Limited coverage drugs – filgrastim

Last updated on October 12, 2022

Generic name

filgrastim

Brand name

Grastofil®

Nivestym®

Strength

300 mcg/0.5 mL, 480 mcg/0.8 mL

300 mcg/0.5 mL, 480 mcg/0.8 mL and 300 mcg/1 mL, 480 mcg/1.6 mL

Form

pre-filled syringe

pre-filled syringe and single-use vial

Special Authority criteria

Approval period

1. For primary prophylaxis of febrile neutropenia in cancer patients receiving potentially curative myelosuppressive chemotherapy regimens where the risk of febrile neutropenia is ≥ 20%

6 months

2. For secondary prophylaxis of febrile neutropenia in cancer patients receiving potentially curative myelosuppressive chemotherapy

6 months

3. For the rescue of prolonged febrile neutropenia following chemotherapy

6 months

4. For cancer patients undergoing peripheral blood progenitor cell collection and therapy

6 months

5. For post-bone-marrow transplant patients to stimulate bone marrow engraftment (start greater than or equal to d+1)

6 months

6. For post-bone-marrow transplant patients requiring rescue of failure to engraft (start greater than or equal to d+14)

6 months

7. For patients with the following benign disorders:

  1. chronic benign cyclical neutropenia
    OR
  2. myelodysplastic disorders or aplastic anemia, while the patient awaits bone marrow transplantation

6 months

Practitioner exemptions

  • None

Special notes

  • For coverage for HIV-infected patients, please contact BC Centre for Excellence in HIV/AIDS.

Special Authority requests