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Ontario Health Insurance Plan

OHIP Bulletins


Physician Services InfoBulletins

Keeping Health Care Providers informed of payment, policy or program changes

To:  Prescribers with the Authority to Prescribe Controlled Substances

Published by:  Ontario Public Drug Programs

Date Issued:  January 25, 2017

Bulletin Number:  4691

Re:  Reminder regarding delisting of high-strength long-acting opioids under the Ontario Drug Benefit program

Posted Electronically Only

PDF Version Portable Document Format | 180 Kb

This is a reminder that as communicated in Bulletin #4675 and subsequently Bulletin #4682, the following products will be delisted from the Ontario Drug Benefit (ODB) Formulary/Comparative Drug Index effective with the January 2017 ODB Formulary update:

  • Higher strengths of long-acting opioids, including:
    • Morphine SR 200 mg tablets;
    • Hydromorphone CR 24 mg and 30 mg capsules;
    • Fentanyl 75 mcg/hr and 100 mcg/hr patches; and
  • Meperidine 50 mg tablets.

The January 2017 ODB Formulary update will take effect Tuesday, January 31, 2017.

Prescribers are reminded that lower-strength, long-acting opioids will continue to be funded under the ODB program. Therefore, patients who may need higher doses of long-acting opioids for adequate pain management may continue to be prescribed lower-strength formulations. There are no daily dose limits being enforced at this time. It is important that healthcare providers assess patients individually and make changes to therapy in a measured manner with appropriate support and monitoring.

Prescribers are reminded that access to high-strength long-acting opioids will be maintained for patients requiring palliative care through the ODB program's:

  1. Palliative Care Facilitated Access (PCFA) mechanism, for physicians who are registered PCFA prescribers through the Ontario Medical Association; and
  2. Exceptional Access Program (EAP) Telephone Request Service (TRS) for physicians who are not PCFA prescribers according to specific criteria.

For further details, please consult Bulletin #4682.

To facilitate the reimbursement process at the pharmacy for a PCFA request, the prescriber is asked to indicate either "Palliative" or "P.C.F.A." on the prescription. The physician's CPSO registration number must be included on the prescription for purposes of verification.

To facilitate the reimbursement process at the pharmacy for a request approved through the EAP TRS, the prescriber is asked to indicate "TRS" on the prescription. This should indicate that the prescriber has obtained approval through the TRS.

The TRS is available between 8:30 am to 5:00 pm Monday to Friday (excluding statutory holidays) and can be reached by calling the Ontario Public Drug Programs toll-free at 1-866-811-9893. Select the TRS option when prompted.


Please contact PublicDrugPrgrms.moh@ontario.ca
or call ServiceOntario, Infoline at 1-866-532-3161 TTY 1-800-387-5559
In Toronto, TTY at 416-327-4282.

Additional Resources

Interested physicians should consult the below resources on how to transition and/or taper patients:

To view Portable Document Format PDF files, you will need to have Adobe Acrobat® Reader installed on your computer. You can download this free software from the Adobe website.

For More Information

Call ServiceOntario, Infoline at:
1-866-532-3161 (Toll-free)
In Toronto, (416) 314-5518
TTY 1-800-387-5559.
In Toronto, TTY 416-327-4282
Hours of operation: Monday to Friday, 8:30am - 5:00pm