Galcanezumab (Emgality)

2022 ◽  
Vol 2 (1) ◽  
Author(s):  
Reimbursement Team
Keyword(s):  
Adult Patients ◽  
Migraine Headaches ◽  
Costly Drug ◽  
Public Drug

CADTH recommends that Emgality should be reimbursed by public drug plans for the prevention of migraine if certain conditions are met. Emgality should only be covered to prevent migraine attacks in adult patients who have tried at least 2 other types of oral preventive medications. Emgality should only be reimbursed if the patient is being cared for by a physician who has experience managing migraine headaches. Emgality will only be reimbursed for 6 months at a time. Emgality should not be more than the least costly drug of the same class used to prevent migraine.

scholarly journals IncobotulinumtoxinA (Xeomin)

2021 ◽  
Vol 1 (9) ◽  
Author(s):  
Reimbursement Team
Keyword(s):  
Neurological Disorders ◽  
Adult Patients ◽  
Swallowing Difficulties ◽  
Neurological Conditions ◽  
The Cost ◽  
Public Drug

CADTH recommends that Xeomin should be reimbursed by public drug plans for the treatment of chronic sialorrhea associated with neurological disorders if certain conditions are met. Xeomin should only be covered to treat adult patients with moderate to severe chronic troublesome sialorrhea who do not have swallowing difficulties. Xeomin should only be reimbursed if prescribed by a specialist with experience in managing neurological conditions, and the cost of Xeomin is reduced.

scholarly journals Luspatercept (Reblozyl)

2021 ◽  
Vol 1 (12) ◽  
Author(s):  
Reimbursement Team
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Myelodysplastic Syndromes ◽  
Adult Patients ◽  
Intermediate Risk ◽  
Ring Sideroblasts ◽  
The Cost ◽  
Public Drug

CADTH recommends that Reblozyl should be reimbursed by public drug plans for the treatment of adult patients with very low- to intermediate-risk myelodysplastic syndromes (MDS)-associated anemia who have ring sideroblasts and require red blood cell (RBC) transfusions, if certain conditions are met. Reblozyl should only be covered to treat patients who have failed or are not suitable for erythropoietin-based therapy. Reblozyl should only be reimbursed if prescribed by a specialist in MDS and if the cost of Reblozyl is reduced. Reimbursement should only be renewed if Reblozyl shows benefit to the patient such that the patient no longer requires RBC transfusions.

scholarly journals Budesonide (Jorveza)

2021 ◽  
Vol 1 (8) ◽  
Author(s):  
Reimbursement Team
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Eosinophilic Esophagitis ◽  
Adult Patients ◽  
Induction Treatment ◽  
Diagnosis And Management ◽  
Maintenance Of Remission ◽  
The Cost ◽  
Public Drug

CADTH recommends that Jorveza should be reimbursed by public drug plans for the maintenance of remission in adults with eosinophilic esophagitis (EoE) if certain conditions are met. Jorveza should only be reimbursed if prescribed by a specialist with experience in the diagnosis and management of EoE, and the cost of Jorveza is reduced. Jorveza should only be covered for adult patients who have a confirmed diagnosis of EoE, in whom treatment with a proton pump inhibitor (PPI) did not work, and whose symptoms (dysphagia and pain during swallowing) have resolved after receiving induction treatment with Jorveza.

scholarly journals Durvalumab (Imfinzi)

2021 ◽  
Vol 1 (7) ◽  
Author(s):  
Reimbursement Team
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Previous Treatment ◽  
Small Cell ◽  
Adult Patients ◽  
Small Cell Lung ◽  
Extensive Stage ◽  
Public Drug

CADTH recommends that Imfinzi should be reimbursed by public drug plans for the treatment of adult patients with extensive-stage small cell lung cancer (ES-SCLC) if certain conditions are met. Imfinzi should only be reimbursed if it is prescribed and monitored by clinicians who have been trained in oncology and immunotherapy, and if the price of Imfinzi is reduced. Imfinzi should only be covered to treat adult patients who have not received previous treatment for ES-SCLC.

scholarly journals Liraglutide (Saxenda)

2021 ◽  
Vol 1 (9) ◽  
Author(s):  
Reimbursement Team
Keyword(s):  
Body Weight ◽  
Sleep Apnea ◽  
Weight Management ◽  
Cardiovascular Complications ◽  
Adult Patients ◽  
Public Drug

CADTH recommends that Saxenda should not be reimbursed by public drug plans for chronic weight management in adult patients. Evidence from 3 studies demonstrated that Saxenda was associated with statistically significant reductions in body weight compared with placebo after 56 weeks of treatment. No conclusions could be drawn about long-term benefits, particularly for clinically meaningful improvements in comorbidities identified as priorities by patients, such as diabetes, sleep apnea, osteoarthritis, and cardiovascular complications. Patients identified a need for treatments that can improve potential obesity-related comorbidities, such as diabetes, sleep apnea, osteoarthritis, and cardiovascular complications. It is not clear whether Saxenda meets these needs.

scholarly journals Daunorubicin and Cytarabine (Vyxeos)

2021 ◽  
Vol 1 (8) ◽  
Author(s):  
Reimbursement Team
Keyword(s):  
Acute Myeloid Leukemia ◽  
Acute Leukemia ◽  
Myeloid Leukemia ◽  
Adult Patients ◽  
Inpatient Setting ◽  
Intensive Chemotherapy ◽  
Newly Diagnosed ◽  
The Cost ◽  
Public Drug ◽  
Acute Myeloid

CADTH recommends that Vyxeos should be reimbursed by public drug plans for the treatment of adults with newly diagnosed therapy-related acute myeloid leukemia (t-AML) or AML with myelodysplasia-related changes (AML-MRC) if certain conditions are met. Vyxeos should only be reimbursed if the induction cycles are administered in an inpatient setting and supervised by a hematologist with expertise in managing patients with acute leukemia and if the cost of Vyxeos is reduced. Vyxeos should only be covered to treat adult patients with newly diagnosed t-AML or AML-MRC who were deemed fit for intensive chemotherapy by the treating physician.

scholarly journals Zanubrutinib (Brukinsa)

2021 ◽  
Vol 1 (12) ◽  
Author(s):  
Reimbursement Team
Keyword(s):  
Tyrosine Kinase ◽  
International Workshop ◽  
Performance Status ◽  
Adult Patients ◽  
Prior Treatment ◽  
Consensus Panel ◽  
Bruton Tyrosine Kinase ◽  
Btk Inhibitor ◽  
Line Of Therapy ◽  
Public Drug

CADTH recommends that Brukinsa be reimbursed by public drug plans for the treatment of adult patients with relapsed or refractory Waldenström macroglobulinemia (WM), if certain conditions are met. Brukinsa should only be covered to treat patients with relapsed or refractory WM who have received at least 1 prior line of therapy, meet at least 1 criterion for treatment according to International Workshop on WM (IWWM) consensus panel criteria, and have good performance status. Patients eligible for reimbursement of Brukinsa should not have disease transformation, which is WM that has transformed into another type of cancer, or received prior treatment with a drug of the same class (i.e., a Bruton tyrosine kinase [BTK] inhibitor) unless such therapy was stopped because the drug was not tolerated and the disease had not progressed. Brukinsa should only be reimbursed if prescribed by a clinician with expertise and experience in the treatment of WM and monitoring of therapy and if it does not cost more than other treatments for WM.

scholarly journals Upadacitinib (Rinvoq)

2021 ◽  
Vol 1 (8) ◽  
Author(s):  
Reimbursement Team
Keyword(s):  
Psoriatic Arthritis ◽  
Adult Patients ◽  
Inadequate Response ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Disease Modifying ◽  
Public Drug

CADTH recommends that Rinvoq should be reimbursed by public drug plans for the treatment of active psoriatic arthritis (PsA) if certain conditions are met. Rinvoq should only be reimbursed if it is prescribed by a rheumatologist or a clinician who has experience treating adult patients with active PsA and if it does not cost more than other biologic disease-modifying antirheumatic drugs (bDMARDs) or targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs). Rinvoq should only be covered to treat adult patients with active PsA who have had an inadequate response or intolerance to methotrexate or other disease-modifying antirheumatic drugs (DMARDs) in a similar way to other bDMARDs currently reimbursed by public drug plans.

scholarly journals Azacitidine (Onureg)

2021 ◽  
Vol 1 (10) ◽  
Author(s):  
Reimbursement Team
Keyword(s):  
Complete Remission ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Adult Patients ◽  
Ecog Performance Status ◽  
Genetic Changes ◽  
Hematopoietic Stem ◽  
First Remission ◽  
Adequate Organ Function ◽  
Public Drug

CADTH recommends that Onureg be reimbursed by public drug plans as maintenance therapy for the treatment of adult patients with acute myeloid leukemia (AML) who have achieved complete remission (CR) or complete remission with incomplete blood count recovery (CRi) after induction therapy with or without consolidation treatment, and are ineligible for hematopoietic stem cell transplantation (HSCT), if certain conditions are met. Onureg should only be covered to treat adult patients (at least 18 years of age) with newly diagnosed AML who have certain genetic changes that lead to greater risk of having unfavourable disease outcomes (i.e., intermediate- or poor-risk cytogenetics) and who are ineligible for HSCT. Patients eligible for reimbursement of Onureg must have achieved first remission (defined as CR or CRi) following induction with or without consolidation chemotherapy, have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 3, and adequate organ function. Onureg should only be reimbursed if prescribed by clinicians with expertise managing patients with AML, familiarity with Onureg’s toxicity profile exists, and its cost is reduced.

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