Limited coverage drugs – leuprolide

Last updated on December 12, 2022

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Generic Name / Strength / Form
leuprolide

Criteria	Approval period
1. Diagnosis of precocious puberty.	1. First approval: One year Renewals: One year
OR
2. Diagnosis of endometriosis.	2. First approval: Six months Renewal: Six months
OR
3. Diagnosis indicating need to reduce sexual drive.	3. Indefinite

Practitioner exemptions

Paediatric endocrinologists

Special notes

For (1) & (2) criteria applicable for all plans excluding Plan G.
For (3) criteria applicable for all plans including Plan G.
For any cancer related condition, please contact the British Columbia Cancer Agency at (604) 877-6098 ext. 4610.

Special Authority request form(s)

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HLTH 5328 - General Special Authority Request (PDF, 656KB)

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Limited coverage drugs – leuprolide

Practitioner exemptions

Special notes

Special Authority request form(s)