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Ministry Status: Activation Status

OHIP+: Children and Youth Pharmacare

OHIP+ Stakeholder E–blast

Patients First

Update: OHIP+ Children and Youth Pharmacare Program

December 13, 2017

Colleagues,

We are pleased to share this update on OHIP+: Children and Youth Pharmacare (OHIP+) with you.
You can count on regular emails like this as your source of ongoing information and updates on OHIP+.  We encourage you to share them with staff members, local stakeholders and other clinicians, and colleagues.

OHIP+ Exceptional Access Program (EAP) Streamlined Request Submission Process

Following the e-blast on October 12, 2017 regarding the EAP streamlined request submission process for eligible OHIP+ recipients, the ministry has received a number of streamlined requests. We appreciate the effort prescribers are making to submit these requests on behalf of their patients before the launch of OHIP+ on January 1, 2018.

We are pleased to inform you that additional medications have been added to the streamlined request form. This streamlined form is intended to transition Ontarians age 24 years and under who are OHIP insured and who have been stabilized on certain medications that require an EAP assessment.

The form has been developed for the medications listed below only:

  • Alcohol Addiction Therapy (acamprosate, naltrexone)
  • Alfacalcidol (drops)
  • Atomoxetine
  • Betahistine
  • Buspirone
  • Cabergoline
  • Colchicine
  • Cortisone acetate (tablet)
  • Dornase alfa
  • Hormone Therapy (conjugated estrogen, estradiol, progesterone, testosterone)
  • Iron dextran or iron sucrose
  • Ketotifen
  • Lamotrigine (chew)
  • Levocarnitine
  • Lithium carbonate ER
  • Metoclopramide (liquid)
  • Modafinil
  • Multiple Sclerosis Therapy (Aubagio, Avonex, Betaseron, Copaxone, Extavia, Rebif, Tecfidera)
  • Mycophenolate mofetil
  • Ondansetron
  • Oxcarbazepine
  • Phenobarbital
  • Phytonadione & Multivitamin (injections)
  • Pinaverium
  • Prochlorperazine (suppository)
  • Sodium Bicarbonate
  • Somatropin
  • Tranexamic acid
  • Triptans (almotriptan, naratriptan, rizatriptan, sumatriptan)
  • Valacyclovir
  • Vigabatrin (sachet)

If the medication you are requesting is not listed above, a full EAP request form can be accessed from the streamlined form by selecting “other” in the drop down menu.

Prescribers can and are encouraged to submit the form before January 1, 2018. The form is available at: www.forms.ssb.gov.on.ca/

Form Number: 014-5067-87E

Title: OHIP+ Eligible Recipient Request for an Unlisted Drug - Exceptional Access Program

There are three ways to submit the OHIP+ EAP Streamlined Request Form:

  1. Fill it out electronically, and then print and fax it to 1-844-227-6590.
  2. Select a drug from the form’s drop down menu and complete the form by hand. Once the form is completed, fax the form to 1-844-227-6590.
  3. Mail it to Ontario Public Drug Programs at:
    Ontario Public Drug Programs
    Drug Programs Delivery Branch
    3rd Floor, 5700 Yonge Street
    Toronto, ON  M2M 4K5

It cannot be used for children and youth who are starting a new drug therapy after January 1, 2018 that requires an EAP assessment. 

EAP Medications

The ministry continues to work closely with clinicians and other stakeholder groups to respond to feedback raised regarding OHIP+. Many clinicians have been requesting the EAP medication list. The ministry is pleased to provide the attached EAP list that represents drugs that have been considered for EAP funding recently to help guide the EAP request process.

In addition to the attached list, we encourage you to visit our website which has EAP Reimbursement Criteria for Frequently Requested Drugs.

www.health.gov.on.ca/en/pro/programs/drugs/pdf/frequently_requested_drugs.pdf

If you are unable to find the information that you require regarding an EAP request, please contact Ontario Public Drug Programs:

E-mail: EAPFeedback.MOH@ontario.ca
Phone: 416-327-8109 or 1-866-811-9893
Fax: 416-327-7526 or 1-866-811-9908
http://health.gov.on.ca/en/pro/programs/drugs/eap_mn.aspx

More details on OHIP+ will continue to be provided. We welcome any comments, feedback or advice that you may have regarding OHIP+ and its implementation. 

Webinars

We will be hosting weekly webinars to provide an overview of OHIP+ and the process to submit EAP requests, as well as to answer questions.  Webinars will be held each week on Thursdays from 12:00-1:00 PM. 

Please join us for our next webinar on December 14 from 12:00-1:00 PM. Click on the link below to access the webinar. 

https://ali.health.gov.on.ca/ohipplusedec14/

More Updates Coming

You can expect regular updates like this as we move forward.

Please Stay in Touch

Visit us online at www.ontario.ca/OHIPplus

OHIP+: Information for Professionals: http://www.health.gov.on.ca/en/pro/programs/drugs/ohipplus/

To automatically receive these updates, join our mailing list by emailing OHIPplus@ontario.ca
This document is available in alternate formats upon request.


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