Limited coverage criteria – tocilizumab for giant cell arteritis
Last updated on May 27, 2025
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Biosimilar transition initiative
PharmaCare is changing coverage of tocilizumab for giant cell arteritis. To maintain PharmaCare coverage, patients currently covered for the originator tocilizumab biologic product, Actemra®, must, in consultation with their prescriber, switch to the approved biosimilar product, Tyenne®.
Prescribers can request a list of their patients who are receiving PharmaCare coverage for Actemra, so they can contact them to start the switch to Tyenne.
May 27, 2025
All new Special Authority (SA) requests, including renewals, for tocilizumab will only be approved for Tyenne.
May 27, 2025 to November 27, 2025
During the six-month transition period, patients with PharmaCare coverage for the originator tocilizumab (Actemra) who wish to maintain their coverage must transition to the biosimilar tocilizumab (Tyenne). A new SA request is not required until the next scheduled renewal date (if applicable). To maintain patients' coverage, prescribers must write a new prescription for their patients on Actemra, indicating the transition to Tyenne.
November 28, 2025
Actemra is no longer an eligible PharmaCare benefit and only Tyenne is authorized for continued coverage.
SA requests for patients who are unable to transition to Tyenne will be considered on an exceptional case-by-case basis.
Generic name |
tocilizumab |
|---|---|
Strength & form |
162 mg/0.9 mL pre-filled syringe |
Special Authority criteria |
Approval period |
|---|---|
|
For the treatment of giant cell arteritis (GCA), according to criteria detailed in Special Authority Request form HLTH 5496, when a Special Authority request is submitted by a rheumatologist or ophthalmologist |
1 year |
Practitioner exemptions
- None
Special notes
- PharmaCare covers a maximum of 56 days' supply per fill when dosed at 14-day intervals. Coverage is limited to 162 mg once weekly