Public drug programs provide drug coverage for a specific population. Federal, provincial and territorial governments offer many different drug programs, most of which have defined criteria for eligibility that include things like age, income, conditions or diseases, or drug costs.
This page gives you an overview of the programs available and their eligibility criteria. It helps you understand program differences so you can interpret data about drug use and spending, and make comparisons.
See the Formulary coverage page for details about the drugs included in each program’s formulary.
Note: An asterisk identifies programs that do not submit data to CIHI’s NPDUIS.
| Jurisdiction | Program group | Programs | Benefit information | Eligibility criteria |
|---|---|---|---|---|
| Ontario | High-cost/expensive drugs for rare diseases | Inherited Metabolic Diseases (IMD) Program * | Eligible outpatient drugs, supplements and specialty foods used in the treatment of specific inherited metabolic disorders |
Residents with a valid Ontario health card number who are under the care of a physician and have 1 of the disorders covered by the program. |
| Ontario | High-cost/expensive drugs for rare diseases | Special Drugs Program (SDP) | Eligible outpatient drugs used in the treatment of specific conditions |
Residents with a valid Ontario health card number who are under the care of a physician, have 1 of the covered conditions and who meet the clinical criteria. |
| Ontario | High-cost/expensive drugs for rare diseases | Trillium Drug Program (TDP) | Eligible high-cost prescription drugs |
Residents with a valid Ontario health card number who have high prescription drug costs relative to their household income; those who qualify for the Trillium Drug Program also qualify for the Ontario Drug Benefit Program. |
| Ontario | High-cost/expensive drugs for rare diseases | Visudyne Program | The drug verteporfin, used to treat age-related macular degeneration, pathologic myopia and presumed ocular histoplasmosis |
Residents with a valid Ontario health card number who are examined by an ophthalmologist participating in the program to confirm the need for treatment. |
| Ontario | Children’s drug plans | Ontario Drug Benefit Program (ODB) | Eligible prescription drugs |
Residents 65 years and older, residents of long-term care homes, residents age 24 and under who are not covered by a private insurance plan and residents receiving social assistance through Ontario Works or the Ontario Disability Support Program. |
| Ontario | Disease management, control and prevention | Respiratory Syncytial Virus (RSV) prevention programs* | The drug palivizumab |
Residents with a valid Ontario health card number who are younger than 2 years of age during the active RSV (respiratory syncytial) season and who are at high risk for RSV disease. |
| Manitoba | Seniors | Manitoba Pharmacare Program | Eligible prescription drugs and medical supplies |
Residents who do not have prescription drug coverage through other provincial or federal programs; eligibility is not restricted by age and coverage is based on factors such as income, family size and prescription drug costs. |
| Manitoba | Low-income | Employment and Income Assistance | Eligible prescription drugs, health-related supplies or equipment not covered by other programs |
Residents in financial need; eligibility is based on factors such as income, family size and essential needs. |
| Manitoba | Long-term care | Personal Care Home Drug Program | Eligible prescription drugs for individuals who can no longer remain safely at home because of a disability or their health care needs |
Residents of a nursing home or long-term care facility. |
| Manitoba | Children’s drug plans | Manitoba Pharmacare Program | Eligible prescription drugs and medical supplies |
Residents who do not have prescription drug coverage through other provincial or federal programs; eligibility is not restricted by age and coverage is based on factors such as income, family size and prescription drug costs. |