High Cost Drug Program

If you need assistance paying for medications, you may be eligible for coverage of approved medication costs through the High Cost Drug Program.  

Am I eligible?

To be eligible for coverage and qualify for assistance according to your household income, you must:

• be a permanent resident of PEI as defined by the Drug Cost Assistance Act;
• have a valid PEI Health Card;
• have filed your most recent income tax return in PEI; and
• have been diagnosed with one of the following approved medical conditions:

Ankylosing Spondylitis:
If you have been diagnosed with moderate to severe ankylosing spondylitis, you may be eligible for coverage of approved medication costs.

Cancer:
You may be eligible for coverage of approved medication costs if you have been diagnosed with:

• chronic myelogenous leukemia;
• advanced/metastatic breast cancer;
• renal cell carcinoma; or
• metastatic colorectal cancer

Crohn’s Disease: 
You may be eligible for coverage of approved medication costs if you have been diagnosed with moderate to severe or fistulizing Crohn’s Disease.

Multiple Sclerosis:
You may be eligible for coverage of approved medication costs if you have been diagnosed with relapsing-remitting or progressive Multiple Sclerosis. Complete the High Cost Drug Program Application Form [PDF | 33 KB]. Your neurologist must complete your Multiple Sclerosis Medications Program Medical Screening Form [PDF |155 KB].

Plaque Psoriasis:
You may be eligible for coverage of approved medication costs if you have been diagnosed with Plaque Psoriasis.

Psoriatic Arthritis:
You may be eligible for coverage of approved medication costs if you have been diagnosed with Psoriatic Arthritis.

Pulmonary Hypertension:
You may be eligible for coverage of approved medication costs if you have been diagnosed with Pulmonary Hypertension.

Rheumatoid Arthritis:
You may be eligible for coverage of approved medication costs if you have been diagnosed with Rheumatoid Arthritis.

Wet Age-Related Macular Degeneration:
You may be eligible for coverage of approved medication costs if you have been diagnosed with Wet Age-Related Macular Degeneration.

How do I apply?

1. Submit a completed High Cost Drug Program Application form [PDF | 33 KB].  
2. Your physician or diagnosing specialist must submit a completed Special Authorization Request form, and any appropriate medical information on your behalf.
3. You must re-apply for coverage two months prior to your expiry date.
4. Your eligibility for coverage and level of co-payment will be confirmed in writing.

How much of the medication cost will be covered?

Your cost of the medication will depend on your household income. You must also pay a pharmacy professional fee, which may vary with each pharmacy. The remainder of the medication cost will be paid to the pharmacy directly.

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 fill your prescription at any community retail pharmacy located in Prince Edward Island. You will receive up to a 30-day supply of medication.

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. 

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