Product Details

Lucentis

Ranibizumab
10 mg/mL
Solution for Intravitreal Injection
Single-Use 0.23-mL Vial (Preservative-Free)

DIN/PIN/NPN

02296810

Manufacturer

Novartis Pharma Canada Inc.

Formulary Listing Date

2008-03-25  

Unit Price

1710.3000

Amount MOH Pays

1710.3000

Coverage Status

Limited Use Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

S01LA04

Interchangeable Products

NO  

LU Clinical Criteria

LU Code Auth. Period Clinical Criteria
655 1 year

For the treatment of age-related macular degeneration (AMD), diabetic macular edema (DME), branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO) or choroidal neovascularization, but only for patients established on Lucentis (ranibizumab) therapy prior to July 31, 2023.

 

EAP Criteria

NO

Product Monograph

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