Product Details

PMS-Pazopanib

Pazopanib
200 mg
Tablet


DIN/PIN/NPN

02525666

Manufacturer

Pharmascience Inc.

Formulary Listing Date

2022-09-29  

Unit Price

30.9655

Amount MOH Pays

30.9655

Coverage Status

Off-Formulary Interchangeable Exceptional Access Program Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

L01EX03

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02525666 PMS-Pazopanib 30.9655 30.9655
02352303 Votrient 40.5046 30.9655
 

LU Clinical Criteria

NO  

EAP Criteria

Therapeutic Class Reimbursement Criteria
Oncology Drugs

Pazopanib

  • Brand(s): Votrient and generics
  • Dosage Form/Strength: 200 mg tablet

For first-line treatment of advanced or metastatic renal cell carcinoma of clear cell histology in patients with good performance status (ECOG* 1)

ECOG = Eastern Cooperative Oncology Group Performance Status The approved dosage is 800 mg once daily.

Duration of Approval: 1 year

Renewals will be considered for patients who have benefited from therapy (i.e., no disease progression) and are expected to continue to do so. Exclusion criteria: Funding for Votrient will not be approved for patients who demonstrate disease progression while on sunitinib, sorafenib, temsirolimus, everolimus or other drugs approved for treatment of metastatic renal cell carcinoma.

Duration of Approval: 1 year

EAP Drug Request Form:

Standard Form for EAP Drug Requests

Product Monograph

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