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Content was last updated on: 2024-06-05

Oral agents and Outpatient Injections

British Columbia

FUNDING:

Medications for active cancer treatment are funded by BC Cancer for all BC Medical Services Plan patients (including First Nations Health Authority clients). These medications are supplied at no charge to registered BC cancer patients at BC Cancer Centres and Clinics. Patients may also have private drug plans that cover some or all of medication costs.

FORMULARIES:

BC Pharmacare Formulary - Click Here 
BC Cancer Benefit Drug List - Click Here

Drug
(Brand Name)
Manufacturer		 Indication Strength, Route DIN Provincial Funding Eligibility Criteria References Patient Assistance Programs
Abiraterone (Zytiga) Janssen Inc. mCSPC

Tablet

Not specified

A BC Cancer Compassionate Access Program request must be approved prior to treatment.1 
Restricted funding*2  

Eligibility (Abiraterone + Prednisone)1:

  • Patients with mCSPC who are either chemotherapy-naïve OR received prior chemotherapy containing docetaxel
    • No prior ADT or ADT for < 6 months for mCSPC
  • Should have ECOG PS 0-2
  • Should have serum potassium > 3.5 mmol/L

Note: Patients treated with abiraterone for mCSPC and develop mCRPC are eligible to receive enzalutamide (but not abiraterone)  
Caution1: Uncontrolled hypertension (systolic blood pressure > 160 mmHg or diastolic > 95 mmHg)  

*Restricted funding is reimbursed for approved indications only. Completion of the BC Cancer Compassionate Access Program Application (formerly Undesignated Indication Form) is necessary to provide the appropriate clinical information for each patient.
  1. BC Cancer Protocol UGUMCSPABI [2-22]
  2. BC Cancer Benefit Drug List [3-22]

Janssen (Janssen BioAdvance Patient Assistance Program): Access Here
 


 
Abiraterone (Zytiga) Janssen Inc. mCRPC

Tablet

Not specified

A BC Cancer Compassionate Access Program request must be approved prior to treatment.1
Restricted funding*2  

Eligibility (Abiraterone + Prednisone)1:

  • Patients with mCRPC who are chemotherapy-naïve OR have received prior chemotherapy containing docetaxel
    • ECOG PS 0-2
    • Life expectancy > 3 months
  • Patients can receive abiraterone (UGUPENZ) OR enzalutamide (UGUPABI, but not sequential use of these agents  

Exclusions1:

  • Active or symptomatic viral hepatitis or chronic liver disease
  • History of adrenal dysfunction
  • Clinically significant heart disease (LVEF < 50% at baseline)
  • Previously received abiraterone, enzalutamide or apalutamide for mCSPC
  • Previously received apalutamide, enzalutamide or darolutamide in nmCRPC  

Caution1:

  • Bilirubin > 1.5 x ULN, ALT > 2.5 x ULN
  • Uncontrolled hypertension  

*Restricted funding is reimbursed for approved indications only. Completion of the BC Cancer Compassionate Access Program Application (formerly Undesignated Indication Form) is necessary to provide the appropriate clinical information for each patient.
  1. BC Cancer Protocol UGUPABI [2-22] 
  2. BC Cancer Benefit Drug List [3-22]

Janssen (Janssen BioAdvance Patient Assistance Program): Access Here
JAMP (JAMP Care): Access Here
Sentrex Health Solutions: Access Here
Pharma-science: Access Here
Apotex: Access Here
ApoAssist: Access Here
Abiraterone Generic mCSPC

Tablet

Not specified

A BC Cancer Compassionate Access Program request must be approved prior to treatment.1 
Restricted funding*2

Eligibility (Abiraterone + Prednisone)1:
Patients with mCSPC who are either chemotherapy-naïve OR received prior chemotherapy containing docetaxel
•    No prior ADT or ADT for < 6 months for mCSPC
Should have ECOG PS 0-2
Should have serum potassium > 3.5 mmol/L 

Note:
Patients treated with abiraterone for mCSPC and develop mCRPC are eligible to receive enzalutamide (but not abiraterone) 

Caution1:
Uncontrolled hypertension (systolic blood pressure > 160 mmHg or diastolic > 95 mmHg)

*Restricted funding is reimbursed for approved indications only. Completion of the BC Cancer Compassionate Access Program Application (formerly Undesignated Indication Form) is necessary to provide the appropriate clinical information for each patient.
 

BC Cancer Protocol UGUMCSPABI

 

BC Cancer Benefit Drug List

JAMP (JAMP Care): Access Here

Sentrex Health Solutions: Access Here

Pharma-science: Access Here

Apotex:

Access Here

Access Here

 
Abiraterone Generic mCRPC

Tablet

Not specified

A BC Cancer Compassionate Access Program request must be approved prior to treatment.1 
Restricted funding*2

Eligibility (Abiraterone + Prednisone)1:
Patients with mCRPC who are chemotherapy-naïve OR have received prior chemotherapy containing docetaxel

  • ECOG PS 0-2
  • Life expectancy > 3 months

Patients can receive abiraterone (UGUPENZ) OR enzalutamide (UGUPABI, but not sequential use of these agents

Exclusions1:
Active or symptomatic viral hepatitis or chronic liver disease
History of adrenal dysfunction
Clinically significant heart disease (LVEF < 50% at baseline)
Previously received abiraterone, enzalutamide or apalutamide for mCSPC
Previously received apalutamide, enzalutamide or darolutamide in nmCRPC 

Caution1:
Bilirubin > 1.5 x ULN, ALT > 2.5 x ULN
Uncontrolled hypertension

*Restricted funding is reimbursed for approved indications only. Completion of the BC Cancer Compassionate Access Program Application (formerly Undesignated Indication Form) is necessary to provide the appropriate clinical information for each patient.
 

BC Cancer Protocol UGUPABI

BC Cancer Benefit Drug List

JAMP (JAMP Care): Access Here 

Sentrex Health Solutions: Access Here

Pharma-science: Access Here

Apotex:

Access Here

Access Here 
Alendronate Generic Osteoporosis

10 mg, 70 mg, 70mg/ 5600 IU VitD3 Tablet

Multiple1

Limited coverage drug requiring Special Authority Request Form2

Eligibility1:

  • Clinical or radiographically documented fracture due to osteoporosis, OR
  • Glucocorticoid-induced osteoporosis in patients who are receiving or expected to receive the equivalent dose of ≥ 7.5 mg of prednisone per day and for ≥ 90 consecutive days
  1. BC Pharmacare Formulary [3-22] 
  2. Limited Coverage Drug Program [3-22]
    https://www2.gov.bc.ca/assets/gov/health/forms/5328fil.pdf

Apotex: Access Here
Apalutamide (Erleada) Janssen Inc. mCSPC

Tablet, PO

60 mg

240 mg

60mg: 02478374

240mg: 02540185

A BC Cancer Compassionate Access Program request must be approved prior to treatment.1

Restricted funding*2

Eligibility1:
•    Patients with mCSPC who meet the following criteria:
    o    Chemotherapy naïve OR received prior chemotherapy containing docetaxel
    o    No prior ADT or ADT for ≤ 6 months for mCSPC immediately prior to starting current protocol
    o    Should have ECOG PS 0-2
    o    Should have serum potassium > 3.5 mmol/L
Exclusions1:
•    Patients with mCSPC are eligible to receive any of the following, but not their sequential use: 
    o    apalutamide (GUMCSPAPA)
    o    enzalutamide (GUMCSPENZ)
    o    abiraterone (GUMCSPABI), or
    o    darolutamide with DOCEtaxel (UGUMCSPDD) 
•    Patients treated with apalutamide for mCSPC and develop mCRPC are NOT eligible to receive abiraterone or enzalutamide

*Restricted funding is reimbursed for approved indications only. Completion of the BC Cancer Compassionate Access Program Application (formerly Undesignated Indication Form) is necessary to provide the appropriate clinical information for each patient.
 

   

    
Apalutamide (Erleada) Janssen Inc. mCRPC

Tablet, PO, 60mg, 240mg

02478374

A BC Cancer Compassionate Access Program request must be approved prior to treatment. 1  

Restricted funding*2

Eligibility1:
Patients with mCSPC who meet the following criteria:

  • Chemotherapy naïve OR received prior chemotherapy containing docetaxel
  • No prior ADT or ADT for < 6 months for mCSPC immediately prior to starting current protocol
  • Should have ECOG PS 0-2
  • Should have serum potassium > 3.5 mmol/L

Exclusions1:
Patients treated with apalutamide for mCSPC and develop mCRPC are NOT eligible to receive abiraterone or enzalutamide 

*Restricted funding is reimbursed for approved indications only. Completion of the BC Cancer Compassionate Access Program Application (formerly Undesignated Indication Form) is necessary to provide the appropriate clinical information for each patient.

**60 mg tablet funded, 240 mg tablet pending provincial funding decision.
 
  1. BC Cancer Protocol UGUMCSPAPA [12-21] 
  2. BC Cancer Benefit Drug List [3-22]

Janssen BioAdvance Patient Assistance Program: Access Here

 
Apalutamide (Erleada) Janssen Inc. nmCRPC

Tablet, PO, 60mg, 240mg

60mg: 02478374

240mg: 02540185
 

A BC Cancer Compassionate Access Program request must be approved prior to treatment.1

Restricted funding*2

Eligibility1:
•    Patients with nmCRPC who meet the following criteria:    
    o    No prior chemotherapy for nmCRPC
    o    ECOG PS 0-2
    o    PSADT ≤ 10 months
    o    No radiologic evidence of metastases (negative bone scan, negative CT of pelvis, abdomen, chest) within the last 6 months (exception: pelvis lymph nodes < 2cm in short axis below the aortic bifurcation)

•    Patients with nmCRPC are eligible to receive any of the following, but not their sequential use:
    o    apalutamide (UGUPAPA),
    o    darolutamide (UGUNMPDAR), or
    o    enzalutamide (UGUNMPENZ)

•    Patients who have progressed to metastatic disease on apalutamide (UGUPAPA) are eligible to receive all of the following:
    o    DOCEtaxel (GUPDOC)
    o    Cabazitaxel (GUPCABA), and
    o    Radium in metastatic CRPC (GUPRAD)
    o    Are NOT eligible to receive enzalutamide (UGUPENZ) or abiraterone (UGUPABI)
Exclusions:
•    Metastatic prostate cancer (exception: pelvic lymph nodes < 2 cm in short axis below the aortic bifurcation)
•    Prior treatment with enzalutamide (UGUNMPENZ) or darolutamide (UGUNMDAR) in nmCRPC
•    Prior chemotherapy for nmCRPC
•    Uncontrolled hypertension (systolic blood pressure greater than 160 mmHg or diastolic greater than 95 mmHg)
*Restricted funding is reimbursed for approved indications only. Completion of the BC Cancer Compassionate Access Program Application (formerly Undesignated Indication Form) is necessary to provide the appropriate clinical information for each patient.

 
  1. BC Cancer Protocol UGUPAPA [8-21] 
  2. BC Cancer Benefit Drug List [3-22]

Janssen BioAdvance Patient Assistance Program: Access Here
Darolutamide (Nubeqa) Bayer mCSPC

Tablet

Not Specified

Restricted funding*

ELIGIBILITY (in combination with DOCEtaxel): 
Patients must have:

  • Metastatic castration sensitive prostate cancer (mCSPC),
  • No prior systemic treatment for metastatic prostate cancer (excluding ADT*), and
  • A BC Cancer “Compassionate Access Program” (CAP) request must be approved prior to treatment.

*Previous ADT permitted if patient received:

  • Less than 6 months of androgen deprivation therapy (ADT) for mCSPC immediately prior to starting this protocol, and
  • No ADT for adjuvant treatment of non-metastatic prostate cancer within 1 year of starting this protocol 

Patients should have:

  • Fitness for treatment containing DOCEtaxel,
  • Good performance status, and
  • Total bilirubin less than ULN, AST/ALT less than 5 x ULN, alkaline phosphatase less than 6 x ULN 


Notes:

  • Patients currently being treated with GUPDOCADT who have not progressed, may switch to UGUMCSPDD if all other eligibility criteria are met
  • Patients with mCSPC are eligible to receive any of the following, but not their sequential use:
    • apalutamide (GUMCSPAPA),
    • enzalutamide (GUMCSPENZ),
    • abiraterone (GUMCSPABI), or
    • darolutamide + DOCEtaxel (UGUMCSPDD)
  • Patients treated with darolutamide for mCSPC who develop castration resistant disease are NOT eligible to receive abiraterone (UGUPABI) or enzalutamide (UGUPENZ)
  • Initiation of darolutamide without DOCEtaxel is not funded


EXCLUSIONS: 
Patients must not have:

  • Completed adjuvant treatment (i.e., prior UGUPAJABI) for prostate cancer less than 1 year prior to initiation of UGUMCSPDD

*Reimbursed for approved indications only. Completion of the BC Cancer Compassionate Access Program Application is necessary to provide the appropriate clinical information for each patient. 

BC Cancer Protocol UGUMCSPDD

BC Cancer Benefit Drug List

NUBEQA® DART Patient Support Program:

Toll free: 1-833-955-3278

Fax: 1-877-208-4393

Email: info@dartsupport.ca
Darolutamide (Nubeqa) Bayer nmCRPC

Tablet

Not specified

Restricted funding* 

ELIBILITY: 

Patients must have: 

  • Non-metastatic castration resistant prostate cancer (nmCRPC) 
  • No radiologic evidence of metastases (negative bone scan, negative CT of pelvis, abdomen, chest) within the last 6 months (exception: pelvic lymph nodes < 2 cm in short axis below the aortic bifurcation) 
  • A BC Cancer “Compassionate Access Program” (CAP) request must be approved prior to treatment. 
  • No prior chemotherapy for nmCRPC 
  • PSADT ≤ 10 months 
  • Should have ECOG PS 0 to 2 

 

Notes: 

  • Patients with nmCRPC are eligible to receive apalutamide (UGUPAPA), darolutamide (UGUNMPDAR) or enzalutamide (UGUNMPENZ/UGUNPENZ), but not sequentially. 
  • Patients who have progressed to mCRPC on darolutamide (UGUNMPDAR) are eligible to received docetaxel (GUPDOC), cabazitaxel (GUPCABA) and radium (GUPRAD) 
  • Patients who have progressed to mCRPC on darolutamide (UGUNMPDAR) are not eligible to receive enzalutamide (UGUPENZ) or abiraterone (UGUPABI) 

 

EXCLUSIONS: 

  • Patients with mCRPC (exception: pelvic lymph nodes < 2 cm in short axis below the aortic bifurcation) 
  • Prior treatment for nmCRPC with apalutamide (UGUPAPA) or enzalutamide (UGUNMPENZ) 
  • Prior chemotherapy for nmCRPC 
  • Reimbursed for approved indications only. Completion of the BC Cancer Compassionate Access Program Application is necessary to provide the appropriate clinical information for each patient.
  1. BC Cancer Protocol UGUNMPDAR [8-21]
  2. BC Cancer Benefit Drug List [3-22]

NUBEQA® DART Patient Support Program: 

Toll free:1-833-955-3278

Fax:1-877-208-4393 

Email: info@dartsupport.ca 
Denosumab (Prolia) Amgen Osteoporosis

60 mg / Syr

023435411

Limited coverage drug requiring Special Authority Request Form2

Eligibility2:

  • Men with osteoporosis AND
  • Clinical or radiographically-documented fracture due to osteoporosis
  • Contraindication to oral bisphosphonates for one of the following reasons:
  • immune-mediated hypersensitivity reaction to oral bisphosphonates OR
  • abnormalities of the esophagus which delay esophageal emptying such as stricture or achalasia
  1. BC Pharmacare Formulary [3-22] 
  2. Limited Coverage Drug Program [3-22]

ProVital Program: Access Here
Denosumab (Xgeva) Amgen mCRPC + Bone mets

120 mg / 1.7 mL Vial

023681531

Covered by BC Pharmacare Plan P (Palliative Drug Benefit). Application form must be submitted prior to treatment initiation2

BC Palliative Care Benefit Application

Eligibility2:

  • Patients with mCRPC with bone metastases
  • Evidence of castration resistance (progressive disease despite testosterone < 1.7 nmol/L)
  • As a supportive care medication, denosumab is not covered by BC Cancer Agency but may be reimbursed by private insurance plans
  1. BC Pharmacare Formulary
  2. BC Cancer Protocol SCDMAB [5-14]

The VICTORY Program: Access Here
Enzalutamide (Xtandi) Astellas mCRPC

Tablet

Not specified

A BC Cancer Compassionate Access Program request must be approved prior to treatment.1

Restricted funding*2

Eligibility1:

  • Patients with mCRPC who meet the following criteria:
  • Chemotherapy-naïve OR received prior chemotherapy containing docetaxel
  • Should have ECOG PS 0-2
  • Should have life expectancy > 3 months
  • Patients treated with abiraterone for mCSPC (UGUMCSPABI) are eligible to receive enzalutamide (UGUPENZ) for mCRPC
  • Patients can receive either enzalutamide (UGUPENZ) or abiraterone (UGUPABI) in mCRPC but not sequential use of these agents

Exclusions1:

  • Previously received enzalutamide, apalutamide or darolutamide for nmCRPC
  • Previously received enzalutamide or apalutamide for mCSPC

Caution1:

  • Uncontrolled hypertension

*Restricted funding is reimbursed for approved indications only. Completion of the BC Cancer Compassionate Access Program Application (formerly Undesignated Indication Form) is necessary to provide the appropriate clinical information for each patient.
  1. BC Cancer Protocol UGUPENZ [12-21]  
  2. BC Cancer Benefit Drug List [3-22]

Xtandi Patient Assistance Program (XPAP): 

Patient Enrolment and Consent Form (English) 

Formulaire D’inscription et de Consentement du Patient (French) 

 
Enzalutamide (Xtandi) Astellas nmCRPC

PO

02407329 

ELIGIBILITY: 

  • ECOG performance status 0-2 

  • Patients with non-metastatic castration resistant prostate cancer (nmCRPC) who are chemotherapy naïve 

  • Patients with nmCRPC with a PSA doubling time of less or equal to 10 months. 

  • Patients with no radiologic evidence of metastases (negative bone scan, negative CT of pelvis, abdomen, chest) 

  • Patients with nmCRPC are eligible to receive one of apalutamide (UGUPAPA), darolutamide (UGUNMPDAR), or enzalutamide (UGUNMPENZ, UGUPENZ), but not their sequential use 

  • Patients who have progressed on enzalutamide in nmCRPC (UGUNMPENZ) 

  • Are eligible to receive DOCEtaxel (GUPDOC) and/or cabazitaxel in metastatic CRPC  

  • Are NOT eligible to receive enzalutamide (UGUPENZ) or abiraterone (UGUPABI) in metastatic CRPC 

  • A BC Cancer “Compassionate Access Program” (CAP) request must be approved prior to treatment 

 

EXCLUSIONS: 

  • Metastatic prostate cancer 

  • Prior treatment with apalutamide (UGUPAPA) or darolutamide (UGUNMDAR) in nmCRPC 

  • Uncontrolled hypertension (systolic blood pressure greater than 160 mmHg or diastolic greater than 95 mmHg) 

 

TESTS: 

  • Baseline: CBC and differential, platelets, creatinine, sodium, potassium, blood pressure 

  • Patients at risk for electrolyte abnormality and QTc prolongation: ECG 

  • Each time seen by physician: PSA, blood pressure. 

  • If clinically indicated: creatinine, sodium, potassium, ECG 

  1. BC Cancer Protocol Summary for Therapy for Non-Metastatic Castration Resistant Prostate Cancer Using Enzalutamide 

     

    BC Cancer Benefit Drug List [3-22] 

Xtandi Patient Assistance Program (XPAP): 

Patient Enrolment and Consent Form (English) 

Formulaire D’inscription et de Consentement du Patient (French) 

 
Enzalutamide (Xtandi) Astellas mCSPC

PO

02407329 

ELIGIBILITY: 

Patients must have:  

  • metastatic castration sensitive prostate cancer (mCSPC) who are either: 

  • chemotherapy naïve or have received prior chemotherapy containing DOCEtaxel 

AND 

  • no prior androgen deprivation therapy (ADT) or have received ADT for not more than 6 months for metastatic castration sensitive prostate cancer (mCSPC) immediately prior to starting current protocol 

Patients should have: 

  • ECOG performance status 0-2 

  • Serum potassium greater than 3.5 mmol/L 

 

EXCLUSIONS: 

  • Patients treated with enzalutamide for mCSPC and develop castration resistant disease are:  

  • NOT eligible to receive abiraterone (UGUPABI)  

TESTS: 

  • Baseline: CBC and differential, platelets, creatinine, sodium, potassium, blood pressure 

  • Patients at risk for electrolyte abnormality and QTc prolongation: ECG 

  • Each time seen by physician: PSA, blood pressure. 

  • If clinically indicated: creatinine, sodium, potassium, ECG 

BC Cancer Protocol Summary for Treatment for Metastatic Castration Sensitive Prostate Cancer using Enzalutamide  

 

BC Cancer Benefit Drug List [3-22] 

Xtandi Patient Assistance Program (XPAP): 

Patient Enrolment and Consent Form (English) 

Formulaire D’inscription et de Consentement du Patient (French) 

 
Niraparib and abiraterone acetate (AKEEGA®) Janssen Inc. mCRPC

Dual-action tablet, PO/ Comprimé à double action, PO: 100mg niraparib/500mg abiraterone acetate

02538563

Pending provincial funding decision

N/A

Janssen BioAdvance Patient Assistance Program: Access Here
Olaparib (Lynparza) AstraZeneca mCRPC

100 mg tab | 150 mg tab

100mg: 02475200 | 150mg: 02475219

BC Cancer Protocol Summary for Treatment of Metastatic CastrationResistant Prostate Cancer using Olaparib   

Patients must have:  

  • Metastatic castration-resistant prostate cancer (mCRPC),  
  • Deleterious germline and/or somatic mutations in homologous recombination repair genes BRCA 1/2 or ATM  
  • Progressed on prior ARAT (androgen receptor-axis-targeted) therapy – enzalutamide, abiraterone/predniSONE, apalutamide or darolutamide in the metastatic castration sensitive (mCSPC), nonmetastatic castration-resistant (nmCRPC), or metastatic castration-resistant (mCRPC) prostate cancer setting with or without prior taxane chemotherapy  
  • A BC Cancer “Compassionate Access Program” (CAP) approval prior to treatment 

Patients should have:  

  • Performance status ECOG 0-2 

BC Cancer Protocol Summary

AstraZeneca Patient Support Program: Access Here

AstraZeneca Patient Assistance Program: Access Here