Pacific Blue Cross: New Prior Authorization Program

Pacific Blue Cross (PBC) has just announced that they will be implementing a Prior Authorization Program for High Cost Drugs starting April 18, 2016. To start, three classes of drugs will be part of this program:

  1. PCK9 Inhibitors – a biologic drug used to treat high cholesterol and costs approximately $7,000 per year
  2. Hepatitis C drugs – these new treatments for Hepatitis C are considered cures in virtually all patients and cost approximately $50,000 to $130,000 per patient (8-12 week treatment)
  3. Botulinum Toxins (Botox and Xeomin) – doctors will need to complete a prior authorization form to ensure that only Health Canada approved conditions are being treated

For your convenience, a PDF copy of the announcement has been attached below.
Prior Authorization Program for High Cost Drugs bulletin March 2016