Bulletin #971 March 20, 2018 NB Drug Plans Formulary Update This update to the New Brunswick Drug Plans Formulary is effective March 20, 2018. Included in this bulletin: Regular Benefit Additions Changes to Existing Special Authorization Benefits Benefit Status Changes Drugs Reviewed and Not Listed If you have any questions, please contact our office at 1-800-332-3691. The Formulary Updates are available online: http://www.gnb.ca/0212/benefitupdates-e.asp. To unsubscribe from the NB Drug Plans email announcements, please send a message to info@nbdrugs-medicamentsnb.ca.
Regular Benefit Additions Special Authorization no longer required Carvedilol (generic brands) 3.125mg film-coated tablet 6.25mg film-coated tablet 12.5mg film-coated tablet 25mg film-coated tablet or List for products ADEFGV Changes to Existing Special Authorization Benefits New Indication Everolimus (Afinitor ) 2.5mg tablet 02369257 5mg tablet 02339501 7.5mg tablet 02450267 10mg tablet 02339528 NVR (SA) MLP For the treatment of patients with unresectable, locally advanced or metastatic, welldifferentiated, non-functional neuroendocrine tumors (NETs) of gastrointestinal or lung origin (GIL) with documented radiological disease progression within six months. Renewal Criteria: Revised Criteria and New Strength Everolimus (Afinitor ) 2.5mg tablet 02369257 5mg tablet 02339501 7.5mg tablet 02450267 10mg tablet 02339528 NVR (SA) MLP Advanced Breast Cancer For the treatment of hormone-receptor positive, HER2 negative advanced breast cancer in postmenopausal women, after recurrence or progression following a non-steroidal aromatase inhibitor, when used in combination with exemestane. New Brunswick Drug Plans 2 March 2018
Renewal Criteria: Sequential use of palbociclib and everolimus will not be reimbursed. Metastatic Renal Cell Carcinoma For the treatment of patients with metastatic renal cell carcinoma (mrcc) after failure of tyrosine kinase inhibitor therapy. Renewal Criteria: Requests for everolimus will not be considered for patients who experience disease progression on axitinib. Sequential use of nivolumab and everolimus will not be reimbursed. Exceptions may be considered in the case of intolerance or contraindication without disease progression. Initial approval period: 6 months. Neuroendocrine Tumors For the treatment of patients with progressive, unresectable, locally advanced or metastatic, well or moderately differentiated pancreatic neuroendocrine tumours (pnet). Renewal Criteria New Brunswick Drug Plans 3 March 2018
Requests for everolimus will not be considered for patients who experience disease progression on sunitinib for pnet. Revised Criteria Fludarabine (Fludara ) 10mg film-coated tablet 02246226 SAV (SA) MLP 1. For the first-line treatment of patients with chronic lymphocytic leukemia (CLL) when used in combination with rituximab (with or without cyclophosphamide). 2. For the treatment of patients with CLL who have failed to respond to, or have relapsed during or after previous therapy with an alkylating agent. Revised Criteria Lansoprazole (Prevacid and generics) 15mg delayed-release 30mg delayed-release or List for products (SA) For patients who have had a therapeutic failure with all proton pump inhibitors listed as regular benefits (e.g. omeprazole, pantoprazole, rabeprazole). Clinical Note: Patients who have failed a minimum eight week trial of standard dose therapy may be considered for an eight week trial of double dose therapy. Coverage beyond eight weeks will be considered if step down to standard dose therapy is not successful. Benefit Status Changes Delisted acid/caffeine/butalbital (Fiorinal and generics) 330mg/40mg/50mg and tablet or List for products acid/caffeine/codeine/ butalbital (Fiorinal C1/4 and generic) 330mg/40mg/15mg/50mg or List for products acid/caffeine/codeine/ butalbital (Fiorinal C1/2 and generic) 330mg/40mg/30mg/50mg or List for products New Brunswick Drug Plans 4 March 2018
Effective March 20, 2018, butalbital-containing products which include Fiorinal, Fiorinal C¼, Fiorinal C½ and generic brands will be delisted as benefits of the Extra-Mural Program. Butalbital-containing products were previously delisted as New Brunswick Prescription Drug Program benefits in 1994. Requests for special authorization will not be considered. There is no evidence for the efficacy of butalbital-containing products in the treatment of pain. They are also associated with physical dependence, risk of overdose even at low doses and the potential for a withdrawal syndrome. Drugs Reviewed and Not Listed The review of the following products found that they did not offer a significant therapeutic and/or cost advantage over existing therapies. Requests for special authorization will not be considered. Product Strength DIN MFR Indication Propiverine hydrochloride (Mictoryl ) 30mg 02460262 45mg 02460270 DUI Overactive bladder in adults New Brunswick Drug Plans 5 March 2018