Limited coverage criteria – lamivudine

Last updated on March 18, 2025

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Generic name		lamivudine
Strength & form		100 mg 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	Indefinite

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

Indefinite

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)

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