BOSENTAN MONOHYDRATE
All products: not a benefit
Other products in the same Health Canada class (C02KX) — coverage varies; not interchangeable
- Ambrisentan (Volibris): not a benefit
- Riociguat (Adempas): not a benefit
PMS-Bosentan · DIN 02383012 · 62.5mg · tablet
Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-02
StatusOff-Formulary Interchangeable, not an ODB benefit
Write on scriptExceptional Access application required. For a drug to be considered for funding, the EAP reimbursement criteria must always be met and the request approved prior to the initiation of treatment with the drug being requested, unless otherwise specified within the criteria. (ontario.ca, Aug 31, 2026 ↗) Submit through SADIE: "The SADIE portal is available to authorized prescribers and their delegates and designates, enabling the creation, submission and tracking of web-based electronic requests directly to the Exceptional Access Program." (ontario.ca, Aug 31, 2026 ↗) Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. Current criteria in SADIE
Coverage criteria
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated April 20, 2021
All requests (initial, renewal, monotherapy, combination therapy) for a PAH drug
must come from one of the following recognized PAH referral centres.
o Pulmonary Hypertension Centre
Hamilton Health Sciences – General Hospital
o The Firestone Institute Pulmonary Hypertension Program
St. Joseph's Healthcare Hamilton and McMaster University
o Pulmonary Hypertension Clinic
Hotel Dieu Hospital/Kingston General Hospital
o Pulmonary Hypertension Program
London Health Science Centre – Victoria Hospital
o Ottawa Pulmonary Hypertension Clinic
University of Ottawa Heart Institute and the Ottawa Hospital
o University Health Network Pulmonary Hypertension Program
Toronto General Hospital
Requests from other physicians/centres must include a recent (less than or equal to 3
months old) consult note/recommendation from a recognized PAH referral centre that
supports the request;
Out-of-province referral centre consults (e.g., from Winnipeg for patients in Northern
Ontario) will also be considered on a case-by-case basis
Initial Criteria:
For the treatment of patients with pulmonary arterial hypertension (PAH) [WHO Group 1
Pulmonary hypertension] who meet all the following criteria;
416
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 416, record 250, corpus 2025-01-01; name match only, not an eligibility decision
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated: April 20, 2021
• PAH defined as a resting mean pulmonary artery pressure (mPAP) of ≥ 25 mmHg
at rest AND normal pulmonary capillary wedge pressure (PCWP) ≤ 15 mmHg on
right heart catheterization1; AND
• The drug request meets one of the following circumstances of use:
o Drug is being used as monotherapy in a patient with WHO-functional class III or
IV; OR
o Drug is being used as monotherapy in a patient with WHO-functional class II
who has contraindication or has intolerance to a PDE-5 inhibitor; OR
o Drug is being used as sequential dual therapy in combination with a funded
PDE-5 (i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol,
treprostinil) in a patient who has had an inadequate response with monotherapy
(i.e., failure to achieve WHO-FC I or II; or 6MWD >440 metres; or no/mild RV
failure); OR
o Drug is being used as up-front dual therapy in combination with a funded PDE-5
(i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol, treprostinil) in
a patient with advanced disease (i.e. WHO-functional class III or IV; OR 6MWD
<380 metres; OR evidence of RV failure.)
1 Note: Left ventricular end-diastolic pressure ≤15 mmHg is also acceptable.
417
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 417, record 253, corpus 2025-01-01; name match only, not an eligibility decision
Brand vs generic price
Lowest DBP recovery rule under medically necessary no-substitution claims:
6.2 Medically Necessary "No Substitution" Claims
The Side Effect Reporting Form will not have to be renewed. However, the
pharmacy must maintain a copy of the prescription that contains a direction that
there be no substitution and the required Health Canada Side Effect Reporting Form
(completed and signed by the prescriber). The prescriber must write “No
Substitution” or “No Sub” on renewal or subsequent new written prescriptions, and
indicate “No Substitution” on subsequent new oral prescriptions. The dispenser will
be reimbursed the DBP plus a mark-up and the lesser of the posted usual and
customary fee or the ODB dispensing fee minus the applicable ODB co-payment
amount. Where a completed Side Effect Reporting Form is not available at the
pharmacy during an inspection, the difference between the cost of the higher-cost
product and the lowest DBP listed for the interchangeable category will be
recovered.
(ontario.ca, Revision #17; 2026-08-03 ↗)
6.2 Medically Necessary "No Substitution" Claims
The Ministry will provide reimbursement of a higher-cost interchangeable product in
medically necessary circumstances where a patient has experienced a significant
adverse reaction with two (2) lower-cost interchangeable drug products, where
available. When a prescriber identifies a patient for which it is medically necessary
that a higher cost interchangeable product be provided, the prescriber must:
• Complete, sign and forward to the pharmacist a copy of the Health Canada
side effect reporting form for each lower-cost interchangeable drug product
trialed (Side Effect Reporting Form[s]); and
• Write “No Substitution” or “No Sub” on a written prescription or indicate “No
Substitution” to the pharmacist in the case of a verbal prescription.
The prescriber should keep a copy of the completed form in the patient’s record for
future use and reference.
In the case of a written prescription, when the pharmacist or dispensing physician
receives a prescription with the written notation “No Substitution” or “No Sub”,
reimbursement will be provided for the higher-cost interchangeable product only if
the prescription is accompanied by a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed.
This form must be completely filled out noting the details of the adverse reaction
and signed by the prescriber.
In the case of a verbal prescription, the prescriber must satisfy the operator of the
pharmacy or dispensing physician that a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed
has been completed and signed by the prescriber. A written record of this verbal
prescription and the completed Health Canada Side Effect Reporting Form must be
received by the pharmacy prior to claim submission.
Upon receipt, the pharmacist must:
• Fax, submit online or mail the completed and signed form to Health Canada’s
Canada Vigilance Program; and
• Retain his or her copy of the completed and signed Side Effect Reporting
Form.
(ontario.ca, Revision #17; 2026-08-03 ↗)How long EAP takes
Turnaround times
The Exceptional Access Program receives between 250 and 500 requests a day. Requests are categorized in order of priority based on how quickly a drug is needed, the type of drug, and the condition for which the drug is being used.
Turnaround times begin on the business day on which the EAP receives a complete request from a physician or nurse practitioner. You may have to wait longer if the request is missing information or supporting documents required by the EAP criteria, if a request requires external review, or if documents are sent by fax or mail instead of submitted via SADIE.
EAP Weekly Progress Report
Date: September 15, 2026
Processing categories and examples | Target | Current |
Priority 1 — for drugs such as antibiotics, cancer medications, and initial requests for pain medications | 3 business days | 2 business day |
Priority 2 — for antiviral drugs to treat HIV, drugs for multiple sclerosis, and pulmonary hypertension | 5 business days | 3 business days |
Biologics — for biologic drugs to treat rheumatoid arthritis, psoriatic arthritis, ulcerative colitis and Crohn’s disease | 10 business days | 4 business days |
Chronic — for drugs used for chronic conditions such as migraines, chronic pain, Ménière's disease and symptoms of Parkinson’s disease. | 4 to 6 weeks | 11 business days |
(ontario.ca, Updated September 15, 2026 ↗)
For selected drugs, the Telephone Request Service is available to authorized prescribers or their delegates. In most cases, the funding decision is provided by the end of the call and processed within one business day.
(ontario.ca, Updated September 15, 2026 ↗)1 brand, same coverage
PMS-Bosentan · DIN 02383012
Manufacturer: Pharmascience Inc.; listing date 2012-07-27
Health Canada: Marketed since 2012-06-12 · brand PMS-BOSENTAN · ATC C02KX01 BOSENTAN · form Tablet · route Oral · ingredients BOSENTAN (BOSENTAN MONOHYDRATE) 62.5 MG · company Pharmascience inc · schedule Prescription
Check this DIN again · Health Canada product recordPMS-Bosentan: Formulary list price $32.0893/unit (unit not stated in source; not the patient's cost)
Ministry pays: $32.0893 per source unit.
Source explanation: The formulary price is what ODB pays; the cash price at the counter is set by the pharmacy.
Formulary data: Ontario extract of Aug 26, 2026 · Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=86880 · Verify on the e-Formulary ↗ (DIN 02383012)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02383012).
DIN 02383012: PMS-Bosentan
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 241200096; group id 363; item number 0849; lccId None; manufacturer id PMS
Source form: Tab; strength: 62.5mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $32.0893; ministry $32.0893
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02383012
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=86880
Interchangeable products
Apo-Bosentan · DIN 02399202 · $32.0893
Co Bosentan · DIN 02386194 · $32.0893
Nat-Bosentan · DIN 02467984 · $32.0893
Sandoz Bosentan · DIN 02386275 · $32.0893
Taro-Bosentan · DIN 02483130 · $32.0893
Tracleer · DIN 02244981 · $32.0893
Shortage status: discontinued (2021-03-10, reported by PHARMASCIENCE INC); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02383012
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Taro-Bosentan · DIN 02483130 · 62.5mg · tablet
Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-02
StatusOff-Formulary Interchangeable, not an ODB benefit
Write on scriptExceptional Access application required. For a drug to be considered for funding, the EAP reimbursement criteria must always be met and the request approved prior to the initiation of treatment with the drug being requested, unless otherwise specified within the criteria. (ontario.ca, Aug 31, 2026 ↗) Submit through SADIE: "The SADIE portal is available to authorized prescribers and their delegates and designates, enabling the creation, submission and tracking of web-based electronic requests directly to the Exceptional Access Program." (ontario.ca, Aug 31, 2026 ↗) Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. Current criteria in SADIE
Coverage criteria
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated April 20, 2021
All requests (initial, renewal, monotherapy, combination therapy) for a PAH drug
must come from one of the following recognized PAH referral centres.
o Pulmonary Hypertension Centre
Hamilton Health Sciences – General Hospital
o The Firestone Institute Pulmonary Hypertension Program
St. Joseph's Healthcare Hamilton and McMaster University
o Pulmonary Hypertension Clinic
Hotel Dieu Hospital/Kingston General Hospital
o Pulmonary Hypertension Program
London Health Science Centre – Victoria Hospital
o Ottawa Pulmonary Hypertension Clinic
University of Ottawa Heart Institute and the Ottawa Hospital
o University Health Network Pulmonary Hypertension Program
Toronto General Hospital
Requests from other physicians/centres must include a recent (less than or equal to 3
months old) consult note/recommendation from a recognized PAH referral centre that
supports the request;
Out-of-province referral centre consults (e.g., from Winnipeg for patients in Northern
Ontario) will also be considered on a case-by-case basis
Initial Criteria:
For the treatment of patients with pulmonary arterial hypertension (PAH) [WHO Group 1
Pulmonary hypertension] who meet all the following criteria;
416
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 416, record 250, corpus 2025-01-01; name match only, not an eligibility decision
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated: April 20, 2021
• PAH defined as a resting mean pulmonary artery pressure (mPAP) of ≥ 25 mmHg
at rest AND normal pulmonary capillary wedge pressure (PCWP) ≤ 15 mmHg on
right heart catheterization1; AND
• The drug request meets one of the following circumstances of use:
o Drug is being used as monotherapy in a patient with WHO-functional class III or
IV; OR
o Drug is being used as monotherapy in a patient with WHO-functional class II
who has contraindication or has intolerance to a PDE-5 inhibitor; OR
o Drug is being used as sequential dual therapy in combination with a funded
PDE-5 (i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol,
treprostinil) in a patient who has had an inadequate response with monotherapy
(i.e., failure to achieve WHO-FC I or II; or 6MWD >440 metres; or no/mild RV
failure); OR
o Drug is being used as up-front dual therapy in combination with a funded PDE-5
(i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol, treprostinil) in
a patient with advanced disease (i.e. WHO-functional class III or IV; OR 6MWD
<380 metres; OR evidence of RV failure.)
1 Note: Left ventricular end-diastolic pressure ≤15 mmHg is also acceptable.
417
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 417, record 253, corpus 2025-01-01; name match only, not an eligibility decision
Brand vs generic price
Lowest DBP recovery rule under medically necessary no-substitution claims:
6.2 Medically Necessary "No Substitution" Claims
The Side Effect Reporting Form will not have to be renewed. However, the
pharmacy must maintain a copy of the prescription that contains a direction that
there be no substitution and the required Health Canada Side Effect Reporting Form
(completed and signed by the prescriber). The prescriber must write “No
Substitution” or “No Sub” on renewal or subsequent new written prescriptions, and
indicate “No Substitution” on subsequent new oral prescriptions. The dispenser will
be reimbursed the DBP plus a mark-up and the lesser of the posted usual and
customary fee or the ODB dispensing fee minus the applicable ODB co-payment
amount. Where a completed Side Effect Reporting Form is not available at the
pharmacy during an inspection, the difference between the cost of the higher-cost
product and the lowest DBP listed for the interchangeable category will be
recovered.
(ontario.ca, Revision #17; 2026-08-03 ↗)
6.2 Medically Necessary "No Substitution" Claims
The Ministry will provide reimbursement of a higher-cost interchangeable product in
medically necessary circumstances where a patient has experienced a significant
adverse reaction with two (2) lower-cost interchangeable drug products, where
available. When a prescriber identifies a patient for which it is medically necessary
that a higher cost interchangeable product be provided, the prescriber must:
• Complete, sign and forward to the pharmacist a copy of the Health Canada
side effect reporting form for each lower-cost interchangeable drug product
trialed (Side Effect Reporting Form[s]); and
• Write “No Substitution” or “No Sub” on a written prescription or indicate “No
Substitution” to the pharmacist in the case of a verbal prescription.
The prescriber should keep a copy of the completed form in the patient’s record for
future use and reference.
In the case of a written prescription, when the pharmacist or dispensing physician
receives a prescription with the written notation “No Substitution” or “No Sub”,
reimbursement will be provided for the higher-cost interchangeable product only if
the prescription is accompanied by a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed.
This form must be completely filled out noting the details of the adverse reaction
and signed by the prescriber.
In the case of a verbal prescription, the prescriber must satisfy the operator of the
pharmacy or dispensing physician that a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed
has been completed and signed by the prescriber. A written record of this verbal
prescription and the completed Health Canada Side Effect Reporting Form must be
received by the pharmacy prior to claim submission.
Upon receipt, the pharmacist must:
• Fax, submit online or mail the completed and signed form to Health Canada’s
Canada Vigilance Program; and
• Retain his or her copy of the completed and signed Side Effect Reporting
Form.
(ontario.ca, Revision #17; 2026-08-03 ↗)How long EAP takes
Turnaround times
The Exceptional Access Program receives between 250 and 500 requests a day. Requests are categorized in order of priority based on how quickly a drug is needed, the type of drug, and the condition for which the drug is being used.
Turnaround times begin on the business day on which the EAP receives a complete request from a physician or nurse practitioner. You may have to wait longer if the request is missing information or supporting documents required by the EAP criteria, if a request requires external review, or if documents are sent by fax or mail instead of submitted via SADIE.
EAP Weekly Progress Report
Date: September 15, 2026
Processing categories and examples | Target | Current |
Priority 1 — for drugs such as antibiotics, cancer medications, and initial requests for pain medications | 3 business days | 2 business day |
Priority 2 — for antiviral drugs to treat HIV, drugs for multiple sclerosis, and pulmonary hypertension | 5 business days | 3 business days |
Biologics — for biologic drugs to treat rheumatoid arthritis, psoriatic arthritis, ulcerative colitis and Crohn’s disease | 10 business days | 4 business days |
Chronic — for drugs used for chronic conditions such as migraines, chronic pain, Ménière's disease and symptoms of Parkinson’s disease. | 4 to 6 weeks | 11 business days |
(ontario.ca, Updated September 15, 2026 ↗)
For selected drugs, the Telephone Request Service is available to authorized prescribers or their delegates. In most cases, the funding decision is provided by the end of the call and processed within one business day.
(ontario.ca, Updated September 15, 2026 ↗)1 brand, same coverage
Taro-Bosentan · DIN 02483130
Manufacturer: Taro Pharmaceuticals Inc.; listing date 2020-05-29
Health Canada: Marketed since 2020-05-07 · brand TARO-BOSENTAN · ATC C02KX01 BOSENTAN · form Tablet · route Oral · ingredients BOSENTAN (BOSENTAN MONOHYDRATE) 62.5 MG · company Taro pharmaceuticals inc · schedule Prescription
Check this DIN again · Health Canada product recordTaro-Bosentan: Formulary list price $32.0893/unit (unit not stated in source; not the patient's cost)
Ministry pays: $32.0893 per source unit.
Source explanation: The formulary price is what ODB pays; the cash price at the counter is set by the pharmacy.
Formulary data: Ontario extract of Aug 26, 2026 · Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=97359 · Verify on the e-Formulary ↗ (DIN 02483130)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02483130).
DIN 02483130: Taro-Bosentan
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 241200096; group id 363; item number 0849; lccId None; manufacturer id TAR
Source form: Tab; strength: 62.5mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $32.0893; ministry $32.0893
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02483130
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=97359
Interchangeable products
Apo-Bosentan · DIN 02399202 · $32.0893
Co Bosentan · DIN 02386194 · $32.0893
Nat-Bosentan · DIN 02467984 · $32.0893
PMS-Bosentan · DIN 02383012 · $32.0893
Sandoz Bosentan · DIN 02386275 · $32.0893
Tracleer · DIN 02244981 · $32.0893
Shortage status: resolved shortage (ended 2025-08-08); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02483130
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Tracleer · DIN 02244981 · 62.5mg · tablet
Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-02
StatusOff-Formulary Interchangeable, not an ODB benefit
Write on scriptExceptional Access application required. For a drug to be considered for funding, the EAP reimbursement criteria must always be met and the request approved prior to the initiation of treatment with the drug being requested, unless otherwise specified within the criteria. (ontario.ca, Aug 31, 2026 ↗) Submit through SADIE: "The SADIE portal is available to authorized prescribers and their delegates and designates, enabling the creation, submission and tracking of web-based electronic requests directly to the Exceptional Access Program." (ontario.ca, Aug 31, 2026 ↗) Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. Current criteria in SADIE
Coverage criteria
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated April 20, 2021
All requests (initial, renewal, monotherapy, combination therapy) for a PAH drug
must come from one of the following recognized PAH referral centres.
o Pulmonary Hypertension Centre
Hamilton Health Sciences – General Hospital
o The Firestone Institute Pulmonary Hypertension Program
St. Joseph's Healthcare Hamilton and McMaster University
o Pulmonary Hypertension Clinic
Hotel Dieu Hospital/Kingston General Hospital
o Pulmonary Hypertension Program
London Health Science Centre – Victoria Hospital
o Ottawa Pulmonary Hypertension Clinic
University of Ottawa Heart Institute and the Ottawa Hospital
o University Health Network Pulmonary Hypertension Program
Toronto General Hospital
Requests from other physicians/centres must include a recent (less than or equal to 3
months old) consult note/recommendation from a recognized PAH referral centre that
supports the request;
Out-of-province referral centre consults (e.g., from Winnipeg for patients in Northern
Ontario) will also be considered on a case-by-case basis
Initial Criteria:
For the treatment of patients with pulmonary arterial hypertension (PAH) [WHO Group 1
Pulmonary hypertension] who meet all the following criteria;
416
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 416, record 250, corpus 2025-01-01; name match only, not an eligibility decision
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated: April 20, 2021
• PAH defined as a resting mean pulmonary artery pressure (mPAP) of ≥ 25 mmHg
at rest AND normal pulmonary capillary wedge pressure (PCWP) ≤ 15 mmHg on
right heart catheterization1; AND
• The drug request meets one of the following circumstances of use:
o Drug is being used as monotherapy in a patient with WHO-functional class III or
IV; OR
o Drug is being used as monotherapy in a patient with WHO-functional class II
who has contraindication or has intolerance to a PDE-5 inhibitor; OR
o Drug is being used as sequential dual therapy in combination with a funded
PDE-5 (i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol,
treprostinil) in a patient who has had an inadequate response with monotherapy
(i.e., failure to achieve WHO-FC I or II; or 6MWD >440 metres; or no/mild RV
failure); OR
o Drug is being used as up-front dual therapy in combination with a funded PDE-5
(i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol, treprostinil) in
a patient with advanced disease (i.e. WHO-functional class III or IV; OR 6MWD
<380 metres; OR evidence of RV failure.)
1 Note: Left ventricular end-diastolic pressure ≤15 mmHg is also acceptable.
417
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 417, record 253, corpus 2025-01-01; name match only, not an eligibility decision
How long EAP takes
Turnaround times
The Exceptional Access Program receives between 250 and 500 requests a day. Requests are categorized in order of priority based on how quickly a drug is needed, the type of drug, and the condition for which the drug is being used.
Turnaround times begin on the business day on which the EAP receives a complete request from a physician or nurse practitioner. You may have to wait longer if the request is missing information or supporting documents required by the EAP criteria, if a request requires external review, or if documents are sent by fax or mail instead of submitted via SADIE.
EAP Weekly Progress Report
Date: September 15, 2026
Processing categories and examples | Target | Current |
Priority 1 — for drugs such as antibiotics, cancer medications, and initial requests for pain medications | 3 business days | 2 business day |
Priority 2 — for antiviral drugs to treat HIV, drugs for multiple sclerosis, and pulmonary hypertension | 5 business days | 3 business days |
Biologics — for biologic drugs to treat rheumatoid arthritis, psoriatic arthritis, ulcerative colitis and Crohn’s disease | 10 business days | 4 business days |
Chronic — for drugs used for chronic conditions such as migraines, chronic pain, Ménière's disease and symptoms of Parkinson’s disease. | 4 to 6 weeks | 11 business days |
(ontario.ca, Updated September 15, 2026 ↗)
For selected drugs, the Telephone Request Service is available to authorized prescribers or their delegates. In most cases, the funding decision is provided by the end of the call and processed within one business day.
(ontario.ca, Updated September 15, 2026 ↗)1 brand, same coverage
Tracleer · DIN 02244981
Manufacturer: Janssen Inc.; listing date 2012-07-27
Health Canada: Marketed since 2020-02-20 · brand TRACLEER · ATC C02KX01 BOSENTAN · form Tablet · route Oral · ingredients BOSENTAN (BOSENTAN MONOHYDRATE) 62.5 MG · company Janssen inc · schedule Prescription
Check this DIN again · Health Canada product recordMinistry pays: $32.0893 per source unit.
Source explanation: The formulary price is what ODB pays; the cash price at the counter is set by the pharmacy.
Formulary data: Ontario extract of Aug 26, 2026 · Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=68979 · Verify on the e-Formulary ↗ (DIN 02244981)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02244981).
DIN 02244981: Tracleer
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 241200096; group id 363; item number 0849; lccId None; manufacturer id JAN
Source form: Tab; strength: 62.5mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $88.8725; ministry $32.0893
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02244981
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=68979
Interchangeable products
Apo-Bosentan · DIN 02399202 · $32.0893
Co Bosentan · DIN 02386194 · $32.0893
Nat-Bosentan · DIN 02467984 · $32.0893
PMS-Bosentan · DIN 02383012 · $32.0893
Sandoz Bosentan · DIN 02386275 · $32.0893
Taro-Bosentan · DIN 02483130 · $32.0893
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02244981
Shortage record checked 2026-09-13T08:10:21.292534+00:00
PMS-Bosentan · DIN 02383020 · 125mg · tablet
Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-02
StatusOff-Formulary Interchangeable, not an ODB benefit
Write on scriptExceptional Access application required. For a drug to be considered for funding, the EAP reimbursement criteria must always be met and the request approved prior to the initiation of treatment with the drug being requested, unless otherwise specified within the criteria. (ontario.ca, Aug 31, 2026 ↗) Submit through SADIE: "The SADIE portal is available to authorized prescribers and their delegates and designates, enabling the creation, submission and tracking of web-based electronic requests directly to the Exceptional Access Program." (ontario.ca, Aug 31, 2026 ↗) Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. Current criteria in SADIE
Coverage criteria
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated April 20, 2021
All requests (initial, renewal, monotherapy, combination therapy) for a PAH drug
must come from one of the following recognized PAH referral centres.
o Pulmonary Hypertension Centre
Hamilton Health Sciences – General Hospital
o The Firestone Institute Pulmonary Hypertension Program
St. Joseph's Healthcare Hamilton and McMaster University
o Pulmonary Hypertension Clinic
Hotel Dieu Hospital/Kingston General Hospital
o Pulmonary Hypertension Program
London Health Science Centre – Victoria Hospital
o Ottawa Pulmonary Hypertension Clinic
University of Ottawa Heart Institute and the Ottawa Hospital
o University Health Network Pulmonary Hypertension Program
Toronto General Hospital
Requests from other physicians/centres must include a recent (less than or equal to 3
months old) consult note/recommendation from a recognized PAH referral centre that
supports the request;
Out-of-province referral centre consults (e.g., from Winnipeg for patients in Northern
Ontario) will also be considered on a case-by-case basis
Initial Criteria:
For the treatment of patients with pulmonary arterial hypertension (PAH) [WHO Group 1
Pulmonary hypertension] who meet all the following criteria;
416
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 416, record 250, corpus 2025-01-01; name match only, not an eligibility decision
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated: April 20, 2021
• PAH defined as a resting mean pulmonary artery pressure (mPAP) of ≥ 25 mmHg
at rest AND normal pulmonary capillary wedge pressure (PCWP) ≤ 15 mmHg on
right heart catheterization1; AND
• The drug request meets one of the following circumstances of use:
o Drug is being used as monotherapy in a patient with WHO-functional class III or
IV; OR
o Drug is being used as monotherapy in a patient with WHO-functional class II
who has contraindication or has intolerance to a PDE-5 inhibitor; OR
o Drug is being used as sequential dual therapy in combination with a funded
PDE-5 (i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol,
treprostinil) in a patient who has had an inadequate response with monotherapy
(i.e., failure to achieve WHO-FC I or II; or 6MWD >440 metres; or no/mild RV
failure); OR
o Drug is being used as up-front dual therapy in combination with a funded PDE-5
(i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol, treprostinil) in
a patient with advanced disease (i.e. WHO-functional class III or IV; OR 6MWD
<380 metres; OR evidence of RV failure.)
1 Note: Left ventricular end-diastolic pressure ≤15 mmHg is also acceptable.
417
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 417, record 253, corpus 2025-01-01; name match only, not an eligibility decision
Brand vs generic price
Lowest DBP recovery rule under medically necessary no-substitution claims:
6.2 Medically Necessary "No Substitution" Claims
The Side Effect Reporting Form will not have to be renewed. However, the
pharmacy must maintain a copy of the prescription that contains a direction that
there be no substitution and the required Health Canada Side Effect Reporting Form
(completed and signed by the prescriber). The prescriber must write “No
Substitution” or “No Sub” on renewal or subsequent new written prescriptions, and
indicate “No Substitution” on subsequent new oral prescriptions. The dispenser will
be reimbursed the DBP plus a mark-up and the lesser of the posted usual and
customary fee or the ODB dispensing fee minus the applicable ODB co-payment
amount. Where a completed Side Effect Reporting Form is not available at the
pharmacy during an inspection, the difference between the cost of the higher-cost
product and the lowest DBP listed for the interchangeable category will be
recovered.
(ontario.ca, Revision #17; 2026-08-03 ↗)
6.2 Medically Necessary "No Substitution" Claims
The Ministry will provide reimbursement of a higher-cost interchangeable product in
medically necessary circumstances where a patient has experienced a significant
adverse reaction with two (2) lower-cost interchangeable drug products, where
available. When a prescriber identifies a patient for which it is medically necessary
that a higher cost interchangeable product be provided, the prescriber must:
• Complete, sign and forward to the pharmacist a copy of the Health Canada
side effect reporting form for each lower-cost interchangeable drug product
trialed (Side Effect Reporting Form[s]); and
• Write “No Substitution” or “No Sub” on a written prescription or indicate “No
Substitution” to the pharmacist in the case of a verbal prescription.
The prescriber should keep a copy of the completed form in the patient’s record for
future use and reference.
In the case of a written prescription, when the pharmacist or dispensing physician
receives a prescription with the written notation “No Substitution” or “No Sub”,
reimbursement will be provided for the higher-cost interchangeable product only if
the prescription is accompanied by a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed.
This form must be completely filled out noting the details of the adverse reaction
and signed by the prescriber.
In the case of a verbal prescription, the prescriber must satisfy the operator of the
pharmacy or dispensing physician that a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed
has been completed and signed by the prescriber. A written record of this verbal
prescription and the completed Health Canada Side Effect Reporting Form must be
received by the pharmacy prior to claim submission.
Upon receipt, the pharmacist must:
• Fax, submit online or mail the completed and signed form to Health Canada’s
Canada Vigilance Program; and
• Retain his or her copy of the completed and signed Side Effect Reporting
Form.
(ontario.ca, Revision #17; 2026-08-03 ↗)How long EAP takes
Turnaround times
The Exceptional Access Program receives between 250 and 500 requests a day. Requests are categorized in order of priority based on how quickly a drug is needed, the type of drug, and the condition for which the drug is being used.
Turnaround times begin on the business day on which the EAP receives a complete request from a physician or nurse practitioner. You may have to wait longer if the request is missing information or supporting documents required by the EAP criteria, if a request requires external review, or if documents are sent by fax or mail instead of submitted via SADIE.
EAP Weekly Progress Report
Date: September 15, 2026
Processing categories and examples | Target | Current |
Priority 1 — for drugs such as antibiotics, cancer medications, and initial requests for pain medications | 3 business days | 2 business day |
Priority 2 — for antiviral drugs to treat HIV, drugs for multiple sclerosis, and pulmonary hypertension | 5 business days | 3 business days |
Biologics — for biologic drugs to treat rheumatoid arthritis, psoriatic arthritis, ulcerative colitis and Crohn’s disease | 10 business days | 4 business days |
Chronic — for drugs used for chronic conditions such as migraines, chronic pain, Ménière's disease and symptoms of Parkinson’s disease. | 4 to 6 weeks | 11 business days |
(ontario.ca, Updated September 15, 2026 ↗)
For selected drugs, the Telephone Request Service is available to authorized prescribers or their delegates. In most cases, the funding decision is provided by the end of the call and processed within one business day.
(ontario.ca, Updated September 15, 2026 ↗)1 brand, same coverage
PMS-Bosentan · DIN 02383020
Manufacturer: Pharmascience Inc.; listing date 2012-07-27
Health Canada: Marketed since 2012-06-12 · brand PMS-BOSENTAN · ATC C02KX01 BOSENTAN · form Tablet · route Oral · ingredients BOSENTAN (BOSENTAN MONOHYDRATE) 125 MG · company Pharmascience inc · schedule Prescription
Check this DIN again · Health Canada product recordPMS-Bosentan: Formulary list price $32.0893/unit (unit not stated in source; not the patient's cost)
Ministry pays: $32.0893 per source unit.
Source explanation: The formulary price is what ODB pays; the cash price at the counter is set by the pharmacy.
Formulary data: Ontario extract of Aug 26, 2026 · Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=86881 · Verify on the e-Formulary ↗ (DIN 02383020)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02383020).
DIN 02383020: PMS-Bosentan
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 241200097; group id 363; item number 0850; lccId None; manufacturer id PMS
Source form: Tab; strength: 125mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $32.0893; ministry $32.0893
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02383020
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=86881
Interchangeable products
Apo-Bosentan · DIN 02399210 · $32.0893
Co Bosentan · DIN 02386208 · $32.0893
Nat-Bosentan · DIN 02467992 · $32.0893
Sandoz Bosentan · DIN 02386283 · $32.0893
Taro-Bosentan · DIN 02483149 · $32.0893
Tracleer · DIN 02244982 · $32.0893
Shortage status: discontinued (2021-03-10, reported by PHARMASCIENCE INC); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02383020
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Taro-Bosentan · DIN 02483149 · 125mg · tablet
Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-02
StatusOff-Formulary Interchangeable, not an ODB benefit
Write on scriptExceptional Access application required. For a drug to be considered for funding, the EAP reimbursement criteria must always be met and the request approved prior to the initiation of treatment with the drug being requested, unless otherwise specified within the criteria. (ontario.ca, Aug 31, 2026 ↗) Submit through SADIE: "The SADIE portal is available to authorized prescribers and their delegates and designates, enabling the creation, submission and tracking of web-based electronic requests directly to the Exceptional Access Program." (ontario.ca, Aug 31, 2026 ↗) Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. Current criteria in SADIE
Coverage criteria
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated April 20, 2021
All requests (initial, renewal, monotherapy, combination therapy) for a PAH drug
must come from one of the following recognized PAH referral centres.
o Pulmonary Hypertension Centre
Hamilton Health Sciences – General Hospital
o The Firestone Institute Pulmonary Hypertension Program
St. Joseph's Healthcare Hamilton and McMaster University
o Pulmonary Hypertension Clinic
Hotel Dieu Hospital/Kingston General Hospital
o Pulmonary Hypertension Program
London Health Science Centre – Victoria Hospital
o Ottawa Pulmonary Hypertension Clinic
University of Ottawa Heart Institute and the Ottawa Hospital
o University Health Network Pulmonary Hypertension Program
Toronto General Hospital
Requests from other physicians/centres must include a recent (less than or equal to 3
months old) consult note/recommendation from a recognized PAH referral centre that
supports the request;
Out-of-province referral centre consults (e.g., from Winnipeg for patients in Northern
Ontario) will also be considered on a case-by-case basis
Initial Criteria:
For the treatment of patients with pulmonary arterial hypertension (PAH) [WHO Group 1
Pulmonary hypertension] who meet all the following criteria;
416
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 416, record 250, corpus 2025-01-01; name match only, not an eligibility decision
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated: April 20, 2021
• PAH defined as a resting mean pulmonary artery pressure (mPAP) of ≥ 25 mmHg
at rest AND normal pulmonary capillary wedge pressure (PCWP) ≤ 15 mmHg on
right heart catheterization1; AND
• The drug request meets one of the following circumstances of use:
o Drug is being used as monotherapy in a patient with WHO-functional class III or
IV; OR
o Drug is being used as monotherapy in a patient with WHO-functional class II
who has contraindication or has intolerance to a PDE-5 inhibitor; OR
o Drug is being used as sequential dual therapy in combination with a funded
PDE-5 (i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol,
treprostinil) in a patient who has had an inadequate response with monotherapy
(i.e., failure to achieve WHO-FC I or II; or 6MWD >440 metres; or no/mild RV
failure); OR
o Drug is being used as up-front dual therapy in combination with a funded PDE-5
(i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol, treprostinil) in
a patient with advanced disease (i.e. WHO-functional class III or IV; OR 6MWD
<380 metres; OR evidence of RV failure.)
1 Note: Left ventricular end-diastolic pressure ≤15 mmHg is also acceptable.
417
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 417, record 253, corpus 2025-01-01; name match only, not an eligibility decision
Brand vs generic price
Lowest DBP recovery rule under medically necessary no-substitution claims:
6.2 Medically Necessary "No Substitution" Claims
The Side Effect Reporting Form will not have to be renewed. However, the
pharmacy must maintain a copy of the prescription that contains a direction that
there be no substitution and the required Health Canada Side Effect Reporting Form
(completed and signed by the prescriber). The prescriber must write “No
Substitution” or “No Sub” on renewal or subsequent new written prescriptions, and
indicate “No Substitution” on subsequent new oral prescriptions. The dispenser will
be reimbursed the DBP plus a mark-up and the lesser of the posted usual and
customary fee or the ODB dispensing fee minus the applicable ODB co-payment
amount. Where a completed Side Effect Reporting Form is not available at the
pharmacy during an inspection, the difference between the cost of the higher-cost
product and the lowest DBP listed for the interchangeable category will be
recovered.
(ontario.ca, Revision #17; 2026-08-03 ↗)
6.2 Medically Necessary "No Substitution" Claims
The Ministry will provide reimbursement of a higher-cost interchangeable product in
medically necessary circumstances where a patient has experienced a significant
adverse reaction with two (2) lower-cost interchangeable drug products, where
available. When a prescriber identifies a patient for which it is medically necessary
that a higher cost interchangeable product be provided, the prescriber must:
• Complete, sign and forward to the pharmacist a copy of the Health Canada
side effect reporting form for each lower-cost interchangeable drug product
trialed (Side Effect Reporting Form[s]); and
• Write “No Substitution” or “No Sub” on a written prescription or indicate “No
Substitution” to the pharmacist in the case of a verbal prescription.
The prescriber should keep a copy of the completed form in the patient’s record for
future use and reference.
In the case of a written prescription, when the pharmacist or dispensing physician
receives a prescription with the written notation “No Substitution” or “No Sub”,
reimbursement will be provided for the higher-cost interchangeable product only if
the prescription is accompanied by a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed.
This form must be completely filled out noting the details of the adverse reaction
and signed by the prescriber.
In the case of a verbal prescription, the prescriber must satisfy the operator of the
pharmacy or dispensing physician that a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed
has been completed and signed by the prescriber. A written record of this verbal
prescription and the completed Health Canada Side Effect Reporting Form must be
received by the pharmacy prior to claim submission.
Upon receipt, the pharmacist must:
• Fax, submit online or mail the completed and signed form to Health Canada’s
Canada Vigilance Program; and
• Retain his or her copy of the completed and signed Side Effect Reporting
Form.
(ontario.ca, Revision #17; 2026-08-03 ↗)How long EAP takes
Turnaround times
The Exceptional Access Program receives between 250 and 500 requests a day. Requests are categorized in order of priority based on how quickly a drug is needed, the type of drug, and the condition for which the drug is being used.
Turnaround times begin on the business day on which the EAP receives a complete request from a physician or nurse practitioner. You may have to wait longer if the request is missing information or supporting documents required by the EAP criteria, if a request requires external review, or if documents are sent by fax or mail instead of submitted via SADIE.
EAP Weekly Progress Report
Date: September 15, 2026
Processing categories and examples | Target | Current |
Priority 1 — for drugs such as antibiotics, cancer medications, and initial requests for pain medications | 3 business days | 2 business day |
Priority 2 — for antiviral drugs to treat HIV, drugs for multiple sclerosis, and pulmonary hypertension | 5 business days | 3 business days |
Biologics — for biologic drugs to treat rheumatoid arthritis, psoriatic arthritis, ulcerative colitis and Crohn’s disease | 10 business days | 4 business days |
Chronic — for drugs used for chronic conditions such as migraines, chronic pain, Ménière's disease and symptoms of Parkinson’s disease. | 4 to 6 weeks | 11 business days |
(ontario.ca, Updated September 15, 2026 ↗)
For selected drugs, the Telephone Request Service is available to authorized prescribers or their delegates. In most cases, the funding decision is provided by the end of the call and processed within one business day.
(ontario.ca, Updated September 15, 2026 ↗)1 brand, same coverage
Taro-Bosentan · DIN 02483149
Manufacturer: Taro Pharmaceuticals Inc.; listing date 2020-05-29
Health Canada: Marketed since 2020-05-07 · brand TARO-BOSENTAN · ATC C02KX01 BOSENTAN · form Tablet · route Oral · ingredients BOSENTAN (BOSENTAN MONOHYDRATE) 125 MG · company Taro pharmaceuticals inc · schedule Prescription
Check this DIN again · Health Canada product recordTaro-Bosentan: Formulary list price $32.0893/unit (unit not stated in source; not the patient's cost)
Ministry pays: $32.0893 per source unit.
Source explanation: The formulary price is what ODB pays; the cash price at the counter is set by the pharmacy.
Formulary data: Ontario extract of Aug 26, 2026 · Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=97360 · Verify on the e-Formulary ↗ (DIN 02483149)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02483149).
DIN 02483149: Taro-Bosentan
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 241200097; group id 363; item number 0850; lccId None; manufacturer id TAR
Source form: Tab; strength: 125mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $32.0893; ministry $32.0893
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02483149
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=97360
Interchangeable products
Apo-Bosentan · DIN 02399210 · $32.0893
Co Bosentan · DIN 02386208 · $32.0893
Nat-Bosentan · DIN 02467992 · $32.0893
PMS-Bosentan · DIN 02383020 · $32.0893
Sandoz Bosentan · DIN 02386283 · $32.0893
Tracleer · DIN 02244982 · $32.0893
Shortage status: resolved shortage (ended 2025-08-08); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02483149
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Tracleer · DIN 02244982 · 125mg · tablet
Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-02
StatusOff-Formulary Interchangeable, not an ODB benefit
Write on scriptExceptional Access application required. For a drug to be considered for funding, the EAP reimbursement criteria must always be met and the request approved prior to the initiation of treatment with the drug being requested, unless otherwise specified within the criteria. (ontario.ca, Aug 31, 2026 ↗) Submit through SADIE: "The SADIE portal is available to authorized prescribers and their delegates and designates, enabling the creation, submission and tracking of web-based electronic requests directly to the Exceptional Access Program." (ontario.ca, Aug 31, 2026 ↗) Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. Current criteria in SADIE
Coverage criteria
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated April 20, 2021
All requests (initial, renewal, monotherapy, combination therapy) for a PAH drug
must come from one of the following recognized PAH referral centres.
o Pulmonary Hypertension Centre
Hamilton Health Sciences – General Hospital
o The Firestone Institute Pulmonary Hypertension Program
St. Joseph's Healthcare Hamilton and McMaster University
o Pulmonary Hypertension Clinic
Hotel Dieu Hospital/Kingston General Hospital
o Pulmonary Hypertension Program
London Health Science Centre – Victoria Hospital
o Ottawa Pulmonary Hypertension Clinic
University of Ottawa Heart Institute and the Ottawa Hospital
o University Health Network Pulmonary Hypertension Program
Toronto General Hospital
Requests from other physicians/centres must include a recent (less than or equal to 3
months old) consult note/recommendation from a recognized PAH referral centre that
supports the request;
Out-of-province referral centre consults (e.g., from Winnipeg for patients in Northern
Ontario) will also be considered on a case-by-case basis
Initial Criteria:
For the treatment of patients with pulmonary arterial hypertension (PAH) [WHO Group 1
Pulmonary hypertension] who meet all the following criteria;
416
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 416, record 250, corpus 2025-01-01; name match only, not an eligibility decision
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated: April 20, 2021
• PAH defined as a resting mean pulmonary artery pressure (mPAP) of ≥ 25 mmHg
at rest AND normal pulmonary capillary wedge pressure (PCWP) ≤ 15 mmHg on
right heart catheterization1; AND
• The drug request meets one of the following circumstances of use:
o Drug is being used as monotherapy in a patient with WHO-functional class III or
IV; OR
o Drug is being used as monotherapy in a patient with WHO-functional class II
who has contraindication or has intolerance to a PDE-5 inhibitor; OR
o Drug is being used as sequential dual therapy in combination with a funded
PDE-5 (i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol,
treprostinil) in a patient who has had an inadequate response with monotherapy
(i.e., failure to achieve WHO-FC I or II; or 6MWD >440 metres; or no/mild RV
failure); OR
o Drug is being used as up-front dual therapy in combination with a funded PDE-5
(i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol, treprostinil) in
a patient with advanced disease (i.e. WHO-functional class III or IV; OR 6MWD
<380 metres; OR evidence of RV failure.)
1 Note: Left ventricular end-diastolic pressure ≤15 mmHg is also acceptable.
417
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 417, record 253, corpus 2025-01-01; name match only, not an eligibility decision
How long EAP takes
Turnaround times
The Exceptional Access Program receives between 250 and 500 requests a day. Requests are categorized in order of priority based on how quickly a drug is needed, the type of drug, and the condition for which the drug is being used.
Turnaround times begin on the business day on which the EAP receives a complete request from a physician or nurse practitioner. You may have to wait longer if the request is missing information or supporting documents required by the EAP criteria, if a request requires external review, or if documents are sent by fax or mail instead of submitted via SADIE.
EAP Weekly Progress Report
Date: September 15, 2026
Processing categories and examples | Target | Current |
Priority 1 — for drugs such as antibiotics, cancer medications, and initial requests for pain medications | 3 business days | 2 business day |
Priority 2 — for antiviral drugs to treat HIV, drugs for multiple sclerosis, and pulmonary hypertension | 5 business days | 3 business days |
Biologics — for biologic drugs to treat rheumatoid arthritis, psoriatic arthritis, ulcerative colitis and Crohn’s disease | 10 business days | 4 business days |
Chronic — for drugs used for chronic conditions such as migraines, chronic pain, Ménière's disease and symptoms of Parkinson’s disease. | 4 to 6 weeks | 11 business days |
(ontario.ca, Updated September 15, 2026 ↗)
For selected drugs, the Telephone Request Service is available to authorized prescribers or their delegates. In most cases, the funding decision is provided by the end of the call and processed within one business day.
(ontario.ca, Updated September 15, 2026 ↗)1 brand, same coverage
Tracleer · DIN 02244982
Manufacturer: Janssen Inc.; listing date 2012-07-27
Health Canada: Marketed since 2019-10-18 · brand TRACLEER · ATC C02KX01 BOSENTAN · form Tablet · route Oral · ingredients BOSENTAN (BOSENTAN MONOHYDRATE) 125 MG · company Janssen inc · schedule Prescription
Check this DIN again · Health Canada product recordMinistry pays: $32.0893 per source unit.
Source explanation: The formulary price is what ODB pays; the cash price at the counter is set by the pharmacy.
Formulary data: Ontario extract of Aug 26, 2026 · Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=68980 · Verify on the e-Formulary ↗ (DIN 02244982)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02244982).
DIN 02244982: Tracleer
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 241200097; group id 363; item number 0850; lccId None; manufacturer id JAN
Source form: Tab; strength: 125mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $88.8725; ministry $32.0893
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02244982
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=68980
Interchangeable products
Apo-Bosentan · DIN 02399210 · $32.0893
Co Bosentan · DIN 02386208 · $32.0893
Nat-Bosentan · DIN 02467992 · $32.0893
PMS-Bosentan · DIN 02383020 · $32.0893
Sandoz Bosentan · DIN 02386283 · $32.0893
Taro-Bosentan · DIN 02483149 · $32.0893
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02244982
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Apo-Bosentan · DIN 02399202 · 62.5mg · tablet
StatusOff-Formulary Interchangeable, not an ODB benefit
Write on scriptExceptional Access application required. For a drug to be considered for funding, the EAP reimbursement criteria must always be met and the request approved prior to the initiation of treatment with the drug being requested, unless otherwise specified within the criteria. (ontario.ca, Aug 31, 2026 ↗) Submit through SADIE: "The SADIE portal is available to authorized prescribers and their delegates and designates, enabling the creation, submission and tracking of web-based electronic requests directly to the Exceptional Access Program." (ontario.ca, Aug 31, 2026 ↗) Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. Current criteria in SADIE
Coverage criteria
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated April 20, 2021
All requests (initial, renewal, monotherapy, combination therapy) for a PAH drug
must come from one of the following recognized PAH referral centres.
o Pulmonary Hypertension Centre
Hamilton Health Sciences – General Hospital
o The Firestone Institute Pulmonary Hypertension Program
St. Joseph's Healthcare Hamilton and McMaster University
o Pulmonary Hypertension Clinic
Hotel Dieu Hospital/Kingston General Hospital
o Pulmonary Hypertension Program
London Health Science Centre – Victoria Hospital
o Ottawa Pulmonary Hypertension Clinic
University of Ottawa Heart Institute and the Ottawa Hospital
o University Health Network Pulmonary Hypertension Program
Toronto General Hospital
Requests from other physicians/centres must include a recent (less than or equal to 3
months old) consult note/recommendation from a recognized PAH referral centre that
supports the request;
Out-of-province referral centre consults (e.g., from Winnipeg for patients in Northern
Ontario) will also be considered on a case-by-case basis
Initial Criteria:
For the treatment of patients with pulmonary arterial hypertension (PAH) [WHO Group 1
Pulmonary hypertension] who meet all the following criteria;
416
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 416, record 250, corpus 2025-01-01; name match only, not an eligibility decision
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated: April 20, 2021
• PAH defined as a resting mean pulmonary artery pressure (mPAP) of ≥ 25 mmHg
at rest AND normal pulmonary capillary wedge pressure (PCWP) ≤ 15 mmHg on
right heart catheterization1; AND
• The drug request meets one of the following circumstances of use:
o Drug is being used as monotherapy in a patient with WHO-functional class III or
IV; OR
o Drug is being used as monotherapy in a patient with WHO-functional class II
who has contraindication or has intolerance to a PDE-5 inhibitor; OR
o Drug is being used as sequential dual therapy in combination with a funded
PDE-5 (i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol,
treprostinil) in a patient who has had an inadequate response with monotherapy
(i.e., failure to achieve WHO-FC I or II; or 6MWD >440 metres; or no/mild RV
failure); OR
o Drug is being used as up-front dual therapy in combination with a funded PDE-5
(i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol, treprostinil) in
a patient with advanced disease (i.e. WHO-functional class III or IV; OR 6MWD
<380 metres; OR evidence of RV failure.)
1 Note: Left ventricular end-diastolic pressure ≤15 mmHg is also acceptable.
417
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 417, record 253, corpus 2025-01-01; name match only, not an eligibility decision
Brand vs generic price
Lowest DBP recovery rule under medically necessary no-substitution claims:
6.2 Medically Necessary "No Substitution" Claims
The Side Effect Reporting Form will not have to be renewed. However, the
pharmacy must maintain a copy of the prescription that contains a direction that
there be no substitution and the required Health Canada Side Effect Reporting Form
(completed and signed by the prescriber). The prescriber must write “No
Substitution” or “No Sub” on renewal or subsequent new written prescriptions, and
indicate “No Substitution” on subsequent new oral prescriptions. The dispenser will
be reimbursed the DBP plus a mark-up and the lesser of the posted usual and
customary fee or the ODB dispensing fee minus the applicable ODB co-payment
amount. Where a completed Side Effect Reporting Form is not available at the
pharmacy during an inspection, the difference between the cost of the higher-cost
product and the lowest DBP listed for the interchangeable category will be
recovered.
(ontario.ca, Revision #17; 2026-08-03 ↗)
6.2 Medically Necessary "No Substitution" Claims
The Ministry will provide reimbursement of a higher-cost interchangeable product in
medically necessary circumstances where a patient has experienced a significant
adverse reaction with two (2) lower-cost interchangeable drug products, where
available. When a prescriber identifies a patient for which it is medically necessary
that a higher cost interchangeable product be provided, the prescriber must:
• Complete, sign and forward to the pharmacist a copy of the Health Canada
side effect reporting form for each lower-cost interchangeable drug product
trialed (Side Effect Reporting Form[s]); and
• Write “No Substitution” or “No Sub” on a written prescription or indicate “No
Substitution” to the pharmacist in the case of a verbal prescription.
The prescriber should keep a copy of the completed form in the patient’s record for
future use and reference.
In the case of a written prescription, when the pharmacist or dispensing physician
receives a prescription with the written notation “No Substitution” or “No Sub”,
reimbursement will be provided for the higher-cost interchangeable product only if
the prescription is accompanied by a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed.
This form must be completely filled out noting the details of the adverse reaction
and signed by the prescriber.
In the case of a verbal prescription, the prescriber must satisfy the operator of the
pharmacy or dispensing physician that a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed
has been completed and signed by the prescriber. A written record of this verbal
prescription and the completed Health Canada Side Effect Reporting Form must be
received by the pharmacy prior to claim submission.
Upon receipt, the pharmacist must:
• Fax, submit online or mail the completed and signed form to Health Canada’s
Canada Vigilance Program; and
• Retain his or her copy of the completed and signed Side Effect Reporting
Form.
(ontario.ca, Revision #17; 2026-08-03 ↗)How long EAP takes
Turnaround times
The Exceptional Access Program receives between 250 and 500 requests a day. Requests are categorized in order of priority based on how quickly a drug is needed, the type of drug, and the condition for which the drug is being used.
Turnaround times begin on the business day on which the EAP receives a complete request from a physician or nurse practitioner. You may have to wait longer if the request is missing information or supporting documents required by the EAP criteria, if a request requires external review, or if documents are sent by fax or mail instead of submitted via SADIE.
EAP Weekly Progress Report
Date: September 15, 2026
Processing categories and examples | Target | Current |
Priority 1 — for drugs such as antibiotics, cancer medications, and initial requests for pain medications | 3 business days | 2 business day |
Priority 2 — for antiviral drugs to treat HIV, drugs for multiple sclerosis, and pulmonary hypertension | 5 business days | 3 business days |
Biologics — for biologic drugs to treat rheumatoid arthritis, psoriatic arthritis, ulcerative colitis and Crohn’s disease | 10 business days | 4 business days |
Chronic — for drugs used for chronic conditions such as migraines, chronic pain, Ménière's disease and symptoms of Parkinson’s disease. | 4 to 6 weeks | 11 business days |
(ontario.ca, Updated September 15, 2026 ↗)
For selected drugs, the Telephone Request Service is available to authorized prescribers or their delegates. In most cases, the funding decision is provided by the end of the call and processed within one business day.
(ontario.ca, Updated September 15, 2026 ↗)1 brand, same coverage
Apo-Bosentan · DIN 02399202
Manufacturer: Apotex Inc.; listing date 2014-10-29
Health Canada: Dormant since 2019-10-04 · brand APO-BOSENTAN · ATC C02KX01 BOSENTAN · form Tablet · route Oral · ingredients BOSENTAN (BOSENTAN MONOHYDRATE) 62.5 MG · company Apotex inc · schedule Prescription
Check this DIN again · Health Canada product recordApo-Bosentan: Formulary list price $32.0893/unit (unit not stated in source; not the patient's cost)
Ministry pays: $32.0893 per source unit.
Source explanation: The formulary price is what ODB pays; the cash price at the counter is set by the pharmacy.
Formulary data: Ontario extract of Aug 26, 2026 · Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=88412 · Verify on the e-Formulary ↗ (DIN 02399202)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02399202).
DIN 02399202: Apo-Bosentan
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 241200096; group id 363; item number 0849; lccId None; manufacturer id APX
Source form: Tab; strength: 62.5mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $32.0893; ministry $32.0893
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02399202
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=88412
Interchangeable products
Co Bosentan · DIN 02386194 · $32.0893
Nat-Bosentan · DIN 02467984 · $32.0893
PMS-Bosentan · DIN 02383012 · $32.0893
Sandoz Bosentan · DIN 02386275 · $32.0893
Taro-Bosentan · DIN 02483130 · $32.0893
Tracleer · DIN 02244981 · $32.0893
Shortage status: discontinued (2018-12-17, reported by APOTEX INC); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02399202
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Health Canada lists this DIN as Dormant since 2019-10-04 — choose a marketed DIN from the same-category list.
Nat-Bosentan · DIN 02467984 · 62.5mg · tablet
Off-Formulary Interchangeable, not an ODB benefitDormant since 2025-12-01 · checked 2026-09-02
StatusOff-Formulary Interchangeable, not an ODB benefit
Write on scriptExceptional Access application required. For a drug to be considered for funding, the EAP reimbursement criteria must always be met and the request approved prior to the initiation of treatment with the drug being requested, unless otherwise specified within the criteria. (ontario.ca, Aug 31, 2026 ↗) Submit through SADIE: "The SADIE portal is available to authorized prescribers and their delegates and designates, enabling the creation, submission and tracking of web-based electronic requests directly to the Exceptional Access Program." (ontario.ca, Aug 31, 2026 ↗) Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. Current criteria in SADIE
Coverage criteria
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated April 20, 2021
All requests (initial, renewal, monotherapy, combination therapy) for a PAH drug
must come from one of the following recognized PAH referral centres.
o Pulmonary Hypertension Centre
Hamilton Health Sciences – General Hospital
o The Firestone Institute Pulmonary Hypertension Program
St. Joseph's Healthcare Hamilton and McMaster University
o Pulmonary Hypertension Clinic
Hotel Dieu Hospital/Kingston General Hospital
o Pulmonary Hypertension Program
London Health Science Centre – Victoria Hospital
o Ottawa Pulmonary Hypertension Clinic
University of Ottawa Heart Institute and the Ottawa Hospital
o University Health Network Pulmonary Hypertension Program
Toronto General Hospital
Requests from other physicians/centres must include a recent (less than or equal to 3
months old) consult note/recommendation from a recognized PAH referral centre that
supports the request;
Out-of-province referral centre consults (e.g., from Winnipeg for patients in Northern
Ontario) will also be considered on a case-by-case basis
Initial Criteria:
For the treatment of patients with pulmonary arterial hypertension (PAH) [WHO Group 1
Pulmonary hypertension] who meet all the following criteria;
416
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 416, record 250, corpus 2025-01-01; name match only, not an eligibility decision
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated: April 20, 2021
• PAH defined as a resting mean pulmonary artery pressure (mPAP) of ≥ 25 mmHg
at rest AND normal pulmonary capillary wedge pressure (PCWP) ≤ 15 mmHg on
right heart catheterization1; AND
• The drug request meets one of the following circumstances of use:
o Drug is being used as monotherapy in a patient with WHO-functional class III or
IV; OR
o Drug is being used as monotherapy in a patient with WHO-functional class II
who has contraindication or has intolerance to a PDE-5 inhibitor; OR
o Drug is being used as sequential dual therapy in combination with a funded
PDE-5 (i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol,
treprostinil) in a patient who has had an inadequate response with monotherapy
(i.e., failure to achieve WHO-FC I or II; or 6MWD >440 metres; or no/mild RV
failure); OR
o Drug is being used as up-front dual therapy in combination with a funded PDE-5
(i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol, treprostinil) in
a patient with advanced disease (i.e. WHO-functional class III or IV; OR 6MWD
<380 metres; OR evidence of RV failure.)
1 Note: Left ventricular end-diastolic pressure ≤15 mmHg is also acceptable.
417
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 417, record 253, corpus 2025-01-01; name match only, not an eligibility decision
Brand vs generic price
Lowest DBP recovery rule under medically necessary no-substitution claims:
6.2 Medically Necessary "No Substitution" Claims
The Side Effect Reporting Form will not have to be renewed. However, the
pharmacy must maintain a copy of the prescription that contains a direction that
there be no substitution and the required Health Canada Side Effect Reporting Form
(completed and signed by the prescriber). The prescriber must write “No
Substitution” or “No Sub” on renewal or subsequent new written prescriptions, and
indicate “No Substitution” on subsequent new oral prescriptions. The dispenser will
be reimbursed the DBP plus a mark-up and the lesser of the posted usual and
customary fee or the ODB dispensing fee minus the applicable ODB co-payment
amount. Where a completed Side Effect Reporting Form is not available at the
pharmacy during an inspection, the difference between the cost of the higher-cost
product and the lowest DBP listed for the interchangeable category will be
recovered.
(ontario.ca, Revision #17; 2026-08-03 ↗)
6.2 Medically Necessary "No Substitution" Claims
The Ministry will provide reimbursement of a higher-cost interchangeable product in
medically necessary circumstances where a patient has experienced a significant
adverse reaction with two (2) lower-cost interchangeable drug products, where
available. When a prescriber identifies a patient for which it is medically necessary
that a higher cost interchangeable product be provided, the prescriber must:
• Complete, sign and forward to the pharmacist a copy of the Health Canada
side effect reporting form for each lower-cost interchangeable drug product
trialed (Side Effect Reporting Form[s]); and
• Write “No Substitution” or “No Sub” on a written prescription or indicate “No
Substitution” to the pharmacist in the case of a verbal prescription.
The prescriber should keep a copy of the completed form in the patient’s record for
future use and reference.
In the case of a written prescription, when the pharmacist or dispensing physician
receives a prescription with the written notation “No Substitution” or “No Sub”,
reimbursement will be provided for the higher-cost interchangeable product only if
the prescription is accompanied by a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed.
This form must be completely filled out noting the details of the adverse reaction
and signed by the prescriber.
In the case of a verbal prescription, the prescriber must satisfy the operator of the
pharmacy or dispensing physician that a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed
has been completed and signed by the prescriber. A written record of this verbal
prescription and the completed Health Canada Side Effect Reporting Form must be
received by the pharmacy prior to claim submission.
Upon receipt, the pharmacist must:
• Fax, submit online or mail the completed and signed form to Health Canada’s
Canada Vigilance Program; and
• Retain his or her copy of the completed and signed Side Effect Reporting
Form.
(ontario.ca, Revision #17; 2026-08-03 ↗)How long EAP takes
Turnaround times
The Exceptional Access Program receives between 250 and 500 requests a day. Requests are categorized in order of priority based on how quickly a drug is needed, the type of drug, and the condition for which the drug is being used.
Turnaround times begin on the business day on which the EAP receives a complete request from a physician or nurse practitioner. You may have to wait longer if the request is missing information or supporting documents required by the EAP criteria, if a request requires external review, or if documents are sent by fax or mail instead of submitted via SADIE.
EAP Weekly Progress Report
Date: September 15, 2026
Processing categories and examples | Target | Current |
Priority 1 — for drugs such as antibiotics, cancer medications, and initial requests for pain medications | 3 business days | 2 business day |
Priority 2 — for antiviral drugs to treat HIV, drugs for multiple sclerosis, and pulmonary hypertension | 5 business days | 3 business days |
Biologics — for biologic drugs to treat rheumatoid arthritis, psoriatic arthritis, ulcerative colitis and Crohn’s disease | 10 business days | 4 business days |
Chronic — for drugs used for chronic conditions such as migraines, chronic pain, Ménière's disease and symptoms of Parkinson’s disease. | 4 to 6 weeks | 11 business days |
(ontario.ca, Updated September 15, 2026 ↗)
For selected drugs, the Telephone Request Service is available to authorized prescribers or their delegates. In most cases, the funding decision is provided by the end of the call and processed within one business day.
(ontario.ca, Updated September 15, 2026 ↗)1 brand, same coverage
Nat-Bosentan · DIN 02467984
Manufacturer: Natco Pharma (Canada) Inc.; listing date 2019-01-31
Health Canada: Dormant since 2025-12-01 · brand NAT-BOSENTAN · ATC C02KX01 BOSENTAN · form Tablet · route Oral · ingredients BOSENTAN (BOSENTAN MONOHYDRATE) 62.5 MG · company Natco pharma (canada) inc · schedule Prescription
Check this DIN again · Health Canada product recordNat-Bosentan: Formulary list price $32.0893/unit (unit not stated in source; not the patient's cost)
Ministry pays: $32.0893 per source unit.
Source explanation: The formulary price is what ODB pays; the cash price at the counter is set by the pharmacy.
Formulary data: Ontario extract of Aug 26, 2026 · Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=95635 · Verify on the e-Formulary ↗ (DIN 02467984)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02467984).
DIN 02467984: Nat-Bosentan
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 241200096; group id 363; item number 0849; lccId None; manufacturer id NAT
Source form: Tab; strength: 62.5mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $32.0893; ministry $32.0893
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02467984
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=95635
Interchangeable products
Apo-Bosentan · DIN 02399202 · $32.0893
Co Bosentan · DIN 02386194 · $32.0893
PMS-Bosentan · DIN 02383012 · $32.0893
Sandoz Bosentan · DIN 02386275 · $32.0893
Taro-Bosentan · DIN 02483130 · $32.0893
Tracleer · DIN 02244981 · $32.0893
Shortage status: active shortage (reported 2024-11-18, estimated to end 2027-06-30, last updated 2026-04-13); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02467984
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Health Canada lists this DIN as Dormant since 2025-12-01 — choose a marketed DIN from the same-category list.
Apo-Bosentan · DIN 02399210 · 125mg · tablet
Off-Formulary Interchangeable, not an ODB benefitDormant since 2019-11-03 · checked 2026-09-02
StatusOff-Formulary Interchangeable, not an ODB benefit
Write on scriptExceptional Access application required. For a drug to be considered for funding, the EAP reimbursement criteria must always be met and the request approved prior to the initiation of treatment with the drug being requested, unless otherwise specified within the criteria. (ontario.ca, Aug 31, 2026 ↗) Submit through SADIE: "The SADIE portal is available to authorized prescribers and their delegates and designates, enabling the creation, submission and tracking of web-based electronic requests directly to the Exceptional Access Program." (ontario.ca, Aug 31, 2026 ↗) Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. Current criteria in SADIE
Coverage criteria
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated April 20, 2021
All requests (initial, renewal, monotherapy, combination therapy) for a PAH drug
must come from one of the following recognized PAH referral centres.
o Pulmonary Hypertension Centre
Hamilton Health Sciences – General Hospital
o The Firestone Institute Pulmonary Hypertension Program
St. Joseph's Healthcare Hamilton and McMaster University
o Pulmonary Hypertension Clinic
Hotel Dieu Hospital/Kingston General Hospital
o Pulmonary Hypertension Program
London Health Science Centre – Victoria Hospital
o Ottawa Pulmonary Hypertension Clinic
University of Ottawa Heart Institute and the Ottawa Hospital
o University Health Network Pulmonary Hypertension Program
Toronto General Hospital
Requests from other physicians/centres must include a recent (less than or equal to 3
months old) consult note/recommendation from a recognized PAH referral centre that
supports the request;
Out-of-province referral centre consults (e.g., from Winnipeg for patients in Northern
Ontario) will also be considered on a case-by-case basis
Initial Criteria:
For the treatment of patients with pulmonary arterial hypertension (PAH) [WHO Group 1
Pulmonary hypertension] who meet all the following criteria;
416
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 416, record 250, corpus 2025-01-01; name match only, not an eligibility decision
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated: April 20, 2021
• PAH defined as a resting mean pulmonary artery pressure (mPAP) of ≥ 25 mmHg
at rest AND normal pulmonary capillary wedge pressure (PCWP) ≤ 15 mmHg on
right heart catheterization1; AND
• The drug request meets one of the following circumstances of use:
o Drug is being used as monotherapy in a patient with WHO-functional class III or
IV; OR
o Drug is being used as monotherapy in a patient with WHO-functional class II
who has contraindication or has intolerance to a PDE-5 inhibitor; OR
o Drug is being used as sequential dual therapy in combination with a funded
PDE-5 (i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol,
treprostinil) in a patient who has had an inadequate response with monotherapy
(i.e., failure to achieve WHO-FC I or II; or 6MWD >440 metres; or no/mild RV
failure); OR
o Drug is being used as up-front dual therapy in combination with a funded PDE-5
(i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol, treprostinil) in
a patient with advanced disease (i.e. WHO-functional class III or IV; OR 6MWD
<380 metres; OR evidence of RV failure.)
1 Note: Left ventricular end-diastolic pressure ≤15 mmHg is also acceptable.
417
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 417, record 253, corpus 2025-01-01; name match only, not an eligibility decision
Brand vs generic price
Lowest DBP recovery rule under medically necessary no-substitution claims:
6.2 Medically Necessary "No Substitution" Claims
The Side Effect Reporting Form will not have to be renewed. However, the
pharmacy must maintain a copy of the prescription that contains a direction that
there be no substitution and the required Health Canada Side Effect Reporting Form
(completed and signed by the prescriber). The prescriber must write “No
Substitution” or “No Sub” on renewal or subsequent new written prescriptions, and
indicate “No Substitution” on subsequent new oral prescriptions. The dispenser will
be reimbursed the DBP plus a mark-up and the lesser of the posted usual and
customary fee or the ODB dispensing fee minus the applicable ODB co-payment
amount. Where a completed Side Effect Reporting Form is not available at the
pharmacy during an inspection, the difference between the cost of the higher-cost
product and the lowest DBP listed for the interchangeable category will be
recovered.
(ontario.ca, Revision #17; 2026-08-03 ↗)
6.2 Medically Necessary "No Substitution" Claims
The Ministry will provide reimbursement of a higher-cost interchangeable product in
medically necessary circumstances where a patient has experienced a significant
adverse reaction with two (2) lower-cost interchangeable drug products, where
available. When a prescriber identifies a patient for which it is medically necessary
that a higher cost interchangeable product be provided, the prescriber must:
• Complete, sign and forward to the pharmacist a copy of the Health Canada
side effect reporting form for each lower-cost interchangeable drug product
trialed (Side Effect Reporting Form[s]); and
• Write “No Substitution” or “No Sub” on a written prescription or indicate “No
Substitution” to the pharmacist in the case of a verbal prescription.
The prescriber should keep a copy of the completed form in the patient’s record for
future use and reference.
In the case of a written prescription, when the pharmacist or dispensing physician
receives a prescription with the written notation “No Substitution” or “No Sub”,
reimbursement will be provided for the higher-cost interchangeable product only if
the prescription is accompanied by a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed.
This form must be completely filled out noting the details of the adverse reaction
and signed by the prescriber.
In the case of a verbal prescription, the prescriber must satisfy the operator of the
pharmacy or dispensing physician that a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed
has been completed and signed by the prescriber. A written record of this verbal
prescription and the completed Health Canada Side Effect Reporting Form must be
received by the pharmacy prior to claim submission.
Upon receipt, the pharmacist must:
• Fax, submit online or mail the completed and signed form to Health Canada’s
Canada Vigilance Program; and
• Retain his or her copy of the completed and signed Side Effect Reporting
Form.
(ontario.ca, Revision #17; 2026-08-03 ↗)How long EAP takes
Turnaround times
The Exceptional Access Program receives between 250 and 500 requests a day. Requests are categorized in order of priority based on how quickly a drug is needed, the type of drug, and the condition for which the drug is being used.
Turnaround times begin on the business day on which the EAP receives a complete request from a physician or nurse practitioner. You may have to wait longer if the request is missing information or supporting documents required by the EAP criteria, if a request requires external review, or if documents are sent by fax or mail instead of submitted via SADIE.
EAP Weekly Progress Report
Date: September 15, 2026
Processing categories and examples | Target | Current |
Priority 1 — for drugs such as antibiotics, cancer medications, and initial requests for pain medications | 3 business days | 2 business day |
Priority 2 — for antiviral drugs to treat HIV, drugs for multiple sclerosis, and pulmonary hypertension | 5 business days | 3 business days |
Biologics — for biologic drugs to treat rheumatoid arthritis, psoriatic arthritis, ulcerative colitis and Crohn’s disease | 10 business days | 4 business days |
Chronic — for drugs used for chronic conditions such as migraines, chronic pain, Ménière's disease and symptoms of Parkinson’s disease. | 4 to 6 weeks | 11 business days |
(ontario.ca, Updated September 15, 2026 ↗)
For selected drugs, the Telephone Request Service is available to authorized prescribers or their delegates. In most cases, the funding decision is provided by the end of the call and processed within one business day.
(ontario.ca, Updated September 15, 2026 ↗)1 brand, same coverage
Apo-Bosentan · DIN 02399210
Manufacturer: Apotex Inc.; listing date 2014-10-29
Health Canada: Dormant since 2019-11-03 · brand APO-BOSENTAN · ATC C02KX01 BOSENTAN · form Tablet · route Oral · ingredients BOSENTAN (BOSENTAN MONOHYDRATE) 125 MG · company Apotex inc · schedule Prescription
Check this DIN again · Health Canada product recordApo-Bosentan: Formulary list price $32.0893/unit (unit not stated in source; not the patient's cost)
Ministry pays: $32.0893 per source unit.
Source explanation: The formulary price is what ODB pays; the cash price at the counter is set by the pharmacy.
Formulary data: Ontario extract of Aug 26, 2026 · Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=88413 · Verify on the e-Formulary ↗ (DIN 02399210)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02399210).
DIN 02399210: Apo-Bosentan
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 241200097; group id 363; item number 0850; lccId None; manufacturer id APX
Source form: Tab; strength: 125mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $32.0893; ministry $32.0893
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02399210
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=88413
Interchangeable products
Co Bosentan · DIN 02386208 · $32.0893
Nat-Bosentan · DIN 02467992 · $32.0893
PMS-Bosentan · DIN 02383020 · $32.0893
Sandoz Bosentan · DIN 02386283 · $32.0893
Taro-Bosentan · DIN 02483149 · $32.0893
Tracleer · DIN 02244982 · $32.0893
Shortage status: discontinued (2018-12-17, reported by APOTEX INC); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02399210
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Health Canada lists this DIN as Dormant since 2019-11-03 — choose a marketed DIN from the same-category list.
Nat-Bosentan · DIN 02467992 · 125mg · tablet
Off-Formulary Interchangeable, not an ODB benefitDormant since 2025-12-01 · checked 2026-09-02
StatusOff-Formulary Interchangeable, not an ODB benefit
Write on scriptExceptional Access application required. For a drug to be considered for funding, the EAP reimbursement criteria must always be met and the request approved prior to the initiation of treatment with the drug being requested, unless otherwise specified within the criteria. (ontario.ca, Aug 31, 2026 ↗) Submit through SADIE: "The SADIE portal is available to authorized prescribers and their delegates and designates, enabling the creation, submission and tracking of web-based electronic requests directly to the Exceptional Access Program." (ontario.ca, Aug 31, 2026 ↗) Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. Current criteria in SADIE
Coverage criteria
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated April 20, 2021
All requests (initial, renewal, monotherapy, combination therapy) for a PAH drug
must come from one of the following recognized PAH referral centres.
o Pulmonary Hypertension Centre
Hamilton Health Sciences – General Hospital
o The Firestone Institute Pulmonary Hypertension Program
St. Joseph's Healthcare Hamilton and McMaster University
o Pulmonary Hypertension Clinic
Hotel Dieu Hospital/Kingston General Hospital
o Pulmonary Hypertension Program
London Health Science Centre – Victoria Hospital
o Ottawa Pulmonary Hypertension Clinic
University of Ottawa Heart Institute and the Ottawa Hospital
o University Health Network Pulmonary Hypertension Program
Toronto General Hospital
Requests from other physicians/centres must include a recent (less than or equal to 3
months old) consult note/recommendation from a recognized PAH referral centre that
supports the request;
Out-of-province referral centre consults (e.g., from Winnipeg for patients in Northern
Ontario) will also be considered on a case-by-case basis
Initial Criteria:
For the treatment of patients with pulmonary arterial hypertension (PAH) [WHO Group 1
Pulmonary hypertension] who meet all the following criteria;
416
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 416, record 250, corpus 2025-01-01; name match only, not an eligibility decision
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated: April 20, 2021
• PAH defined as a resting mean pulmonary artery pressure (mPAP) of ≥ 25 mmHg
at rest AND normal pulmonary capillary wedge pressure (PCWP) ≤ 15 mmHg on
right heart catheterization1; AND
• The drug request meets one of the following circumstances of use:
o Drug is being used as monotherapy in a patient with WHO-functional class III or
IV; OR
o Drug is being used as monotherapy in a patient with WHO-functional class II
who has contraindication or has intolerance to a PDE-5 inhibitor; OR
o Drug is being used as sequential dual therapy in combination with a funded
PDE-5 (i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol,
treprostinil) in a patient who has had an inadequate response with monotherapy
(i.e., failure to achieve WHO-FC I or II; or 6MWD >440 metres; or no/mild RV
failure); OR
o Drug is being used as up-front dual therapy in combination with a funded PDE-5
(i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol, treprostinil) in
a patient with advanced disease (i.e. WHO-functional class III or IV; OR 6MWD
<380 metres; OR evidence of RV failure.)
1 Note: Left ventricular end-diastolic pressure ≤15 mmHg is also acceptable.
417
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 417, record 253, corpus 2025-01-01; name match only, not an eligibility decision
Brand vs generic price
Lowest DBP recovery rule under medically necessary no-substitution claims:
6.2 Medically Necessary "No Substitution" Claims
The Side Effect Reporting Form will not have to be renewed. However, the
pharmacy must maintain a copy of the prescription that contains a direction that
there be no substitution and the required Health Canada Side Effect Reporting Form
(completed and signed by the prescriber). The prescriber must write “No
Substitution” or “No Sub” on renewal or subsequent new written prescriptions, and
indicate “No Substitution” on subsequent new oral prescriptions. The dispenser will
be reimbursed the DBP plus a mark-up and the lesser of the posted usual and
customary fee or the ODB dispensing fee minus the applicable ODB co-payment
amount. Where a completed Side Effect Reporting Form is not available at the
pharmacy during an inspection, the difference between the cost of the higher-cost
product and the lowest DBP listed for the interchangeable category will be
recovered.
(ontario.ca, Revision #17; 2026-08-03 ↗)
6.2 Medically Necessary "No Substitution" Claims
The Ministry will provide reimbursement of a higher-cost interchangeable product in
medically necessary circumstances where a patient has experienced a significant
adverse reaction with two (2) lower-cost interchangeable drug products, where
available. When a prescriber identifies a patient for which it is medically necessary
that a higher cost interchangeable product be provided, the prescriber must:
• Complete, sign and forward to the pharmacist a copy of the Health Canada
side effect reporting form for each lower-cost interchangeable drug product
trialed (Side Effect Reporting Form[s]); and
• Write “No Substitution” or “No Sub” on a written prescription or indicate “No
Substitution” to the pharmacist in the case of a verbal prescription.
The prescriber should keep a copy of the completed form in the patient’s record for
future use and reference.
In the case of a written prescription, when the pharmacist or dispensing physician
receives a prescription with the written notation “No Substitution” or “No Sub”,
reimbursement will be provided for the higher-cost interchangeable product only if
the prescription is accompanied by a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed.
This form must be completely filled out noting the details of the adverse reaction
and signed by the prescriber.
In the case of a verbal prescription, the prescriber must satisfy the operator of the
pharmacy or dispensing physician that a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed
has been completed and signed by the prescriber. A written record of this verbal
prescription and the completed Health Canada Side Effect Reporting Form must be
received by the pharmacy prior to claim submission.
Upon receipt, the pharmacist must:
• Fax, submit online or mail the completed and signed form to Health Canada’s
Canada Vigilance Program; and
• Retain his or her copy of the completed and signed Side Effect Reporting
Form.
(ontario.ca, Revision #17; 2026-08-03 ↗)How long EAP takes
Turnaround times
The Exceptional Access Program receives between 250 and 500 requests a day. Requests are categorized in order of priority based on how quickly a drug is needed, the type of drug, and the condition for which the drug is being used.
Turnaround times begin on the business day on which the EAP receives a complete request from a physician or nurse practitioner. You may have to wait longer if the request is missing information or supporting documents required by the EAP criteria, if a request requires external review, or if documents are sent by fax or mail instead of submitted via SADIE.
EAP Weekly Progress Report
Date: September 15, 2026
Processing categories and examples | Target | Current |
Priority 1 — for drugs such as antibiotics, cancer medications, and initial requests for pain medications | 3 business days | 2 business day |
Priority 2 — for antiviral drugs to treat HIV, drugs for multiple sclerosis, and pulmonary hypertension | 5 business days | 3 business days |
Biologics — for biologic drugs to treat rheumatoid arthritis, psoriatic arthritis, ulcerative colitis and Crohn’s disease | 10 business days | 4 business days |
Chronic — for drugs used for chronic conditions such as migraines, chronic pain, Ménière's disease and symptoms of Parkinson’s disease. | 4 to 6 weeks | 11 business days |
(ontario.ca, Updated September 15, 2026 ↗)
For selected drugs, the Telephone Request Service is available to authorized prescribers or their delegates. In most cases, the funding decision is provided by the end of the call and processed within one business day.
(ontario.ca, Updated September 15, 2026 ↗)1 brand, same coverage
Nat-Bosentan · DIN 02467992
Manufacturer: Natco Pharma (Canada) Inc.; listing date 2019-01-31
Health Canada: Dormant since 2025-12-01 · brand NAT-BOSENTAN · ATC C02KX01 BOSENTAN · form Tablet · route Oral · ingredients BOSENTAN (BOSENTAN MONOHYDRATE) 125 MG · company Natco pharma (canada) inc · schedule Prescription
Check this DIN again · Health Canada product recordNat-Bosentan: Formulary list price $32.0893/unit (unit not stated in source; not the patient's cost)
Ministry pays: $32.0893 per source unit.
Source explanation: The formulary price is what ODB pays; the cash price at the counter is set by the pharmacy.
Formulary data: Ontario extract of Aug 26, 2026 · Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=95636 · Verify on the e-Formulary ↗ (DIN 02467992)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02467992).
DIN 02467992: Nat-Bosentan
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 241200097; group id 363; item number 0850; lccId None; manufacturer id NAT
Source form: Tab; strength: 125mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $32.0893; ministry $32.0893
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02467992
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=95636
Interchangeable products
Apo-Bosentan · DIN 02399210 · $32.0893
Co Bosentan · DIN 02386208 · $32.0893
PMS-Bosentan · DIN 02383020 · $32.0893
Sandoz Bosentan · DIN 02386283 · $32.0893
Taro-Bosentan · DIN 02483149 · $32.0893
Tracleer · DIN 02244982 · $32.0893
Shortage status: active shortage (reported 2024-11-18, estimated to end 2027-06-30, last updated 2026-04-13); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02467992
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Health Canada lists this DIN as Dormant since 2025-12-01 — choose a marketed DIN from the same-category list.
Co Bosentan · DIN 02386194 · 62.5mg · tablet
Off-Formulary Interchangeable, not an ODB benefit; Health Canada lists this DIN as Cancelled post market since 2018-04-25 — choose a marketed DIN from the same-category list.Discontinued 2018-04-25 · checked 2026-09-02
StatusOff-Formulary Interchangeable, not an ODB benefit; Health Canada lists this DIN as Cancelled post market since 2018-04-25 — choose a marketed DIN from the same-category list.
Write on scriptExceptional Access application required. For a drug to be considered for funding, the EAP reimbursement criteria must always be met and the request approved prior to the initiation of treatment with the drug being requested, unless otherwise specified within the criteria. (ontario.ca, Aug 31, 2026 ↗) Submit through SADIE: "The SADIE portal is available to authorized prescribers and their delegates and designates, enabling the creation, submission and tracking of web-based electronic requests directly to the Exceptional Access Program." (ontario.ca, Aug 31, 2026 ↗); Health Canada lists this DIN as Cancelled post market since 2018-04-25 — choose a marketed DIN from the same-category list. Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. Current criteria in SADIE
Coverage criteria
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated April 20, 2021
All requests (initial, renewal, monotherapy, combination therapy) for a PAH drug
must come from one of the following recognized PAH referral centres.
o Pulmonary Hypertension Centre
Hamilton Health Sciences – General Hospital
o The Firestone Institute Pulmonary Hypertension Program
St. Joseph's Healthcare Hamilton and McMaster University
o Pulmonary Hypertension Clinic
Hotel Dieu Hospital/Kingston General Hospital
o Pulmonary Hypertension Program
London Health Science Centre – Victoria Hospital
o Ottawa Pulmonary Hypertension Clinic
University of Ottawa Heart Institute and the Ottawa Hospital
o University Health Network Pulmonary Hypertension Program
Toronto General Hospital
Requests from other physicians/centres must include a recent (less than or equal to 3
months old) consult note/recommendation from a recognized PAH referral centre that
supports the request;
Out-of-province referral centre consults (e.g., from Winnipeg for patients in Northern
Ontario) will also be considered on a case-by-case basis
Initial Criteria:
For the treatment of patients with pulmonary arterial hypertension (PAH) [WHO Group 1
Pulmonary hypertension] who meet all the following criteria;
416
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 416, record 250, corpus 2025-01-01; name match only, not an eligibility decision
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated: April 20, 2021
• PAH defined as a resting mean pulmonary artery pressure (mPAP) of ≥ 25 mmHg
at rest AND normal pulmonary capillary wedge pressure (PCWP) ≤ 15 mmHg on
right heart catheterization1; AND
• The drug request meets one of the following circumstances of use:
o Drug is being used as monotherapy in a patient with WHO-functional class III or
IV; OR
o Drug is being used as monotherapy in a patient with WHO-functional class II
who has contraindication or has intolerance to a PDE-5 inhibitor; OR
o Drug is being used as sequential dual therapy in combination with a funded
PDE-5 (i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol,
treprostinil) in a patient who has had an inadequate response with monotherapy
(i.e., failure to achieve WHO-FC I or II; or 6MWD >440 metres; or no/mild RV
failure); OR
o Drug is being used as up-front dual therapy in combination with a funded PDE-5
(i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol, treprostinil) in
a patient with advanced disease (i.e. WHO-functional class III or IV; OR 6MWD
<380 metres; OR evidence of RV failure.)
1 Note: Left ventricular end-diastolic pressure ≤15 mmHg is also acceptable.
417
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 417, record 253, corpus 2025-01-01; name match only, not an eligibility decision
Brand vs generic price
Lowest DBP recovery rule under medically necessary no-substitution claims:
6.2 Medically Necessary "No Substitution" Claims
The Side Effect Reporting Form will not have to be renewed. However, the
pharmacy must maintain a copy of the prescription that contains a direction that
there be no substitution and the required Health Canada Side Effect Reporting Form
(completed and signed by the prescriber). The prescriber must write “No
Substitution” or “No Sub” on renewal or subsequent new written prescriptions, and
indicate “No Substitution” on subsequent new oral prescriptions. The dispenser will
be reimbursed the DBP plus a mark-up and the lesser of the posted usual and
customary fee or the ODB dispensing fee minus the applicable ODB co-payment
amount. Where a completed Side Effect Reporting Form is not available at the
pharmacy during an inspection, the difference between the cost of the higher-cost
product and the lowest DBP listed for the interchangeable category will be
recovered.
(ontario.ca, Revision #17; 2026-08-03 ↗)
6.2 Medically Necessary "No Substitution" Claims
The Ministry will provide reimbursement of a higher-cost interchangeable product in
medically necessary circumstances where a patient has experienced a significant
adverse reaction with two (2) lower-cost interchangeable drug products, where
available. When a prescriber identifies a patient for which it is medically necessary
that a higher cost interchangeable product be provided, the prescriber must:
• Complete, sign and forward to the pharmacist a copy of the Health Canada
side effect reporting form for each lower-cost interchangeable drug product
trialed (Side Effect Reporting Form[s]); and
• Write “No Substitution” or “No Sub” on a written prescription or indicate “No
Substitution” to the pharmacist in the case of a verbal prescription.
The prescriber should keep a copy of the completed form in the patient’s record for
future use and reference.
In the case of a written prescription, when the pharmacist or dispensing physician
receives a prescription with the written notation “No Substitution” or “No Sub”,
reimbursement will be provided for the higher-cost interchangeable product only if
the prescription is accompanied by a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed.
This form must be completely filled out noting the details of the adverse reaction
and signed by the prescriber.
In the case of a verbal prescription, the prescriber must satisfy the operator of the
pharmacy or dispensing physician that a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed
has been completed and signed by the prescriber. A written record of this verbal
prescription and the completed Health Canada Side Effect Reporting Form must be
received by the pharmacy prior to claim submission.
Upon receipt, the pharmacist must:
• Fax, submit online or mail the completed and signed form to Health Canada’s
Canada Vigilance Program; and
• Retain his or her copy of the completed and signed Side Effect Reporting
Form.
(ontario.ca, Revision #17; 2026-08-03 ↗)How long EAP takes
Turnaround times
The Exceptional Access Program receives between 250 and 500 requests a day. Requests are categorized in order of priority based on how quickly a drug is needed, the type of drug, and the condition for which the drug is being used.
Turnaround times begin on the business day on which the EAP receives a complete request from a physician or nurse practitioner. You may have to wait longer if the request is missing information or supporting documents required by the EAP criteria, if a request requires external review, or if documents are sent by fax or mail instead of submitted via SADIE.
EAP Weekly Progress Report
Date: September 15, 2026
Processing categories and examples | Target | Current |
Priority 1 — for drugs such as antibiotics, cancer medications, and initial requests for pain medications | 3 business days | 2 business day |
Priority 2 — for antiviral drugs to treat HIV, drugs for multiple sclerosis, and pulmonary hypertension | 5 business days | 3 business days |
Biologics — for biologic drugs to treat rheumatoid arthritis, psoriatic arthritis, ulcerative colitis and Crohn’s disease | 10 business days | 4 business days |
Chronic — for drugs used for chronic conditions such as migraines, chronic pain, Ménière's disease and symptoms of Parkinson’s disease. | 4 to 6 weeks | 11 business days |
(ontario.ca, Updated September 15, 2026 ↗)
For selected drugs, the Telephone Request Service is available to authorized prescribers or their delegates. In most cases, the funding decision is provided by the end of the call and processed within one business day.
(ontario.ca, Updated September 15, 2026 ↗)1 brand, same coverage
Co Bosentan · DIN 02386194
Manufacturer: Cobalt Pharmaceuticals Company; listing date 2012-07-27
Health Canada: Cancelled post market since 2018-04-25 · brand ACT BOSENTAN · ATC C02KX01 BOSENTAN · form Tablet · route Oral · ingredients BOSENTAN (BOSENTAN MONOHYDRATE) 62.5 MG · company Actavis pharma company · schedule Prescription
Check this DIN again · Health Canada product recordCo Bosentan: Formulary list price $32.0893/unit (unit not stated in source; not the patient's cost)
Ministry pays: $32.0893 per source unit.
Source explanation: The formulary price is what ODB pays; the cash price at the counter is set by the pharmacy.
Formulary data: Ontario extract of Aug 26, 2026 · Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=87177 · Verify on the e-Formulary ↗ (DIN 02386194)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02386194).
DIN 02386194: Co Bosentan
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 241200096; group id 363; item number 0849; lccId None; manufacturer id COB
Source form: Tab; strength: 62.5mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $32.0893; ministry $32.0893
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02386194
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=87177
Interchangeable products
Apo-Bosentan · DIN 02399202 · $32.0893
Nat-Bosentan · DIN 02467984 · $32.0893
PMS-Bosentan · DIN 02383012 · $32.0893
Sandoz Bosentan · DIN 02386275 · $32.0893
Taro-Bosentan · DIN 02483130 · $32.0893
Tracleer · DIN 02244981 · $32.0893
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02386194
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Health Canada lists this DIN as Cancelled post market since 2018-04-25 — choose a marketed DIN from the same-category list.
Sandoz Bosentan · DIN 02386275 · 62.5mg · tablet
Off-Formulary Interchangeable, not an ODB benefit; Health Canada lists this DIN as Cancelled post market since 2020-04-30 — choose a marketed DIN from the same-category list.Discontinued 2020-04-30 · checked 2026-09-02
StatusOff-Formulary Interchangeable, not an ODB benefit; Health Canada lists this DIN as Cancelled post market since 2020-04-30 — choose a marketed DIN from the same-category list.
Write on scriptExceptional Access application required. For a drug to be considered for funding, the EAP reimbursement criteria must always be met and the request approved prior to the initiation of treatment with the drug being requested, unless otherwise specified within the criteria. (ontario.ca, Aug 31, 2026 ↗) Submit through SADIE: "The SADIE portal is available to authorized prescribers and their delegates and designates, enabling the creation, submission and tracking of web-based electronic requests directly to the Exceptional Access Program." (ontario.ca, Aug 31, 2026 ↗); Health Canada lists this DIN as Cancelled post market since 2020-04-30 — choose a marketed DIN from the same-category list. Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. Current criteria in SADIE
Coverage criteria
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated April 20, 2021
All requests (initial, renewal, monotherapy, combination therapy) for a PAH drug
must come from one of the following recognized PAH referral centres.
o Pulmonary Hypertension Centre
Hamilton Health Sciences – General Hospital
o The Firestone Institute Pulmonary Hypertension Program
St. Joseph's Healthcare Hamilton and McMaster University
o Pulmonary Hypertension Clinic
Hotel Dieu Hospital/Kingston General Hospital
o Pulmonary Hypertension Program
London Health Science Centre – Victoria Hospital
o Ottawa Pulmonary Hypertension Clinic
University of Ottawa Heart Institute and the Ottawa Hospital
o University Health Network Pulmonary Hypertension Program
Toronto General Hospital
Requests from other physicians/centres must include a recent (less than or equal to 3
months old) consult note/recommendation from a recognized PAH referral centre that
supports the request;
Out-of-province referral centre consults (e.g., from Winnipeg for patients in Northern
Ontario) will also be considered on a case-by-case basis
Initial Criteria:
For the treatment of patients with pulmonary arterial hypertension (PAH) [WHO Group 1
Pulmonary hypertension] who meet all the following criteria;
416
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 416, record 250, corpus 2025-01-01; name match only, not an eligibility decision
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated: April 20, 2021
• PAH defined as a resting mean pulmonary artery pressure (mPAP) of ≥ 25 mmHg
at rest AND normal pulmonary capillary wedge pressure (PCWP) ≤ 15 mmHg on
right heart catheterization1; AND
• The drug request meets one of the following circumstances of use:
o Drug is being used as monotherapy in a patient with WHO-functional class III or
IV; OR
o Drug is being used as monotherapy in a patient with WHO-functional class II
who has contraindication or has intolerance to a PDE-5 inhibitor; OR
o Drug is being used as sequential dual therapy in combination with a funded
PDE-5 (i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol,
treprostinil) in a patient who has had an inadequate response with monotherapy
(i.e., failure to achieve WHO-FC I or II; or 6MWD >440 metres; or no/mild RV
failure); OR
o Drug is being used as up-front dual therapy in combination with a funded PDE-5
(i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol, treprostinil) in
a patient with advanced disease (i.e. WHO-functional class III or IV; OR 6MWD
<380 metres; OR evidence of RV failure.)
1 Note: Left ventricular end-diastolic pressure ≤15 mmHg is also acceptable.
417
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 417, record 253, corpus 2025-01-01; name match only, not an eligibility decision
Brand vs generic price
Lowest DBP recovery rule under medically necessary no-substitution claims:
6.2 Medically Necessary "No Substitution" Claims
The Side Effect Reporting Form will not have to be renewed. However, the
pharmacy must maintain a copy of the prescription that contains a direction that
there be no substitution and the required Health Canada Side Effect Reporting Form
(completed and signed by the prescriber). The prescriber must write “No
Substitution” or “No Sub” on renewal or subsequent new written prescriptions, and
indicate “No Substitution” on subsequent new oral prescriptions. The dispenser will
be reimbursed the DBP plus a mark-up and the lesser of the posted usual and
customary fee or the ODB dispensing fee minus the applicable ODB co-payment
amount. Where a completed Side Effect Reporting Form is not available at the
pharmacy during an inspection, the difference between the cost of the higher-cost
product and the lowest DBP listed for the interchangeable category will be
recovered.
(ontario.ca, Revision #17; 2026-08-03 ↗)
6.2 Medically Necessary "No Substitution" Claims
The Ministry will provide reimbursement of a higher-cost interchangeable product in
medically necessary circumstances where a patient has experienced a significant
adverse reaction with two (2) lower-cost interchangeable drug products, where
available. When a prescriber identifies a patient for which it is medically necessary
that a higher cost interchangeable product be provided, the prescriber must:
• Complete, sign and forward to the pharmacist a copy of the Health Canada
side effect reporting form for each lower-cost interchangeable drug product
trialed (Side Effect Reporting Form[s]); and
• Write “No Substitution” or “No Sub” on a written prescription or indicate “No
Substitution” to the pharmacist in the case of a verbal prescription.
The prescriber should keep a copy of the completed form in the patient’s record for
future use and reference.
In the case of a written prescription, when the pharmacist or dispensing physician
receives a prescription with the written notation “No Substitution” or “No Sub”,
reimbursement will be provided for the higher-cost interchangeable product only if
the prescription is accompanied by a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed.
This form must be completely filled out noting the details of the adverse reaction
and signed by the prescriber.
In the case of a verbal prescription, the prescriber must satisfy the operator of the
pharmacy or dispensing physician that a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed
has been completed and signed by the prescriber. A written record of this verbal
prescription and the completed Health Canada Side Effect Reporting Form must be
received by the pharmacy prior to claim submission.
Upon receipt, the pharmacist must:
• Fax, submit online or mail the completed and signed form to Health Canada’s
Canada Vigilance Program; and
• Retain his or her copy of the completed and signed Side Effect Reporting
Form.
(ontario.ca, Revision #17; 2026-08-03 ↗)How long EAP takes
Turnaround times
The Exceptional Access Program receives between 250 and 500 requests a day. Requests are categorized in order of priority based on how quickly a drug is needed, the type of drug, and the condition for which the drug is being used.
Turnaround times begin on the business day on which the EAP receives a complete request from a physician or nurse practitioner. You may have to wait longer if the request is missing information or supporting documents required by the EAP criteria, if a request requires external review, or if documents are sent by fax or mail instead of submitted via SADIE.
EAP Weekly Progress Report
Date: September 15, 2026
Processing categories and examples | Target | Current |
Priority 1 — for drugs such as antibiotics, cancer medications, and initial requests for pain medications | 3 business days | 2 business day |
Priority 2 — for antiviral drugs to treat HIV, drugs for multiple sclerosis, and pulmonary hypertension | 5 business days | 3 business days |
Biologics — for biologic drugs to treat rheumatoid arthritis, psoriatic arthritis, ulcerative colitis and Crohn’s disease | 10 business days | 4 business days |
Chronic — for drugs used for chronic conditions such as migraines, chronic pain, Ménière's disease and symptoms of Parkinson’s disease. | 4 to 6 weeks | 11 business days |
(ontario.ca, Updated September 15, 2026 ↗)
For selected drugs, the Telephone Request Service is available to authorized prescribers or their delegates. In most cases, the funding decision is provided by the end of the call and processed within one business day.
(ontario.ca, Updated September 15, 2026 ↗)1 brand, same coverage
Sandoz Bosentan · DIN 02386275
Manufacturer: Sandoz Canada Inc.; listing date 2012-07-27
Health Canada: Cancelled post market since 2020-04-30 · brand SANDOZ BOSENTAN · ATC C02KX01 BOSENTAN · form Tablet · route Oral · ingredients BOSENTAN (BOSENTAN MONOHYDRATE) 62.5 MG · company Sandoz canada incorporated · schedule Prescription
Check this DIN again · Health Canada product recordSandoz Bosentan: Formulary list price $32.0893/unit (unit not stated in source; not the patient's cost)
Ministry pays: $32.0893 per source unit.
Source explanation: The formulary price is what ODB pays; the cash price at the counter is set by the pharmacy.
Formulary data: Ontario extract of Aug 26, 2026 · Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=87185 · Verify on the e-Formulary ↗ (DIN 02386275)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02386275).
DIN 02386275: Sandoz Bosentan
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 241200096; group id 363; item number 0849; lccId None; manufacturer id SDZ
Source form: Tab; strength: 62.5mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $32.0893; ministry $32.0893
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02386275
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=87185
Interchangeable products
Apo-Bosentan · DIN 02399202 · $32.0893
Co Bosentan · DIN 02386194 · $32.0893
Nat-Bosentan · DIN 02467984 · $32.0893
PMS-Bosentan · DIN 02383012 · $32.0893
Taro-Bosentan · DIN 02483130 · $32.0893
Tracleer · DIN 02244981 · $32.0893
Shortage status: resolved shortage (ended 2018-03-23); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02386275
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Health Canada lists this DIN as Cancelled post market since 2020-04-30 — choose a marketed DIN from the same-category list.
Co Bosentan · DIN 02386208 · 125mg · tablet
Off-Formulary Interchangeable, not an ODB benefit; Health Canada lists this DIN as Cancelled post market since 2018-04-25 — choose a marketed DIN from the same-category list.Discontinued 2018-04-25 · checked 2026-09-02
StatusOff-Formulary Interchangeable, not an ODB benefit; Health Canada lists this DIN as Cancelled post market since 2018-04-25 — choose a marketed DIN from the same-category list.
Write on scriptExceptional Access application required. For a drug to be considered for funding, the EAP reimbursement criteria must always be met and the request approved prior to the initiation of treatment with the drug being requested, unless otherwise specified within the criteria. (ontario.ca, Aug 31, 2026 ↗) Submit through SADIE: "The SADIE portal is available to authorized prescribers and their delegates and designates, enabling the creation, submission and tracking of web-based electronic requests directly to the Exceptional Access Program." (ontario.ca, Aug 31, 2026 ↗); Health Canada lists this DIN as Cancelled post market since 2018-04-25 — choose a marketed DIN from the same-category list. Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. Current criteria in SADIE
Coverage criteria
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated April 20, 2021
All requests (initial, renewal, monotherapy, combination therapy) for a PAH drug
must come from one of the following recognized PAH referral centres.
o Pulmonary Hypertension Centre
Hamilton Health Sciences – General Hospital
o The Firestone Institute Pulmonary Hypertension Program
St. Joseph's Healthcare Hamilton and McMaster University
o Pulmonary Hypertension Clinic
Hotel Dieu Hospital/Kingston General Hospital
o Pulmonary Hypertension Program
London Health Science Centre – Victoria Hospital
o Ottawa Pulmonary Hypertension Clinic
University of Ottawa Heart Institute and the Ottawa Hospital
o University Health Network Pulmonary Hypertension Program
Toronto General Hospital
Requests from other physicians/centres must include a recent (less than or equal to 3
months old) consult note/recommendation from a recognized PAH referral centre that
supports the request;
Out-of-province referral centre consults (e.g., from Winnipeg for patients in Northern
Ontario) will also be considered on a case-by-case basis
Initial Criteria:
For the treatment of patients with pulmonary arterial hypertension (PAH) [WHO Group 1
Pulmonary hypertension] who meet all the following criteria;
416
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 416, record 250, corpus 2025-01-01; name match only, not an eligibility decision
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated: April 20, 2021
• PAH defined as a resting mean pulmonary artery pressure (mPAP) of ≥ 25 mmHg
at rest AND normal pulmonary capillary wedge pressure (PCWP) ≤ 15 mmHg on
right heart catheterization1; AND
• The drug request meets one of the following circumstances of use:
o Drug is being used as monotherapy in a patient with WHO-functional class III or
IV; OR
o Drug is being used as monotherapy in a patient with WHO-functional class II
who has contraindication or has intolerance to a PDE-5 inhibitor; OR
o Drug is being used as sequential dual therapy in combination with a funded
PDE-5 (i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol,
treprostinil) in a patient who has had an inadequate response with monotherapy
(i.e., failure to achieve WHO-FC I or II; or 6MWD >440 metres; or no/mild RV
failure); OR
o Drug is being used as up-front dual therapy in combination with a funded PDE-5
(i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol, treprostinil) in
a patient with advanced disease (i.e. WHO-functional class III or IV; OR 6MWD
<380 metres; OR evidence of RV failure.)
1 Note: Left ventricular end-diastolic pressure ≤15 mmHg is also acceptable.
417
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 417, record 253, corpus 2025-01-01; name match only, not an eligibility decision
Brand vs generic price
Lowest DBP recovery rule under medically necessary no-substitution claims:
6.2 Medically Necessary "No Substitution" Claims
The Side Effect Reporting Form will not have to be renewed. However, the
pharmacy must maintain a copy of the prescription that contains a direction that
there be no substitution and the required Health Canada Side Effect Reporting Form
(completed and signed by the prescriber). The prescriber must write “No
Substitution” or “No Sub” on renewal or subsequent new written prescriptions, and
indicate “No Substitution” on subsequent new oral prescriptions. The dispenser will
be reimbursed the DBP plus a mark-up and the lesser of the posted usual and
customary fee or the ODB dispensing fee minus the applicable ODB co-payment
amount. Where a completed Side Effect Reporting Form is not available at the
pharmacy during an inspection, the difference between the cost of the higher-cost
product and the lowest DBP listed for the interchangeable category will be
recovered.
(ontario.ca, Revision #17; 2026-08-03 ↗)
6.2 Medically Necessary "No Substitution" Claims
The Ministry will provide reimbursement of a higher-cost interchangeable product in
medically necessary circumstances where a patient has experienced a significant
adverse reaction with two (2) lower-cost interchangeable drug products, where
available. When a prescriber identifies a patient for which it is medically necessary
that a higher cost interchangeable product be provided, the prescriber must:
• Complete, sign and forward to the pharmacist a copy of the Health Canada
side effect reporting form for each lower-cost interchangeable drug product
trialed (Side Effect Reporting Form[s]); and
• Write “No Substitution” or “No Sub” on a written prescription or indicate “No
Substitution” to the pharmacist in the case of a verbal prescription.
The prescriber should keep a copy of the completed form in the patient’s record for
future use and reference.
In the case of a written prescription, when the pharmacist or dispensing physician
receives a prescription with the written notation “No Substitution” or “No Sub”,
reimbursement will be provided for the higher-cost interchangeable product only if
the prescription is accompanied by a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed.
This form must be completely filled out noting the details of the adverse reaction
and signed by the prescriber.
In the case of a verbal prescription, the prescriber must satisfy the operator of the
pharmacy or dispensing physician that a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed
has been completed and signed by the prescriber. A written record of this verbal
prescription and the completed Health Canada Side Effect Reporting Form must be
received by the pharmacy prior to claim submission.
Upon receipt, the pharmacist must:
• Fax, submit online or mail the completed and signed form to Health Canada’s
Canada Vigilance Program; and
• Retain his or her copy of the completed and signed Side Effect Reporting
Form.
(ontario.ca, Revision #17; 2026-08-03 ↗)How long EAP takes
Turnaround times
The Exceptional Access Program receives between 250 and 500 requests a day. Requests are categorized in order of priority based on how quickly a drug is needed, the type of drug, and the condition for which the drug is being used.
Turnaround times begin on the business day on which the EAP receives a complete request from a physician or nurse practitioner. You may have to wait longer if the request is missing information or supporting documents required by the EAP criteria, if a request requires external review, or if documents are sent by fax or mail instead of submitted via SADIE.
EAP Weekly Progress Report
Date: September 15, 2026
Processing categories and examples | Target | Current |
Priority 1 — for drugs such as antibiotics, cancer medications, and initial requests for pain medications | 3 business days | 2 business day |
Priority 2 — for antiviral drugs to treat HIV, drugs for multiple sclerosis, and pulmonary hypertension | 5 business days | 3 business days |
Biologics — for biologic drugs to treat rheumatoid arthritis, psoriatic arthritis, ulcerative colitis and Crohn’s disease | 10 business days | 4 business days |
Chronic — for drugs used for chronic conditions such as migraines, chronic pain, Ménière's disease and symptoms of Parkinson’s disease. | 4 to 6 weeks | 11 business days |
(ontario.ca, Updated September 15, 2026 ↗)
For selected drugs, the Telephone Request Service is available to authorized prescribers or their delegates. In most cases, the funding decision is provided by the end of the call and processed within one business day.
(ontario.ca, Updated September 15, 2026 ↗)1 brand, same coverage
Co Bosentan · DIN 02386208
Manufacturer: Cobalt Pharmaceuticals Company; listing date 2012-07-27
Health Canada: Cancelled post market since 2018-04-25 · brand ACT BOSENTAN · ATC C02KX01 BOSENTAN · form Tablet · route Oral · ingredients BOSENTAN (BOSENTAN MONOHYDRATE) 125 MG · company Actavis pharma company · schedule Prescription
Check this DIN again · Health Canada product recordCo Bosentan: Formulary list price $32.0893/unit (unit not stated in source; not the patient's cost)
Ministry pays: $32.0893 per source unit.
Source explanation: The formulary price is what ODB pays; the cash price at the counter is set by the pharmacy.
Formulary data: Ontario extract of Aug 26, 2026 · Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=87178 · Verify on the e-Formulary ↗ (DIN 02386208)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02386208).
DIN 02386208: Co Bosentan
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 241200097; group id 363; item number 0850; lccId None; manufacturer id COB
Source form: Tab; strength: 125mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $32.0893; ministry $32.0893
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02386208
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=87178
Interchangeable products
Apo-Bosentan · DIN 02399210 · $32.0893
Nat-Bosentan · DIN 02467992 · $32.0893
PMS-Bosentan · DIN 02383020 · $32.0893
Sandoz Bosentan · DIN 02386283 · $32.0893
Taro-Bosentan · DIN 02483149 · $32.0893
Tracleer · DIN 02244982 · $32.0893
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02386208
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Health Canada lists this DIN as Cancelled post market since 2018-04-25 — choose a marketed DIN from the same-category list.
Sandoz Bosentan · DIN 02386283 · 125mg · tablet
Off-Formulary Interchangeable, not an ODB benefit; Health Canada lists this DIN as Cancelled post market since 2021-01-30 — choose a marketed DIN from the same-category list.Discontinued 2021-01-30 · checked 2026-09-02
StatusOff-Formulary Interchangeable, not an ODB benefit; Health Canada lists this DIN as Cancelled post market since 2021-01-30 — choose a marketed DIN from the same-category list.
Write on scriptExceptional Access application required. For a drug to be considered for funding, the EAP reimbursement criteria must always be met and the request approved prior to the initiation of treatment with the drug being requested, unless otherwise specified within the criteria. (ontario.ca, Aug 31, 2026 ↗) Submit through SADIE: "The SADIE portal is available to authorized prescribers and their delegates and designates, enabling the creation, submission and tracking of web-based electronic requests directly to the Exceptional Access Program." (ontario.ca, Aug 31, 2026 ↗); Health Canada lists this DIN as Cancelled post market since 2021-01-30 — choose a marketed DIN from the same-category list. Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. Current criteria in SADIE
Coverage criteria
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated April 20, 2021
All requests (initial, renewal, monotherapy, combination therapy) for a PAH drug
must come from one of the following recognized PAH referral centres.
o Pulmonary Hypertension Centre
Hamilton Health Sciences – General Hospital
o The Firestone Institute Pulmonary Hypertension Program
St. Joseph's Healthcare Hamilton and McMaster University
o Pulmonary Hypertension Clinic
Hotel Dieu Hospital/Kingston General Hospital
o Pulmonary Hypertension Program
London Health Science Centre – Victoria Hospital
o Ottawa Pulmonary Hypertension Clinic
University of Ottawa Heart Institute and the Ottawa Hospital
o University Health Network Pulmonary Hypertension Program
Toronto General Hospital
Requests from other physicians/centres must include a recent (less than or equal to 3
months old) consult note/recommendation from a recognized PAH referral centre that
supports the request;
Out-of-province referral centre consults (e.g., from Winnipeg for patients in Northern
Ontario) will also be considered on a case-by-case basis
Initial Criteria:
For the treatment of patients with pulmonary arterial hypertension (PAH) [WHO Group 1
Pulmonary hypertension] who meet all the following criteria;
416
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 416, record 250, corpus 2025-01-01; name match only, not an eligibility decision
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive):
Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange
Ambrisentan
Brand(s): Volibris
DOSAGE FORM/ STRENGTH: 5 mg, 10 mg tablet
Bosentan
Brand(s): Tracleer, Generics (Co-, Mylan-. PMS-, Sandoz-)
DOSAGE FORM/ STRENGTH: 62.5 mg, 125 mg tablet
Macitentan
Brand(s): Opsumit
DOSAGE FORM/ STRENGTH: 10 mg tablet
Updated: April 20, 2021
• PAH defined as a resting mean pulmonary artery pressure (mPAP) of ≥ 25 mmHg
at rest AND normal pulmonary capillary wedge pressure (PCWP) ≤ 15 mmHg on
right heart catheterization1; AND
• The drug request meets one of the following circumstances of use:
o Drug is being used as monotherapy in a patient with WHO-functional class III or
IV; OR
o Drug is being used as monotherapy in a patient with WHO-functional class II
who has contraindication or has intolerance to a PDE-5 inhibitor; OR
o Drug is being used as sequential dual therapy in combination with a funded
PDE-5 (i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol,
treprostinil) in a patient who has had an inadequate response with monotherapy
(i.e., failure to achieve WHO-FC I or II; or 6MWD >440 metres; or no/mild RV
failure); OR
o Drug is being used as up-front dual therapy in combination with a funded PDE-5
(i.e. sildenafil, tadalafil) or a funded prostanoid (i.e. epoprostenol, treprostinil) in
a patient with advanced disease (i.e. WHO-functional class III or IV; OR 6MWD
<380 metres; OR evidence of RV failure.)
1 Note: Left ventricular end-diastolic pressure ≤15 mmHg is also acceptable.
417
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 417, record 253, corpus 2025-01-01; name match only, not an eligibility decision
Brand vs generic price
Lowest DBP recovery rule under medically necessary no-substitution claims:
6.2 Medically Necessary "No Substitution" Claims
The Side Effect Reporting Form will not have to be renewed. However, the
pharmacy must maintain a copy of the prescription that contains a direction that
there be no substitution and the required Health Canada Side Effect Reporting Form
(completed and signed by the prescriber). The prescriber must write “No
Substitution” or “No Sub” on renewal or subsequent new written prescriptions, and
indicate “No Substitution” on subsequent new oral prescriptions. The dispenser will
be reimbursed the DBP plus a mark-up and the lesser of the posted usual and
customary fee or the ODB dispensing fee minus the applicable ODB co-payment
amount. Where a completed Side Effect Reporting Form is not available at the
pharmacy during an inspection, the difference between the cost of the higher-cost
product and the lowest DBP listed for the interchangeable category will be
recovered.
(ontario.ca, Revision #17; 2026-08-03 ↗)
6.2 Medically Necessary "No Substitution" Claims
The Ministry will provide reimbursement of a higher-cost interchangeable product in
medically necessary circumstances where a patient has experienced a significant
adverse reaction with two (2) lower-cost interchangeable drug products, where
available. When a prescriber identifies a patient for which it is medically necessary
that a higher cost interchangeable product be provided, the prescriber must:
• Complete, sign and forward to the pharmacist a copy of the Health Canada
side effect reporting form for each lower-cost interchangeable drug product
trialed (Side Effect Reporting Form[s]); and
• Write “No Substitution” or “No Sub” on a written prescription or indicate “No
Substitution” to the pharmacist in the case of a verbal prescription.
The prescriber should keep a copy of the completed form in the patient’s record for
future use and reference.
In the case of a written prescription, when the pharmacist or dispensing physician
receives a prescription with the written notation “No Substitution” or “No Sub”,
reimbursement will be provided for the higher-cost interchangeable product only if
the prescription is accompanied by a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed.
This form must be completely filled out noting the details of the adverse reaction
and signed by the prescriber.
In the case of a verbal prescription, the prescriber must satisfy the operator of the
pharmacy or dispensing physician that a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed
has been completed and signed by the prescriber. A written record of this verbal
prescription and the completed Health Canada Side Effect Reporting Form must be
received by the pharmacy prior to claim submission.
Upon receipt, the pharmacist must:
• Fax, submit online or mail the completed and signed form to Health Canada’s
Canada Vigilance Program; and
• Retain his or her copy of the completed and signed Side Effect Reporting
Form.
(ontario.ca, Revision #17; 2026-08-03 ↗)How long EAP takes
Turnaround times
The Exceptional Access Program receives between 250 and 500 requests a day. Requests are categorized in order of priority based on how quickly a drug is needed, the type of drug, and the condition for which the drug is being used.
Turnaround times begin on the business day on which the EAP receives a complete request from a physician or nurse practitioner. You may have to wait longer if the request is missing information or supporting documents required by the EAP criteria, if a request requires external review, or if documents are sent by fax or mail instead of submitted via SADIE.
EAP Weekly Progress Report
Date: September 15, 2026
Processing categories and examples | Target | Current |
Priority 1 — for drugs such as antibiotics, cancer medications, and initial requests for pain medications | 3 business days | 2 business day |
Priority 2 — for antiviral drugs to treat HIV, drugs for multiple sclerosis, and pulmonary hypertension | 5 business days | 3 business days |
Biologics — for biologic drugs to treat rheumatoid arthritis, psoriatic arthritis, ulcerative colitis and Crohn’s disease | 10 business days | 4 business days |
Chronic — for drugs used for chronic conditions such as migraines, chronic pain, Ménière's disease and symptoms of Parkinson’s disease. | 4 to 6 weeks | 11 business days |
(ontario.ca, Updated September 15, 2026 ↗)
For selected drugs, the Telephone Request Service is available to authorized prescribers or their delegates. In most cases, the funding decision is provided by the end of the call and processed within one business day.
(ontario.ca, Updated September 15, 2026 ↗)1 brand, same coverage
Sandoz Bosentan · DIN 02386283
Manufacturer: Sandoz Canada Inc.; listing date 2012-07-27
Health Canada: Cancelled post market since 2021-01-30 · brand SANDOZ BOSENTAN · ATC C02KX01 BOSENTAN · form Tablet · route Oral · ingredients BOSENTAN (BOSENTAN MONOHYDRATE) 125 MG · company Sandoz canada incorporated · schedule Prescription
Check this DIN again · Health Canada product recordSandoz Bosentan: Formulary list price $32.0893/unit (unit not stated in source; not the patient's cost)
Ministry pays: $32.0893 per source unit.
Source explanation: The formulary price is what ODB pays; the cash price at the counter is set by the pharmacy.
Formulary data: Ontario extract of Aug 26, 2026 · Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=87186 · Verify on the e-Formulary ↗ (DIN 02386283)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02386283).
DIN 02386283: Sandoz Bosentan
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 241200097; group id 363; item number 0850; lccId None; manufacturer id SDZ
Source form: Tab; strength: 125mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $32.0893; ministry $32.0893
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02386283
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=87186
Interchangeable products
Apo-Bosentan · DIN 02399210 · $32.0893
Co Bosentan · DIN 02386208 · $32.0893
Nat-Bosentan · DIN 02467992 · $32.0893
PMS-Bosentan · DIN 02383020 · $32.0893
Taro-Bosentan · DIN 02483149 · $32.0893
Tracleer · DIN 02244982 · $32.0893
Shortage status: avoided shortage; reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02386283
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Health Canada lists this DIN as Cancelled post market since 2021-01-30 — choose a marketed DIN from the same-category list.
Other drugs in the same formulary class (24:12 Vasodilating Drugs) and how they are covered
Matched class: 24:12 Vasodilating Drugs
Drug-class inventory only. Lists recorded Ontario formulary products, not every Canadian medication; does not recommend treatment.
Some products covered without a code (check the product listing): ISOSORBIDE DINITRATE, NITROGLYCERIN
24:12 Vasodilating Drugs
· 7 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 5mg, 10mg · Tab
· 10 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 0.5mg, 1.5mg, 1mg, 2.5mg, 2mg · Tab
· 6 products · General benefit (3), Listed, not a benefit (3) · strengths: 5mg, 10mg, 30mg · SL Tab, Tab
· 20 products · General benefit (13), Temporary benefit (2), Listed, not a benefit (1), Off-Formulary Interchangeable, not an ODB benefit (4) · strengths: 0.4mg/Hr/20 Sq Cm, 0.6mg/Hr/30 Sq Cm, 0.4mg/Hr/14 Sq Cm, 0.6mg/Hr/21 Sq Cm, 0.3mg, 0.6mg, 0.4mg/Metered Dose, 0.2mg/Hr, 0.4mg/Hr, 0.6mg/Hr, 0.8mg/Hr · Patch, SL Tab, Sp-180 Dose Pk, Sp-75 Dose Pk, Spray-200 Dose Pk, Transdermal Patch
· 2 products · Listed, not a benefit (1),
Limited Use, codes 349 (1) · strengths: 200mg/25mg · Cap
· 1 products ·
Limited Use, codes 42, 43 · strengths: 30mg · Tab
· 3 products ·
Limited Use, codes 685 · strengths: 2.5mg, 5mg, 10mg · Tab
· 24 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 8mg, 16mg, 24mg · Tab
· 6 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 25mg, 50mg, 75mg · Tab
· 3 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 60mg · ER Tab
· 73 products · Off-Formulary Interchangeable, not an ODB benefit (72), Off-Formulary Interchangeable, not an ODB benefit; DIN status E (meaning unconfirmed); confirm discontinuation/availability with Health Canada (1) · strengths: 2.5mg, 5mg, 10mg, 20mg · Tab
· 16 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 10mg, 5mg, 20mg · Orally Disintergrating Tab, Tab
Source: formulary-ed43-front-matter.txt Part V; ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26; class 24:12
Full class listing
Related classes: 24:04 Cardiac Drugs, 24:06 Antilipemic Drugs, 24:08 Hypotensive Drugs (For Diuretics See 40:28), 24:32 Renin-Angiotensin Aldosterone Inhibitors
Same formulary class, not same indication: class membership alone does not establish equivalent uses.