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Application Instructions – Case-by-Case Review Program

Requests are accepted only from oncologists who are licensed to practice in Ontario.

Follow these steps to apply to the Case-by-Case Review Program:

  1. Confirm that the patient meets the criteria for the Case-by-Case Review Program. For criteria, see the Case-by-Case Review Policy for Cancer Drugs.
  2. Download and complete the appropriate form:

Request Form (new requests)

Appeals/Resubmission Form

Renewal Form

Make sure to download and use the most recent forms each time, as forms may have been revised since your last visit. 

  1. Review the express consent provision in the Request Form with the patient. This ensures the patient is informed of the use and disclosure of their personal health information as outlined.
  2. Gather all required supporting documentation.
  3. Submit the application using our eClaims tool (see instructions below).

 

Submit an Application

eClaims Instructions

You must have eClaims access to submit an application. If you do not have access, contact your site’s LRA (Local Registration Authority) to request an eClaims account for CBCRP submissions. Processing new accounts for eClaims may take 1 to 3 weeks. If your submission is urgent, your site’s pharmacy can upload the application to eClaims for you.

  1. Log in to eClaims.
  2. Under Communications, select “New” button.
  3. Fill in Subject Line with “Patient Name – Drug/Indication” or “Tracking Number” of request.
  4. Under Categories, select the option that best represents the reason for your request. Refer to the following chart to help make your selection:
To Complete This Task: Select This Option:
Submit a new request Case-by-Case Review Program: 1 – Initial Request
Submit additional requested information on a previously submitted request Case-by-Case Review Program: 2 – Additional Info
Submit the Case-by-Case Review Program Treatment Data Template (for hospital pharmacies and cancer centres) Case-by-Case Review Program: 3 – Treatment Data
Request an extension or renewal on a previously approved request Case-by-Case Review Program: 4 – Renewal Request
Submit the Appeals/Resubmission Form Case-by-Case Review Program: 5 – Appeal

 

  1. Select “Attach a file” and browse to select file (e.g., request form, supporting clinical documents and evidence) to upload. Repeat for each additional file.
  2. Select “Send” button once you have completed browsing and selecting all files.

A tracking number will be assigned by the CBCRP Pharmacist and provided to you through an eClaims secure message once your application is received. The program will use this number in all communications about your application. You must include this number in any new communication threads with the program regarding your application.

Please do not email any documents containing personal health information (PHI) to Ontario Health.

For information about review timelines and duration of coverage, see the Case-by-Case Review Program page.

Contact Information

Questions on program eligibility or the application process?
Email the CBCRP at OH-CCO_cbcrp@ontariohealth.ca. Please do not email any documents containing personal health information (PHI) to Ontario Health.

Issues related to eClaims?
Contact the Service Desk. Standard support hours are 8 a.m. to 8 p.m. EST, Monday to Friday. Call 1-866-729-9787, or email OH-CCO_ITSM-ITServiceDesk@ontariohealth.ca.