provides clients registered First Nations and recognized Inuit with coverage for a range of health. Note: all Alias names should be registered by the client by contacting the The program maintains a formulary called the Drug benefit list which includes eligible drugs primarily used in a home or ambulatory setting. Providers will be notified of these exceptions. Any price that exceeds the maximum price requires specific and separate approval by NIHB.Prior approvals are entered electronically in the claims processing system. 3 1 New Chemical Entities New Combination Drug Products Existing Chemical Entities. Table of Contents,1 Background on NIHB Program iii. responsibility for the health of First Nations as shared amongst various levels of government the private.

9 Nutrition Supplement Formulary x,10 Drug Utilization Evaluation xi. Where opioids, benzodiazepines, gabapentin, pregabalin, stimulants and nabilone are prescribed to be dispensed for a longer duration as a single prescription, NIHB will reimburse up to a maximum of 30 days at a time. The prescriber is responsible for submitting the form to the Canada Vigilance program. F Exclusions vii,5 Policies viii, A Best Price Alternative and Interchangeability viii. and practical expert medical and pharmaceutical advice to the NIHB Program to promote. demonstrated , Long Acting Sustained Extended Release Products may be listed when . These recommendations are forwarded to participating drug plans, including the NIHB program, for consideration. 5 there is no suitable conventional dosage form s of the drug listed that is readily available .

The listed drugs are those primarily used in a home or ambulatory setting. 3 2 Line Extensions Generics and All Other Submissions. The listed drugs are those primarily used in a home or ambulatory setting.

NIHB may not necessarily reimburse at the cost listed in the provincial drug plan formulary.NIHB will consider reimbursement for a higher-cost interchangeable product when a patient has experienced an adverse reaction with a lower-cost alternative.

effectiveness or, 4 there is evidence that the long acting product is at least as cost effective as the best price. Prescribers include, but are not limited to, medical doctors, medical specialists, dentists, pharmacists, and nurse practitioners corresponding to respective provincial or territorial legislation and policies.Drugs considered for, or currently listed on, the Drug benefit list must meet the minimum criteria. processed as a benefit Practitioners are health professionals authorized to prescribe drugs within the. This should include:In the event a client loses their medication, a provider can use an intervention code to override a drug utilization review reject message for "fill too soon". additional cost or, 5 an improvement in compliance resulting in an increase in clinical effectiveness is. The dispensing frequency is at the discretion of the prescriber and pharmacist; however, compensation to the pharmacist under the NIHB program is based on program policies.No. A prescription from a licensed practitioner is required for any listed drug to be processed as a benefit. Introduction to NIHB Drug Benefit List Effective October 2019. following address , C o Director of Policy Development Pharmacy. the labeling of the drug and, 4 the cost is reduced or scientific evidence indicates that the advantages outweigh any. 4 Benefit Criteria v, A Drug Benefit Listings v, B Deletion Criteria vi. Any usual and customary dispensing fee exceeding the allowable maximum are not to be charged to NIHB clients.To be eligible for reimbursement, the following conditions must be met by all prescribers:In addition, the NIHB Program accepts client-specific written recommendations for Schedule The NIHB program requires providers to maintain documentation related to claims submitted as a result of a health professional’s recommendation. Prescriptions for opioids and benzodiazepines have a maximum 30-day supply. The program has introduced several strategies to monitor these medications which include: gradually reducing dose limits, the NIHB Client safety program (as described above), and reviewing the utilization of medications prescribed and dispensed for our clients.The following policies affect the benefits under which the NIHB program will reimburse pharmacy goods and services provided to eligible clients. These monitored drugs include: benzodiazepines, opioids, stimulants, gabapentin-pregabalin and nabilone. to listed drug products Significant changes include changes in DIN product. Appendix I New Listings H 1,Alphabetical Index of drug products I 1.

The DBL is updated regularly and published regularly. procedures for the CDR or pCODR process Inquiries should be directed to . The manufacturer will provide a statement indicating the rationale and evidence. Physicians and pharmacists can also use this list to select the most optimal and cost-effective drug therapy.

Introduction to NIHB Drug Benefit List Effective October 2019. the NIHB Drugs and Therapeutics Advisory Committee DTAC Generic drug products are.

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