Product Details
Act Tadalafil
Tadalafil20 mg
Tablet
DIN/PIN/NPN
02428652
Manufacturer
Actavis Pharma Company
Formulary Listing Date
2016-09-29
Unit Price
12.3569
Amount MOH Pays
12.3569
Coverage Status
Off-Formulary Interchangeable Exceptional Access Program Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
G04BE08
Interchangeable Products
DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
---|---|---|---|
02440172 | Teva-Tadalafil | 13.0838 | 13.0838 |
02457032 | Tadalafil | 12.3569 | 12.3569 |
02454742 | Riva-Tadalafil | 12.3569 | 12.3569 |
02452111 | Ran-Tadalafil | 12.3569 | 12.3569 |
02409445 | PMS-Tadalafil | 12.3569 | 12.3569 |
02410664 | Mylan-Tadalafil | 12.3569 | 12.3569 |
02451697 | Mint-Tadalafil | 12.3576 | 12.3576 |
02452243 | Mar-Tadalafil | 12.3575 | 12.3575 |
02451859 | Jamp-Tadalafil | 12.3569 | 12.3569 |
02248089 | Cialis | NA | NA |
02435942 | Auro-Tadalafil | 12.3575 | 12.3575 |
02422115 | Apo-Tadalafil | 12.3575 | 12.3575 |
02481421 | AG-Tadalafil | 12.3569 | 12.3569 |
02428652 | Act Tadalafil | 12.3569 | 12.3569 |
02512130 | M-Tadalafil | 12.3575 | 12.3575 |
02520966 | NRA-Tadalafil | 12.3575 | 12.3575 |
02452502 | Priva-Tadalafil | 12.3575 | 12.3575 |
02512297 | PRZ-Tadalafil | 12.3575 | 12.3575 |
02516004 | Ach-Tadalafil | 12.3575 | 12.3575 |
02536706 | Tadalafil | 13.0838 | 13.0838 |
LU Clinical Criteria
NOEAP Criteria
Therapeutic Class | Reimbursement Criteria |
---|---|
Cardiology Drugs | Tadalafil
For the treatment of severe Raynaud’s phenomenon (RP) and/or digital ulcers secondary to scleroderma (systemic sclerosis) or scleroderma-like disease:
Duration of initial approval: 6 months Renewals will be considered on a case-by-case basis for patients who demonstrate benefit from treatment (e.g., positive response in the duration, frequency and or severity of RP and/or improvement in the size or number of digital ulcers.) |
Pulmonary Arterial Hypertension | Sildenafil
Tadalafil
Drugs for Pulmonary Arterial Hypertension (PAH) under EAP
All requests (initial, renewal, monotherapy, combination therapy) for a PAH drug must come from one of the following recognized PAH referral centres:
Requests from other physicians/centres must include a recent (less than or equal to 3 months old) consult note/recommendation from a recognized PAH referral centre that supports the request; Out-of-province referral centre consults (e.g., from Winnipeg for patients in Northern Ontario) will also be considered on a case-by-case basis Initial Criteria: For the treatment of patients with pulmonary arterial hypertension (PAH) [WHO Group 1 Pulmonary hypertension] who meet all the following criteria:
1Note: Left ventricular end-diastolic pressure ≤ 15 mmHg is also acceptable. For all funded PAH Drugs, case-by-case consideration may be provided for the following:
Exclusion Criteria: Combinations of drugs targeting similar pathways will not be funded (i.e., combination regimen may only include one agent from each drug class -- phosphodiesterase type 5 [PDE-5] inhibitors, endothelin receptor antagonists (ERA), and/or prostanoids) Renewal criteria for funded PAH Drugs: Renewals will be provided for patients who remain under the care of a physician from a recognized PAH Centre (see list above) and who continue to benefit from therapy. Approval Durations: EAP Drug Request Form: |