New category for Sun Life’s prior authorization program

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If you have Sun Life’s prior authorization program on your Pay Direct Drug plan, a new category will be added to the program, effective immediately. 

The category being added to your plan and the drug it includes are:

New drug category Drug added
Diabetes Victoza

Why is there a new category?

The program continuously follows new drugs coming to market in Canada, as well as new prescription patterns (e.g. disruption in the prescribing pattern, or increased off-label use for certain products) and adapts the categories accordingly. This is all done with the aim to manage drug plan costs while providing your plan members with coverage for the right treatment for them.

Grandfathering

When categories are added, we “grandfather” any plan members already taking any of the drugs being added to the prior authorization program. What that means is that a plan member who has already been reimbursed for the listed drug in the 120 days before the drug was added to the prior authorization program will not need to apply for prior authorization approval for their prescription.

Checking out the prior authorization program online

Simply go to mysunlife.ca/priorauthorization to find the list of prior authorization drugs and forms that are relevant to the prior authorization program. You can see the new category at the time it is added, as well as any drugs under the category. 

Sharing the news

We have attached a plan member communication for you to share this information with your plan members.

Questions?

Contact your Sun Life Financial Group Benefits representative.