Ontario Drug Benefits (ODB) Program

The Ontario Drug Benefit (ODB) program is the public drug funding system of Ontario. It covers 4,400 prescription drugs products contained in the provincial formulary.
ODB FORMULARY
In addition to the formulary drugs listed, there are additional drugs under the Exceptional Access Program (EAP). This is a branch of the ODB program where funding of specific drugs for a specific purpose are requested by a physician and approved through a review process. A list of drugs accessed through EAP can be seen here:
EAP CRITERIA LIST
Many oncology and hematology medications are obtained through the EAP process.

How Drugs Are Funded in Ontario

Contact a local oncology Drug Access Navigator here

Who is Eligible for Coverage

You are eligible for ODB program benefits if you live in Ontario, you have a valid Ontario health card and at least one of these statements applies to you:

If you are covered by the ODB program and your prescription drugs are listed in the formulary, or have been given pre-approval through the Exceptional Access Program, the program will pay most of your costs.

For Seniors Over the Age of 65

On the first day of the month after you turn 65 years of age, take your prescription and health card to your pharmacy. Tell the pharmacist that you are now eligible for the ODB program. Depending on your income, you might be able to pay a lower payment per prescription and avoid the yearly deductible through the Seniors Co-Payment Program.

Manual Reimbursement Process

To receive reimbursement for drugs paid for out-of-pocket, you need to send a letter to the Ministry of Health that includes:

–  a note explaining that you need a refund.

–  the health card number for the person the refund is for.

–  the original (not fax or photocopy) prescription receipt (this is different from the cash register receipt) – if you’ve lost the original prescription receipt, the pharmacist can reprint it for you.

 

Then send everything to:

Ministry of Health and Long-Term Care

P.O. Box 337, Station D

Etobicoke ON M9A 4X3

 

They will then issue a cheque for any owed funds. This can take up to 8 weeks.