PRINCE EDWARD ISLAND
FIRAZYR is covered by Prince Edward Island Pharmacare (Special Authorization)
Eligibility
For FIRAZYR to be eligible for coverage by PEI Pharmacare, prescribers must submit a request for Special Authorization and approval must be in place before the patient fills the prescription. Patients must also apply for coverage by the High Cost Drug Program. 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 Prince Edward Island for your hereditary angioedema (HAE) patients who meet the following criteria:
For the treatment of acute attacks of HAE in adults with lab confirmed C1-esterase inhibitor deficiency (type I or type II) if the following conditions are met:
- Treatment of non-laryngeal attacks of at least moderate severity, OR
- Treatment of acute laryngeal attacks
Limited to a single dose for self-administration per attack AND prescribed by physicians with experience in the treatment of HAE.
Program Eligibility:
- High Cost Drug Program
- May be considered for the Catastrophic Drug Program†
OnePath® Patient Support Program will help navigate insurance coverage and access reimbursement to medication through private and public insurance companies.
† A Catastrophic Drug Program request form is required to be considered for coverage under this program. This form is available at
https://www.princeedwardisland.ca/sites/default/files/forms/catastrophic_drug_program_application_form.pdf
Source: PEI Pharmacare Formulary. March 2022.
https://www.princeedwardisland.ca/sites/default/files/publications/pei_pharmacare_formulary.pdf