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c/glp1canada·posted 1 year ago by u/ayesha_erdogan

formulary — 11 things I got wrong before I got it right

Private Plan Receipts ×9

formulary — 11 things I got wrong before I got it right. Not a hot take, just something I have not seen said plainly here.

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.

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.

Cash pricing, which people skip because they assume coverage is the only route.

Prices at the counter vary between pharmacies, sometimes substantially, in the same city. Members here have found spreads worth a real amount per month by ringing four places and asking for the cash price of a specific presentation.

That does not make coverage unimportant. It does mean that while an authorization is in process — which can take weeks — knowing the actual cash spread is worth half an hour of phone calls. Post what you find with the province and the month; the comparison threads here work for exactly the same reason the UK pricing tracker does.

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

3,713 up / 3,236 down53% upvoted25 commentsid hqmiqc29 Aug 2024

25 comments

21 in this archive, depth 6

best — the order this archive was captured in

u/mariam_mensa80 points·1 year 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/amara_haddad65 points·1 year ago

Disagree — that is your province’s formulary position and it does not carry to another.

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u/injection_site_iris76 points·1 year ago

What did the denial actually say?

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u/ayesha_erdoganOP-5 points·1 year ago

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

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u/ayesha_erdoganOP1 point·1 year ago

Correcting myself: it was a quantity limit rather than a denial, which changes the whole process.

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u/paper_trail_paulavetting1 point·1 year ago

ask the pharmacy what the cash price is, it varies

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u/ayesha_erdoganOP59 points·1 year ago

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

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u/samir_falk36 points·1 year ago

Push back: approval by the national regulator says nothing about whether any plan will pay.

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u/incretin_ivypharmacology11 points·1 year ago

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

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u/nikhil_asante8 points·1 year ago

Have you seen the special authorization criteria for your province?

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u/anya_antonsen10 points·1 year ago

Same view — private and provincial plans are genuinely different processes with different appeal routes.

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u/spreadsheet_gremlindata3 points·1 year ago

employer plans have their own criteria and their own appeals

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u/pavel_kravchenko1 point·1 year ago

keep every form, every date, every reference number

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u/hedda_aguirre1 point·1 year ago

formulary decisions are provincial, so the province is the first fact

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u/egfr_watcher1 point·1 year ago

Which province?

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u/quiet_reader_9931 points·1 year ago

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

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u/laila_wojcik21 points·1 year 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/anya_antonsen5 points·1 year ago

say the province or the answers will be wrong

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u/omar_eriksen4 points·1 year ago

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

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u/ferritin_low6 points·1 year ago

Yes. Approval and coverage are separate, and this board conflates them in about half its threads.

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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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