[Discussion] we are measuring province at the wrong time and calling it noise
The title is the argument: we are measuring province at the wrong time and calling it noise. Here is the rest of it.
Nothing here is medical or legal advice. The pharmacist and the prescriber are the people who can act, and both are faster than a forum.
Formulary criteria are revised, and plan renewal is a natural point at which a previously refused request may succeed without anything about the applicant changing.
Employer-sponsored plans have their own criteria and appeal processes, independent of the provincial formulary. Which one applies determines everything about the route.
Screenshot none of this. Read the whole thread, including the parts where I am told I am wrong.
best — the order this archive was captured in
National regulatory approval establishes that a product may be sold. Whether any plan pays for it is a separate decision, and public drug plans are administered provincially.
Spent three weeks on what turned out to be a quantity limit rather than a coverage question.
Cosigning on quantity limits. They stop as many people as outright denials do and get discussed far less.
That is an employer plan process, and the provincial route is different in both form and timeline.
Quantity limits restrict how much may be dispensed in a period even where coverage exists. They are a distinct barrier and require a distinct request.