Original version : WSIB Drug Benefit Program
Health Care Practitioner Access Line
Call our Access Line about WSIB billing, registration and programs, at 1-800-569-7919 or 416-344-4526.
If you have questions about your patient’s claim, please contact your patient’s adjudicator or nurse case manager at 1-800-387-5540 or 416-344-1000.
WSIB Drug Benefit Program
Our WSIB Drug Benefit Program pays the cost for medication prescribed by physicians for work-related injury or illness. Through this program, we provide medications to treat workplace-related conditions for more than 55,000 Ontario workers each year.
The program also has an automated online approval and billing system that allows Ontario pharmacies to obtain authorization for worker's prescriptions and to bill us directly through the system.
New Partnership
In 2005 we created a new partnership with the Leslie L. Dan Faculty of Pharmacy, University of Toronto, to improve our WSIB Drug Benefit Program. This partnership will continue to provide services on issues requiring pharmacy-related expertise, previously provided by Sunnybrook and Women's College Health Sciences Centre. It includes two key aspects:
- formulary management and
- research and educational initiatives.
Review of the formularies
The partnership's goal of reviewing the contents of the formularies is underway. The purpose of the review is to improve efficiency in the administration of the Drug Benefit Program, based on five guiding principles:
- Efficacy in treating the injury/illness
- Therapeutic uniqueness and the availability of alternatives
- Safety
- Interchangeability within its drug class
- Cost-effectiveness
Future plans include revising the contents of each of the current injury-/illness-specific formularies, and the possible addition to or modification of formularies currently in use. Following an impact analysis, we will implement revisions in an incremental manner that ensures the quality of care for workers receiving health benefits from WSIB is not compromised.
Retrospective drug utilization analysis
To more easily identify opportunities for further improvement and for potential practice-based research, we engaged the Medical Outcomes and Research in Economics (MORE) Group.
The MORE Research Group performed a retrospective drug utilization analysis of medications workers received through the WSIB Drug Benefit Program for the years 1997 through 2005. This provides an update of the drug utilization studies previously done for this population by the Health Outcomes and PharmacoEconomics (HOPE) Research Centre.
Based on results that will be presented by MORE in 2006, several specific, targeted interventions will be designed. These strategies will add to the interventions previously recommended by HOPE which included decreasing the long-term use of ketorolac, a highly gastrotoxic non-steroidal anti-inflammatory agent (NSAID) indicated for short-term use only and increasing the use of generic substitution.
Rational drug use and fiscal accountability go hand in hand with providing quality care to the workers of Ontario. These initiatives, have been designed to advance these goals.
Regular communication
Communication with treating physicians and relevant colleges and associations is of great importance, and we will make every effort to ensure this is provided on a regular basis.
If you have any comments please feel free to contact
Dr. Michel Schofield
Acting Director, Clinical Services Branch
Health Services Division, WSIB
(416) 344-3001
Fax: (416) 344-5678
E-mail:michel_schofield@wsib.on.ca
Please note: Dr. Schofield cannot respond to any e-mails from non-health care practitioners.
The Workplace Safety and Insurance Board
200 Front Street West
Toronto, ON M5V 3J1
Phone: (416) 344-1000
Toll free: 1-800-387-5540
Ontario Toll free: 1-800-387-0750
TTY: 1-800-387-0050
Web site: www.wsib.on.ca
