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Limited coverage criteria – pegfilgrastim

Last updated on May 27, 2026

 

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Generic name

 pegfilgrastim

Brand name

Strength

Form
Fulphila 6 mg/0.6 mL pre-filled syringe
Ziextenzo 6 mg/0.6 mL pre-filled syringe
Lapelga 6 mg/0.6 mL pre-filled syringe

Special Authority criteria

Approval period

For the treatment of patients with non-myeloid malignancies to decrease the incidence of infection, as manifested by febrile neutropenia1, if one of the following are met:

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

OR

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

OR

  • For the rescue of prolonged febrile neutropenia following chemotherapy

6 months

Practitioner exemptions

  • None

Special notes

  • 1Febrile neutropenia defined as:
    • Oral temperature ≥ 38.3 °C (or ≥ 38.0 °C for more than 1 hour) AND
    • Absolute neutrophil count < 0.5 x 109/L (or < 1 x 109/L with expected further decline)
  • For coverage for HIV-infected patients, please contact BC Centre for Excellence in HIV/AIDS

Special Authority request form(s)