When a product is designated as being covered, generally reimbursement is relatively straightforward. However, I can give you a few examples of cases that have posed a problem. The federal government is trying to follow the provincial program model, but there are many differences where coverage is concerned. The federal government reimburses the quantity of the product that results in the cheaper price per unit. It is different under Quebec's provincial program. Pharmacists tend to supply the smallest prescription quantity or the quantity best suited to the length of the treatment program. These smaller quantities are not subject to reimbursement under the federal program. This has led to disputes as reimbursement of the cost of these products is not necessarily automatic.
It isn't always logical. For instance, the blood glucose testing strips that patients use come in packages of 50 or 100 units. Obviously, the unit cost for the 100-strip package is lower and that is the quantity covered by the federal government. However, in Quebec, the cost of the 50-unit package is reimbursed. Fifty test strips represents a one-year supply, while 100 strips is enough for two years of testing. But after one year, the strips are no longer good and must be discarded. Clearly this decision makes no sense. Pharmacists tend to go with the quantity that does makes sense, but then they are not reimbursed.