NORTHWEST TERRITORIES

FIRAZYR is covered by the Government of Northwest Territories Health Benefits Program (Limited Use)

Eligibility

For FIRAZYR to be eligible for coverage by the Government of Northwest Territories Health Benefits Program, prescribers must submit an Extended Health Benefit Specified Disease Conditions Program Application. For more information concerning the reimbursement process, contact OnePath®.

Reimbursement Criteria

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

For the treatment of acute attacks of hereditary angioedema (HAE) in adults with lab confirmed C1-esterase inhibitor deficiency (type I or type II); and

  • treatment of acute non-laryngeal attacks of at least moderate severity; or
  • treatment of acute laryngeal attacks; and
  • is prescribed by physician with experience in the treatment of HAE.

Note: Limited to two (2) doses of prefilled syringes per dispense.

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

Find Out More

Source:

  1. Government of Northwest Territories Health Benefits Program. January 13, 2021.
  2. Government of Northwest Territories. Applying for the Extended Health Benefits for Specified Disease Conditions Program.
    https://www.hss.gov.nt.ca/en/services/applying-extended-health-benefits-specified-disease-conditions-program