CUA

Oral agents and Outpatient Injections

Northwest Territories

FUNDING:

FORMULARIES:

Drug (Brand Name) Manufacturer	Indication	Strength, Route	DIN	Provincial Funding Eligibility Criteria	References	Patient Assistance Programs
Olaparib (Lynparza) AstraZeneca	mCRPC	100 mg tab \| 150 mg tab	100mg: 02475200 \| 150mg: 02475219	Funded as per NIHB criteria: Criteria for initial 12-month coverage: For the treatment of adult patients with metastatic castration-resistant prostate cancer (mCRPC); and Olaparib is used as monotherapy; and Patient has good performance status; and Patient has progressed following prior treatment with a new hormonal agent/androgen-receptor-axis-targeted therapy (ARAT); and Patient has deleterious or suspected deleterious mutations (germline or somatic) in the homologous recombination repair (HRR) genes BRCA or ATM.	NIHB Drug Benefit List	AstraZeneca Patient Support Program: Access Here AstraZeneca Patient Assistance Program: Access Here

Drug
(Brand Name)
Manufacturer

Indication

Strength, Route

DIN

Provincial Funding Eligibility Criteria

References

Patient Assistance Programs

Olaparib (Lynparza) AstraZeneca

mCRPC

100 mg tab | 150 mg tab

100mg: 02475200 | 150mg: 02475219

Funded as per NIHB criteria:

For the treatment of adult patients with metastatic castration-resistant prostate cancer (mCRPC); and
Olaparib is used as monotherapy; and
Patient has good performance status; and
Patient has progressed following prior treatment with a new hormonal agent/androgen-receptor-axis-targeted therapy (ARAT); and
Patient has deleterious or suspected deleterious mutations (germline or somatic) in the homologous recombination repair (HRR) genes BRCA or ATM.

AstraZeneca Patient Support Program: Access Here

AstraZeneca Patient Assistance Program: Access Here

Drug Access Listing