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PharmaCare is changing coverage of tocilizumab for neuromyelitis optica spectrum disorder (NMOSD). 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.
All new Special Authority (SA) requests, including renewals, for tocilizumab will only be approved for Tyenne.
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.
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 |
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Strength & form |
80 mg/4 mL, 200 mg/10 mL, 400 mg/20 mL intravenous infusion vial 162 mg/0.9 mL pre-filled syringe, autoinjector pen |
Special Authority criteria |
Approval period |
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InitialFor the treatment of neuromyelitis optica spectrum disorder (NMOSD), when a Special Authority request is submitted by a neurologist with expertise in the diagnosis and management of NMOSD, in patients with:
|
1 year |
RenewalPatient has maintained an EDSS score of less than 8 points taken within the 3-month period immediately preceding the renewal request AND Special Authority request is submitted by a neurologist with expertise in the diagnosis and management of NMOSD |
1 year |