WSIB drug benefit program
The WSIB drug benefit program pays for prescription drugs for workers related to their workplace injury/illness. Online billing by pharmacies ensures that drug payment transactions are completed quickly and with ease.
WSIB’s management of the Drug Benefit Program includes:
Drug Advisory Committee
The Drug Advisory Committee (DAC) was formed in January 2008. The DAC consists of WSIB staff and highly qualified independent experts coming from a variety of relevant clinical practice backgrounds in medicine, pharmacy, and nursing. Using independent reviews, the DAC provides advice on formulary listings and conditions/criteria for coverage. In addition, the DAC provides ad hoc advice on other issues such as formulary review and modernization, drug use evaluation, and drug safety.
External drug reviews
The WSIB undertakes the administration of the drug benefit program in an evidence-based manner and in accordance with current clinical knowledge and best practices. As such, the WSIB has engaged external, independent providers to complete comprehensive reviews on the efficacy, safety, and cost-effectiveness of drugs. These reviews are used to inform decision-making relating to the composition and management of WSIB drug formularies in ensuring safe and appropriate pharmacotherapy for injured/ill workers.
Reviewing of formularies
Reviewing the WSIB formularies is an ongoing initiative. Reviews are completed to modernize and update the formularies in an efficient, clinically relevant, and transparent manner so they remain current with scientific evidence.
- Read our Formulary Drug Listing Decisions.
The review is guided by the principles of:
- Evidence-based medicine (as it pertains to ensuring access to proven drug therapy to treat work-related injuries/illnesses)
- Best practices (e.g., considering guidance from other formularies such as Ontario Drug Benefit Program)
- Accessibility (ensuring an appropriate breadth of drug classes and categories is available)
Changes to the WSIB drug benefit program are assessed to determine the effectiveness and utility of listing decisions and formulary updates. Regular monitoring assists in identifying opportunities for further improvement.
WSIB partnerships with external organizations to improve the Drug Benefit Program and ensure workers have access to medications and treatments supported by evidence and best practices. These partnerships focus on identifying issues related to safe and appropriate drug use in injured/ill workers and practice gaps in optimal prescribing of medications and developing targeted interventions to address them. For example, WSIB is collaborating with the College of Physicians and Surgeons of Ontario (CPSO) regarding narcotics for the treatment of chronic non-malignant pain.
Health professionals with questions regarding the WSIB Drug Benefit Program can contact the Health Care Access Line at 416-344-4526 or toll-free 1-800-569-7919. The Access Line will connect you to the individual who can answer your questions.