Therapeutic Substitution


If there is a medication that will have an equivalent effect as the one you take, but has an additional benefit such as, it is less expensive, or less likely to cause you a side effect, your pharmacist can perform an assessment. If appropriate, your pharmacist can prescribe and substitute your medication with another option.

Therapeutic substitution is an insured service for beneficiaries of the Nova Scotia Pharmacare Programs fo therapeutic substitution of Proton Pump Inhibitors (PPIs) in the following circumstances:

  • To allow a beneficiary of a Pharmacare Program access to an open benefit PPI in situations where the beneficiary has been prescribed a non-benefit product and/or one requiring special authorization for payment. Reimbursement is restricted to one payment per beneficiary per year.
  • Pharmacists are responsible for determining the appropriateness of the therapeutic substitution before performing the service.
  • The beneficiary provides written consent to authorize the pharmacist to make the therapeutic substitution

In some instances, Pharmacare will also authorize pharmacists to provide this service in cases where a medication has been recalled, or is no longer available.