Exceptional Access Program (EAP) – Biosimilar Exemption Request

This form is only to be used by prescribers to request an exemption for Ontario’s Biosimilar Switch Policy for a patient who HAS BEEN USING AN ORIGINATOR BIOLOGIC REIMBURSED THROUGH THE ONTARIO DRUG BENEFIT (ODB) PROGRAM previously authorized through the Exceptional Access Program and is unable to switch from an originator biologic or who is requesting to switch back to the originator following biosimilar switch.

Need help downloading or filling forms?

Please check our Help page for solutions to common issues.

Alert!

PDF Forms will no longer work with older versions of Adobe Reader including Adobe Reader XI. Please update your free Adobe Reader to the latest version from the Acrobat Reader download page so that you can continue to access these forms.


Download Adobe Reader Free Version

Make the most of your experience with accessing, downloading, and filling forms acquired from the Central Forms Repository by watching this brief video overview.

single frame of the linked video. Click to begin playback in a new browser window
Download English Transcript

Forms, Links, and Information

Additional Information

Form Number on00521
Title Exceptional Access Program (EAP) – Biosimilar Exemption Request
Description This form is only to be used by prescribers to request an exemption for Ontario’s Biosimilar Switch Policy for a patient who HAS BEEN USING AN ORIGINATOR BIOLOGIC REIMBURSED THROUGH THE ONTARIO DRUG BENEFIT (ODB) PROGRAM previously authorized through the Exceptional Access Program and is unable to switch from an originator biologic or who is requesting to switch back to the originator following biosimilar switch.