Oral agents and Outpatient Injections
FUNDING:
Cancer drugs that are routinely dispensed from community pharmacies are funded by private insurance plans first, and then one or more PEI Pharmacare programs.
FORMULARIES:
PEI Pharmacare Formulary: Click Here
Health PEI Formulary Drugs: Oncology: Click Here
Drug (Brand Name) Manufacturer |
Indication | Strength, Route | DIN | Provincial Funding Eligibility Criteria | References | Patient Assistance Programs |
---|---|---|---|---|---|---|
Abiraterone (Zytiga) Janssen Inc. Generic | mCRPC | 250 mg tab | 500 mg tab |
Multiple |
Special Authorization Status1,2: Form Special Authorization Criteria1,2:
Notes1,2:
*High-Cost Drug Program: Approved high-cost medications for persons eligible for PEI Medicare and approved for coverage for one or more of the medications included in the program. Patients must apply for coverage on an annual basis and provide income information to the program. **Catastrophic Drug Program: Once an applicant’s out of pocket eligible drug expenses exceed the annual household limit the program will cover any further eligible drug expenses in the program year. |
|
Janssen (Janssen BioAdvance Patient Assistance Program): Access Here |
Abiraterone (Zytiga) Janssen Inc. Generic | mCSPC | 250 mg Tab |
Multiple |
Notes1,2:
|
|
Janssen (Janssen BioAdvance Patient Assistance Program): Access Here |
Alendronate Generic | Osteoporosis | 10 mg Tab | 70 mg PO |
Multiple |
Covered under multiple provincial programs including: Generic Drug Program, Senior Drug Program, Family Health Benefit Drug Program (form), Financial Assistance Drug Program, Nursing Home Program or Institutional Pharmacy Program, and Catastrophic Drug Program* (form)
*Catastrophic Drug Program: Once an applicant’s out of pocket eligible drug expenses exceed the annual household limit the program will cover any further eligible drug expenses in the program year. |
|
Apotex: Access Here |
Apalutamide (Erleada) Janssen Inc. | nmCRPC | Tablet, PO, 60mg, 240mg |
02478374 |
Patients must apply for coverage under the High-Cost Drug Program. If written by an oncologist, this medication does not require the submission of a Pharmacare Special Authorization form.1
Eligibility1:
Clinical Notes1:
** 60 mg tablet funded, 240 mg tablet pending provincial funding decision |
Janssen BioAdvance Patient Assistance Program: Access Here |
|
Apalutamide (Erleada) Janssen Inc. | mCSPC | Tablet, PO, 60mg, 240mg |
02478374 |
Patients much apply for coverage under the High-Cost Drug Program. If written by an oncologist, this medication does not require the submission of a Pharmacare Special Authorization form.1
Eligibility1:
Clinical Notes1:
Claim Notes1:
**60mg tablet funded, 240mg tablet pending provincial funding decision |
Janssen BioAdvance Patient Assistance Program: Access Here |
|
Darolutamide (Nubeqa) Bayer | nmCRPC | 300 mg Tab |
Not Specified |
Eligibility:
Clinical Notes:
Prescriptions written by PEI oncologists do not require Special Authorization
Patients requesting coverage through the High-Cost Drug Program must submit a patient application, available from the Drug Programs Office or online at http://healthpei.ca/pharmacareforms. |
NUBEQA® DART Patient Support Program: Toll free: 1-833-955-3278 Fax:1-877-208-4393 Email: info@dartsupport.ca |
|
Darolutamide (Nubeqa) Bayer | mCSPC | 300 mg Tab |
Not Specified |
Eligibility:
Renewal Criteria:
Clinical Notes:
Claim Notes:
Prescriptions written by PEI oncologists do not require Special Authorization
Patients requesting coverage through the High-Cost Drug Program must submit a patient application, available from the Drug Programs Office or online at http://healthpei.ca/pharmacareforms. |
NUBEQA® DART Patient Support Program: Toll free: 1-833-955-3278 Fax:1-877-208-4393 Email: info@dartsupport.ca |
|
Denosumab (Prolia) Amgen | Osteoporosis | 60 mg / ml Syr |
02343541 |
Special Authorization Status1,2: Form Coverage: Senior Drug Program, Family Health Benefit Drug Program (form), Financial Assistance Drug Program, Nursing Home Program or Institutional Pharmacy Program and Catastrophic Drug Program* (form)1,2 Special Authorization Criteria1,2:
Clinical Notes1,2:
*Catastrophic Drug Program: Once an applicant’s out of pocket eligible drug expenses exceed the annual household limit the program will cover any further eligible drug expenses in the program year. |
|
ProVital Program: Access Here |
Denosumab (Prolia) Amgen | mCRPC + Bone mets | - |
- |
No listing information as of Mar. 2022. |
- |
The VICTORY Program: Access Here |
Enzalutamide (Xtandi) Astellas | mCRPC | 40 mg capsule |
02407329 |
Eligibility: For treatment of patients with metastatic castration resistant prostate cancer who:
OR
Notes:
Prescriptions written by PEI oncologists do not require written Special Authorization.
Patients requesting coverage through the High-Cost Drug Program must submit a patient application, available from the Drug Programs Office or online at http://healthpei.ca/pharmacareforms. |
Xtandi Patient Assistance Program (XPAP): Patient Enrolment and Consent Form (English) Formulaire D’inscription et de Consentement du Patient (French)
|
|
Enzalutamide (Xtandi) Astellas | nmCRPC | 40 mg capsule |
02407329 |
Eligibility: In combination with androgen deprivation therapy (ADT) for the treatment of patients with non-metastatic castration-resistant prostate cancer (nmCRPC) who are at high risk of developing metastases1.
Clinical Notes:
1High risk of developing metastases is defined as a prostate-specific antigen (PSA) doubling time of ≤ 10 months during continuous ADT
Prescriptions written by PEI oncologists do not require written Special Authorization.
Patients requesting coverage through the High-Cost Drug Program must submit a patient application, available from the Drug Programs Office or online at http://healthpei.ca/pharmacareforms. |
Xtandi Patient Assistance Program (XPAP): Patient Enrolment and Consent Form (English) Formulaire D’inscription et de Consentement du Patient (French)
|
|
Enzalutamide (Xtandi) Astellas | mCSPC | 40 mg capsule |
02407329 |
Eligibility: In combination with androgen deprivation therapy (ADT) for the treatment of patients with metastatic castration-sensitive prostate cancer (mCSPC). Patients must have had either no prior ADT or are within six months of beginning ADT in the metastatic setting.
Clinical Notes:
Prescriptions written by PEI oncologists do not require written Special Authorization.
Patients requesting coverage through the High-Cost Drug Program must submit a patient application, available from the Drug Programs Office or online at http://healthpei.ca/pharmacareforms. |
Xtandi Patient Assistance Program (XPAP): Patient Enrolment and Consent Form (English) Formulaire D’inscription et de Consentement du Patient (French)
|
|
Niraparib and abiraterone acetate (AKEEGA®) Janssen Inc. | mCRPC | Dual-action tablet, PO/ Comprimé à double action, PO: 100mg niraparib/500mg abiraterone acetate |
02538563 |
Pending provincial funding decision |
N/A |
Janssen BioAdvance Patient Assistance Program: Access Here |
Olaparib (Lynparza) AstraZeneca | mCRPC | 100 mg tab | 150 mg tab |
100mg: 02475200 | 150mg: 02475219 |
For the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC) who meet all the following criteria:
Renewal Criteria: Written confirmation that the patient has responded to treatment and there is no evidence of disease progression.
Clinical Notes:
|
AstraZeneca Patient Support Program: Access Here AstraZeneca Patient Assistance Program: Access Here |