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  4. Clarification regarding including indication with formulary criteria
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Clarification regarding including indication with formulary criteria

Scheduled Pinned Locked Moved Claims & Support/References for Claims
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  • K Offline
    K Offline
    kshulist
    wrote on last edited by
    #1

    I have a question regarding the newer update on provincial formulary statements for when the formulary criteria is broader than the indication (found here https://www.paab.ca/resources/provincial-formulary-coverage-statements/).

    According to this RAMQ advisory (https://www.paab.ca/resources/advisory-regarding-use-of-ramq-in-aps-april-2016/), we are advised that the RAMQ "criteria may appear in a footnote on the same page." Then, if we look at the newer update above (https://www.paab.ca/resources/provincial-formulary-coverage-statements/), we see that the "indication is presented prominently directly before the criteria to establish the context. The indication should reflect the same condition as the criteria and, at a bare minimum, the font size should be 75% of the size of the criteria."

    Since the RAMQ criteria can be footnote, and the indication needs to reflect the same condition as the criteria, taken together, does this mean that we can include BOTH the indication and the RAMQ criteria in a footnote together (indication coming first)?

    So, it would look something like this:

    RAMQ formulary coverage claim* [body copy]

    *Indication statement. RAMQ criteria statement. [footnote]

    Jennifer CarrollJ 1 Reply Last reply
    0
    • K kshulist

      I have a question regarding the newer update on provincial formulary statements for when the formulary criteria is broader than the indication (found here https://www.paab.ca/resources/provincial-formulary-coverage-statements/).

      According to this RAMQ advisory (https://www.paab.ca/resources/advisory-regarding-use-of-ramq-in-aps-april-2016/), we are advised that the RAMQ "criteria may appear in a footnote on the same page." Then, if we look at the newer update above (https://www.paab.ca/resources/provincial-formulary-coverage-statements/), we see that the "indication is presented prominently directly before the criteria to establish the context. The indication should reflect the same condition as the criteria and, at a bare minimum, the font size should be 75% of the size of the criteria."

      Since the RAMQ criteria can be footnote, and the indication needs to reflect the same condition as the criteria, taken together, does this mean that we can include BOTH the indication and the RAMQ criteria in a footnote together (indication coming first)?

      So, it would look something like this:

      RAMQ formulary coverage claim* [body copy]

      *Indication statement. RAMQ criteria statement. [footnote]

      Jennifer CarrollJ Offline
      Jennifer CarrollJ Offline
      Jennifer Carroll
      wrote on last edited by
      #2

      Hello @kshulist

      As long as 2.10.1 is satisfied elsewhere in the piece, the indication could appear in the footnote with the criteria. If this option is selected, it must be overtly clear which text refers to the indication and which text refers to the coverage criteria, in order to satisfy the spirit of the RAMQ request which was to include the coverage criteria in order to not suggest that the indication was the coverage criteria.

      K 1 Reply Last reply
      0
      • Jennifer CarrollJ Jennifer Carroll

        Hello @kshulist

        As long as 2.10.1 is satisfied elsewhere in the piece, the indication could appear in the footnote with the criteria. If this option is selected, it must be overtly clear which text refers to the indication and which text refers to the coverage criteria, in order to satisfy the spirit of the RAMQ request which was to include the coverage criteria in order to not suggest that the indication was the coverage criteria.

        K Offline
        K Offline
        kshulist
        wrote on last edited by
        #3

        @jennifer-carroll Thank you very much Jen!!

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