Limited Coverage Drugs - Lamivudine

Generic Name

lamivudine

Strength

100 mg
Form tablet

Special Authority Criteria

Approval Period

Diagnosis of chronic hepatitis B - non-cirrhosis

According to established protocols; lab work required, as per the chronic hepatitis B form.

Indefinite

Diagnosis of chronic hepatitis B - with cirrhosis

According to established protocols; lab work required, as per the chronic hepatitis B form.

Practitioner Exemptions

  • None

Special Notes

  • In exceptional cases, PharmaCare may consider requests for coverage of patients who do not meet the established criteria if the physician provides additional documentation supporting the patient's specific clinical need. The Hepatitis Drug Benefit Adjudication Advisory Committee reviews exceptional case submissions.

Special Authority Request Form(s)