Limited Coverage Drugs - Valganciclovir
Generic Name |
valganciclovir |
Strength |
450 mg, 50 mg / mL |
Form | oral tablet, oral solution |
Special Authority Criteria |
Approval Period |
For the prophylaxis of cytomegalovirus (CMV) infection post stem cell transplant, in patients who test positive for CMV upon polymerase chain reaction (PCR) laboratory testing. Notes:
Valganciclovir should be dose-adjusted according to renal function. |
Approval lasts until there are two (2) consecutive negative CMV PCR results obtained one (1) week apart. |
Practitioner Exemptions
- PharmaCare coverage is only available for patients who meet the Limited Coverage criteria and whose prescription has been written by a specialist physician with the Leukemia/Bone Marrow Transplant (BMT) Program at Vancouver General Hospital who has entered into a Collaborative Prescribing Agreement (CPA).
- Specialist physicians with the Leukemia/BMT Program at Vancouver General Hospital that have entered into a CPA are exempted practitioners and therefore do not need to submit Special Authority Request forms to receive coverage for their patients.
- Due to the individual nature of each CPA, the agreement must be signed by the specialist physician who is requesting coverage and not a delegate.
- Prescriptions written by other specialists who have not entered into a CPA will not be covered automatically and a Special Authority Request form is required.
Special Notes
- None
Special Authority Request Form(s)
- None