Drug Access Listing

250 mg tab | 500 mg tab

Multiple

Exception status applies^1,2: Form

Eligibility^1,2:

• Patients with mCRPC

Clinical notes^1,2:

• Patients should have good performance status
• Treatment should be discontinued upon disease progression or unacceptable toxicity

1. NS Formulary [3-22] 
2. Criteria for Exception Status Coverage [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

250 mg tab | 500 mg tab

Multiple

Exception status applies^1,2: Exception status Drug request form

Eligibility^1,2:

• In combination with prednisone and ADT for the treatment of patients with mCSPC

• Patients must have had either no prior ADT, or are within six months of beginning ADT in the metastatic setting

Clinical notes^1,2:

• Patients should have good performance status
• Treatment should be discontinued upon disease progression or unacceptable toxicity

Claim Notes^,1,2:

• Patients receiving abiraterone for the treatment of mCSPC will be eligible for funding of enzalutamide at the time of disease progression to mCRPC.

1. NS Formulary [9-213-22] 
2. Criteria for Exception Status Coverage [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

5 mg Tab | 10 mg Tab | 70 mg Tab

Multiple

Eligibility:

• Senior’s pharmacare
• Community services pharmacare (under 65-long term care pharmacare,
  family pharmacare)
• Drug assistance for Cancer Patients

1. NS Formulary [3-22]

Apotex: Access Here

Tablet, PO, 60mg, 240mg

02478374

Exception status applies1,2: Form

Eligibility1,2:

• In combination with ADT for the treatment  patients with CRPC who have no detectable distant metastasis (M0) by either CT, MRI or technetium-99m bone scan and who are at high risk of developing metastases (defined as PSADT ≤ 10 months during continuous ADT) 
• Patients should have a good performance status and no risk factors for seizures
• Treatment should continue until unacceptable toxicity or radiographic disease progression

Clinical Notes1,2:

• Castration-resistance must be demonstrated during continuous ADT and is defined as 3 PSA rises ≥ 1 week apart, with the last PSA > 2 ng/mL
• Castrate levels of testosterone must be maintained
• Patients with N1 disease, pelvic lymph nodes < 2cm in short axis located below the common iliac vessels are eligible for apalutamide
• Apalutamide will not be funded for patients who experience disease progression on enzalutamide
• Patients receiving apalutamide for the treatment of nmCRPC will be eligible for funding of abiraterone at the time of disease progression to mCRPC
• Enzalutamide is not funded for patients who experience disease progression to mCRPC while on apalutamide
• Abiraterone or enzalutamide may be used to treat mCRPC patients who discontinued apalutamide in the non-metastatic setting due to intolerance without disease progression

**60 mg tablet funded, 240 mg tablet pending provincial funding decision

1. NS Formulary [3-22] 
2. Criteria for Exception Status Coverage [3-22]

Janssen BioAdvance Patient Assistance Program: Access Here

Tablet, 60mg, 240mg

02478374

Exception status applies1,2: Form

Eligibility1,2:

• In combination with ADT for the treatment patients with mCSPC

• Patients must have had either no prior ADT, or are within six months of beginning ADT in the metastatic setting. 

Clinical Notes1,2:

• Patients should have a good performance status and no risk factors for seizures
• Treatment should continue until unacceptable toxicity or disease progression

Claim Notes1,2:

• Patients receiving apalutamide for the treatment of metastatic CSPC will be eligible for funding of abiraterone at the time of disease progression to metastatic CRPC
• Enzalutamide is not funded for patients who experience disease progression to metastatic CRPC while on apalutamide

**60 mg tablet funded, 240 mg tablet pending provincial funding decision

1. NS Formulary [3-22] 
2. Criteria for Exception Status Coverage [3-22]

Janssen BioAdvance Patient Assistance Program: Access Here

300 mg Tab

Not specified

Exception status applies: Form

Eligibility:

• In combination with ADT for the treatment of patients with nmCRPC

• Patients who are at high risk of developing metastases (defined as PSADT ≤ 10 months during continuous ADT)
• Patients should have a good performance status.

• Treatment should continue until unacceptable toxicity or radiographic disease progression.

Clinical Notes:

• Castration-resistance must be demonstrated during continuous ADT and is defined as 3 PSA rises ≥ 1 week apart, with the last PSA > 2 ng/mL
• No detectable distant metastasis (M0) by either CT, MRI or technetium-99m bone scan
• Castrate levels of testosterone must be maintained
• Patients with N1 disease, pelvic lymph nodes < 2cm in short axis located below the aortic bifurcation are eligible for darolutamide
• Darolutamide will not be funded for patients who experience disease progression on apalutamide or enzalutamide
• Patients receiving darolutamide for the treatment of nmCRPC will be eligible for funding of abiraterone at the time of disease progression to mCRPC, enzalutamide is not funded for patients who experience disease progression to mCRPC while on darolutamide
• Abiraterone or enzalutamide may be used to treat mCRPC patients who discontinued darolutamide in the non-metastatic setting due to intolerance without disease progression

1. NS Formulary [3-22] 
2. Criteria for Exception Status Coverage [3-22]

NUBEQA® DART Patient Support Program: 

Toll free:  

1-833-955-3278 

Fax: 

1-877-208-4393 

Email: 

info@dartsupport.ca 

300mg Tab

02496348 

Exception status applies: Form 

Eligibility: 

• In combination with docetaxel and androgen deprivation therapy (ADT) for the treatment of patients with metastatic castration-sensitive prostate cancer (mCSPC) 

Clinical Notes: 

• Patients should have a good performance status and be eligible for chemotherapy. 

• Treatment should continue until disease progression or unacceptable toxicity. 

• Patients should have had no prior ADT in the metastatic setting, or are within 6 months of initiating ADT in the metastatic setting with no disease progression. 

• Patients will be eligible if they received ADT in the non-metastatic setting as long as at least a one year interval has passed since completion.  

• Darolutamide will not be funded for patients who experience disease progression on enzalutamide or apalutamide. 

NS Formulary 

NUBEQA® DART Patient Support Program: 

Toll free:  

1-833-955-3278 

Fax: 

1-877-208-4393 

Email: 

info@dartsupport.ca 

60 mg / ml Injection

02343541

Exception status applies^1,2: Form

Eligibility^1,2:

• For the treatment of osteoporosis in men who meet the following criteria:

• Have a contraindication to oral bisphosphonates
• High risk for fracture, or refractory or intolerant to other available osteoporosis therapies. 

Clinical Notes^1,2:

• Refractory is defined as a fragility fracture or evidence of a decline in bone mineral density below pre-treatment baseline levels, despite adherence for one year to other available osteoporosis therapies.
• High fracture risk is defined as:

• Moderate 10-year fracture risk (10% to 20%) as defined by the Canadian Association of Radiologists and Osteoporosis Canada (CAROC) tool or the World Health Organization’s Fracture Risk Assessment (FRAX) tool with a prior fragility fracture; or
• High 10-year fracture risk (≥ 20%) as defined by the CAROC or FRAX tool

1. NS Formulary [3-22] 
2. Criteria for Exception Status Coverage [3-22]

ProVital Program: Access Here

120 mg / 1.7 ml Sol

02368153

Exception status applies^1,2: Form

Eligibility^1,2:

• As a single agent for the prevention of skeletal related events (SREs) for mCRPC patients with:
  • ≥ 1 documented bone metastases
  • ECOG PS 0-2

1. NS Formulary [3-22] 
2. Criteria for Exception Status Coverage [3-22]

The VICTORY Program: Access Here

40 mg Cap

02407329

Exception status applies1,2: Form

Eligibility1,2,:

• Patients with mCRPC

Clinical Notes1,2:

• Patients should have a good performance status and no risk factors for seizures
• Treatment should be discontinued upon disease progression or unacceptable toxicity

Claim Notes1,2:

• Requests for enzalutamide will not be considered for patients who experience disease progression on apalutamide

1. NS Formulary [3-22] 
2. Criteria for Exception Status Coverage [3-22]

Xtandi Patient Assistance Program (XPAP): 

Patient Enrolment and Consent Form (English) 

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

40 mg Cap

02407329

Exception status applies1,2: Form

Eligibility1,2:

• In combination with ADT for the treatment of patients with nmCRPC who are at high risk of developing metastases (defined as a PSADT of ≤ 10 months during continuous ADT)
• Patients should have a good performance status and no risk factors for seizures
• Treatment should continue until unacceptable toxicity or radiographic disease progression

Clinical Notes1,2:

• Castration-resistance must be demonstrated during continuous ADT and is defined as 3 PSA rises ≥ 1week apart, with the last PSA > 2 ng/mL
• Castrate levels of testosterone must be maintained
• Patients with N1 disease, pelvic lymph nodes < 2cm in short axis located below the common iliac vessels are eligible for enzalutamide

Claim Notes1,2:

• Enzalutamide will not be funded for patients who experience disease progression on apalutamide
• Patients receiving enzalutamide for the treatment of nmCRPC will be eligible for funding of abiraterone at the time of disease progression to mCRPC

1. NS Formulary [3-22] 
2. Criteria for Exception Status Coverage [3-22]

Xtandi Patient Assistance Program (XPAP): 

Patient Enrolment and Consent Form (English) 

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

40 mg Cap

02407329

Exception status applies1,2: Form

Eligibility1,2:

• In combination with ADT for the treatment of patients with mCSPC

• Patients must have had either no prior ADT or are within six months of beginning ADT in the metastatic setting

Clinical Notes1,2:

• Patients should have a good performance status and no risk factors for seizures
• Treatment should continue until unacceptable toxicity or disease progression

Claim Notes1,2:

• Patients receiving enzalutamide for the treatment of mCSPC will be eligible for funding of abiraterone at the time of disease progression to mCRPC

1. NS Formulary [3-22] 
2. Criteria for Exception Status Coverage [3-22]

Xtandi Patient Assistance Program (XPAP): 

Patient Enrolment and Consent Form (English) 

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

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: Acess Here

100 mg tab | 150 mg tab

100mg: 02475200 | 150mg: 02475219

For the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC) with deleterious or suspected deleterious germline and/or somatic mutations in the homologous recombination repair (HRR) genes BRCA1, BRCA2 or ATM and who have progressed on prior treatment with androgen-receptor-axis-targeted (ARAT) therapy.

Clinical Note: Patients should have a good performance status and treatment should be continued until disease progression or unacceptable toxicity. 

Nova Scotia Formulary

AstraZeneca Patient Support Program: Access Here
AstraZeneca Patient Assistance Program: Access Here