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. 

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

 

Published date: 
December 7, 2021
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General Inquiries

Health PEI
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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