Limited coverage criteria – tocilizumab for giant cell arteritis

Last updated on April 1, 2026

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Generic name	tocilizumab
Brand name	Strength	Form
Avtozma^™	162 mg/0.9 mL	pre-filled syringe autoinjector
Tyenne^®	162 mg/0.9 mL	pre-filled syringe autoinjector

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

Special Authority request form(s)

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Limited coverage criteria – tocilizumab for giant cell arteritis

Generic name

Brand name

Strength

Form

Special Authority criteria

Approval period

Practitioner exemptions

Special notes

Special Authority request form(s)