Product Details

Aubagio

Teriflunomide
14 mg
Tablet

DIN/PIN/NPN

02416328

Manufacturer

Sanofi Genzyme, a Division of Sanofi-Aventis Canada Inc.

Formulary Listing Date

2022-07-29

Unit Price

NA

Amount MOH Pays

NA

Coverage Status

Not a Benefit

ODB Formulary Therapeutic Classification

92:00:00 Unclassified Therapeutic Agents

Therapeutic Note

NO

ATC Code

L04AA31

Interchangeable Products

DIN/ PIN/ NPN	Brand name	Unit Price	Amount MOH pays
02502933	Ach-Teriflunomide	14.9300	14.9300
02500639	Apo-Teriflunomide	14.9300	14.9300
02416328	Aubagio	NA	NA
02504170	Jamp Teriflunomide	14.9300	14.9300
02523833	M-Teriflunomide	14.9300	14.9300
02500469	Mar-Teriflunomide	14.9300	14.9300
02500310	Nat-Teriflunomide	14.9300	14.9300
02500434	PMS-Teriflunomide	14.9300	14.9300
02505843	Sandoz Teriflunomide	14.9300	14.9300
02501090	Teva-Teriflunomide	14.9300	14.9300

LU Clinical Criteria

NO

EAP Criteria

Therapeutic Class	Reimbursement Criteria
Renewals of Multiple Sclerosis Drugs – Telephone Request Service (TRS) Drugs	Teriflunomide Brand(s): Aubagio Dosage Form/Strength: 14mg tablet EAP will renew coverage of teriflunomide for patients who are stable and experienced no more than one disabling attack/relapse in the past year and have an EDSS score less than or equal to 5. Prescriber must provide the following information: Description of the patient’s clinical course in the last year, including details of all attacks; Date and details of the most recent neurological examination (within the last 90 days); AND EDSS score Dosage: 14 mg daily Standard Approval Duration: 2 years for first renewal, 5 years for 2nd and subsequent renewals Renewal requests where patients have experienced more than 1 attack in the past year will be externally reviewed.

Product Monograph