Reimbursement of brand‐name drugs at the cost of the least expensive generic version ‐ Exceptions procedure
Since January 8, 2016, iA Financial Group (Industrial Alliance Insurance and Financial Services Inc.) is reimbursing brand‐name drugs based on the cost of the least expensive generic version for all Quebec group insurance plan members whose plan includes a generic substitution clause.
In order to comply with the minimum reimbursement requirements established by the the Régie de l’assurance maladie du Québec (RAMQ), iA Financial Group will now implement a default exceptions procedure for groups whose plan contains a mandatory generic substitution clause without an exceptions procedure already in place. Thus, members who present a form filled and signed by a physician requesting exemption from taking a generic drug, for the reasons below, will see their reimbursement adjusted to correspond to the minimum amount determined by the RAMQ for the drug submitted.The exceptions procedure applies in the following situations:
- Members suffering from a documented allergy to a non‐medicinal ingredient of the generic drug not used in the brand‐name drug.
- Members suffering from a documented intolerance to a non‐medicinal ingredient of the generic drug not used in the brand‐name drug.
If you have any questions or concerns regarding this communiqué, please contact your benefits advisor or your iA Financial Group account executive.