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NIHB Exception Drugs Request Form for Prescribers

The Non-Insured Health Benefits program can cover a drug that is not on its Drug Benefit List for a First Nations or Inuit client when the licensed prescriber completes this request. It arises after the pharmacy contacts the NIHB Drug Exception Centre about a prescription needing prior approval. Approval depends on clinical justification, since personal preference alone does not justify an exception.

Who completes it

The licensed prescriber completes the whole request with the clinical justification; the pharmacy provider starts it with the Drug Exception Centre and receives the confirmation letter if it is approved.

Submitting and payment

How to submit it
The pharmacy contacts the Drug Exception Centre, which may fax the request form to the prescriber to complete and return; pharmacies can also submit prior approval requests through their NIHB web account.

Good to know

  • Approval grounds include a recognized indication and dose backed by published evidence, significant evidence of superiority, alternatives that are ineffective or contraindicated, or an adverse reaction to the best-price alternative.
  • For a higher-cost interchangeable product after a reaction, the prescriber must also submit a signed Side Effect Reporting Form to Canada Vigilance and write 'No substitution' on the prescription.
  • Verbal 'no substitution' authorizations are not accepted, but the side effect form does not need resubmitting when the same drug is renewed.
  • Review time depends on how quickly the prescriber supplies the required information; the confirmation letter with the approval period goes to the pharmacy provider.

Get the official form

Download the current version from the source each time; forms change without notice.

Exception Drugs Request Form (NIHB)

Official page

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How this list is checked

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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Frequently asked questions

What justifies an NIHB exception drug approval?

The NIHB Pharmacy Benefits Guide lists situations such as a recognized indication and dose supported by published evidence or authoritative opinion, significant evidence the drug is superior to listed benefits, ineffective or contraindicated alternatives, or an adverse reaction to the best-price alternative. Personal preference alone does not justify coverage.

Can I download the NIHB Exception Drugs Request Form?

NIHB does not publish it as a public download. When a pharmacy contacts the Drug Exception Centre about a drug that needs prior approval, the Centre may fax an Exception or Limited Use Benefit Request Form to the prescriber to complete and send back.

How long does an NIHB exception request take?

The guide gives no fixed timeline: review time depends on how quickly the prescriber provides the required information, and a Drug Exception Centre representative may contact the provider for more. Once approved, a confirmation letter outlining the approval period is faxed or mailed to the provider.