Information for Health Professionals

Notice: The Manitoba Enhanced Pharmacare Program was implemented effective April 15, 2025. More information on this program can be found here.

On This Page:

• Pharmacy Claims Submission Procedures and Audit
• Manitoba Drug Benefits Formulary and Manitoba Drug Interchangeability Formulary
• Submitting New or Updated Pharmacy Information
• Current Topics & Client Resources
• Provincial Acts and Regulations
• Contact Information

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Pharmacy Claims Submission Procedures and Audit

Manitoba Health's current claim submission procedures and audit processes for community pharmacies are available below. (For all documents related to Claim Submission Procedures, the word “Manitoba” refers to “Manitoba Health.")

Notices

• Notice – COVID-19
• Drug Shortage Quantity Restrictions List (UPDATED March 20, 2025)
• Supply Restriction Update
• EDS Extension (UPDATED April 2021)
• 30 – Day Supply
• Notice – Pharmacy Software Vendor Price file
  • PSV file April 1, 2025 CHANGES ONLY – FINAL
  • Excel file April 1, 2025 CHANGES ONLY – FINAL
  • PSV file April 1, 2025 COMPLETE DIN LIST INCLUDING CHANGES – FINAL
  • Excel file April 1, 2025 COMPLETE DIN LIST INCLUDING CHANGES – FINAL
• Notice – Tiered Biologics Reimbursement Policy
• Notice – Approved Compounds for Pain Management – January 19, 2018
• Notice to Healthcare Professionals – Dispensing Frequency Update – January 20, 2025
• Notice to Pharmacists – Changes to Schedule “B” Approvals – February 10, 2025
• Notice – Infliximab Product Transition – March 25, 2025

Pharmacy Submission Procedure Manual

The DPIN Pharmacy Manual may be updated from time to time, as communicated directly to pharmacies. The current version includes all Claims Submission Procedures and associated lists/forms provided below.

• Claims Submission Procedure – Manitoba Enhanced Pharmacare Program (EFFECTIVE April 15, 2025)
  • Manitoba Enhanced Pharmacare Program Drug List (EFFECTIVE April 15, 2025)
  • FAQ – Manitoba Enhanced Pharmacare Program (EFFECTIVE April 15, 2025)
• Claims Submission Procedure – Inflectra (EFFECTIVE April 1, 2025)
• Claims Submission Procedure – Advanced Glucose Monitors (UPDATED August 27, 2024)
• Claims Submission Procedure – Blood Glucose Test Strips (Revised November 7, 2024)
• Claims Submission Procedure – Uncomplicated Cystitis Assessment (EFFECTIVE March 7, 2022)
• Claims Submission Procedure – Insulin Pump Supplies (UPDATED April 1, 2025)
  • FAQ – Insulin Pump Supplies (UPDATED April 1, 2025)
• Claims Submission Procedure – Professional Fee Cap
• Claims Submission Procedure – Oral Oncology Drugs Dispensed at CancerCare Manitoba
  • List of Oral Oncology Drugs Dispensed at CancerCare Manitoba (Updated April 1, 2025)
• Claims Submission Procedure – Extemporaneous Products (Compounding)
  • Monitored Drugs Compound List (UPDATED March 31, 2022)
  • PIN Flowsheet
• Claims Submission Procedure – Outsourced Extemporaneous Products
• Claims Submission Procedure – Special Authority Compounding
  • Form – Special Authority Compound Worksheet
• Claims Submission Procedure – Manitoba Designated Drug Shortages
  • Drug Shortage PIN List to March 20, 2025
  • CSP Compounded Efudex 5% Topical Cream - effective February 28, 2025
  • Drug Shortage PIN – Chlorthalidone 50mg Tablets - effective January 31, 2025
  • Drug Shortage PIN – Glucagon Injection Kit 1mg – effective February 2, 2024
  • Drug Shortage Compound – COTRIMOXAZOLE 40mg – 8mg per ml Oral Suspension
• Claims Submission Procedure – Dispensing Frequency (UPDATED January 27, 2025)
  • Frequency of Dispensing List (UPDATED May 2019)
  • FAQ: Updates to Claims Submission Procedure – Dispensing Frequency (January 27, 2025)
• Claims Submission Procedure – Claims with Cost Exceeding $9999.99
• Claims Submission Procedure – Methadone (UPDATED August 2021)
  • FAQ – Methadone (UPDATED August 2021)
• Claims Submission Procedure – Pharmaceutical Distribution Rate Changes (UPDATED May 2019)
• Claims Submission Procedure – Mifegymiso
• List of Designated High-Cost Drugs for Reduced Pharmaceutical Distribution (Updated April 1, 2025)
• FAQ – Pharmacare Audit and Investigations
• Form – Reversal/Adjustment
• Template – Pharmacy Agreement

If your questions are not answered by reviewing the Claims Submission Procedures and FAQs provided here, please contact PDPInfoAudit@gov.mb.ca.

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Manitoba Drug Benefits Formulary and Manitoba Drug Interchangeability Formulary

About the Manitoba Drug Benefits and Interchangeability Formularies

• Bulletin Archive
  This is the archive of Manitoba Drug Benefits and Interchangeability Formulary Amendments.
• Manitoba Drug Benefits Formulary
  A list of drugs and other items specified as eligible benefits under the Manitoba Pharmacare drug benefit program.
• Manitoba Drug Interchangeability Formulary
  A list of interchangeable drugs, categories and prices specific to drugs listed on the Manitoba Drug Benefits Formulary. Please note that Manitoba Pharmacare will reimburse only up to the lowest price in an interchangeable category for those interchangeable drugs which are Pharmacare benefits.
  Effective date of transition from Regulation to Policy: October 18, 2021.
  
• 2024 Pan-Canadian Price Initiative
• Manitoba Drug Formulary Lookup
  Search the Manitoba Drug Benefits Formulary by brand name, active ingredient, Drug Identification Number (DIN); or more advanced search options such as Therapeutic Classification.
• Manitoba Drug Formulary Glossary of Terms
• EDS
  Certain drugs are approved for coverage under the Exception Drug Status (EDS) Program when the use meets specific criteria as recommended by the Manitoba Drug Standards and Therapeutics Committee (MDSTC).
  Effective October 18, 2021, "Part 3 Exception Drug Status" or "Part 3 benefits" will be referred to as "Exception Drug Status" or "EDS benefits".
  Updated April 1 , 2024
  • EDS Application Processing Times
  • Changes to Exception Drug Status (EDS) Approval Process and Expiry Dates
  • Exception Drug Status (EDS) Request Form
  • EDS Request Form: Ajovy (fremanezumab)/Emgality (galcanezumab)/Vyepti (eptinezumab)/Qulipta (atogepant)
  • EDS Request Form: Atopic Dermatitis ( Abrocitinib, Dupilumab, Upadacitinib)
  • EDS Request Form: Camzyos (Mavacamten)
  • EDS Request Form: Dupixent (Dupilumab) for Eosinophilic Asthma
  • EDS Request Form: Kerendia (Finerenone)
  • EDS Request Form: Kesimpta (Ofatumumab)
  • EDS Request Form: Nucala (Mepolizumab) for CRSwNP
  • EDS Request Form: Nucala (Mepolizumab)/Fasenra (Benralizumab) for Asthma
  • EDS Request Form: Ofev (Nintedanib)
  • EDS Request Form: Oral Anti-Diabetic Medications (canagliflozin, empagliflozin, linagliptin, saxagliptin, sitagliptin)
  • EDS Request Form: Personal Care Home
  • EDS Request Form: Praluent (Alirocumab)/Repatha (Evolocumab)
  • EDS Request Form: Prevymis (Letermovir)
  • EDS Request Form: Vascepa (Icosapent ethyl)
  • EDS Indefinite Drug List (updated December 19, 2024)
• pCPA
  The pan-Canadian Pharmaceutical Alliance (pCPA) conducts joint provincial/territorial negotiations for brand name drugs in Canada to achieve greater value for publicly funded drug programs and patients.
• CADTH Common Drug Review (CDR) Reports
  Through the Common Drug Review (CDR) Process, CADTH conducts thorough and objective evaluations of the clinical, economic and patient evidence on drugs, and uses this evaluation to provide reimbursement recommendations and advice to Canada’s federal, provincial and territorial public drug plans.

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Submitting New or Updated Pharmacy Information

• DPIN Registration Form (Revised Feb. 28, 2023)

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Current Topics & Client Resources

Pharmacare

• About Pharmacare
  • Applying for Pharmacare
  • Application and Consent Authorization Form
  • General Pharmacare Questions
• Deductible Instalment Payment Program for Pharmacare (DIPPP)
  • DIPPP Guide
  • DIPPP Application, Consent and Authorization Form
• FAQ – Advanced Glucose Monitors

Naloxone Kits

• Take-Home Naloxone Program

Drug Shortages Canada

• The website for reporting drug shortages and discontinuations in Canada.

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Provincial Acts and Regulations

Provincial Acts and Regulations are available through the website of the Statutory Publications Office.

• The Prescription Drugs Cost Assistance Act
  • Prescription Drugs Payment of Benefits Regulation
  • Specified Drugs Regulation
    This is the regulation that provides for the benefit lists of specified drugs under The Prescription Drugs Cost Assistance Act. It lists the drugs and criteria for eligibility for the Manitoba Pharmacare program.
    Effective: April 20, 2017
• The Pharmaceutical Act
  • Manitoba Drug Interchangeability Formulary
    This regulation under The Pharmaceutical Act includes a list of interchangeable drugs, categories and prices. Please note that Manitoba Pharmacare will reimburse only up to the lowest price in an interchangeable category for those interchangeable drugs which are Pharmacare benefits.
    Effective: April 20, 2017
• The Personal Health Information Act (PHIA)
  • PHIA - Information for Trustees
  • The Personal Health Information Regulation
    This regulation has no legislative sanction and the original should be consulted for purposes of interpreting and applying the law.

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Contact Information
Provincial Drug Programs
Manitoba Health
300 Carlton Street
Winnipeg, Manitoba R3B 3M9

PDP Information and Audit
FAX: 204-786-8560
E-mail: PDPInfoAudit@gov.mb.ca