Province: Manitoba
Indication: rheumatoid arthritis
Medication: certolizumab pegol (Cimzia®)
Listing Status: Listed—CBC
Listing Criteria:
Dosing form/strength: 200 mg/mL, injection; 200 mg/mL, autoinjector
For the treatment of patients over 18 years of age who have moderate to severe rheumatoid arthritis, who have failed treatment with at least three (3) DMARD therapies, one of which is methotrexate and/or leflunomide unless intolerance or contraindications to these agents is documented. One combination therapy of DMARDs must also be tried. Initial application information should include information on disease activity such as the number of tender joints, swollen joints, erythrocyte sedimentation rate and C-reactive protein value.
Request for coverage must be made by a physician who is a specialist in rheumatology.
Tiered Biologics Reimbursement Policy
Effective August 15, 2018
- Effective August 15, 2018, Manitoba Health, Seniors and Active Living will be implementing a Tiered Biologics Reimbursement Policy.
- This Policy will ONLY apply to New Patients (biologic naïve) and Existing Patients that have previously been trialed and deemed unresponsive to biologic therapy as follows:
- New Patients (biologic-naïve);
- Select product from Tier 1 → Fail → Select second product from Tier 1 → Fail → Select any agent (Tier 1 or Tier 2)
- Existing Patients (ONLY those that have previously been trialed and deemed unresponsive to biologic therapy)
- Currently on Tier 1* product → Fail → Select second product from Tier 1 → Fail → Select any agent (Tier 1 or Tier 2)
- Currently on Tier 2** product → Fail → Select product from Tier 1 → Fail → Select second product from Tier 1 → Fail → Select any agent (Tier 1 or Tier 2)
**NOTE: Patients will not be permitted to switch from Remicade or Enbrel to another infliximab or etanercept product listed in Tier 1 if previously trialed and deemed unresponsive to therapy.
Please click here to read the details of the Tiered Biologics Reimbursement Policy on Bulletin #100.