Resource Database

PharmaCare Drug Coverage Decisions

Updated on July 31, 2024

PharmaCare considers a drug for coverage upon receiving a request by the drug’s manufacturer. After completing its review, PharmaCare will decide whether a drug will be a full benefit, a partial benefit, a limited coverage benefit (covered only if a patient meets specific criteria) or a non-benefit.

This page outlines:

  • how drug coverage decisions are made
  • how you can provide input into those decisions
  • why and when a coverage decision was made
  • whether PharmaCare covers a specific drug
  • how manufacturers can request that a drug be considered for PharmaCare coverage

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