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.
