Other products in the same Health Canada class (L04A, L04AX) — coverage varies; not interchangeable
Azathioprine (Imuran): general benefit
Lenalidomide (Revlimid): limited Use 630, 631, 632, 659, 741
Cyclosporine (Neoral): general benefit
Leflunomide (Arava): general benefit
Mycophenolate mofetil (CellCept): general benefit, Limited Use 556
Mycophenolate (Myfortic): general benefit
15 more in the class list below
Jamp Pirfenidone · DIN 02509938 · 267mg · capsule
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
Pirfenidone
Brand(s): Esbriet and generics (see formulary for OFIs)
DOSAGE FORM/ STRENGTH: 267 mg capsule, 267 mg tablet, 801 mg tablet
Initial approval criteria:
For the treatment of adult patients with a diagnosis of mild to moderate idiopathic
pulmonary fibrosis (IPF):
• Diagnosis confirmed by a respirologist and a high-resolution CT scan.
• All other causes of restrictive lung disease (e.g. collagen vascular disorder or
hypersensitivity pneumonitis) should be excluded.
• Mild to moderate IPF is defined as forced vital capacity (FVC) greater than or equal
to 50% of predicted.
• Patient is under the care of a physician with experience in IPF.
Initial approval period: 7 months (allow 4 weeks for repeat pulmonary function tests)
Initial renewal criteria (at 6 months):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% from initiation of therapy until renewal (initial 6 month
treatment period). If a patient has experienced progression as defined above, then the
results should be validated with a confirmatory pulmonary function test conducted 4 weeks
later.
Approval period: 6 months
Second and subsequent renewals (at 12 months and thereafter):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% within any 12 month period. If a patient has experienced
progression as defined above, then the results should be validated with a confirmatory
pulmonary function test conducted 4 weeks later.
Approval period: 12 months
Documentation/information required:
• If high-resolution CT scan is not available, lung biopsy may be provided to support
the diagnosis of IPF as applicable and available
• Full pulmonary function test results.
Exclusion Criteria:
Combination use of Esbriet (pirfenidone) and Ofev (nintedanib) will not be funded.
437
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 437, record 267, 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
Jamp Pirfenidone · DIN 02509938
Manufacturer: Jamp Pharma Corporation; listing date 2021-07-30
Health Canada: Marketed since 2021-06-04 · brand JAMP PIRFENIDONE · ATC L04AX05 PIRFENIDONE · form Capsule · route Oral · ingredients PIRFENIDONE 267 MG · company Jamp pharma corporation · schedule Prescription
Jamp Pirfenidone: Formulary list price $6.7120/unit (unit not stated in source; not the patient's cost)
Ministry pays: $6.7120 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=99919 · Verify on the e-Formulary ↗ (DIN 02509938)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02509938).
DIN 02509938: Jamp Pirfenidone
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 920000699; group id 948; item number 2254; lccId None; manufacturer id JPC
Source form: Cap; strength: 267mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $6.7120; ministry $6.7120
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02509938
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=99919Interchangeable products
Esbriet · DIN 02393751 · not recorded
Sandoz Pirfenidone Capsules · DIN 02488833 · $6.7120
Shortage status: resolved shortage (ended 2024-04-26); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02509938
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Sandoz Pirfenidone Capsules · DIN 02488833 · 267mg · capsule
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
Pirfenidone
Brand(s): Esbriet and generics (see formulary for OFIs)
DOSAGE FORM/ STRENGTH: 267 mg capsule, 267 mg tablet, 801 mg tablet
Initial approval criteria:
For the treatment of adult patients with a diagnosis of mild to moderate idiopathic
pulmonary fibrosis (IPF):
• Diagnosis confirmed by a respirologist and a high-resolution CT scan.
• All other causes of restrictive lung disease (e.g. collagen vascular disorder or
hypersensitivity pneumonitis) should be excluded.
• Mild to moderate IPF is defined as forced vital capacity (FVC) greater than or equal
to 50% of predicted.
• Patient is under the care of a physician with experience in IPF.
Initial approval period: 7 months (allow 4 weeks for repeat pulmonary function tests)
Initial renewal criteria (at 6 months):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% from initiation of therapy until renewal (initial 6 month
treatment period). If a patient has experienced progression as defined above, then the
results should be validated with a confirmatory pulmonary function test conducted 4 weeks
later.
Approval period: 6 months
Second and subsequent renewals (at 12 months and thereafter):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% within any 12 month period. If a patient has experienced
progression as defined above, then the results should be validated with a confirmatory
pulmonary function test conducted 4 weeks later.
Approval period: 12 months
Documentation/information required:
• If high-resolution CT scan is not available, lung biopsy may be provided to support
the diagnosis of IPF as applicable and available
• Full pulmonary function test results.
Exclusion Criteria:
Combination use of Esbriet (pirfenidone) and Ofev (nintedanib) will not be funded.
437
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 437, record 267, 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
Sandoz Pirfenidone Capsules · DIN 02488833
Manufacturer: Sandoz Canada Inc.; listing date 2021-11-30
Health Canada: Marketed since 2021-10-25 · brand SANDOZ PIRFENIDONE CAPSULES · ATC L04AX05 PIRFENIDONE · form Capsule · route Oral · ingredients PIRFENIDONE 267 MG · company Sandoz canada incorporated · schedule Prescription
Sandoz Pirfenidone Capsules: Formulary list price $6.7120/unit (unit not stated in source; not the patient's cost)
Ministry pays: $6.7120 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=97891 · Verify on the e-Formulary ↗ (DIN 02488833)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02488833).
DIN 02488833: Sandoz Pirfenidone Capsules
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 920000699; group id 948; item number 2254; lccId None; manufacturer id SDZ
Source form: Cap; strength: 267mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $6.7120; ministry $6.7120
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02488833
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=97891Interchangeable products
Esbriet · DIN 02393751 · not recorded
Jamp Pirfenidone · DIN 02509938 · $6.7120
Shortage status: resolved shortage (ended 2026-03-23); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02488833
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Auro-Pirfenidone · DIN 02537753 · 267mg · 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
Pirfenidone
Brand(s): Esbriet and generics (see formulary for OFIs)
DOSAGE FORM/ STRENGTH: 267 mg capsule, 267 mg tablet, 801 mg tablet
Initial approval criteria:
For the treatment of adult patients with a diagnosis of mild to moderate idiopathic
pulmonary fibrosis (IPF):
• Diagnosis confirmed by a respirologist and a high-resolution CT scan.
• All other causes of restrictive lung disease (e.g. collagen vascular disorder or
hypersensitivity pneumonitis) should be excluded.
• Mild to moderate IPF is defined as forced vital capacity (FVC) greater than or equal
to 50% of predicted.
• Patient is under the care of a physician with experience in IPF.
Initial approval period: 7 months (allow 4 weeks for repeat pulmonary function tests)
Initial renewal criteria (at 6 months):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% from initiation of therapy until renewal (initial 6 month
treatment period). If a patient has experienced progression as defined above, then the
results should be validated with a confirmatory pulmonary function test conducted 4 weeks
later.
Approval period: 6 months
Second and subsequent renewals (at 12 months and thereafter):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% within any 12 month period. If a patient has experienced
progression as defined above, then the results should be validated with a confirmatory
pulmonary function test conducted 4 weeks later.
Approval period: 12 months
Documentation/information required:
• If high-resolution CT scan is not available, lung biopsy may be provided to support
the diagnosis of IPF as applicable and available
• Full pulmonary function test results.
Exclusion Criteria:
Combination use of Esbriet (pirfenidone) and Ofev (nintedanib) will not be funded.
437
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 437, record 267, 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
Auro-Pirfenidone · DIN 02537753
Manufacturer: Auro Pharma Inc.; listing date 2024-03-28
Health Canada: Marketed since 2024-03-05 · brand AURO-PIRFENIDONE · ATC L04AX05 PIRFENIDONE · form Tablet · route Oral · ingredients PIRFENIDONE 267 MG · company Auro pharma inc · schedule Prescription
Auro-Pirfenidone: Formulary list price $6.7119/unit (unit not stated in source; not the patient's cost)
Ministry pays: $6.7119 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=102653 · Verify on the e-Formulary ↗ (DIN 02537753)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02537753).
DIN 02537753: Auro-Pirfenidone
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 480200003; group id 570; item number 1521; lccId None; manufacturer id AUR
Source form: Tab; strength: 267mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $6.7119; ministry $6.7119
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02537753
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=102653Interchangeable products
Esbriet · DIN 02464489 · $6.7120
Jamp Pirfenidone · DIN 02514702 · $6.7120
M-Pirfenidone · DIN 02550644 · $6.7120
PMS-Pirfenidone · DIN 02531526 · $6.7120
Sandoz Pirfenidone Tablets · DIN 02488507 · $6.7120
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=02537753
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Esbriet · DIN 02464489 · 267mg · 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
Pirfenidone
Brand(s): Esbriet and generics (see formulary for OFIs)
DOSAGE FORM/ STRENGTH: 267 mg capsule, 267 mg tablet, 801 mg tablet
Initial approval criteria:
For the treatment of adult patients with a diagnosis of mild to moderate idiopathic
pulmonary fibrosis (IPF):
• Diagnosis confirmed by a respirologist and a high-resolution CT scan.
• All other causes of restrictive lung disease (e.g. collagen vascular disorder or
hypersensitivity pneumonitis) should be excluded.
• Mild to moderate IPF is defined as forced vital capacity (FVC) greater than or equal
to 50% of predicted.
• Patient is under the care of a physician with experience in IPF.
Initial approval period: 7 months (allow 4 weeks for repeat pulmonary function tests)
Initial renewal criteria (at 6 months):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% from initiation of therapy until renewal (initial 6 month
treatment period). If a patient has experienced progression as defined above, then the
results should be validated with a confirmatory pulmonary function test conducted 4 weeks
later.
Approval period: 6 months
Second and subsequent renewals (at 12 months and thereafter):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% within any 12 month period. If a patient has experienced
progression as defined above, then the results should be validated with a confirmatory
pulmonary function test conducted 4 weeks later.
Approval period: 12 months
Documentation/information required:
• If high-resolution CT scan is not available, lung biopsy may be provided to support
the diagnosis of IPF as applicable and available
• Full pulmonary function test results.
Exclusion Criteria:
Combination use of Esbriet (pirfenidone) and Ofev (nintedanib) will not be funded.
437
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 437, record 267, 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
Esbriet · DIN 02464489
Manufacturer: Hoffmann-La Roche Limited; listing date 2021-06-30
Health Canada: Marketed since 2017-07-26 · brand ESBRIET · ATC L04AX05 PIRFENIDONE · form Tablet · route Oral · ingredients PIRFENIDONE 267 MG · company Hoffmann-la roche limited · schedule Prescription
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=95262 · Verify on the e-Formulary ↗ (DIN 02464489)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02464489).
DIN 02464489: Esbriet
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 480200003; group id 570; item number 1521; lccId None; manufacturer id HLR
Source form: Tab; strength: 267mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $13.4240; ministry $6.7120
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02464489
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=95262Interchangeable products
Auro-Pirfenidone · DIN 02537753 · $6.7119
Jamp Pirfenidone · DIN 02514702 · $6.7120
M-Pirfenidone · DIN 02550644 · $6.7120
PMS-Pirfenidone · DIN 02531526 · $6.7120
Sandoz Pirfenidone Tablets · DIN 02488507 · $6.7120
Shortage status: discontinued (2021-11-25, reported by HOFFMANN-LA ROCHE LIMITED); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02464489
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Jamp Pirfenidone · DIN 02514702 · 267mg · 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
Pirfenidone
Brand(s): Esbriet and generics (see formulary for OFIs)
DOSAGE FORM/ STRENGTH: 267 mg capsule, 267 mg tablet, 801 mg tablet
Initial approval criteria:
For the treatment of adult patients with a diagnosis of mild to moderate idiopathic
pulmonary fibrosis (IPF):
• Diagnosis confirmed by a respirologist and a high-resolution CT scan.
• All other causes of restrictive lung disease (e.g. collagen vascular disorder or
hypersensitivity pneumonitis) should be excluded.
• Mild to moderate IPF is defined as forced vital capacity (FVC) greater than or equal
to 50% of predicted.
• Patient is under the care of a physician with experience in IPF.
Initial approval period: 7 months (allow 4 weeks for repeat pulmonary function tests)
Initial renewal criteria (at 6 months):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% from initiation of therapy until renewal (initial 6 month
treatment period). If a patient has experienced progression as defined above, then the
results should be validated with a confirmatory pulmonary function test conducted 4 weeks
later.
Approval period: 6 months
Second and subsequent renewals (at 12 months and thereafter):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% within any 12 month period. If a patient has experienced
progression as defined above, then the results should be validated with a confirmatory
pulmonary function test conducted 4 weeks later.
Approval period: 12 months
Documentation/information required:
• If high-resolution CT scan is not available, lung biopsy may be provided to support
the diagnosis of IPF as applicable and available
• Full pulmonary function test results.
Exclusion Criteria:
Combination use of Esbriet (pirfenidone) and Ofev (nintedanib) will not be funded.
437
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 437, record 267, 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
Jamp Pirfenidone · DIN 02514702
Manufacturer: Jamp Pharma Corporation; listing date 2021-08-31
Health Canada: Marketed since 2021-10-08 · brand JAMP PIRFENIDONE · ATC L04AX05 PIRFENIDONE · form Tablet · route Oral · ingredients PIRFENIDONE 267 MG · company Jamp pharma corporation · schedule Prescription
Jamp Pirfenidone: Formulary list price $6.7120/unit (unit not stated in source; not the patient's cost)
Ministry pays: $6.7120 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=100410 · Verify on the e-Formulary ↗ (DIN 02514702)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02514702).
DIN 02514702: Jamp Pirfenidone
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 480200003; group id 570; item number 1521; lccId None; manufacturer id JPC
Source form: Tab; strength: 267mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $6.7120; ministry $6.7120
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02514702
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=100410Interchangeable products
Auro-Pirfenidone · DIN 02537753 · $6.7119
Esbriet · DIN 02464489 · $6.7120
M-Pirfenidone · DIN 02550644 · $6.7120
PMS-Pirfenidone · DIN 02531526 · $6.7120
Sandoz Pirfenidone Tablets · DIN 02488507 · $6.7120
Shortage status: resolved shortage (ended 2022-07-13); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02514702
Shortage record checked 2026-09-13T08:10:21.292534+00:00
M-Pirfenidone · DIN 02550644 · 267mg · 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
Pirfenidone
Brand(s): Esbriet and generics (see formulary for OFIs)
DOSAGE FORM/ STRENGTH: 267 mg capsule, 267 mg tablet, 801 mg tablet
Initial approval criteria:
For the treatment of adult patients with a diagnosis of mild to moderate idiopathic
pulmonary fibrosis (IPF):
• Diagnosis confirmed by a respirologist and a high-resolution CT scan.
• All other causes of restrictive lung disease (e.g. collagen vascular disorder or
hypersensitivity pneumonitis) should be excluded.
• Mild to moderate IPF is defined as forced vital capacity (FVC) greater than or equal
to 50% of predicted.
• Patient is under the care of a physician with experience in IPF.
Initial approval period: 7 months (allow 4 weeks for repeat pulmonary function tests)
Initial renewal criteria (at 6 months):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% from initiation of therapy until renewal (initial 6 month
treatment period). If a patient has experienced progression as defined above, then the
results should be validated with a confirmatory pulmonary function test conducted 4 weeks
later.
Approval period: 6 months
Second and subsequent renewals (at 12 months and thereafter):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% within any 12 month period. If a patient has experienced
progression as defined above, then the results should be validated with a confirmatory
pulmonary function test conducted 4 weeks later.
Approval period: 12 months
Documentation/information required:
• If high-resolution CT scan is not available, lung biopsy may be provided to support
the diagnosis of IPF as applicable and available
• Full pulmonary function test results.
Exclusion Criteria:
Combination use of Esbriet (pirfenidone) and Ofev (nintedanib) will not be funded.
437
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 437, record 267, 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
M-Pirfenidone · DIN 02550644
Manufacturer: Mantra Pharma Inc.; listing date 2025-03-31
Health Canada: Marketed since 2025-01-29 · brand M-PIRFENIDONE · ATC L04AX05 PIRFENIDONE · form Tablet · route Oral · ingredients PIRFENIDONE 267 MG · company Mantra pharma inc · schedule Prescription
M-Pirfenidone: Formulary list price $6.7120/unit (unit not stated in source; not the patient's cost)
Ministry pays: $6.7120 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=103943 · Verify on the e-Formulary ↗ (DIN 02550644)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02550644).
DIN 02550644: M-Pirfenidone
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 480200003; group id 570; item number 1521; lccId None; manufacturer id MAT
Source form: Tab; strength: 267mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $6.7120; ministry $6.7120
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02550644
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=103943Interchangeable products
Auro-Pirfenidone · DIN 02537753 · $6.7119
Esbriet · DIN 02464489 · $6.7120
Jamp Pirfenidone · DIN 02514702 · $6.7120
PMS-Pirfenidone · DIN 02531526 · $6.7120
Sandoz Pirfenidone Tablets · DIN 02488507 · $6.7120
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=02550644
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Sandoz Pirfenidone Tablets · DIN 02488507 · 267mg · 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
Pirfenidone
Brand(s): Esbriet and generics (see formulary for OFIs)
DOSAGE FORM/ STRENGTH: 267 mg capsule, 267 mg tablet, 801 mg tablet
Initial approval criteria:
For the treatment of adult patients with a diagnosis of mild to moderate idiopathic
pulmonary fibrosis (IPF):
• Diagnosis confirmed by a respirologist and a high-resolution CT scan.
• All other causes of restrictive lung disease (e.g. collagen vascular disorder or
hypersensitivity pneumonitis) should be excluded.
• Mild to moderate IPF is defined as forced vital capacity (FVC) greater than or equal
to 50% of predicted.
• Patient is under the care of a physician with experience in IPF.
Initial approval period: 7 months (allow 4 weeks for repeat pulmonary function tests)
Initial renewal criteria (at 6 months):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% from initiation of therapy until renewal (initial 6 month
treatment period). If a patient has experienced progression as defined above, then the
results should be validated with a confirmatory pulmonary function test conducted 4 weeks
later.
Approval period: 6 months
Second and subsequent renewals (at 12 months and thereafter):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% within any 12 month period. If a patient has experienced
progression as defined above, then the results should be validated with a confirmatory
pulmonary function test conducted 4 weeks later.
Approval period: 12 months
Documentation/information required:
• If high-resolution CT scan is not available, lung biopsy may be provided to support
the diagnosis of IPF as applicable and available
• Full pulmonary function test results.
Exclusion Criteria:
Combination use of Esbriet (pirfenidone) and Ofev (nintedanib) will not be funded.
437
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 437, record 267, 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 Pirfenidone Tablets · DIN 02488507
Manufacturer: Sandoz Canada Inc.; listing date 2021-06-30
Health Canada: Marketed since 2021-05-04 · brand SANDOZ PIRFENIDONE TABLETS · ATC L04AX05 PIRFENIDONE · form Tablet · route Oral · ingredients PIRFENIDONE 267 MG · company Sandoz canada incorporated · schedule Prescription
Sandoz Pirfenidone Tablets: Formulary list price $6.7120/unit (unit not stated in source; not the patient's cost)
Ministry pays: $6.7120 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=97860 · Verify on the e-Formulary ↗ (DIN 02488507)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02488507).
DIN 02488507: Sandoz Pirfenidone Tablets
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 480200003; group id 570; item number 1521; lccId None; manufacturer id SDZ
Source form: Tab; strength: 267mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $6.7120; ministry $6.7120
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02488507
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=97860Interchangeable products
Auro-Pirfenidone · DIN 02537753 · $6.7119
Esbriet · DIN 02464489 · $6.7120
Jamp Pirfenidone · DIN 02514702 · $6.7120
M-Pirfenidone · DIN 02550644 · $6.7120
PMS-Pirfenidone · DIN 02531526 · $6.7120
Shortage status: resolved shortage (ended 2026-01-30); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02488507
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Auro-Pirfenidone · DIN 02537761 · 801mg · 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
Pirfenidone
Brand(s): Esbriet and generics (see formulary for OFIs)
DOSAGE FORM/ STRENGTH: 267 mg capsule, 267 mg tablet, 801 mg tablet
Initial approval criteria:
For the treatment of adult patients with a diagnosis of mild to moderate idiopathic
pulmonary fibrosis (IPF):
• Diagnosis confirmed by a respirologist and a high-resolution CT scan.
• All other causes of restrictive lung disease (e.g. collagen vascular disorder or
hypersensitivity pneumonitis) should be excluded.
• Mild to moderate IPF is defined as forced vital capacity (FVC) greater than or equal
to 50% of predicted.
• Patient is under the care of a physician with experience in IPF.
Initial approval period: 7 months (allow 4 weeks for repeat pulmonary function tests)
Initial renewal criteria (at 6 months):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% from initiation of therapy until renewal (initial 6 month
treatment period). If a patient has experienced progression as defined above, then the
results should be validated with a confirmatory pulmonary function test conducted 4 weeks
later.
Approval period: 6 months
Second and subsequent renewals (at 12 months and thereafter):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% within any 12 month period. If a patient has experienced
progression as defined above, then the results should be validated with a confirmatory
pulmonary function test conducted 4 weeks later.
Approval period: 12 months
Documentation/information required:
• If high-resolution CT scan is not available, lung biopsy may be provided to support
the diagnosis of IPF as applicable and available
• Full pulmonary function test results.
Exclusion Criteria:
Combination use of Esbriet (pirfenidone) and Ofev (nintedanib) will not be funded.
437
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 437, record 267, 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
Auro-Pirfenidone · DIN 02537761
Manufacturer: Auro Pharma Inc.; listing date 2024-03-28
Health Canada: Marketed since 2024-03-05 · brand AURO-PIRFENIDONE · ATC L04AX05 PIRFENIDONE · form Tablet · route Oral · ingredients PIRFENIDONE 801 MG · company Auro pharma inc · schedule Prescription
Auro-Pirfenidone: Formulary list price $20.1361/unit (unit not stated in source; not the patient's cost)
Ministry pays: $20.1361 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=102654 · Verify on the e-Formulary ↗ (DIN 02537761)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02537761).
DIN 02537761: Auro-Pirfenidone
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 480200004; group id 570; item number 1522; lccId None; manufacturer id AUR
Source form: Tab; strength: 801mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $20.1361; ministry $20.1361
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02537761
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=102654Interchangeable products
Esbriet · DIN 02464500 · $20.1361
Jamp Pirfenidone · DIN 02514710 · $20.1360
M-Pirfenidone · DIN 02550652 · $20.1360
PMS-Pirfenidone · DIN 02531534 · $20.1360
Sandoz Pirfenidone Tablets · DIN 02488515 · $20.1360
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=02537761
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Esbriet · DIN 02464500 · 801mg · 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
Pirfenidone
Brand(s): Esbriet and generics (see formulary for OFIs)
DOSAGE FORM/ STRENGTH: 267 mg capsule, 267 mg tablet, 801 mg tablet
Initial approval criteria:
For the treatment of adult patients with a diagnosis of mild to moderate idiopathic
pulmonary fibrosis (IPF):
• Diagnosis confirmed by a respirologist and a high-resolution CT scan.
• All other causes of restrictive lung disease (e.g. collagen vascular disorder or
hypersensitivity pneumonitis) should be excluded.
• Mild to moderate IPF is defined as forced vital capacity (FVC) greater than or equal
to 50% of predicted.
• Patient is under the care of a physician with experience in IPF.
Initial approval period: 7 months (allow 4 weeks for repeat pulmonary function tests)
Initial renewal criteria (at 6 months):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% from initiation of therapy until renewal (initial 6 month
treatment period). If a patient has experienced progression as defined above, then the
results should be validated with a confirmatory pulmonary function test conducted 4 weeks
later.
Approval period: 6 months
Second and subsequent renewals (at 12 months and thereafter):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% within any 12 month period. If a patient has experienced
progression as defined above, then the results should be validated with a confirmatory
pulmonary function test conducted 4 weeks later.
Approval period: 12 months
Documentation/information required:
• If high-resolution CT scan is not available, lung biopsy may be provided to support
the diagnosis of IPF as applicable and available
• Full pulmonary function test results.
Exclusion Criteria:
Combination use of Esbriet (pirfenidone) and Ofev (nintedanib) will not be funded.
437
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 437, record 267, 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
Esbriet · DIN 02464500
Manufacturer: Hoffmann-La Roche Limited; listing date 2021-06-30
Health Canada: Marketed since 2017-07-26 · brand ESBRIET · ATC L04AX05 PIRFENIDONE · form Tablet · route Oral · ingredients PIRFENIDONE 801 MG · company Hoffmann-la roche limited · schedule Prescription
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=95264 · Verify on the e-Formulary ↗ (DIN 02464500)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02464500).
DIN 02464500: Esbriet
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 480200004; group id 570; item number 1522; lccId None; manufacturer id HLR
Source form: Tab; strength: 801mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $40.2720; ministry $20.1361
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02464500
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=95264Interchangeable products
Auro-Pirfenidone · DIN 02537761 · $20.1361
Jamp Pirfenidone · DIN 02514710 · $20.1360
M-Pirfenidone · DIN 02550652 · $20.1360
PMS-Pirfenidone · DIN 02531534 · $20.1360
Sandoz Pirfenidone Tablets · DIN 02488515 · $20.1360
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=02464500
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Jamp Pirfenidone · DIN 02514710 · 801mg · 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
Pirfenidone
Brand(s): Esbriet and generics (see formulary for OFIs)
DOSAGE FORM/ STRENGTH: 267 mg capsule, 267 mg tablet, 801 mg tablet
Initial approval criteria:
For the treatment of adult patients with a diagnosis of mild to moderate idiopathic
pulmonary fibrosis (IPF):
• Diagnosis confirmed by a respirologist and a high-resolution CT scan.
• All other causes of restrictive lung disease (e.g. collagen vascular disorder or
hypersensitivity pneumonitis) should be excluded.
• Mild to moderate IPF is defined as forced vital capacity (FVC) greater than or equal
to 50% of predicted.
• Patient is under the care of a physician with experience in IPF.
Initial approval period: 7 months (allow 4 weeks for repeat pulmonary function tests)
Initial renewal criteria (at 6 months):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% from initiation of therapy until renewal (initial 6 month
treatment period). If a patient has experienced progression as defined above, then the
results should be validated with a confirmatory pulmonary function test conducted 4 weeks
later.
Approval period: 6 months
Second and subsequent renewals (at 12 months and thereafter):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% within any 12 month period. If a patient has experienced
progression as defined above, then the results should be validated with a confirmatory
pulmonary function test conducted 4 weeks later.
Approval period: 12 months
Documentation/information required:
• If high-resolution CT scan is not available, lung biopsy may be provided to support
the diagnosis of IPF as applicable and available
• Full pulmonary function test results.
Exclusion Criteria:
Combination use of Esbriet (pirfenidone) and Ofev (nintedanib) will not be funded.
437
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 437, record 267, 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
Jamp Pirfenidone · DIN 02514710
Manufacturer: Jamp Pharma Corporation; listing date 2021-08-31
Health Canada: Marketed since 2021-10-07 · brand JAMP PIRFENIDONE · ATC L04AX05 PIRFENIDONE · form Tablet · route Oral · ingredients PIRFENIDONE 801 MG · company Jamp pharma corporation · schedule Prescription
Jamp Pirfenidone: Formulary list price $20.1360/unit (unit not stated in source; not the patient's cost)
Ministry pays: $20.1360 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=100411 · Verify on the e-Formulary ↗ (DIN 02514710)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02514710).
DIN 02514710: Jamp Pirfenidone
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 480200004; group id 570; item number 1522; lccId None; manufacturer id JPC
Source form: Tab; strength: 801mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $20.1360; ministry $20.1360
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02514710
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=100411Interchangeable products
Auro-Pirfenidone · DIN 02537761 · $20.1361
Esbriet · DIN 02464500 · $20.1361
M-Pirfenidone · DIN 02550652 · $20.1360
PMS-Pirfenidone · DIN 02531534 · $20.1360
Sandoz Pirfenidone Tablets · DIN 02488515 · $20.1360
Shortage status: resolved shortage (ended 2022-04-05); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02514710
Shortage record checked 2026-09-13T08:10:21.292534+00:00
M-Pirfenidone · DIN 02550652 · 801mg · 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
Pirfenidone
Brand(s): Esbriet and generics (see formulary for OFIs)
DOSAGE FORM/ STRENGTH: 267 mg capsule, 267 mg tablet, 801 mg tablet
Initial approval criteria:
For the treatment of adult patients with a diagnosis of mild to moderate idiopathic
pulmonary fibrosis (IPF):
• Diagnosis confirmed by a respirologist and a high-resolution CT scan.
• All other causes of restrictive lung disease (e.g. collagen vascular disorder or
hypersensitivity pneumonitis) should be excluded.
• Mild to moderate IPF is defined as forced vital capacity (FVC) greater than or equal
to 50% of predicted.
• Patient is under the care of a physician with experience in IPF.
Initial approval period: 7 months (allow 4 weeks for repeat pulmonary function tests)
Initial renewal criteria (at 6 months):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% from initiation of therapy until renewal (initial 6 month
treatment period). If a patient has experienced progression as defined above, then the
results should be validated with a confirmatory pulmonary function test conducted 4 weeks
later.
Approval period: 6 months
Second and subsequent renewals (at 12 months and thereafter):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% within any 12 month period. If a patient has experienced
progression as defined above, then the results should be validated with a confirmatory
pulmonary function test conducted 4 weeks later.
Approval period: 12 months
Documentation/information required:
• If high-resolution CT scan is not available, lung biopsy may be provided to support
the diagnosis of IPF as applicable and available
• Full pulmonary function test results.
Exclusion Criteria:
Combination use of Esbriet (pirfenidone) and Ofev (nintedanib) will not be funded.
437
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 437, record 267, 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
M-Pirfenidone · DIN 02550652
Manufacturer: Mantra Pharma Inc.; listing date 2025-03-31
Health Canada: Marketed since 2025-01-29 · brand M-PIRFENIDONE · ATC L04AX05 PIRFENIDONE · form Tablet · route Oral · ingredients PIRFENIDONE 801 MG · company Mantra pharma inc · schedule Prescription
M-Pirfenidone: Formulary list price $20.1360/unit (unit not stated in source; not the patient's cost)
Ministry pays: $20.1360 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=103944 · Verify on the e-Formulary ↗ (DIN 02550652)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02550652).
DIN 02550652: M-Pirfenidone
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 480200004; group id 570; item number 1522; lccId None; manufacturer id MAT
Source form: Tab; strength: 801mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $20.1360; ministry $20.1360
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02550652
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=103944Interchangeable products
Auro-Pirfenidone · DIN 02537761 · $20.1361
Esbriet · DIN 02464500 · $20.1361
Jamp Pirfenidone · DIN 02514710 · $20.1360
PMS-Pirfenidone · DIN 02531534 · $20.1360
Sandoz Pirfenidone Tablets · DIN 02488515 · $20.1360
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=02550652
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Sandoz Pirfenidone Tablets · DIN 02488515 · 801mg · 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
Pirfenidone
Brand(s): Esbriet and generics (see formulary for OFIs)
DOSAGE FORM/ STRENGTH: 267 mg capsule, 267 mg tablet, 801 mg tablet
Initial approval criteria:
For the treatment of adult patients with a diagnosis of mild to moderate idiopathic
pulmonary fibrosis (IPF):
• Diagnosis confirmed by a respirologist and a high-resolution CT scan.
• All other causes of restrictive lung disease (e.g. collagen vascular disorder or
hypersensitivity pneumonitis) should be excluded.
• Mild to moderate IPF is defined as forced vital capacity (FVC) greater than or equal
to 50% of predicted.
• Patient is under the care of a physician with experience in IPF.
Initial approval period: 7 months (allow 4 weeks for repeat pulmonary function tests)
Initial renewal criteria (at 6 months):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% from initiation of therapy until renewal (initial 6 month
treatment period). If a patient has experienced progression as defined above, then the
results should be validated with a confirmatory pulmonary function test conducted 4 weeks
later.
Approval period: 6 months
Second and subsequent renewals (at 12 months and thereafter):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% within any 12 month period. If a patient has experienced
progression as defined above, then the results should be validated with a confirmatory
pulmonary function test conducted 4 weeks later.
Approval period: 12 months
Documentation/information required:
• If high-resolution CT scan is not available, lung biopsy may be provided to support
the diagnosis of IPF as applicable and available
• Full pulmonary function test results.
Exclusion Criteria:
Combination use of Esbriet (pirfenidone) and Ofev (nintedanib) will not be funded.
437
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 437, record 267, 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 Pirfenidone Tablets · DIN 02488515
Manufacturer: Sandoz Canada Inc.; listing date 2021-06-30
Health Canada: Marketed since 2021-05-04 · brand SANDOZ PIRFENIDONE TABLETS · ATC L04AX05 PIRFENIDONE · form Tablet · route Oral · ingredients PIRFENIDONE 801 MG · company Sandoz canada incorporated · schedule Prescription
Sandoz Pirfenidone Tablets: Formulary list price $20.1360/unit (unit not stated in source; not the patient's cost)
Ministry pays: $20.1360 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=97861 · Verify on the e-Formulary ↗ (DIN 02488515)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02488515).
DIN 02488515: Sandoz Pirfenidone Tablets
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 480200004; group id 570; item number 1522; lccId None; manufacturer id SDZ
Source form: Tab; strength: 801mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $20.1360; ministry $20.1360
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02488515
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=97861Interchangeable products
Auro-Pirfenidone · DIN 02537761 · $20.1361
Esbriet · DIN 02464500 · $20.1361
Jamp Pirfenidone · DIN 02514710 · $20.1360
M-Pirfenidone · DIN 02550652 · $20.1360
PMS-Pirfenidone · DIN 02531534 · $20.1360
Shortage status: active shortage (reported 2026-07-06, estimated to end 2026-09-19, last updated 2026-07-07); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02488515
Shortage record checked 2026-09-13T08:10:21.292534+00:00
PMS-Pirfenidone · DIN 02531526 · 267mg · tablet
Off-Formulary Interchangeable, not an ODB benefitDormant since 2026-07-31 · checked 2026-09-02 · What does dormant mean?
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
Pirfenidone
Brand(s): Esbriet and generics (see formulary for OFIs)
DOSAGE FORM/ STRENGTH: 267 mg capsule, 267 mg tablet, 801 mg tablet
Initial approval criteria:
For the treatment of adult patients with a diagnosis of mild to moderate idiopathic
pulmonary fibrosis (IPF):
• Diagnosis confirmed by a respirologist and a high-resolution CT scan.
• All other causes of restrictive lung disease (e.g. collagen vascular disorder or
hypersensitivity pneumonitis) should be excluded.
• Mild to moderate IPF is defined as forced vital capacity (FVC) greater than or equal
to 50% of predicted.
• Patient is under the care of a physician with experience in IPF.
Initial approval period: 7 months (allow 4 weeks for repeat pulmonary function tests)
Initial renewal criteria (at 6 months):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% from initiation of therapy until renewal (initial 6 month
treatment period). If a patient has experienced progression as defined above, then the
results should be validated with a confirmatory pulmonary function test conducted 4 weeks
later.
Approval period: 6 months
Second and subsequent renewals (at 12 months and thereafter):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% within any 12 month period. If a patient has experienced
progression as defined above, then the results should be validated with a confirmatory
pulmonary function test conducted 4 weeks later.
Approval period: 12 months
Documentation/information required:
• If high-resolution CT scan is not available, lung biopsy may be provided to support
the diagnosis of IPF as applicable and available
• Full pulmonary function test results.
Exclusion Criteria:
Combination use of Esbriet (pirfenidone) and Ofev (nintedanib) will not be funded.
437
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 437, record 267, 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-Pirfenidone · DIN 02531526
Manufacturer: Pharmascience Inc.; listing date 2022-12-21
Health Canada: Dormant since 2026-07-31 · brand PMS-PIRFENIDONE · ATC L04AX05 PIRFENIDONE · form Tablet · route Oral · ingredients PIRFENIDONE 267 MG · company Pharmascience inc · schedule Prescription
PMS-Pirfenidone: Formulary list price $6.7120/unit (unit not stated in source; not the patient's cost)
Ministry pays: $6.7120 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=102064 · Verify on the e-Formulary ↗ (DIN 02531526)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02531526).
DIN 02531526: PMS-Pirfenidone
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 480200003; group id 570; item number 1521; lccId None; manufacturer id PMS
Source form: Tab; strength: 267mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $6.7120; ministry $6.7120
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02531526
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=102064Interchangeable products
Auro-Pirfenidone · DIN 02537753 · $6.7119
Esbriet · DIN 02464489 · $6.7120
Jamp Pirfenidone · DIN 02514702 · $6.7120
M-Pirfenidone · DIN 02550644 · $6.7120
Sandoz Pirfenidone Tablets · DIN 02488507 · $6.7120
Shortage status: active shortage (reported 2024-05-23, last updated 2025-08-27); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02531526
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Health Canada lists this DIN as Dormant since 2026-07-31 — choose a marketed DIN from the same-category list.
PMS-Pirfenidone · DIN 02531534 · 801mg · tablet
Off-Formulary Interchangeable, not an ODB benefitDormant since 2026-07-31 · 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
Pirfenidone
Brand(s): Esbriet and generics (see formulary for OFIs)
DOSAGE FORM/ STRENGTH: 267 mg capsule, 267 mg tablet, 801 mg tablet
Initial approval criteria:
For the treatment of adult patients with a diagnosis of mild to moderate idiopathic
pulmonary fibrosis (IPF):
• Diagnosis confirmed by a respirologist and a high-resolution CT scan.
• All other causes of restrictive lung disease (e.g. collagen vascular disorder or
hypersensitivity pneumonitis) should be excluded.
• Mild to moderate IPF is defined as forced vital capacity (FVC) greater than or equal
to 50% of predicted.
• Patient is under the care of a physician with experience in IPF.
Initial approval period: 7 months (allow 4 weeks for repeat pulmonary function tests)
Initial renewal criteria (at 6 months):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% from initiation of therapy until renewal (initial 6 month
treatment period). If a patient has experienced progression as defined above, then the
results should be validated with a confirmatory pulmonary function test conducted 4 weeks
later.
Approval period: 6 months
Second and subsequent renewals (at 12 months and thereafter):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% within any 12 month period. If a patient has experienced
progression as defined above, then the results should be validated with a confirmatory
pulmonary function test conducted 4 weeks later.
Approval period: 12 months
Documentation/information required:
• If high-resolution CT scan is not available, lung biopsy may be provided to support
the diagnosis of IPF as applicable and available
• Full pulmonary function test results.
Exclusion Criteria:
Combination use of Esbriet (pirfenidone) and Ofev (nintedanib) will not be funded.
437
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 437, record 267, 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-Pirfenidone · DIN 02531534
Manufacturer: Pharmascience Inc.; listing date 2022-12-21
Health Canada: Dormant since 2026-07-31 · brand PMS-PIRFENIDONE · ATC L04AX05 PIRFENIDONE · form Tablet · route Oral · ingredients PIRFENIDONE 801 MG · company Pharmascience inc · schedule Prescription
PMS-Pirfenidone: Formulary list price $20.1360/unit (unit not stated in source; not the patient's cost)
Ministry pays: $20.1360 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=102065 · Verify on the e-Formulary ↗ (DIN 02531534)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02531534).
DIN 02531534: PMS-Pirfenidone
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 480200004; group id 570; item number 1522; lccId None; manufacturer id PMS
Source form: Tab; strength: 801mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $20.1360; ministry $20.1360
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02531534
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=102065Interchangeable products
Auro-Pirfenidone · DIN 02537761 · $20.1361
Esbriet · DIN 02464500 · $20.1361
Jamp Pirfenidone · DIN 02514710 · $20.1360
M-Pirfenidone · DIN 02550652 · $20.1360
Sandoz Pirfenidone Tablets · DIN 02488515 · $20.1360
Shortage status: active shortage (reported 2024-05-23, last updated 2025-08-27); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02531534
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Health Canada lists this DIN as Dormant since 2026-07-31 — choose a marketed DIN from the same-category list.
Esbriet · DIN 02393751 · 267mg · capsule
Off-Formulary Interchangeable, not an ODB benefit; Health Canada lists this DIN as Cancelled post market since 2023-07-01 — choose a marketed DIN from the same-category list.Discontinued 2023-07-01 · checked 2026-09-02
StatusOff-Formulary Interchangeable, not an ODB benefit; Health Canada lists this DIN as Cancelled post market since 2023-07-01 — 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 2023-07-01 — 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
Pirfenidone
Brand(s): Esbriet and generics (see formulary for OFIs)
DOSAGE FORM/ STRENGTH: 267 mg capsule, 267 mg tablet, 801 mg tablet
Initial approval criteria:
For the treatment of adult patients with a diagnosis of mild to moderate idiopathic
pulmonary fibrosis (IPF):
• Diagnosis confirmed by a respirologist and a high-resolution CT scan.
• All other causes of restrictive lung disease (e.g. collagen vascular disorder or
hypersensitivity pneumonitis) should be excluded.
• Mild to moderate IPF is defined as forced vital capacity (FVC) greater than or equal
to 50% of predicted.
• Patient is under the care of a physician with experience in IPF.
Initial approval period: 7 months (allow 4 weeks for repeat pulmonary function tests)
Initial renewal criteria (at 6 months):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% from initiation of therapy until renewal (initial 6 month
treatment period). If a patient has experienced progression as defined above, then the
results should be validated with a confirmatory pulmonary function test conducted 4 weeks
later.
Approval period: 6 months
Second and subsequent renewals (at 12 months and thereafter):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% within any 12 month period. If a patient has experienced
progression as defined above, then the results should be validated with a confirmatory
pulmonary function test conducted 4 weeks later.
Approval period: 12 months
Documentation/information required:
• If high-resolution CT scan is not available, lung biopsy may be provided to support
the diagnosis of IPF as applicable and available
• Full pulmonary function test results.
Exclusion Criteria:
Combination use of Esbriet (pirfenidone) and Ofev (nintedanib) will not be funded.
437
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 437, record 267, 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
Esbriet · DIN 02393751
Manufacturer: InterMune Canada, Inc.; listing date 2021-07-30
Health Canada: Cancelled post market since 2023-07-01 · brand ESBRIET · ATC L04AX05 PIRFENIDONE · form Capsule · route Oral · ingredients PIRFENIDONE 267 MG · company Hoffmann-la roche limited · schedule Prescription
Esbriet: Formulary list price not recorded/unit (unit not stated in source; not the patient's cost)
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=87895 · Verify on the e-Formulary ↗ (DIN 02393751)
Source record
DIN 02393751: Esbriet
Raw flags: notABenefit=Y, sec3=Y, sec3b=Y
Item: 920000699; group id 948; item number 2254; lccId None; manufacturer id INT
Source form: Cap; strength: 267mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit
Source prices (unrounded): not recorded; ministry not recorded
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02393751
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=87895Interchangeable products
Jamp Pirfenidone · DIN 02509938 · $6.7120
Sandoz Pirfenidone Capsules · DIN 02488833 · $6.7120
Shortage status: discontinued (2023-03-20, reported by HOFFMANN-LA ROCHE LIMITED); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02393751
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Health Canada lists this DIN as Cancelled post market since 2023-07-01 — choose a marketed DIN from the same-category list.
Other drugs in the same formulary classes and how they are covered
Other drugs in the same formulary class (48:00 COUGH PREPARATIONS) and how they are covered
Matched class: 48:00 COUGH PREPARATIONS
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): DEXTROMETHORPHAN HBR, HYDROCODONE BITARTRATE
48:00 COUGH PREPARATIONS
· 28 products · Off-Formulary Interchangeable, not an ODB benefit (4), Listed, not a benefit (1), General benefit (23) · strengths: 5mg, 10mg, 70mg · Tab
Source: formulary-ed43-front-matter.txt Part V; ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26; class 92:00
and 75 more
Full class listing
Related classes:
Same formulary class, not same indication: class membership alone does not establish equivalent uses.Other drugs whose Health Canada label lists a similar indication: pulmonary fibrosis
From Health Canada product monographs; label wording only, not a treatment recommendation.
Matching is lexical and uses one held product label per generic; formulations and qualifying criteria may differ.
No displayed matched alternative is a general benefit.
NINTEDANIB · Off-Formulary Interchangeable, not an ODB benefit
• The treatment of Idiopathic Pulmonary Fibrosis (IPF)
PM: https://pdf.hres.ca/dpd_pm/00077134.PDF; date JUN 25, 2015; DIN 02443066; fetched 2026-09-10
Product monograph
Coverage source: ON formulary extract 2026-08-26
What the Health Canada label says it is for
1 INDICATIONS
ESBRIET® (pirfenidone) is indicated for treatment of idiopathic pulmonary fibrosis (IPF) in adults.
1.1. Pediatrics
Pediatrics (<18 years of age): The safety and effectiveness of ESBRIET in pediatric patients have not
been established.
1.2. Geriatrics
No dose adjustment is necessary in patients 65 years and older (see 10 CLINICAL PHARMACOLOGY).
https://pdf.hres.ca/dpd_pm/00073373.PDF
PM date: November 9, 2023
Source product: ESBRIET; DIN 02464489; fetched 2026-09-10
Product monograph posted by Health Canada; excerpt for lookup only.
Availability
Esbriet · DIN 02464489
Shortage status: discontinued (2021-11-25, reported by HOFFMANN-LA ROCHE LIMITED); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02464489
Sandoz Pirfenidone Tablets · DIN 02488515
Shortage status: active shortage (reported 2026-07-06, estimated to end 2026-09-19, last updated 2026-07-07); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02488515
PMS-Pirfenidone · DIN 02531526
Shortage status: active shortage (reported 2024-05-23, last updated 2025-08-27); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02531526
PMS-Pirfenidone · DIN 02531534
Shortage status: active shortage (reported 2024-05-23, last updated 2025-08-27); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02531534
Health Canada defines dormant products as: “products that were previously marketed in Canada but for which the manufacturer has suspended sale for period of at least 12 months.” (canada.ca, Sep 10, 2026 ↗)
Prepare an Exceptional Access request
SADIE has its own form for many drugs; this checklist prepares the answers; the ministry decides. Open SADIE
Use this text in SADIE’s free-text fields or read from it on a Telephone Request Service call. Review marks do not indicate eligibility. Evidence stays in this page until you copy it; nothing entered here is sent or saved. Do not enter patient identifiers.
EAP Telephone Request Service: The TRS can be accessed by calling toll-free at 1-866-811-9893 or 416-327-8109 (Toronto area) between 8:30 a.m. and 5:00 p.m. Monday through Friday (except holidays) and selecting the TRS option. Source; updated September 15, 2026
Posted turnaround and Telephone Request Service scope
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 |
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.
Pirfenidone
Brand(s): Esbriet and generics (see formulary for OFIs)
DOSAGE FORM/ STRENGTH: 267 mg capsule, 267 mg tablet, 801 mg tablet
Initial approval criteria:
For the treatment of adult patients with a diagnosis of mild to moderate idiopathic
pulmonary fibrosis (IPF):
• Diagnosis confirmed by a respirologist and a high-resolution CT scan.
• All other causes of restrictive lung disease (e.g. collagen vascular disorder or
hypersensitivity pneumonitis) should be excluded.
• Mild to moderate IPF is defined as forced vital capacity (FVC) greater than or equal
to 50% of predicted.
• Patient is under the care of a physician with experience in IPF.
Initial approval period: 7 months (allow 4 weeks for repeat pulmonary function tests)
Initial renewal criteria (at 6 months):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% from initiation of therapy until renewal (initial 6 month
treatment period). If a patient has experienced progression as defined above, then the
results should be validated with a confirmatory pulmonary function test conducted 4 weeks
later.
Approval period: 6 months
Second and subsequent renewals (at 12 months and thereafter):
Patients must NOT demonstrate progression of disease defined as an absolute decline in
percent predicted FVC of ≥10% within any 12 month period. If a patient has experienced
progression as defined above, then the results should be validated with a confirmatory
pulmonary function test conducted 4 weeks later.
Approval period: 12 months
Documentation/information required:
• If high-resolution CT scan is not available, lung biopsy may be provided to support
the diagnosis of IPF as applicable and available
• Full pulmonary function test results.
Exclusion Criteria:
Combination use of Esbriet (pirfenidone) and Ofev (nintedanib) will not be funded.
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Prepared from the ministry's published criteria; eligibility is decided by the Exceptional Access Program.