explicitly, in their own terms, in the same order. Attach what has been documented — what was tried, at what dose, for how long, with what outcome — as dates rather than narrative. Where a criterion cannot be met, have the prescriber say why in the criterion’s own language rather than around it.

Members here who have done this describe a much better hit rate than those who submitted a clinical letter that did not engage with the form. It is an administrative exercise, and treating it as one is the whole trick. None of which is advice — it is what the threads report.

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.

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.

Corrections welcome, especially the pedantic ones. Pedantry is how this board earns its reputation.