The Individual Clinical Review process is being phased out and a more streamlined Exceptional Access Program has been created to handle requests for drugs that are not listed in the Formulary.

The ministry's Exceptional Access Program is a comprehensive approach to help patients access medications where formulary drugs were ineffective, not tolerated and there is no alternative available on the Ontario Formulary. This new program ensures appropriate prescribing based on cost-effective, evidence-based care. It also minimizes the impact on prescribers and will make the process more transparent to prescribers and patients.

Pursuant to section 15 of O.Reg. 201/96 made under the Ontario Drug Benefit Act (ODBA), the Executive Officer (EO) has entered into agreements with manufacturers to establish Drug Benefit Prices (DBPs) for products reimbursed under the Exceptional Access Program (EAP).

For the following products reimbursed under the EAP, the Health Network System (HNS) will adjudicate claims at the DBP listed below.

Until further notice, for all other products reimbursed under the EAP, pharmacists will continue to be reimbursed their acquisition cost plus the applicable markup (currently 8%).