Limited coverage criteria – tofacitinib for rheumatoid arthritis
Last updated on July 18, 2025
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Tofacitinib coverage transition
PharmaCare is transitioning tofacitinib coverage from the brand name product Xeljanz® to generic tofacitinib products. According to Health Canada, generic drugs are pharmaceutically equivalent to brand name drugs; they contain the identical medicinal ingredients, in the same amounts and in a similar dosage form.
To maintain coverage, patients currently covered for the brand name product Xeljanz must transition to a generic tofacitinib product. PharmaCare is providing six-month transitional coverage ending January 15, 2026, to allow time for patients to switch. For patients with existing Xeljanz Special Authority approval, the generic tofacitinib products will automatically be covered; prescribers do not need to submit a new Special Authority request until the next scheduled renewal date (if applicable).
| July 16, 2025 | July 16, 2025, to January 15, 2026 | January 16, 2026 |
|---|---|---|
| All new Special Authority requests, including renewals, for tofacitinib will only be approved for the generic brand products. The brand product Xeljanz will not be approved for new Special Authority requests, including renewals. | To maintain coverage, patients with existing Xeljanz Special Authority approval must transition to the generic brand of tofacitinib within the six-month transition period. | Xeljanz is no longer a PharmaCare benefit and only the generic tofacitinib products are covered. |
Special Authority requests for patients who are unable to transition to any formulation of generic tofacitinib will be considered on a case-by-case basis. Prescribers can submit HLTH 5861 – Tofacitinib patient list request (PDF, 968KB) form to request a list of their patients who are receiving PharmaCare coverage for Xeljanz so they can contact them to start the switch. PharmaCare will not be offering patient support fees for the transition.
Some patients with rheumatoid arthritis may take Xeljanz 11 mg XR formulation. To maintain PharmaCare coverage, these patients must, in consultation with their prescriber, switch to the equivalent dose of a generic tofacitinib product (5 mg twice daily).
Prescribers do not need to submit a new Special Authority request until the next scheduled renewal date (if applicable).
Patient support programs
For patients transitioning to a generic tofacitinib product, a different patient support program is available. PharmaCare coverage is not tied to participation in a patient support program.
| Generic manufacturer | Patient support program (PSP) | |
| Taro (taro-tofacitinib) |
Sun360 |
|
| PharmaScience (PMS-tofacitinib) |
Tel: 1-888-255-9777
|
|
| JAMP (JAMP-tofacitinib) |
JAMP Care |
|
| Auro (Auro-tofacitinib) | Auro generics are available; please follow up with them for their PSP information. Their general contact information is provided below:
Tel: 1-905-856-8063 Ext: 242 |
|
For questions or concerns, please contact the Formulary Management team by email at FM.GenericMailbox@gov.bc.ca.
Generic name |
tofacitinib |
|---|---|
Strength & form |
5 mg tablet |
Special Authority criteria |
Approval period |
|---|---|
|
For the treatment of rheumatoid arthritis when a Special Authority request for tofacitinib is submitted by a rheumatologist according to established criteria, as noted in eForms submission (and on the Special Authority forms linked below) Tofacitinib is to be used in combination with methotrexate, or without methotrexate in patients who are intolerant to methotrexate |
Initial: 1 year Renewal: 1 year, 3 years or indefinite |
Practitioner exemptions
- None
Special notes
- PharmaCare covers a maximum 30 days' supply per fill
- PharmaCare coverage is limited to 5 mg of tofacitinib twice daily