Product Details

Movapo

Apomorphine
30 mg/3 mL
Solution for Subcutaneous Injection
3-mL Prefilled Multi-Dose Pen (Preservative-Free)

DIN/PIN/NPN

02459132

Manufacturer

Paladin Labs Inc.

Formulary Listing Date

2021-04-30  

Unit Price

45.5400

Amount MOH Pays

45.5400

Coverage Status

Exceptional Access Program Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

N04BC07

Interchangeable Products

NO  

LU Clinical Criteria

NO  

EAP Criteria

Therapeutic Class Reimbursement Criteria
Parkinson’s Disease Treatments

Apomorphine

  • Brand(s): Movapo
  • Dosage Form/Strength: 30mg/3mL Prefilled Multi-dose Pen for Injection
  • Effective date: August 22, 2019

Initiation Criteria: 

For the acute, intermittent treatment of patients with advanced Parkinson’s disease (PD) who meet the following criteria:

  1. Apomorphine is used as adjunctive treatment in patients receiving optimal PD treatment1 with a levodopa-based drug and a dopamine agonist (DA); AND 

  1. Despite receiving optimal treatment1, the patient continues to experience intermittent hypomobility defined as either “off” episodes as the drug wears off or unpredictable on/off episodes; AND 

  1. Patient is under the care of a physician experienced in Parkinson’s disease who is practicing in one of the province’s specialized movement disorder clinics2 or in consultation with an expert from one of these clinics (consult note must be included). 

1Optimal treatment is defined as receiving maximally tolerated dose of a levodopa-based therapy (such as levodopa/carbidopa or levodopa/benserazide) AND a dopamine agonist (such as bromocriptine, pramipexole, ropinirole, rotigotine) for at least 30 days. If the patient is intolerant to or unable take a DA, provide a description of the intolerance or clinical contraindication. In such cases, another class of PD therapy [i.e., the catechol-O- methyl transferase (COMT) inhibitor (such as entacapone) or a monoamine oxidase-B inhibitor (such as rasagiline, selegiline)] may be considered with the levodopa-based regimen.

2An Ontario specialized movement disorder clinic listed on the website of the Canadian Movement Disorder Group http://www.cmdg.org/AcrossCanada/acrosscanada.htm#que (Patients in border communities seeing specialists in a listed Manitoba or Quebec clinic are also eligible.)

Exclusion:
Concomitant use with 5-hydroxytryptamine type 3 (5HT3) antagonists (e.g., ondansetron, granisetron, dolasetron) 

Recommended dose: 0.2 mL (2 mg) to 0.6 mL (6 mg) per dose, to be administered subcutaneously as an adjunct to regular oral anti-PD medications. 

Renewal criteria:
Renewals will be considered in patients who continue to benefit from treatment3 and who do not develop unacceptable toxicities to treatment with apomorphine. At the time of renewal, please confirm the dose and average frequency of use. 

3Provide an improved outcome resulting from treatment with apomorphine (e.g., improvement in the frequency or duration of mobility or hypomobility, duration of off episodes, quality of life measure, symptom improvements) compared to baseline before treatment with apomorphine. 

Approval duration of initials and renewals: 1 year

EAP Drug Request Form:

Standard Form for EAP Drug Requests

Product Monograph

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