Product Details
Pamidronate Disodium for Injection
Pamidronate Disodium3 mg/mL
Solution for Injection
10-mL Vial
DIN/PIN/NPN
02246597
Manufacturer
Fresenius Kabi Canada Ltd.
Formulary Listing Date
2019-08-30
Unit Price
86.7800
Amount MOH Pays
86.7800
Coverage Status
Off-Formulary Interchangeable Exceptional Access Program Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
M05BA03
Interchangeable Products
DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
---|---|---|---|
02249669 | Pamidronate Disodium Omega | 86.7800 | 86.7800 |
02246597 | Pamidronate Disodium for Injection | 86.7800 | 86.7800 |
02059762 | Aredia | NA | NA |
LU Clinical Criteria
NOEAP Criteria
Therapeutic Class | Reimbursement Criteria |
---|---|
Palliative Care Medications – Telephone Request Service (TRS) Drugs | 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. Pamidronate
For the treatment of tumor-induced/malignancy-related hypercalcemia in a palliative care patient. Standard Approval Duration: 12 months |