Drug list
EYE, EAR, NOSE AND THROAT PREPARATIONS › OTHER EYE, EAR, NOSE AND THROAT AGENTS

AFLIBERCEPT (Eylea HD)

8mg/0.07mLInj Sol-0.07mL Pref SyrInj Sol-0.07mL Vial Pk
LU694
QUICK SCAN

For the treatment of patients with neovascular (wet) age-related macular degeneration (AMD) in a treatment-naive eye.

LU Authorization Period: 1 year
Complete Ontario criteria

For the treatment of patients with neovascular (wet) age-related macular degeneration (AMD) in a treatment-naive eye. Initial diagnosis should be confirmed by an appropriate diagnostic procedure and administration should be done by a qualified ophthalmologist experienced in intravitreal injections. Patients receiving concurrent administration of other anti-VEGF intravitreal injections are not eligible for reimbursement. Treatment with anti-VEGF agents should only be continued in patients who maintain adequate response to therapy. Coverage will be provided for patients responding to therapy with another anti-VEGF agent who switch to Eylea HD. Coverage will not be provided for patients who have failed to respond to other anti-VEGF agents. Recommended Dose: Treatment should be initiated with a monthly intravitreal injection for the first 3 consecutive doses, followed by one injection every 8 to 16 weeks.

LU695
QUICK SCAN

For the treatment of patients with clinically significant diabetic macular edema (DME) for whom laser photocoagulation is also indicated; and a hemoglobin A1c of less than 12 percent.

LU Authorization Period: 1 year
Complete Ontario criteria

For the treatment of patients with clinically significant diabetic macular edema (DME) for whom laser photocoagulation is also indicated; and a hemoglobin A1c of less than 12 percent. Patients receiving concurrent administration of other anti-VEGF intravitreal injections are not eligible for reimbursement. Treatment with anti-VEGF agents should only be continued in patients who maintain adequate response to therapy. Coverage will be provided for patients responding to therapy with another anti-VEGF agent who switch to Eylea HD. Coverage will not be provided for patients who have failed to respond to other anti-VEGF agents. Recommended Dose: Treatment should be initiated with a monthly intravitreal injection for the first 3 consecutive doses, followed by one injection every 8 to 16 weeks.

Clinical verification required

Quick summaries support scanning only. Confirm eligibility against the complete Ontario criteria and current Ontario e-Formulary before billing.

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