Diabetes Drug Program

Effective May 1, 2025, many insulin products and oral diabetes medications are eligible for full coverage under the National Pharmacare Program (NPP); see National Pharmacare Program for more information.

If you have been diagnosed with diabetes, you may be eligible for coverage of approved medications which are not eligible under NPP, as well as supplies (urine-testing materials and blood glucose test strips), through the Diabetes Drug Program.
 
The Diabetes Drug Program provides assistance toward the cost of approved medications not eligible under NPP, and supplies including urine-testing materials, and blood glucose test strips.

Am I eligible?

You are eligible for the program if you:

• are a PEI resident as defined by the Drug Cost Assistance Act;
• have a valid PEI Health Card; and
• have been diagnosed with diabetes

How do I apply?

Your physician, nurse practitioner or other health care provider must complete a Referral Form [PDF | 112 KB] to request registration into the Diabetes Drug Program.   

How much will I have to pay for my approved medication that is not eligible in the National Pharmacare Program?

Your coverage will begin when PEI Pharmacare receives your Referral Form. Under the current co-pay schedule, you will pay the following:

• $10.00/10 mL vial or $20.00/5 x 3 mL cartridges of insulin. As part of Prescription Care, copays for eligible medications (identified in the formulary with ⑤) will be $5 per vial or cartridge.
• $11.00 per oral medication prescription. As part of Prescription Care, copays for eligible medications (identified in the formulary with ⑤) will be $5 per prescription.
• $11.00 per prescription for 100 test strips every 25 days (if you have taken insulin within the past 5 months).
• $11.00 per prescription for 100 test strips if you take a diabetes medication with a high risk of causing hypoglycemia, to a maximum of 300 strips in 12 months
• $11.00 per prescription for 100 test strips if you take a diabetes medication with a low risk of causing hypoglycemia, to a maximum of 200 strips in 12 months
• $5.00 per glucagon device (maximum of 2 per year if you have taken insulin within the past 5 months).
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You may qualify for the Insulin Pump Program or the Glucose Sensor Program.

What if my medication is not listed in the PEI Pharmacare Formulary?

Some medications in the PEI Pharmacare Formulary are approved on a special authorization basis only. If your authorized prescriber prescribes a drug in this category, they can submit a Standard Special Authorization Request form  [PDF | 34 KB] to have a medication considered for coverage.

If your medication is not included in the PEI Pharmacare Formulary, it will not be eligible for coverage.  

What if I have private insurance?

You or your pharmacy must submit all claims to your private insurer first. The remaining out-of-pocket eligible expense can then be submitted to PEI Pharmacare for assessment.

Where can I get my medication?

You can have your prescription filled at any community retail pharmacy located in Prince Edward Island.

Will I get a refund for medication I already purchased?

Coverage is not retroactive, you will not be reimbursed for medications you have already purchased.

Will my medications be eligible for coverage if they are filled at an out of province pharmacy?

Claims are eligible for manual submission only if the  medication or any formulation of the medication cannot be dispensed through a PEI pharmacy.

What if I move away from PEI?

Your eligibility for this program will end the day you leave PEI to take up residency elsewhere.

How can I contact PEI Pharmacare?

PEI Pharmacare 
16 Fitzroy Street
Sullivan Building
Charlottetown, PE   C1A 7N8

Telephone: (902) 368-4947 
Toll free: 1-877-577-3737