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

[Question] special authorization — what am I missing here

Question Cold Box ×3 Sourced ×1

Asking properly rather than in a comment on somebody else’s thread: special authorization — what am I missing here.

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

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

Criteria changed at plan renewal and the denial that had been immovable simply did not apply any more.

Not medical advice, obviously, and nothing here is approved for human use. One person with a spreadsheet.

2,422 up / 723 down77% upvoted53 commentsid iklbt922 Sep 2024

53 comments

27 in this archive, depth 4

best — the order this archive was captured in

u/karim_restrepo265 points·1 year ago

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.

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u/zeynep_ndiaye62 points·1 year ago

Quantity limits restrict how much may be dispensed in a period even where coverage exists.

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

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u/jarno_karlsen49 points·1 year ago

employer plans have their own criteria and their own appeals

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u/enzo_ferrari40 points·1 year ago

a rejected claim is not the same as a denied authorization

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u/aurel_lindqvist-34 points·1 year ago

Provincial plan, employer plan, or paying cash?

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u/gradient_goblin51 points·1 year ago

Confused a rejected claim with a denied authorization for a month and pursued entirely the wrong process.

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u/karim_ilunga272 points·1 year 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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u/diego_sorensen395 points·1 year ago

Compared cash prices across four pharmacies before pursuing coverage and the spread was larger than I expected.

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u/aurel_lindqvist308 points·1 year ago

the criteria change at plan renewal and nobody announces it

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u/milos_vestergaardOP177 points·1 year ago

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

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u/aurel_lindqvist187 points·1 year ago

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

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u/adaeze_batista138 points·1 year 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/milos_vestergaardOP0 points·1 year ago

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

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u/egfr_watcher104 points·1 year ago

Spent three weeks on what turned out to be a quantity limit rather than a coverage question.

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u/osman_ferrari82 points·1 year ago·edited

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/camila_mensa57 points·1 year ago·edited

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.

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u/gradient_goblin44 points·1 year ago

That is an employer plan process, and the provincial route is different in both form and timeline.

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u/dario_vermeulen30 points·1 year ago·edited

Have you asked the pharmacist to check?

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u/milos_vestergaardOP15 points·1 year ago

Was this a denied authorization or a rejected claim?

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u/mariam_mensa7 points·1 year ago

keep every form, every date, every reference number

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u/lipid_panel_larrybloodwork12 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/niels_norgaard35 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/karim_restrepo8 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_fighterappeals17 points·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/spreadsheet_gremlindata0 points·1 year ago

Nothing here is medical or legal advice.

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

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u/lipid_panel_larrybloodwork0 points·1 year ago

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

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u/laila_wojcik5 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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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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