Oxy.IR

NOTE: Specific products used to treat ODB-eligible patients undergoing palliative care are reimbursed under the Ontario Public Drug Programs, as Limited use benefits on the ODB formulary or through the Facilitated Access process. Under this process, a select group of participating physicians and nurse practitioners are exempt from obtaining approval under EAP on a case-by-case basis. This assumes that the prescriber has met the qualifications set by their professional associations who administer the enrollment of their members. The prescriber’s license number with their regulatory body must appear on the prescription, for purposes of verification.

Palliative Care medication claims to be reimbursed by the ODB program must be prescribed in accordance with the following patient eligibility criteria: “This patient has a progressive, life-limiting illness and has chosen outpatient palliative treatment. Life expectancy of one year is applied to request durations.

In order to participate in the Facilitated Access to Palliative Care Drugs process, these prescribers must be registered with their professional association as meeting the qualifications for pCFA enrollement.. For physicians this is by the Ontario Medical Association (“OMA”) and must meet pre-defined criteria the OMA sets. For nurse practitioners, this may be the NPAO or the Nurse practitioners Association of Ontario (NPAO) or the RNAO, th Registered Nurse Association of Ontario. To facilitate the reimbursement process at the pharmacy, these prescribers are asked to indicate either, “Palliative” or “P.C.F.A.” on the prescription.

Prescribers who are not registered through this process must obtain approval through the Exceptional Access Program. A prescriber must provide the details of the patient’s diagnosis, current clinical status, and life expectancy.

For further information regarding the list of physicians and/or the criteria physicians require to be included on the list, please contact the Ontario Medical Association: (416) 340-2234, or via email. The following products can be reimbursed for the management of patients receiving palliative care through the Telephone Request Service. Note that many Palliative Care drugs have transpositioned to the ODB formulary for funding under Limited Use and do not require EAP authorization.

Oxycodone

• Brand(s): Supeudol
• Dosage Form/Strength: 5 mg, 10 mg, 20 mg

For use when palliative patient cannot use combination oxycodone and acetaminophen.

Standard Approval Duration: 12 months

Oxycodone HCl Controlled Release

• Brand(s): OxyNEO
• Dosage Form/Strength: 10 mg, 15 mg, 20 mg, 30 mg, 40 mg tablets

For the treatment of cancer-related pain or pain in patients receiving end-of-life palliative care AND the patient has experienced intolerance or has failed an adequate trial (for example, three months) of at least one other listed long-acting opioid product.

Standard Approval Duration: 12 months

EAP Drug Request Form:

Oxycodone HCl controlled release (OxyNEO) Drug Request Form

Oxycodone Controlled Release Tablet

• Brand(s): OxyNeo
• Dosage Form/Strength: 10 mg CR,15 mg CR, 20 mg CR, 30 mg CR, 40 mg CR

For the treatment of chronic pain in patients who have experienced intolerance or have failed an adequate trial (for example, three months) of at least one other listed long-acting opioid product.

Note: Physicians should consider best practice guidelines for the safe and effective use of opioids in chronic non-cancer pain, such as the Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain.

Please include the following information in your request:

1. The diagnosis for which the pain management is required must be documented.
2. All concomitant pain medication therapy must be documented.
3. Other medications with potential for abuse or interaction with opioid therapy should be documented.

Duration of Approval: 1 Year

Renewals will be considered if treatment continues to be appropriate for the management of the patient’s chronic pain. Please include the following information on your renewal request:

Duration of Approval: 1 Year

1. All concomitant pain medication therapy must be documented.
2. Other medications with potential for abuse or interaction with opioid therapy should be documented.

Note: OxyNEO 60mg and 80mg tablets are NOT funded.

Note: Physicians registered on the Ontario Medical Association’s Palliative Care Facilitated Access List and Nurse Practitioners registered on the PCFA list through the Registered Nurses Association of Ontario or the Nurse Practitioner Association of Ontario can access OxyNeo for chronic pain management of their palliative care patient for an initial duration of one year without approval through the Exceptional Access Program.

EAP Drug Request Form:

Oxycodone HCl controlled release (OxyNEO) Drug Request Form