First Nations and Inuit clients of the Non-Insured Health Benefits program who need end-of-life care can get a list of supplemental drug benefits that are not on the NIHB Drug Benefit List. Once the Drug Exception Centre learns of the need, it generates this application and faxes it to the prescriber. Approval gives the client six months of coverage without further prior approval.
The prescriber completes the application after the Drug Exception Centre generates and faxes it; there is no public version to download in advance.
Download the current version from the source each time; forms change without notice.
End-of-life care formulary application form (NIHB)
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There is no public download. The NIHB Pharmacy Benefits Guide says the application is generated by the Drug Exception Centre and faxed to the prescriber once the Centre is informed that a client needs end-of-life care. The prescriber then completes and returns it.
Approved clients are eligible for six months without further prior approval. An additional six months may be granted when the Drug Exception Centre receives a new application form, according to section 2.8 of the NIHB Pharmacy Benefits Guide.
Yes, in a limited way. For clients awaiting approval, NIHB pharmacy providers may dispense an initial emergency course of treatment of up to a 14-day supply, according to the NIHB Pharmacy Benefits Guide.