Drug Access Listing

250 mg Tab, 500 mg Tab

Multiple¹

Exceptional Drug Status (EDS) Benefits – Part 3 Benefits: will be considered for Pharmacare reimbursement upon an individual prescriber/patient request basis²

Eligibility²:

For patients with histologically confirmed mCRPC with disease progression after prior ADT or with disease progression after prior chemotherapy with docetaxel

1. Manitoba Drug Interchangeability Formulary [2-22] 
2. MB Drug Benefits Bulletin 111 [11-21]

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

Multiple¹

Exceptional Drug Status (EDS) Benefits – Part 3 Benefits: will be considered for Pharmacare reimbursement upon an individual prescriber/patient request basis¹

Eligibility¹:

• Abiraterone and prednisone in combination with ADT for mCSPC

• Good performance status
• Must be castration-sensitive (ie, no prior ADT for mCSPC or within 6 months of beginning ADT)
• Treatment is continued until disease progression or unacceptable toxicity

1. MB Drug Benefits Bulletin 114 [11-21]

​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

10 mg Tab, 70 mg Tab

Multiple¹

Part 1 Benefit – no therapeutic criteria attached to the benefit¹

1. MB Drug Benefits Formulary [3-22]

-

Tablet, PO, 60mg, 240mg

02478374

Exceptional Drug Status (EDS) Benefits – Part 3 Benefits: will be considered for Pharmacare reimbursement upon an individual prescriber/patient request basis1

Eligibility1:

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

**60 mg tablet funded, 204 mg table pending provincial funding decision.

1. MB Drugs Benefit Bulletin 106 [3-20]

Janssen BioAdvance Patient Assistance Program: Access Here

Tablet, PO, 60mg, 240mg

02478374

Exceptional Drug Status (EDS) Benefits – Part 3 Benefits: will be considered for Pharmacare reimbursement upon an individual prescriber/patient request basis1

Eligibility1:

• Apalutamide in combination with ADT for mCSPC
  • Must be castration sensitive (ie, no prior ADT or within 6 months of beginning ADT)
  • Good performance status
  • Treatment should be continued until unacceptable toxicity or disease progression

**60 mg tablet funded, 204 mg table pending provincial funding decision.

1. MB Drug Benefits Bulletin 114 [11-21]

Janssen BioAdvance Patient Assistance Program: Access Here

300 mg Tab

02496348

Exceptional Drug Status (EDS) Benefits – Part 3 Benefits: will be considered for Pharmacare reimbursement upon an individual prescriber/patient request basis1

Eligibility1:

• Darolutamide in combination with ADT for the treatment of patients with nmCRPC who are at high risk of developing metastases

• High risk is defined as PSADT ≤ 10 months during continuous ADT
• Castration-resistant according to the Prostate Cancer Working Group 2 (PCWG2) criteria which was used in the ARAMIS trial
• Absence of metastases was determined by a negative CT scan and negative bone scan
• Should have good performance status
• Treatment should continue until unacceptable toxicity or radiographic disease progression

1. MB Drug Benefits Bulletin 112 [8-21]

NUBEQA® DART Patient Support Program: 

Toll free:  

1-833-955-3278 

Fax: 

1-877-208-4393 

Email: 

info@dartsupport.ca 

300 mg Tab

02496348

Exceptional Drug Status (EDS) Benefits: Will be considered for Pharmacare reimbursement upon an individual prescriber/patient request basis

Criteria:

• In combination with docetaxel and androgen deprivation therapy (ADT) for the treatment of patients with metastatic castration-sensitive prostate cancer who are chemotherapy eligible and have a good performance status.
• Eligible patients must not have received prior treatment with an androgen receptor axis–targeted therapy, chemotherapy, or immunotherapy for prostate cancer and must not have received ADT in the metastatic setting for more than 6 months or within 1 year of completing adjuvant ADT in the non-metastatic setting.

MB Drug Benefits Bulletin 131

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

Exceptional Drug Status (EDS) Benefits – Part 3 Benefits: will be considered for Pharmacare reimbursement upon an individual prescriber/patient request basis¹

Eligibility:

• To increase bone mass in men with osteoporosis who are at a high risk for fracture or who have failed or are intolerant to other available osteoporosis therapy, where the following clinical criteria are met:

• High fracture risk defined as either:
  • moderate 10-year fracture risk (10% to 20%) as defined by either the CAROC tool or (FRAX) tool with a prior fragility fracture; OR
  • high 10-year fracture risk (≥ 20%) as defined by either the CAROC or FRAX
    AND
• Contraindication to oral bisphosphonates

Notes:

• Bisphosphonate failure will be defined as a fragility fracture and/or evidence of a decline in bone mineral density below pre-treatment baseline levels, despite adherence for one year
• Contraindication to oral bisphosphonates will be considered. Contraindications include renal impairment, hypersensitivity, and abnormalities of the esophagus (e.g., esophageal stricture or achalasia).

1. MB EDS [2-22]

ProVital Program: Access Here

120 mg Injection

02368153

Exceptional Drug Status (EDS) Benefits – Part 3 Benefits: will be considered for Pharmacare reimbursement upon an individual prescriber/patient request basis¹

• For the prevention of skeletal-related events (SREs) in patients with CRPC

• One or more documented bony metastases
• ECOG performance status 0-2

1. MB EDS [2-22]

The VICTORY Program: Access Here

40 mg Cap

02407329

Exceptional Drug Status (EDS) Benefits – Part 3 Benefits: will be considered for Pharmacare reimbursement upon an individual prescriber/patient request basis1

Eligibility:

• For the treatment of histologically confirmed mCRPC with disease progression after prior chemotherapy with docetaxel1
• For the treatment of histologically confirmed mCRPC with disease progression after prior ADT and no prior chemotherapy2

1. MB Drug Benefits Bulletin 77 [4-14] 
2. MB Drug Benefits Bulletin 85 [1-16]

Xtandi Patient Assistance Program (XPAP): 

Patient Enrolment and Consent Form (English) 

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

40 mg Cap

02407329

Exceptional Drug Status (EDS) Benefits – Part 3 Benefits: will be considered for Pharmacare reimbursement upon an individual prescriber/patient request basis1

Eligibility1:

• Enzalutamide in combination with ADT for patients with nmCRPC who are at high risk of developing metastases

• High risk is defined as PSADT ≤ 10 months during continuous ADT
• Should have good performance status
• No risk factors for seizures

• Treatment should continue until unacceptable toxicity or radiographic disease progression

1. MB Drug Benefit Bulletin 108 [7-20]

Xtandi Patient Assistance Program (XPAP): 

Patient Enrolment and Consent Form (English) 

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

40 mg Cap

02407329

Exceptional Drug Status (EDS) Benefits – Part 3 Benefits: will be considered for Pharmacare reimbursement upon an individual prescriber/patient request basis¹

Eligibility:

• Enzalutamide in combination with ADT for the treatment of mCSPC
  • Patients must be castration-sensitive (ie, no prior ADT in the metastatic setting or within 6 months of beginning ADT)
  • Should have good performance status
  • No risk for seizures
• Treatment should continue until unacceptable toxicity or radiographic disease progression

1. MB Drug Benefits Bulletin 114 [11-21]

Expedite^® Patient Assistance Program: Access Here

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

100 mg tab | 150 mg tab

100mg: 02475200 | 150mg: 02475219

• Listed on Manitoba List of Oral Oncology Drugs Dispensed at CCMB1
• Funding effective June 1, 2022 (Manitoba Drug Benefit Bulletin #118)2 : As monotherapy for the treatment of adult patients with metastatic castration-resistant prostate cancer (mCRPC) and deleterious or suspected deleterious germline and/or somatic mutations in the homologous recombination repair (HRR) genes BRCA or ATM who have progressed following prior treatment with a new hormonal agent/androgen receptor-axis-targeted therapy (ARAT).

1. MB Oral Onc Drugs [11-21] 
2. MB Bulletin Archive

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