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Mrs. T, a senior citizen, has been prescribed a generic medication from the provincial drug benefit ...

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Mrs. T, a senior citizen, has been prescribed a generic medication from the provincial drug benefit ...

Mrs. T, a senior citizen, has been prescribed a generic medication from the provincial drug benefit formulary. It is not managing her pain and makes her feel sick and lethargic. Previously she was using a brand name medication with good results and fewer side effects, but it was not listed in the drug benefit formulary and so was not paid for by the plan. How can the doctor attempt to get the more effective drug paid for by the provincial drug benefits plan when it is not on the list of selected drugs covered by the drug benefit plan?
a.   The doctor can call the pharmacy and explain the situation.
b.   The doctor can call the Ministry of Health and demand they allow the client the use of the best drug.
c.   The doctor can submit a limited-use form for some drugs or write a letter and submit a different form for other drugs.
d.   The doctor can call the local media and put out a public call for help in funding the more effective drug.

Textbook

Administrative and Clinical Procedures for the Canadian Health Professional

Edition: 4^th

Author: Thompson

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