Limited coverage drugs – selumetinib
Last updated on February 12, 2025
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Generic name |
selumetinib |
|
Strength & form |
10 mg capsule |
|
Special Authority criteria |
Approval period |
|---|---|
InitialFor the treatment of neurofibromatosis type 1 with symptomatic1 and inoperable plexiform neurofibromas (PN)2 in pediatric patients (aged 2 to under 18) when requested by a neurooncologist or a pediatrician with expertise in neurooncology. |
18 months |
RenewalPatient must have demonstrated improvement or stabilization of clinical status from baseline, and Special Authority request must be submitted by a neurooncologist or a pediatrician with expertise in neurooncology. |
12 months |
Practitioner exemptions
- None
Special notes
- 1A symptomatic PN is one that causes significant morbidity, such as head or neck PN that compromises the airway or great vessels, paraspinal PN that causes myelopathy, or brachial/lumbar plexus PN that causes nerve compression or loss of function. May also include a PN that results in major deformity (e.g., orbital PN, etc.) or significant disfigurement, PN of the extremity that causes limb hypertrophy, or PN that results in loss of function or pain
- 2An inoperable PN is a PN that could not be completely surgically removed without risk of substantial morbidity due to encasement of, or close proximity to, vital structures, or invasiveness, or high vascularity of the PN
- PharmaCare covers a maximum 30-day supply of selumetinib per fill
- Selumetinib should be discontinued upon occurrence of disease progression (e.g., tumour growth, increased pain, worsening functioning, worsening quality of life, or worsening of symptoms, etc.)