Product Details
Rosiglitazone
Rosiglitazone8 mg
Tablet
DIN/PIN/NPN
02403382
Manufacturer
A A Pharma Inc.
Formulary Listing Date
2017-02-28
Unit Price
2.7452
Amount MOH Pays
2.7452
Coverage Status
Off-Formulary Interchangeable Exceptional Access Program Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
A10BG02
Interchangeable Products
DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
---|---|---|---|
02403382 | Rosiglitazone | 2.7452 | 2.7452 |
02241114 | Avandia | NA | NA |
LU Clinical Criteria
NOEAP Criteria
Therapeutic Class | Reimbursement Criteria |
---|---|
Antidiabetic Agents | Rosiglitazone
For the treatment of type 2 diabetes mellitus in patients with:
*Oral antidiabetics include the following agents:
Note: A trial with acarbose is not a mandatory requirement. Note: It is not necessary for patients to have tried the following oral antidiabetic agents that are currently not funded by the OPDP for the purposes of obtaining rosiglitazone:
Duration of Approval: 5 years Renewals will be considered where patients have benefited and continue to benefit from rosiglitazone treatment as demonstrated by recent HbA1c levels ≤7% while on treatment with rosiglitazone AND in those who continue to have no known contraindication(s) to rosiglitazone. |
Oral Hypoglycemic Agents – Telephone Request Service (TRS) Drugs | Rosiglitazone
Note: Prescribers do not need to make an EAP request for patients currently receiving pioglitazone or rosiglitazone through ODB. Physicians will be required to make an application for coverage for any patient new to ODB that is being started on either of these drugs or any ODB recipient who is new to using these drugs. Requests for ongoing treatment with pioglitazone or rosiglitazone for patients who were previously covered by other means may be considered according to renewal criteria. Funding under the EAP for pioglitazone or rosiglitazone will not be provided in the following clinical settings:
For the treatment of type 2 diabetes mellitus in patients with:
*Oral antidiabetics that need to be tried prior to consideration of rosiglitazone include the following agents currently reimbursed through the Ontario Public Drug Programs:
Note: A trial with acarbose is not a mandatory requirement. Note: It is not necessary for patients to have tried the following oral antidiabetic agents that are currently not funded by the Ontario Public Drug Programs for the purposes of obtaining rosiglitazone:
Standard Approval Duration: 5 years Renewals will be considered where patients have benefited and continue to benefit from rosiglitazone treatment as demonstrated by achieving adequate glycemic control. This is shown by a recent HbA1c levels ≤7% while on treatment with rosiglitazone AND in who continue to have no known contraindication(s) to rosiglitazone. Standard Approval Duration: 5 years |