Page 57 - CUA Adv Prostate Ca Drug Acccess Listing

PRINCE EDWARD ISLAND Link to Patient Assistance Programs

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.

Formulary:
PEI Pharmacare Formulary https://www.princeedwardisland.ca/sites/default/files/publications/pei_pharmacare_formulary.pdf

DRUG Strength, References
(Brand Name) Indication Route DIN Provincial Funding Eligibility Criteria
Manufacturer

High-cost Drug Program, Special Authorization Status 1 1. PEI
Patient application: Form Pharmacare
Also covered under the Catastrophic Drug Program Formulary [9-
1
21]
1
Abiraterone Special Authorization Criteria:
(Zytiga and 250 mg Tab • In combination with prednisone for the treatment of mCRPC in patients who are
Others) mCRPC 500 mg Tab Multiple asymptomatic or mildly symptomatic after failure of ADT, or have received prior
Janssen and chemotherapy containing docetaxel after failure of ADT.
Others
Notes:
• Prescriptions written by PEI oncologists do not require Special Authorization

Covered under multiple provincial programs including: Generic Drug Program, Senior Drug 1. PEI
Alendronate Osteoporosis 10 mg Tab Multiple Program, Family Health Benefit Drug Program, Financial Assistance Drug Program, and Pharmacare
Formulary [9-
70 mg Tab
Catastrophic Drug Program
21]
1. Provincial

nmCRPC - Not Under provincial consideration Funding
Summary [10-
specified
Apalutamide 20]
(Erleada)
Janssen 1. Provincial
mCSPC - Not Under negotiation with manufacturer Funding
specified Summary [10-
20]

Darolutamide
(Nubeqa) nmCRPC - - No listing information as of Sep. 2021.
Bayer
Covered under multiple provincial programs including: Senior Drug Program, Family Health 1. PEI
Benefit Drug Program, Financial Assistance Drug Program, and Catastrophic Drug Program Pharmacare
Formulary [9-
Special Authorization Criteria: 21]
1
Denosumab 60 mg/mL
(Prolia) Osteoporosis Syr 02343541 • For the treatment of osteoporosis in postmenopausal women and in men who meet the
following criteria:
Amgen
o Have a contraindication to oral bisphosphonates;
AND
o High risk for fracture, or refractory or intolerant to other available osteoporosis
therapies.

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v.01-SEP-2021