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ALENDRONATE 10MG TABLET 02201011 02247373 02248728 02270129 02288087

FOSAMAX NOVO-ALENDRONATE APO-ALENDRONATE GEN-ALENDRONATE SANDOZ ALENDRONATE

70MG TABLET 02245329 02248730 02258110 02261715 02275279 02284006 02288109 02286335

FOSAMAX APO-ALENDRONATE CO-ALENDRONATE NOVO-ALENDRONATE RATIO-ALENDRONATE PMS-ALENDRONATE-FC SANDOZ ALENDRONATE GEN-ALENDRONATE

MSD NOP APX GPM SDZ

MSD APX COB NOP RPH PMS SDZ GPM

RISEDRONATE 5MG TABLET 02242518

ACTONEL

35MG TABLET 02246896

ACTONEL

PGA

PGA

The criteria for coverage of both Alendronate and Risedronate are as follows:

  • 1.

    For the treatment of osteoporosis in patients with a documented fragility fracture.

  • 2.

    For use in patients without documented fracture but with a high 10-year fracture risk (see fracture risk tables). A copy of the bone density report, including the T-score, supporting the diagnosis must accompany the Special Authorization.

3.

For prophylaxis of corticosteroid induced osteoporosis in patients who will be or have been on systemic corticosteroid therapy for $ 3 months.

CALCITONIN (SALMON SYNTHETIC)

200IU/DOSE NASAL SPRAY

02240775

MIACALCIN

02247585

APO-CALCITONIN

02261766

SANDOZ CALCITONIN NS

NVR APX SDZ

  • 1.

    For the treatment of osteoporosis in patients with a documented fragility fracture and when etidronate, alendronate and risedronate are not tolerated or are contraindicated.

  • 2.

    For use in patients without documented fracture but with a high 10-year fracture risk (see fracture risk tables) and when etidronate, alendronate and risedronate are not tolerated or are contraindicated. A copy of the bone density report, including the T-score, supporting the diagnosis must accompany the Special Authorization.

3.

For the short term (up to 3 months) treatment of pain associated with osteoporotic fragility fractures, bone metastases, or pathological fractures. A copy of the radiological or specialist report supporting the diagnosis must accompany the Special Authorization.

PEI Drug Programs Update - Issue 09-01- Page 6

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