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The active ingredient is the chemical that makes the drug work.
Biologic drugs, and Biosimilar drugs
A biologic drug is a drug that is made using human or animal tissue or micro-organisms. Biologics are generally larger and more complex than traditional chemically produced drugs.
Copies of biologic drugs are called biosimilars, or subsequent entry biologics (SEBs). Biosimilars are not exact copies of the original biologic and are not considered generic drugs. However, they are highly similar to a biologic drug, and have the same efficacy and safety as an approved biologic.
Brand name drug
A pharmaceutical company must spend many years studying a new brand name drug before it can be approved for sale in Canada. Essentially a brand name drug is the first version of the drug to be sold within a country. A brand name drug must be approved by Health Canada before it can be sold on the market.
The company that first researched and developed the drug holds a patent on the drug so that no other company is allowed to sell it. When the patent expires, other companies are allowed to make copies of the drug.
A co-pay is the percentage of the cost of the prescription that you pay for your drug. Let's say the co-pay for a drug is 20%. This means you will pay 20% of the cost of your prescription — and your drug plan will cover the remaining 80% of the cost. In other words, if the drug costs $100 at the pharmacy, you would pay 20%, or $20. Your drug plan would pay 80%, or $80. In the Reformulary, there are three different co-pay levels or 'tiers'.
A Drug Identification Number (DIN) is an eight-digit number located on the labels of drug products authorized for sale in Canada.
A drug class is a group of drugs that have something in common. They are similar in some way, but not identical. Drugs in the same drug class may have similar chemical structures, they may work the same way, and they are used for the same purpose – that is, to treat the same medical condition.
DrugFinder™ is a search tool for the Reformulary, an evidence-based list of drugs that relies on the trusted advice of an independent panel of doctors and pharmacists. Our panel reviews massive amounts of research and evidence about thousands of drugs, and recommends drugs based on how well they work (clinical effectiveness) and how much they cost (cost-effectiveness).
A formulary is a list of drugs covered by an employer, through its extended health plan, or through a publicly funded drug plan such as BC Fair PharmaCare or the Ontario Drug Benefit Program.
Generic drugs are copies of brand-name drugs. Generic drugs are "bioequivalent", which is a pharmaceutical term that essentially means that a generic drug has a similar clinical effectiveness as the brand drug, and is safe and similarly effective at treating a medical condition. Generic drugs have the same active ingredient, the same amount of active ingredient, and work the same way in the body as brand name drugs.
Like brand drugs, generics are approved by Health Canada before they can be sold on the market.
Grandfathering means the old rules will apply for a specific period of time. After the grandfathering period is over, the new rules kick in and the amount you pay for the drug will likely increase. Some drugs are grandfathered indefinitely.
The Reformulary includes both preferred and non-preferred drugs. Non-preferred drugs are reviewed by our expert panel and characterized as providing a 'less-good' (poorer) combination of clinical effectiveness (how well they work) and cost-effectiveness (how much they cost). Non-preferred drugs on the Reformulary include both brand and generic drugs.
If you are taking a non-preferred drug, search DrugFinder to look up the preferred alternatives.
Over-the-counter (OTC) drug
Over-the-counter (OTC) drugs do not require a doctor's prescription, and can be bought off the shelves – or over-the-counter – in stores.
The Reformulary includes both preferred and non-preferred drugs. Preferred drugs are recommended by our expert panel as providing the best combination of clinical effectiveness (how well they work) and cost-effectiveness (how much they cost). Preferred drugs on the Reformulary include both brand and generic drugs.
For some drugs, there is a limit on how much of the drug The Reformulary will cover. This is called 'quantity limits'. For example, based on treatment guidelines, a drug may have a quantity limit of 1 pill per day for 35 days. Not all drugs on The Reformulary have quantity limits.
The Reformulary® is an evidence-based list of drugs that relies on the trusted advice of an independent panel of doctors and pharmacists. Our panel reviews massive amounts of research and evidence about thousands of drugs, and recommends drugs based on how well they work (clinical effectiveness) and how much they cost (cost-effectiveness). DrugFinder is a digital tool to search the Reformulary – it provides built-in advice to help Canadians make smart drug choices.
Each tier has a different reimbursement level. The reimbursement level determines how much your employer pays for a drug covered under your plan. Drugs on the Reformulary are reimbursed according to whether they are on tier 1 (preferred drugs), or tier 2 or 3 (non-preferred drugs).
Certain drugs on the Reformulary require Special Authorization (SA) to be eligible for coverage.
To request coverage, you and your doctor need to fill out a SA request form and provide a well-documented medical reason why you need to take the SA drug. You will then need to submit the request to your insurance company or plan administrator.
Drugs are placed on tiers – or levels – based on healthcare value. Preferred drugs are on tier 1, and include drugs that provide the best combination of clinical effectiveness (how well the drug works) and cost-effectiveness (how much the drug costs).
Non-preferred drugs are on tier 2 or tier 3, and include drugs that provide a 'less-good' (poorer) combination of clinical effectiveness and cost-effectiveness.
Drugs on the Reformulary are reimbursed according to whether they are on tier 1 (preferred drugs), or tier 2 or 3 (non-preferred drugs).
What is evidence
The term evidence refers to the available clinical data related to the efficacy, safety, tolerability, adverse events of a drug, as well as the cost of the drug compared to the clinical benefit.
Our expert panel relies on evidence from clinical trials studying the drug, as well as independent reviews by expert organizations around the world, including the Common Drug Review. Using the evidence, our panel conducts a rigorous and thorough review of each drug compared to other drugs used to treat the same medical condition.
Our drug review process has an international patent pending.