Forum Update: Supporting Community-Led Discussion
The forum was created as a space for shared learning and peer support, and as the community grows, we want to lean more fully into that purpose.
Going forward, PAAB will be taking a more listening-first role in forum discussions. Rather than responding immediately to every question, we’ll be encouraging members to engage with one another, share experiences, and help build collective understanding. PAAB will continue to monitor conversations and will step in to:
- Correct any misunderstandings
- Provide guidance when questions remain unanswered after a few days
- Support discussions where official clarification is needed
Our goal is to foster a collaborative, trusted community where knowledge is shared and strengthened by everyone’s contributions.
Thank you for being part of the conversation.
reporting criteria for special authorization products
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Hello PAAB! In cases where provincial formulary coverage of a product is restricted (e.g., special authorization) do all of the coverage criteria, definitions, and notes have to be included with the APS or can you simply link to them (via a "See Coverage Criteria" button) on the corresponding page on the provincial formulary web site. As well, if a criterion is one where we have no data in our PM, do we have to disclaim the criteria in some way? (i.e. "Product X has not been studied for this criterion"?
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Hello PAAB! In cases where provincial formulary coverage of a product is restricted (e.g., special authorization) do all of the coverage criteria, definitions, and notes have to be included with the APS or can you simply link to them (via a "See Coverage Criteria" button) on the corresponding page on the provincial formulary web site. As well, if a criterion is one where we have no data in our PM, do we have to disclaim the criteria in some way? (i.e. "Product X has not been studied for this criterion"?
Hi @constance
Please see PAAB resource Provincial Formulary Coverage Statements
Per the guidance document, the requirement for full formulary criteria disclosure is dependent on the nature of the claim e.g. inclusion of coverage codes requires disclosure of the full coverage criteria. Criterion are usually restrictions for coverage and act as qualification. Criteria generally do not require disclaimers if they are consistent and do not extend beyond the indication. Per the above reference, the indication acts as the limitations for initial consideration. There may be scenarios where disclaimers may be requested. This would be a case based assessment.
