In partnership with the Government of Canada, effective May 1st, 2025, the National Pharmacare Program provides coverage for certain diabetes medications and contraceptives, and expands access to 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; and
- have a valid PEI Health Card; and
- take medication that is included in the list of drugs covered by the National Pharmacare program (see below).
How do I apply?
There is no application process for medication coverage with the exception of blood glucose test strips. You are automatically included in the National Pharmacare Program if you meet the above eligibility criteria.
For coverage of blood glucose test strips, you must enroll in the Diabetes Drug Program. More information about expanded coverage of blood glucose test strips can be found below.
How much will I have to pay for my medication?
Medications included in the National Pharmacare Program will be available at no cost. Some medications in the National Pharmacare Program are approved on a special authorization basis only. Please refer to the PEI Pharmacare Formulary for more information about special authorization criteria.
If you choose to access a brand medication where there is a generic product available, you will be responsible for paying the difference in cost between the brand medication and price paid by the government for the least expensive generic medication.
Diabetes medications:
|
Drug/related product categories |
Conditions of coverage (Open benefit unless otherwise specified) |
|
fast-acting insulin (Humulin-R, Novolin GE Toronto, Entuzity) |
Special authorization access for Entuzity |
|
fast-acting insulin lispro (Admelog) |
|
|
fast-acting insulin aspart (Kirsty, Trurapi) |
|
|
fast-acting insulin glulisine (Apidra) |
|
|
intermediate-acting insulin (Humulin-N, Novolin GE NPH) |
|
|
intermediate or long-acting combined with fast-acting insulin (Humulin 30/70, Novolin GE 30/70, Humalog Mix 25) |
|
|
long-acting insulin glargine (Basaglar, Semglee, Toujeo, Toujeo Double star) |
Special authorization access for Toujeo and Toujeo Doublestar |
|
long-acting insulin detemir (Levemir) |
Special authorization access |
|
long-acting insulin degludec (Tresiba) |
|
|
metformin (Glucophage and generics) |
Includes immediate-release metformin only. If requesting brand name Glucophage, residents may be responsible for a portion of costs; other listed metformin products are available at zero cost. |
|
glyburide |
|
|
gliclazide (Diamicron MR and generics) |
If requesting brand name Diamicron MR, residents may be responsible for a portion of costs; other listed gliclazide products are available at zero cost. |
|
saxagliptin and metformin (Komboglyze) |
|
|
empagliflozin and metformin (Synjardy) |
|
|
linagliptin and metformin (Jentadueto) |
|
|
Dapagliflozin (Forxiga and generics) |
If requesting brand name Forxiga, residents may be responsible for a portion of costs; other listed dapagliflozin products are available at zero cost. |
|
|
Contraceptives:
|
Drug/related product categories |
Conditions of coverage (Open benefit unless otherwise specified) |
|
levonorgestrel and ethinylestradiol (Alesse, Min-Ovral and generics) |
If requesting brand name Alesse or Min-Ovral, residents may be responsible for a portion of costs; other listed levonorgestrel and ethinylestradiol products are available at zero cost. |
|
desogestrel and ethinylestradiol (Marvelon and generics) |
If requesting brand name Marvelon, residents may be responsible for a portion of costs; other listed desogestrel and ethinylestradiol products are available at zero cost. |
|
drospierenone and ethinylestradiol (Yasmin and generics) |
If requesting brand name Yasmin, residents may be responsible for a portion of costs; other listed drospierenone and ethinylestradiol products are available at zero cost. |
|
norethisterone and ethinylestradiol |
|
|
levonorgestrel and ethinylestradiol |
|
|
norethisterone and ethinylestradiol |
|
|
norgestimate and ethinylestradiol |
|
|
norethisterone |
|
|
Medroxyprogesterone (Depo-Provera) |
|
|
etonogestrel |
|
|
Levonorgestrel (Plan B and generic) |
If requesting brand name Plan B, residents may be responsible for a portion of costs; other listed levonorgestrel products are available at zero cost. |
|
plastic IUD with copper |
|
|
plastic IUD with progestogen |
|
|
vaginal ring with progestrogen and estrogen (Nuvaring and generic) |
If requesting brand name Nuvaring, residents may be responsible for a portion of costs; other listed vaginal rings with progestrogen and estrogen products are available at zero cost. |
What if my medication is not listed on the National Pharmacare list of drugs?
If your medication is not included in the National Pharmacare Program list of drugs, it will not be eligible for coverage through the National Pharmacare Program.
Diabetes medications and contraceptives that are not included in the National Pharmacare Program drug list but are currently included in the PEI Pharmacare Formulary, will continue to be available through PEI Pharmacare drug programs.
What if I have private insurance?
The costs of contraceptives and diabetes medications included in the National Pharmacare Program will be paid for publicly. This means you won’t need to coordinate benefits for covered products with private insurance plans (exception: blood glucose test strips, see Blood Glucose Test Strips section below for more details).
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 purchased before May 1, 2025.
Will my medications be eligible for coverage if they are filled at an out-of-province pharmacy?
No, your medications will not be eligible for coverage if they are filled at an out-of-province 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. If you re-locate to another Canadian province which has a National Pharmacare Program, you must meet the eligibility criteria for that province.
Blood Glucose Test Strips
As part of the National Pharmacare Program, islanders taking non-insulin diabetes medications for diabetes can now receive coverage for blood glucose test strips.
To qualify for coverage of blood glucose test strips, you must be enrolled in the PEI Pharmacare Diabetes Drug Program.
Under the current co-pay schedule for the Diabetes Drug Program, you will pay the following:
- $11.00 per prescription for 100 test strips
- If you are taking insulin, you can access 100 test strips up to every 25 days
- If you are taking a non-insulin diabetes medication that has a lower risk of causing hypoglycemia (low-blood sugar), you can access a maximum of 200 strips annually.
- If you are taking a non-insulin diabetes medication that has a higher risk of causing hypoglycemia (low blood sugars) (i.e. a sulfonylurea (glyburide, gliclazide, glimepiride) or repaglinide), you can access a maximum of 300 strips annually.
- If you have private health insurance, a prescription for the test strips may be required to submit to your insurance, thereby reducing your co-pay to $2.20 or less ( depending on the level of coverage within you health insurance plan).
Please see the Diabetes Drug Program information page for additional details about this program.
For more information
See National Pharmacare Q&A Residents.pdf
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