Interactive Drug Benefit List
DIN/NPN/PIN 02244265 CANCIDAS 50 MG / VIAL INJECTION CASPOFUNGIN
080000 ANTI-INFECTIVE AGENTS
081400 ANTIFUNGALS
081416 ECHINOCANDINS
Date Listed/Coverage Update: 01-Feb-2017
Unit Price: 222.0000
LCA Price: 188.7000
MAC Price:

N/A

Unit of Issue: Vial
Manufacturer: MERCK CANADA INC. (MFC)
ATC: J02AX04
1
Interchangeable Products: Yes

Coverage Status: RESTRICTED BENEFIT/ SPECIAL AUTHORIZATION
Applies to Clients of: Non-Group Coverage (Group 1)
Coverage for Seniors (Group 66)
Palliative Coverage (Group 20514, Please note your client may have Group 1 or Group 66 coverage)
Child and Family Services (Group 20403)
Alberta Child Health Benefit (Group 20400)
Children and Youth Services (Group 19824)
Income Support (Group 19823)
Alberta Human Services (AISH) (Group 19823)
Alberta Adult Health Benefit (AAHB) (Group 23609)

Special Authorization Request Form:

Drug Special Authorization Request Form (ABC 60015)

RESTRICTED BENEFIT

This product is a benefit when prescribed by a Specialist in Infectious Diseases or a designated prescriber.

(Refer to Section 3 - Criteria for Special Authorization of Select Drug Products of the Alberta Drug Benefit List for eligibility when the prescriber prescribing the medication is not a Specialist in Infectious Diseases or a designated prescriber.)


SPECIAL AUTHORIZATION

(Refer to Section 1 - Restricted Benefits of the Alberta Drug Benefit List for coverage of the product when prescribed by a Specialist in Infectious Diseases or a designated prescriber.)

"For treatment of esophageal candidiasis in patients who are resistant or intolerant to fluconazole or itraconazole.

For treatment of invasive candidiasis resistant or intolerant to fluconazole.

For treatment of Invasive Aspergillosis in patients who are refractory to or intolerant of other therapies."*

*Special Authorization is only required when the prescriber prescribing the medication is not a Specialist in Infectious Diseases or a designated prescriber.

Review Status / Past Decisions

Indication Reviewing
Body
Submission
Completion
Date
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
CDR
Recommendation
Review
Status
N/A Expert Committee 2016/11/24 2018/03/01 Restricted Benefit/Special Authorization Criteria Change
N/A Expert Committee 2016/11/24 2017/02/01 Change to Restricted Benefit/Special Authorization
N/A Expert Committee 2016/11/24 2018/03/01 Restricted Benefit/Special Authorization Criteria Change
N/A Expert Committee 2016/11/24 2017/02/01 Change to Restricted Benefit/Special Authorization
N/A Expert Committee 2005/08/10 2006/01/01 No Special Authorization Criteria Change
N/A Expert Committee 2005/08/10 2006/01/01 No Special Authorization Criteria Change
N/A Expert Committee 2004/02/19 2005/04/01 Special Authorization
N/A Expert Committee 2004/02/19 2005/01/01 Under Review
N/A Expert Committee 2004/02/19 2005/04/01 Special Authorization
N/A Expert Committee 2004/02/19 2005/01/01 Under Review
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2016/11/24
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2018/03/01
CDR
Recommendation
Review
Status
Restricted Benefit/Special Authorization Criteria Change
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2016/11/24
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2017/02/01
CDR
Recommendation
Review
Status
Change to Restricted Benefit/Special Authorization
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2016/11/24
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2018/03/01
CDR
Recommendation
Review
Status
Restricted Benefit/Special Authorization Criteria Change
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2016/11/24
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2017/02/01
CDR
Recommendation
Review
Status
Change to Restricted Benefit/Special Authorization
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2005/08/10
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2006/01/01
CDR
Recommendation
Review
Status
No Special Authorization Criteria Change
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2005/08/10
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2006/01/01
CDR
Recommendation
Review
Status
No Special Authorization Criteria Change
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2004/02/19
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2005/04/01
CDR
Recommendation
Review
Status
Special Authorization
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2004/02/19
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2005/01/01
CDR
Recommendation
Review
Status
Under Review
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2004/02/19
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2005/04/01
CDR
Recommendation
Review
Status
Special Authorization
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2004/02/19
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2005/01/01
CDR
Recommendation
Review
Status
Under Review
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