Product Details
Votrient
Pazopanib200 mg
Tablet
DIN/PIN/NPN
02352303
Manufacturer
GlaxoSmithKline Inc., GlaxoSmithKline Consumer Health Care
Formulary Listing Date
2022-09-29
Unit Price
40.5046
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
NOEAP Criteria
| Therapeutic Class | Reimbursement Criteria |
|---|---|
| Oncology Drugs | Pazopanib
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. |