Canada’s Healthcare system is popular around the world, and for a good reason – we have some of the best Healthcare coverage in the world. Unlike many places around the world, like the United States, many of our procedures and medications are covered by the Canadian Government, meaning that we don’t have to pay for them out of pocket. But when you’re ordering medications, some are covered by healthcare and others that are not.
What is an LU Code?
When you order medications, you will often see codes on the side of them. If you see something that says, “LU”, this stands for “Limited Use” drugs. You may also hear these being referred to as “Special Access” drugs or drugs with “Exceptional Drug Status”, or EDS.
Under private or provincial drug programs, these medications are typically more expensive. To receive them under a drug plan, you must fulfill certain criteria. If the medications are for a specific disease, for example, you may need to prove how far advanced or severe the condition is before the LU medication is covered.
The LU code is the unique code needed for the LU medications to be covered under your provincial or private medical plan.
When are drugs listed as LU?
Limited Use Drugs are drugs that are not appropriate for general listing. They often serve a purpose and value but are not recommended unless used in specific circumstances or with certain diseases. Medications are often defined by the Committee to Evaluate Drugs as Limited Use when they are very expensive and cheaper alternatives are available.
Drugs may also be listed as limited use when they are commonly used for purposes other than those listed or associated with adverse side effects (and less toxic options are available).
Why do I need to know if my medication is listed as LU?
If you’re ordering medications, you must understand whether or not they are listed as Limited Use. If you purchase the medications and the necessary conditions are not fulfilled, you might not be reimbursed by your drug plan.
In return, you would have to pay for the medications out of your own pocket. As mentioned early, most Limited Use Medications are costly, so paying out of your own pocket may not be something you want to do.
How do I order Limited Use Medications?
In Canada, Limited Use medications must be ordered by your doctor. If your doctor deems that you need a Limited Use medication, they will send an LU code to your pharmacy of choice to inform them that you meet the conditions necessary to receive benefits for the drugs.
There may be some cases in which doctors recommend limited use medications, but you do not qualify for benefits. In such a case, it’s up to you to determine whether or not you would like to pay out of pocket. As mentioned earlier, there are often cheaper alternatives to most Limited Use medications, so it may be worth speaking to your doctor about these instead.