Limited Use (LU) products are drugs that are listed in the Ontario Drug Benefit (ODB) Formulary/ Comparative Drug Index (Formulary) with specific LU clinical criteria or conditions for use.  Products are listed as LU drugs in the Formulary.  Generally drug products are recommended for LU status when there are specific circumstances where use is particularly beneficial.

The ODB program reimburses LU drug products only when prescribed for an ODB-eligible recipient according to criteria or conditions outlined for each LU product in the Formulary.  A searchable electronic Formulary is available to outline these criteria.

A physician must confirm that the patient meets the clinical criteria by writing the appropriate numerical LU code on a prescription. The patient takes the prescription to the pharmacist who will review the LU prescription and process the claim only if all the required information is provided and signed by the physician. Certain LU drugs used in chronic conditions have been granted extended authorization periods. During the authorization period, any repeat prescription may be given verbally to a pharmacist as long as a valid LU prescription is on file at the pharmacy.

In cases where an ODB-eligible patient does not meet the listed LU criteria, the patient’s physician can make a written request for funding consideration through the Exceptional Access Program (EAP).  To assist physicians applying to the EAP, the ministry has developed a standard form for EAP requests.