Product Details
Vyndamax
Tafamidis61 mg
Capsule
DIN/PIN/NPN
02517841
Manufacturer
Pfizer Canada Inc.
Formulary Listing Date
2022-09-15
Unit Price
534.2800
Amount MOH Pays
534.2800
Coverage Status
Exceptional Access Program Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
N07XX08
Interchangeable Products
NOLU Clinical Criteria
NOEAP Criteria
Therapeutic Class | Reimbursement Criteria |
---|---|
Metabolic/Genetic Modifiers | Tafamidis Meglumine
Tafamidis
Initiation criteria: For the treatment of adult patients with cardiomyopathy due to transthyretin (TTR)-mediated amyloidosis in patients meeting the following criteria:
1A biopsy is required if results from the Tc-99m-PYP scintigraphy are equivocal, unavailable or clinical suspicion remains high despite negative results. Exclusion criteria: Patients meeting one or more of the following will not be eligible for funding:
Discontinuation criteria: Treatment with tafamidis will not be funded upon meeting one or more of the following discontinuation criteria:
Renewal criteria: Renewals will be considered in patients who do not meet the discontinuation criteria. Recommended dose: - Vyndaqel (tafamidis meglumine): - Vyndamax (tafamidis): Note that Vyndaqel (tafamidis meglumine) capsules and Vyndamax (tafamidis) capsules are different formulations with the active moiety tafamidis and are not interchangeable. To avoid dosing errors, it is important that prescriptions of tafamidis/tafamidis meglumine specify the salt form and the prescribed dose. Initial approval duration: 6 months First renewal duration: 6 months Second and subsequent renewal duration: 1 year EAP Drug Request Form: |