NOVA SCOTIA
TAKHZYRO is covered by the Nova Scotia Formulary (Exception Status Benefit Program)
Eligibility
For TAKHZYRO to be eligible for coverage by the Nova Scotia Formulary, prescribers must submit a request 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 TAKHZYRO (lanadelumab injection) is reimbursed in Nova Scotia for your hereditary angioedema (HAE) patients who meet the following criteria:
For the routine prevention of attacks of HAE Type I or II in patients 12 years of age and older who have experienced at least three HAE attacks within any four-week period and required the use of an acute injectable treatment.
Discontinuation criteria
- No reduction in the number of HAE attacks for which acute injectable treatment was received during the first three months of treatment with lanadelumab compared to the number of attacks observed before initiating treatment with lanadelumab.
OR - Increase in the number of HAE attacks for which acute injectable treatment was received compared to the number of attacks before initiating treatment with lanadelumab.
Clinical note
- The pre-treatment attack rate must be provided for those patients who are already receiving long-term prophylactic treatment for HAE and intend to transition to lanadelumab.
Claim notes
- Must be prescribed by a physician experienced in the diagnosis and treatment of HAE.
- Combination use of TAKHZYRO (lanadelumab) with other long-term prophylactic treatment of HAE (e.g., C1 esterase inhibitor) will not be funded.
- Approvals will be for a maximum of 300 mg every two weeks.
- Initial approval period: 3 months.
- Renewal approval period: 6 months.
- Claims for TAKHZYRO 300 mg/2 mL pre-filled syringe that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate transactions using the DIN first and then the following PINs:
- TAKHZYRO 300 mg/2 mL pre‑filled syringe
- 00904638
- 00904639
- TAKHZYRO 300 mg/2 mL pre‑filled syringe
