Limited Coverage Drugs - Insulin Detemir

Generic Name

insulin detemir 

Strength

100 U/mL
Form solution for injection; solution for injection in a pre–filled pen

Special Authority Criteria

Approval Period

Type 1 Diabetes – Patient of any age

Patient has a diagnosis of Type 1 Diabetes requiring insulin and is currently taking insulin NPH and/or pre-mix insulin daily at optimal dosing

AND

  1. Has experienced unexplained nocturnal hypoglycemia at least once a month despite optimal management

OR

  1. Has experienced or continues to experience severe, systemic or local allergic reaction to existing insulin treatment.

Indefinite

OR

Type 2 Diabetes – Patient over 17 years of age only

Patient has a diagnosis of Type 2 Diabetes requiring insulin and is currently taking insulin NPH and/or pre-mix insulin daily at optimal dosing

AND

  1. Has experienced unexplained nocturnal hypoglycemia at least once a month despite optimal management

OR

  1. Has experienced or continues to experience severe, systemic or local allergic reaction to existing insulin treatment.

Indefinite

Practitioner Exemptions

Practitioners in the following specialty are not required to submit a Special Authority Request form for coverage: Endocrinology.

Special Notes

  • Specialists with experience in paediatric diabetes management may also have prescriptions covered for patients who meet the coverage criteria but are required to submit a Special Authority request.
  • For patients that have experienced severe, systemic or local allergic reaction to existing insulin treatment, documentation of previous trials (i.e., specific insulin tried and patient's response) is required.

Special Authority Request Form(s)