Certain drugs are approved for coverage under the Exception Drug Status (EDS) Program, upon review and recommendation of the Saskatchewan Formulary Committee.

The drugs usually fall into one of these categories:

1. The drug is ordinarily administered only to hospital in-patients but is being administered outside of a hospital because of unusual circumstances.
2. The drug is not ordinarily prescribed or administered in Saskatchewan, but is being prescribed because it is required in the diagnosis or treatment of an illness, disability or condition rarely found in Saskatchewan.
3. The drug is infrequently used because Formulary products are usually effective, but cannot be used or have been found to be ineffective due to the clinical condition of the patient.
4. The drug has been deleted from the Formulary but is required by patients previously stabilized on the drug.
5. The drug has potential for use in other than approved indications.
6. The drug has potential for the development of widespread inappropriate use.
7. The drug is more expensive than listed alternatives and offers an advantage in only a limited number of indications.

If the EDS drug is approved as a benefit, then the patient would pay for the EDS drug in the same manner as they would for any other benefit drug, subject to the patient's drug coverage, as well as Ministry policies such as generic interchangeability and the Maximum Allowable Cost policy.

Prescribers and pharmacists may apply for EDS requests by telephone, mail or fax. A toll-free line with an electronic message system is available exclusively for requests on a 24-hour basis. The telephone number to access this line is: 1-800-667-2549; the Drug Plan phone number is (306) 787-8744 and the fax number is (306) 787-8679.

All EDS requests must include the patient name, patient health services number (nine digits), name of drug, diagnosis relevant to use of drug, prescriber name and phone number. Requests are processed daily on a continuous basis.

Patients and prescribers are notified by letter if coverage has been approved and the time period for which coverage has been approved.

If a request has been denied, letters are sent to the patient and prescriber notifying them of the reason for the denial. In most cases, the Drug Plan requires more information to determine the patient's eligibility for coverage and will reconsider coverage at such time as further information is received.

If the drug requested is not a benefit under the Drug Plan, the patient and prescriber are notified. Payment for the medication is the responsibility of the patient in these cases. Not all medications currently available on the market in Canada are benefits under the Saskatchewan Drug Plan or under the EDS Program of the Drug Plan.

The majority of EDS requests are routinely backdated 30 days from the time the Drug Plan receives the request. Provision can be made for further backdating of EDS coverage on a case-by-case basis. However, the Drug Plan cannot backdate further than one year from the current date.