ALBERTA

FIRAZYR is covered by Alberta Health (Special Authorization)

Eligibility

For FIRAZYR to be eligible for coverage by Alberta Health, prescribers must submit a request for Special Authorization and approval must be granted before the patient fills the prescription. Deductibles may apply. For more information concerning the reimbursement process, contact OnePath®.

Reimbursement Criteria

We are pleased to inform you that FIRAZYR (icatibant acetate) is reimbursed in Alberta for your hereditary angioedema (HAE) patients who meet the following criteria:

For the treatment of acute attacks of confirmed type I or type II HAE in patients with C1-esterase inhibitor deficiency. Icatibant is to be used for:

  • Acute non-laryngeal attack(s) of at least moderate severity, OR
  • Acute laryngeal attack(s) of any severity

This medication must be prescribed by, or in consultation with, a physician experienced in the treatment of HAE.

Special Authorization may be granted for 12 months.

Patients will be limited to a maximum of two doses of icatibant per prescription at their pharmacy.

This product is eligible for auto-renewal.

OnePath® Patient Support Program will help navigate insurance coverage and access reimbursement to medication through private and public insurance companies.

Source: Alberta Health Drug Benefit List. April 2021.
https://www.ab.bluecross.ca/dbl/pdfs/dbl_full_list.pdf