Drugs and pharmacy benefits
Find information about coverage for prescription drugs and over-the-counter products under the Non-Insured Health Benefits (NIHB) program.
On this page
About drugs and pharmacy benefits
The program covers prescription and over-the-counter medications that are:
- included on the NIHB drug benefit list, including benefits that are:
- open, which do not require prior approval
- limited use, which may be eligible for coverage if the criteria for coverage are met
- prescribed by an NIHB recognized health professional, such as a physician
Exception drugs are not listed in the drug benefit list but may be approved in special circumstances.
The program provides eligible clients with coverage for benefits not otherwise available under federal, provincial, territorial or private health insurance.
Drug benefit list
The Drug Benefit List is a listing of the drugs provided as a benefit by the Non-Insured Health Benefits (NIHB) Program. The listed drugs are those primarily used in a home or ambulatory setting.
The NIHB Drug Benefit list is available online by visiting Express Scripts Canada's NIHB claims processing site. Once at the page, select EN : English or FR : French at the top of the page to select the language. Express Scripts Canada provides claims processing and related services under contract to Indigenous Services Canada.
The purpose of the Drug Benefit List is to:
- indicate which drug products are eligible benefits
- provide a tool for physicians and pharmacists that encourages the selection of optimal, cost-effective drug therapy
The online Drug Benefit List is updated daily. It is easy to search using the brand or chemical name of the medication.
The PDF version of the Drug Benefit List, which links from this page, does not contain the most recent information, and will be archived. In its place, Express Scripts Canada will be making a printable version available on their website as a companion to the online version.
The information contained in the Non-Insured Health Benefits Drug Benefit List requires knowledgeable interpretation and is intended primarily for professional health care practitioners, pharmacies, hospitals and organizations associated with the manufacture, distribution and use of pharmaceutical preparations.
How to access drugs and pharmacy benefits
You can access the drugs and pharmacy benefits from a licensed pharmacy.
A prescription from a licensed practitioner is required for any listed drug to be processed as a benefit. Practitioners are those people authorized to prescribe drugs within the scope of practice in their province or territory.
Providers who are enrolled in the program generally send in claims to bill the program directly. This means you do not have to pay a deductible or co-payment. You will need to show client identification in order for providers to bill the program directly.
Express Scripts Canada administers claims on behalf of the program.