Manitoba Pharmacare publishes 33 drug-specific Exception Drug Status (EDS) request forms that walk prescribers through the coverage criteria for individual drugs or drug groups, such as Ajovy, Emgality, Vyepti and Qulipta, atopic dermatitis drugs, Entresto, Kerendia, and Praluent or Repatha. The EDS office approves coverage only when the patient meets criteria recommended by the Manitoba Drug Standards and Therapeutics Committee.
The prescriber completes each form, giving their licence number (not billing number), the patient's PHIN and Manitoba Health registration number, and the drug-specific criteria; some forms expect specialist involvement, such as a cardiac specialist's referral letter for Entresto.
Download the current version from the source each time; forms change without notice.
Drug-specific Exception Drug Status request forms
If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.
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The Pharmacare health professionals page lists 33, including Ajovy, Emgality, Vyepti and Qulipta; atopic dermatitis drugs; Entresto; Kerendia; Kesimpta, Mavenclad and Ocrevus; Nucala or Fasenra for asthma; oral anti-diabetic medications; Praluent and Repatha; Vascepa; and Vyndaqel or Vyndamax. The general EDS Request Form is used for other EDS drugs.
Yes, though some forms ask for specialist input. The Entresto form asks a family physician to attach the cardiac specialist's referral letter and to confirm that initiation and up-titration happen under a physician experienced in heart failure. The CGRP form asks whether a physician experienced in managing migraine is caring for the patient.
Manitoba's processing notice gives triage targets: 1 to 2 business days for urgent drugs such as antibiotics, 3 to 5 for priority drugs such as cancer and palliative care medications, and 5 to 10 business days for chronic conditions such as type 2 diabetes. The clock starts when a complete application arrives.