Product Details
Galafold
Migalastat123 mg
Capsule
DIN/PIN/NPN
02468042
Manufacturer
Innomar Strategies, Inc.
Formulary Listing Date
2019-05-13
Unit Price
1700.0000
Amount MOH Pays
1700.0000
Coverage Status
Exceptional Access Program Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
A16AX14
Interchangeable Products
NOLU Clinical Criteria
NOEAP Criteria
| Therapeutic Class | Reimbursement Criteria |
|---|---|
| Metabolic/Genetic Modifiers | Migalastat
EAP Initiation criteria: For the treatment of Fabry disease (FD) in adult patients who meet ALL the following criteria:
1Refer to Canadian Fabry Disease treatment guidelines 2017 at http://www.garrod.ca/wp-content/uploads/Canadian-FD-Treatment-Guidelines-2017.pdf
2Definition of an amenable mutation: mutation that increases activity of alpha galactosidase A in an in vitro cell culture system (human embryonic kidney or HEK cells) by 1.2 times the baseline activity with an absolute value for enzyme activity of 3% or greater when compared with wildtype values. 3Enzyme replacement therapies (ERT) for Fabry disease (e.g., agalsidase alfa [Replagal, agalsidase beta [Fabrazyme]) Exclusion criteria:
Note: Patients should be monitored every 6 months or more frequently during the first 3 to 5 years of treatment. Recommended dose: 123 mg every other day Approval duration: 6 months Renewal criteria: Renewals will be considered on a case-by-case basis in individuals who:
Requests for ongoing reimbursement should include information related to the patient’s renal and cardiac function, cerebrovascular events, hospitalizations or emergency room visits for FD-related issues, health related quality of life measures as evaluated through a valid HRQL test (SF-36), gastrointestinal symptoms, pain measures, and other relevant clinical outcomes from treatment. Please address the patient’s adherence/compliance with treatment and any adverse effects / toxicities from treatment with migalastat. The Fabry disease expert panel may be consulted for renewal recommendations. |