Product Details
Probuphine
Buprenorphine Hydrochloride80 mg
Subdermal Implant
Kit Pack
DIN/PIN/NPN
02474921
Manufacturer
Knight Therapeutics Inc.
Formulary Listing Date
2020-04-30
Unit Price
1495.0000
Amount MOH Pays
1495.0000
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
N07BC01
Interchangeable Products
NOLU Clinical Criteria
LU Code | Auth. Period | Clinical Criteria |
---|---|---|
578 | 2 years | For the management of opioid use disorder in combination with counseling and psychosocial support in adult patients who meet the following criteria: - The patient is stabilized on a dose of no more than 8mg per day of sublingual buprenorphine for the preceding 90 days; AND Recommended dose: Four 80mg implants inserted subdermally in the inner side of the upper arm for up to six months. The maximum quantity that can be claimed per patient is four (4) implant cycles (i.e. two (2) years of therapy). Note: The product monograph indicates that dosing beyond two (2) years cannot be recommended at this time. Probuphine subdermal implants are intended to be in place for six months of treatment. Probuphine implants are removed at the end of the six-month period. If continued treatment is desired, the implants should be replaced by new implants (implanted in the opposite arm) at the time of removal |