Product Details
Hepsera
Adefovir Dipivoxil10 mg
Tablet
DIN/PIN/NPN
02247823
Manufacturer
Gilead Sciences Canada, Inc.
Formulary Listing Date
2014-04-30
Unit Price
NA
Amount MOH Pays
NA
Coverage Status
Off-Formulary Interchangeable Exceptional Access Program Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
J05AF08
Interchangeable Products
DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
---|---|---|---|
02247823 | Hepsera | NA | NA |
02420333 | AA-Adefovir | 20.9130 | NA |
LU Clinical Criteria
NOEAP Criteria
Therapeutic Class | Reimbursement Criteria |
---|---|
Hepatology Drugs | Adefovir
For the treatment of chronic hepatitis B in patients with objective evidence of lamivudine virologic* breakthrough where failure is not due to poor adherence to therapy; AND
Duration of Approval: 1 year (If Cirrhotic: Lifetime) Duration of Approval for Renewal: 5 years Note: Effective February 28, 2018, Entecavir, Lamivudine, and Tenofovir became a Limited Use Benefit on the Ontario Drug Benefit Formulary – Please refer to the formulary for the Limited Use Criteria. EAP Drug Request Form: |