PharmaCare Tie-In Update
PharmaCare Tie-In Update
Prescription drug coverage for members in the Facilities Bargaining Association (FBA) are tied to B.C.’s PharmaCare program – a change negotiated in the last round of bargaining.
This change has been effective since June 1, 2013.
This means that if a drug is covered under PharmaCare, it’s covered under the FBA extended health care plan. If the drug is not covered under PharmaCare, then it’s not covered under the FBA plan.
B.C.’s PharmaCare program encourages the use of lower-priced, therapeutically-proven drugs as an alternative to unproven or more expensive drugs. It’s an approach that helps reduce the rapidly escalating costs of the FBA’s extended health care plan, while maintaining the integrity of members’ drug coverage.
- many drugs are automatically covered;
- other drugs are available to members only in certain circumstances, based on the member’s specific medical condition and needs. For a member to request full coverage of these drugs, their doctor will need to fill out a Special Authority Request; and
- some drugs are not covered in any circumstances, where PharmaCare has determined that the drug does not have a proven record of safety and effectiveness, or the drug is not the most cost-effective compared to other drugs already covered by PharmaCare to treat the same medical condition.
How are members affected by this change?
- If you already use a drug covered by PharmaCare, then you are not affected by this change.
- If you do not know if the drug you are taking is covered by PharmaCare, then you should check with your doctor or pharmacist. This information is also available on the PharmaCare website.
- If you are told that a drug is not available to you, then you should talk to your doctor or pharmacist about options. You may be eligible for your doctor to submit a Special Authority Request for full coverage. Any fees charged by a doctor for filling out these forms are covered by the FBA extended health care plan. If a Special Authority is not available or not approved for your drug, you can talk to your doctor about alternative therapies that are covered by PharmaCare.
The PharmaCare tie-in is the only change to members’ health benefits coverage. Pacific Blue Cross is still our provider and members’ continue to make claims in the same way as in the past.
If you have any questions about the PharmaCare tie-in please contact your local.