Product Details
Priva-Tadalafil
Tadalafil10 mg
Tablet
DIN/PIN/NPN
02452499
Manufacturer
Nora Pharma
Formulary Listing Date
2022-08-31
Unit Price
11.9250
Amount MOH Pays
11.9250
Coverage Status
Off-Formulary Interchangeable Exceptional Access Program Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
G04BE08
Interchangeable Products
DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
---|---|---|---|
02440164 | Teva-Tadalafil | 12.6270 | 12.6270 |
02457024 | Tadalafil | 11.9250 | 11.9250 |
02452103 | Ran-Tadalafil | 11.9255 | 11.9255 |
02409437 | PMS-Tadalafil | 11.9255 | 11.9255 |
02410656 | Mylan-Tadalafil | 11.9255 | 11.9255 |
02452251 | Mar-Tadalafil | 11.9250 | 11.9250 |
02451840 | Jamp-Tadalafil | 11.9255 | 11.9255 |
02248088 | Cialis | NA | NA |
02435934 | Auro-Tadalafil | 11.9250 | 11.9250 |
02422107 | Apo-Tadalafil | 11.9250 | 11.9250 |
02428644 | Act Tadalafil | 11.9255 | 11.9255 |
02512122 | M-Tadalafil | 11.9250 | 11.9250 |
02452499 | Priva-Tadalafil | 11.9250 | 11.9250 |
02512289 | PRZ-Tadalafil | 11.9250 | 11.9250 |
02515997 | Ach-Tadalafil | 11.9250 | 11.9250 |
02451689 | Mint-Tadalafil | 11.9255 | 11.9255 |
02536692 | Tadalafil | 12.6270 | 12.6270 |
LU Clinical Criteria
NOEAP Criteria
Therapeutic Class | Reimbursement Criteria |
---|---|
Cardiology Drugs | Tadalafil
For the treatment of severe Raynaud’s phenomenon (RP) and/or digital ulcers secondary to scleroderma (systemic sclerosis) or scleroderma-like disease:
Duration of initial approval: 6 months Renewals will be considered on a case-by-case basis for patients who demonstrate benefit from treatment (e.g., positive response in the duration, frequency and or severity of RP and/or improvement in the size or number of digital ulcers.) |
Pulmonary Arterial Hypertension | Sildenafil
Tadalafil
Drugs for Pulmonary Arterial Hypertension (PAH) under EAP
All requests (initial, renewal, monotherapy, combination therapy) for a PAH drug must come from one of the following recognized PAH referral centres:
Requests from other physicians/centres must include a recent (less than or equal to 3 months old) consult note/recommendation from a recognized PAH referral centre that supports the request; Out-of-province referral centre consults (e.g., from Winnipeg for patients in Northern Ontario) will also be considered on a case-by-case basis Initial Criteria: For the treatment of patients with pulmonary arterial hypertension (PAH) [WHO Group 1 Pulmonary hypertension] who meet all the following criteria:
1Note: Left ventricular end-diastolic pressure ≤ 15 mmHg is also acceptable. For all funded PAH Drugs, case-by-case consideration may be provided for the following:
Exclusion Criteria: Combinations of drugs targeting similar pathways will not be funded (i.e., combination regimen may only include one agent from each drug class -- phosphodiesterase type 5 [PDE-5] inhibitors, endothelin receptor antagonists (ERA), and/or prostanoids) Renewal criteria for funded PAH Drugs: Renewals will be provided for patients who remain under the care of a physician from a recognized PAH Centre (see list above) and who continue to benefit from therapy. Approval Durations: EAP Drug Request Form: |