Formulary coverage

A formulary is a list of the drugs covered for eligible populations, and the type of coverage provided. Every public drug program in Canada has a unique formulary.

This page gives you details about the drugs included in each program’s formulary. It helps you understand program differences so you can interpret data about drug use and spending, and make comparisons.

Interactive data

View the list by jurisdiction, program/plan or drug. Search for a drug by entering a drug identification number (DIN), chemical, brand name, or anatomical therapeutic chemical (ATC) code or description. Definitions for all the data elements are below the table.

Learn more about how to use this tool. Definitions for all the data elements are below the table.

The downloadable data file includes additional data (e.g., active ingredient, ATC descriptions). Download an accessible version of the interactive data from the Accessible data table section below.

Data element definitions

  • active ingredient: Any component that has medicinal properties and that supplies pharmacological activity or other direct effect in the diagnosis, cure, mitigation, treatment or prevention of disease, or that affects the structure or any function of the body. The active ingredient is as reported in Health Canada’s Drug Product Database.
  • ATC4 code/ATC5 code: Anatomical therapeutic chemical code defined by the World Health Organization. It divides the active substances in drugs into different groups according to the organ or system on which they act and their therapeutic, pharmacological and chemical properties. Health Canada assigns ATC codes to products. ATC level 4 codes represent chemical/pharmacological/therapeutic subgroups, while ATC level 5 codes represent chemical substances.
  • benefit status: Identifies the type of drug benefit coverage:
    • benefit: Drugs included as regular benefits in a program that don’t require patient-specific justification to receive reimbursement.
    • limited: Drugs included in a program that require regular (automated) adjudication processes against a set of specific published criteria (coded by either the prescriber or the pharmacy/service provider).
    • restricted: Drugs included in a program that require the prescriber to complete a formal request for coverage for a patient. The program reviews and then approves or denies the request against a set of specific published criteria.
  • brand name: Commercial name of the drug.
  • coverage end date: The date on which a program’s given combination of coverage attributes was removed for a DIN/PDIN. If the field is blank, the coverage remains effective as of the start date.
  • coverage start date: The date on which a program’s given combination of coverage attributes became effective for a DIN/PDIN.
  • DIN: A drug identification number (DIN) that Health Canada assigns to uniquely identify drug products sold in a dosage form in Canada. It’s specific to a manufacturer, product name, active ingredient(s), strength(s) of active ingredient(s) and pharmaceutical form.
  • DIN market date: The date when the drug product first entered the Canadian market.
  • drug type: Identifies whether a DIN is for a brand name, generic or biologic drug.
  • PDIN flag: A flag to identify the pseudo-drug identification number (PDIN) that programs assign to a drug or product they cover when Health Canada has not assigned it a DIN. Programs typically do this to identify non-drug benefits (e.g., diabetes supplies) and to differentiate benefits based on package size or covered indication (e.g., methadone for substance use treatment versus for pain control).

Accessible data table

Download full formulary data in XLSX format.

Download data table(XLSX)

 
 

How to cite:

Canadian Institute for Health Information. Formulary coverage. Accessed April 28, 2024.

If you have a disability and would like CIHI information in a different format, visit our Accessibility page.