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:

You may be eligible for coverage for approved medication costs for several medical conditions, including but not limited to:

  • Ankylosing Spondylitis;
  • Cancer;​​​​
  • Crohn's Disease;
  • Multiple Sclerosis;
  • Plaque Psoriasis;
  • Pulmonary Hypertension;
  • Psoriatic Arthritis;
  • Rheumatoid Arthritis; and
  • Wet Age-Related Macular Degeneration

If your medical condition is:

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 Special Authorization Request Form [PDF |155 KB].

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

 

Published date: 
December 7, 2021
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General Inquiries

Health PEI
16 Garfield Street
PO Box 2000
Charlottetown, PE   C1A 7N8

Phone: 902-368-6130
Fax: 902-368-6136

healthpei@gov.pe.ca

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If you are unsure what to do about a health issue or if you need health information, call 8-1-1.

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