Limited coverage criteria – tenofovir
Last updated on March 24, 2025
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Generic name |
tenofovir |
|---|---|
Strength & form |
300 mg tablet |
Special Authority criteria |
Approval period |
|---|---|
| For the treatment of chronic hepatitis B in treatment-naïve patients, if the Special Authority request includes all required lab work (as detailed in the HLTH 5372 – Chronic Hepatitis B form) |
Indefinite
|
|
For the treatment of chronic hepatitis B in treatment-experienced patients, when: The patient demonstrates lamivudine resistance (previous use of lamivudine for a minimum of 3 months) OR The patient is adefovir-experienced with persistent viremia AND a history of lamivudine resistance The patient is medication-compliant |
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 requests