Page 10 - CUA Adv Prostate Ca Drug Acccess Listing
P. 10
1. Limited
1
Limited coverage drug requiring Special Authority Request Form 2 Coverage
Drug Program
1
Eligibility : 2. Special
10 mg, 70 • Clinical or radiographically documented fracture due to osteoporosis Authority
mg, 70mg/ Request Form
Alendronate Osteoporosis 5600 IU Multiple • OR
VitD3 • Glucocorticoid-induced osteoporosis in patients who are receiving or expected to receive
Tablet the equivalent dose of ≥ 7.5 mg of prednisone per day and for ≥ 90 consecutive days
A BC Cancer Compassionate Access Program request must be approved prior to treatment. 1. BC Cancer
1
Restricted funding* Protocol
2
UGUPAPA [8-
Eligibility : 21]
1
• nmCRPC 2. BC Cancer
• ECOG PS 0-2 Benefit Drug
• Chemotherapy naïve List [9-21]
• PSADT ≤ 10 months
• No radiologic evidence of metastates (negative bone scan, negative CT of pelvis,
abdomen, chest)
Not
nmCRPC Tablet specified • Patients with nmCRPC are eligible to receive one of apalutamide, darolutamide, or
Apalutamide enzalutamide but not their sequential use
(Erleada)
Janssen Patients who have progressed on apalutamide in nmCRPC are eligible to receive docetaxel
and/or cabazitaxel in mCRPC. They are not eligible to receive enzalutamide or abiraterone in
mCRPC.
1
Exclusions :
• mCRPC
• Prior treatment with enzalutamide or darolutamide in nmCRPC
• Uncontrolled hypertension (systolic BP > 160 mmHg or diastolic > 95 mmHg)
1. Provincial
Not Funding
mCSPC - specified Under negotiation with manufacturer Summary [10-
20]
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