Drugs With Special Ordering Procedures (SAP Chart)

1 Drugs with Special Ordering Procedures (SAP chart ) drug Supplier BCCA Requirements Ordering Procedures Abiraterone Janssen Ortho tel: 416-382-5078 or 416-805-4648 CAP approval See Patient Assistance Programs Now marketed Alemtuzumab (MABCAMPATH ) Genzyme Phone: 905-267-3184 Distributed through the MabCampath Distribution Program which is managed by the Clinigen Group Phone : +44 1283 494340 Fax: +44 1283 494341 Email: Contact Clnigen Group to open an account company will send a Cliniport registration form Complete Cliniport Registration form with an email address for authorizing physician(s) and pharmacist(s)

2 Placing the order via Cliniport and fax back to +44 1283 494341 Once registered, company will send guidance on using the Cliniport portal for Ordering , tracking orders, reassigning vials, and closing out patients records Reports detailing all shipments and current status of Campath can be downloaded through the Cliniport portal 05 Sep 2018 1/15 Drugs with Special Ordering Procedures (SAP chart ) drug Supplier BCCA Requirements Ordering Procedures Amifostine - SAP (ETHYOL ) Not marketed in Canada, try SAP US company: Medimmune phone: 800-949-3789 email: (NB: this company will not provide the drug to Canadian patients) International distributer: Pinnacle David Young: phone: 866-248-2039 email.

3 Pinnacle has agreed to work with their French distributor Bioprojet Pharma to provide the drug to Canadian patients through the Health Canada Special Access Programme (SAP) HNOTAMIRT or CAP Health Canada Special Access Request Form A Atezolizumab (TECENTRIQ ) Hoffmann-La Roche Not currently funded by BCCA. See Patient Assistance Programs Now marketed. 05 Sep 2018 2/15 Drugs with Special Ordering Procedures (SAP chart ) drug Supplier BCCA Requirements Ordering Procedures Avelumab SAP (Bavencio ) EMD Serono A Business of Merck KGaA, Darmstadt, Germany EMD Inc.

4 , Canada | 200-2695 North Sheridan Way | Mississauga, Ontario L5K 2N6 | Canada Phone: +1 905 919 0200 ext. 5534 | Mobile: +1 416-729-3254 | Fax: +1 905 919 0299 CAP approval (no cost) Health Canada Special Access Request Form A drug provided free of charge by company, physicians can submit their requests via company s online portal: Azacitidine - (VIDAZA ) Celgene: 1-888-712-2353 ext 4807 CAP approval Now marketed Aztreonam - SAP (AZACTAM ) Bristol-Myers 1-514-333-2037 For inpatients only.

5 Health Canada Special Access Request Form A Bazedoxifene SAP (CONBRIZA) Martina Vlahakis Pfizer Canada Tel: 514-695-0500 or 877-633-2001 CAP approval (no cost) Health Canada Special Access Request Form A Belinostat SAP (Beleodaq ) Servier Canada Tel: 450-978-0409 #4381 CAP approval (no cost) Health Canada Special Access Request Form A Bexarotene - SAP (TARGRETIN ) Valeant Pharmaceuticals Phone: 1-800-361-4261 Email: CAP approval (cost) Health Canada Special Access Request Form A Brigatinib (ALUNBRIG ) Takeda Canada 1-844-884-4968 Not funded by BCCA Now marketed Contact the Patient Assistance Program Tel: 844-884-4968 05 Sep 2018 3/15 Drugs with Special Ordering Procedures (SAP chart ) drug Supplier BCCA Requirements Ordering Procedures Cabozantinib - SAP (Cometriq ) Ipsen Canada 5060 Spectrum Way, suite 502 MISSISSAUGA, Ontario L4W 5N5 T.

6 +1 (905)-238-5423 CAP approval (no cost) Health Canada Special Access Request Form A drug provided free of charge by company. Canakinumab (IDARIA ) Novartis Not funded by BCCA Contact the Patient Assistance Program EXPOSE 1-844-279-7673 Carbidopa SAP Merke-Frosst tel: 1-800-361-7031 x3212 N/A Now marketed Carfilzomib (Kyprolis ) Amgen Not currently funded by BCCA Now marketed - Contact the Victory Program (1-888-706-4717) for drug access and private infusion clinic Carmustine Heritage Pharmaceuticals Inc 732-429-1000 local 132 Now marketed Carmustine Implant (GLIADEL Wafers) - SAP Eisai Limited Company contact Alex Flint Medical Director Phone: 647-299-2983 or 905-361-7137 Email.

7 Distributor Idis/Clinigen CAP approval (cost) Health Canada Special Access Request Form A Chloroprocaine - SAP (NESACAINE ) Fresenius Kabi Tel: 905-238-1234 email: N/A Health Canada Special Access Request Form A 05 Sep 2018 4/15 Drugs with Special Ordering Procedures (SAP chart ) drug Supplier BCCA Requirements Ordering Procedures Cisplatin, lyophilized powder, SAP (PLATINOL ) Bristol-Myers Squibb tel: 514-333-2287 CAP approval Health Canada Special Access Form A Clofarabine SAP (Evoltra ) SAP supply from UK during back order period in Canada Sanofi Genzyme Canada Tel: 1-800-265-7927 Health Canada Special Access Request Form A drug provided free of charge by company.

8 Cytarabine Hospira tel: 1-866-488-6088 No longer on back order. Cytarabine liposome injection - SAP (DEPOCYT ) sigma-tau Rare dedication Support Centre US tel: 1-888-276-2217 fax: 1-866-489-1898 CAP approval (cost) Discontinued by manufacturer (May 2018) Health Canada Special Access Request Form A htt Daratumumab (DARAZALEX ) Janssen Not currently funced by BCCA (cost) See Patient Assistance Programs Now Marketed Daunorubicin liposomal - SAP Please see DaunoXome - SAP DaunoXome - SAP (liposomal daunorubicin) GALEN PHARMA (UK) Phone.

9 02838334974 Email: CAP approval Health Canada Special Access Request Form A 05 Sep 2018 5/15 Drugs with Special Ordering Procedures (SAP chart ) drug Supplier BCCA Requirements Ordering Procedures Decitabine SAP (DACOGEN ) Eisai Arlene Nugent phone: 647-302-2947 email: CAP approval Health Canada Special Access Request Form A Denileukin Diftiox - SAP (ONTAK ) Ligand Pharmaceuticals 1-508-435-8484 x 353 CAP approval Health Canada Special Access Request Form A Dexrazoxane (ZINECARD ) Pfizer tel: 1-800-387-4974 CAP approval No longer on back order Diazoxide SAP (Proglycem ) Teva Pharmaceuticals Sellerville, PA, USA 18960 Phone.

10 305-575-6284 CAP approval Health Canada Special Access Request Form A Doxorubicin non-pegylated liposomal Please see MYOCET Eltrombopag Glaxo See Patient Assistance Programs Not funded by BCCA. Erwinase l-asparaginase - SAP (ERWINASE ) CGF Pharmatech 1-866-343-0344 (cost) Health Canada Special Access Request Form A Etomidate SAP (AMIDATE ) Hospira tel: 514-905-2619 Health Canada Special Access Request Form B (for future use) Etoposide phosphate - SAP (ETOPOPHOS ) Bristol Myers Squibb Tel.