Each public drug plan provided by the federal, provincial, or territorial governments covers medication differently. Access to standard care drugs depends on where patients live. 

You'll see that some are considered "Special Access" or "Restricted Access" which means they usually require you to have tried (and 'failed') other therapies first and require your doctor to send some forms in to the Ministry of Health or to the Health Authority for approval. In this case, your dermatologist or rheumatologist may require access to your medical records. 

Some provinces have implemented a biosimilar policy, where the public drug plan will cover the cost of biosimilars and not the originator drug. If you live in a province affected by this policy, talk with your doctor about treatment implications. Switching from an originator biologic to its biosimilar version has been shown to be safe and effective.  

The following table details which medications are covered and what criteria have to be met for people covered by public drug plans.

Table: Funding status by province of medications to treat psoriasis and psoriatic arthritis

• Yes - Public health coverage is available for this medication. If you are not currently registered for public health coverage in your province or if you have questions about your eligibility, please talk to your pharmacist.
• No-Public health coverage is not available for this medication; however, it may be covered by some private health plans. 
• SA (aka “Special Authorization”, “Limited Use”, or Exceptional Drug Status”) àThis medication requires patients to meet specific criteria to be eligible for coverage. Your doctor may need to complete certain forms or documentation to apply for coverage. 
• N/A - This medication is not on the provincial formulary or information is not available

Psoriasis

Psoriatic Arthritis

• Yes  - Public health coverage is available for this medication. If you are not currently registered for public health coverage in your province or if you have questions about your eligibility, please talk to your pharmacist.
• No- Public health coverage is not available for this medication; however, it may be covered by some private health plans. 
• SA (aka “Special Authorization”, “Limited Use”, or Exceptional Drug Status”) àThis medication requires patients to meet specific criteria to be eligible for coverage. Your doctor may need to complete certain forms or documentation to apply for coverage. 
• N/A àThis medication is not on the provincial formulary or information is not available.

Special Authorization Criteria per Province

Each province and territory has different criteria that a patient must meet in order to qualify to receive a biologic medication. The criteria may differ depending on what condition the drug is prescribed for. Some provinces may require patients to be assessed by a certain specialist such as a rheumatologist before they can apply for coverage. For the most comprehensive and up to date information on special authority criteria, please see the following resources and talk with your doctor or pharmacist. 

Resources:

• Drug formulary: This is a list of drugs that are eligible for coverage under the provincial drug plan
• SA/EDS details: This explains the criteria that needs to be met in order to qualify for drug coverage 
• Pso or PsA Form: This is an application form that must be completed by your physician to apply for special authority coverage

BC: 

• Drug Formulary: https://pharmacareformularysearch.gov.bc.ca/faces/Search.xhtml
• Pso Form: https://www2.gov.bc.ca/assets/gov/health/forms/5380fil.pdf
• PsA Form: https://www2.gov.bc.ca/assets/gov/health/forms/5360fil.pdf

AB

• Drug Formulary: https://idbl.ab.bluecross.ca/idbl/load.do?reset=true
• SA details: https://www.ab.bluecross.ca/dbl/pdfs/ahwdbl_sec3.pdf
• PSo Form: https://www.ab.bluecross.ca/dbl/pdfs/60030.pdf
• PsA Form: https://www.ab.bluecross.ca/dbl/pdfs/60029.pdf

SK

• Formulary: https://formulary.drugplan.ehealthsask.ca/SearchFormulary/BG/455680
• SA details: https://formulary.drugplan.ehealthsask.ca/PDFs/APPENDIXA.pdf

MB

• Formulary https://web22.gov.mb.ca/eFormulary/
• EDS details: https://www.gov.mb.ca/health/mdbif/docs/edsnotice.pdf

ON

• Drug Formulary: https://www.formulary.health.gov.on.ca/formulary/
• SA details: https://health.gov.on.ca/en/pro/programs/drugs/docs/frequently_requested_drugs.pdf

QC

• Drug Formulary and SA details: https://www.ramq.gouv.qc.ca/sites/default/files/documents/liste_med_2022-02-02_en_0.pdf

NB

• Drug Formulary: https://www2.gnb.ca/content/dam/gnb/Departments/h-s/pdf/en/NBDrugPlan/NewBrunswickDrugPlansFormulary.pdf
• SA details: https://www2.gnb.ca/content/dam/gnb/Departments/h-s/pdf/en/NBDrugPlan/SpecialAuthorization/Special_Authorization_Criteria-e.pdf

PE 

• Drug Formulary: https://www.princeedwardisland.ca/sites/default/files/publications/pei_pharmpdf

NS

• Drug Formulary: https://novascotia.ca/dhw/pharmacare/documents/formulary.pdf
• Interchangeable Drug Products: https://novascotia.ca/dhw/pharmacare/new-interchangeable-products/interchangeable-products-2021.pdf
• ESC details: https://novascotia.ca/dhw/pharmacare/documents/Criteria-for-Exception-Status-Coverage.pdf

NL

• Drug Formulary:https://www.health.gonl.ca/health/prescription/coverage_status_table.pdf
• Interchangeable Drug Products: https://www.gov.nl.ca/hcs/files/nlpdp-formularyvol85.pdf
• Pso Form: https://www.gov.nl.ca/hcs/files/Chronic-Plaque-Psoriasis-Medications.pdf

YT

• Drug Formulary: https://ihs.gov.yk.ca/drugs/f?p=161:9000

NIHB

• Drug Benefit List (PDF): https://www.sac-isc.gc.ca/DAM/DAM-ISC-SAC/DAM-HLTH/STAGING/texte-text/nihb_benefits-services_drugs_dbl-index_1573pdf
• Drug Benefit List (Search Engine): https://nihb-ssna.express-scripts.ca/en/0205140506092019/16/160407