Codes / Indications RAMQ

EN23

When a sulfonylurea is not tolerated or ineffective.

  • Amaryl®

EN167

For the treatment of people with type 2 diabetes:
- As monotherapy when metformin and a sulfonylurea are contraindicated or not tolerated.

  • Invokana®
  • Januvia®
  • Jardiance®
  • Nesina®
  • Trajenta®

EN148

For the treatment of people with type 2 diabetes:
- In combination with metformin, when a sulfonylurea is contraindicated, not tolerated or ineffective.

  • Invokana®
  • Onglyza®
  • Januvia®
  • Jardiance®
  • Nesina®
  • Forxiga®

EN149

For the treatment of people with type 2 diabetes:
- In combination with a sulfonylurea, when metformin is contraindicated, not tolerated or ineffective.

  • Invokana®
  • Onglyza®
  • Nesina®
  • Forxiga®

EN150

For the treatment of people with type 2 diabetes:
When a sulfonylurea is contraindicated, not tolerated or ineffective; AND
- When the daily doses of metformin have been stable for at least a month.

  • Janumet®
  • Janumet®XR
  • Komboglyze®
  • JentaduetoTM
  • KazanoTM
  • Xigduo®

EN179

For the treatment of type 2 diabetes, in combination with one or more antidiabetic agents, in persons with a history of atherosclerotic heart disease (ASIC) or atherosclerotic vascular disease (ASK) and whose glycated hemoglobin (HbA1c) is ≥ 7%.

The nature of atherosclerotic heart disease (MCAS) or atherosclerotic vascular disease (MVAS) should be provided upon request by the Régie.

  • Jardiance®

EN219

For the treatment of people with type 2 diabetes whose optimal maximum dose of metformin has been stable for at least one month.
Individuals must also meet the requirements of the recognized indication for the payment of empagliflozin.

  • SynjardyTM

Endocrinology (2020-03-04) (FR) Complete List (2020-03-04) (FR)

Cost

Cost price per molecule

NIHB Canada (Non-Insured Health Benefits)

Drug Benefit List

Patient Exception

Form

Form

Reimbursement
(exception drugs)

Ozempic®

For the treatment of people with type 2 diabetes:

  • In combination with metformin, for the treatment of people with type 2 diabetes.
  • When a sulfonylurea is contraindicated, not tolerated or ineffective.
  • Authorization is given for a maximum weekly dose of 1mg.
  • Inefficacy means non-achievement of an HbA1c value tailored to the patient.

To note:

  • Unlike other GLP-1RA (Victoza and Trulicity), your patients do not need to have tried an iDPP4 or have a BMI > 30 to start treatment.
  • Both doses (0.5mg and 1mg) are reimbursed.


Victoza®

For the treatment of people with type 2 diabetes:

  • In combination with metformin, for the treatment of people with type 2 diabetes with inadequate glycemic control and with a body mass index (BMI) above 30 kg/m2.
  • When a DPP-4 inhibitor is contraindicated, not tolerated or ineffective.
  • The maximum duration of each authorization is 12 months.
  • At the time of the first request to extend treatment, the physician is required to provide proof of benefit through a glycosylated hemoglobin (HbA1c) reduction of at least 0.5% or through the achievement of a target value of 7% or less.
  • Authorization is given for a maximum daily dose of 1.8 mg.
  • Inefficacy means non-achievement of an HbA1c value tailored to the patient.

Trulicity®

For the treatment of people with type 2 diabetes:

  • In combination with metformin, for the treatment of people with type 2 diabetes with inadequate glycemic control and with a body mass index (BMI) above 30 kg/m2.
  • When a DPP-4 inhibitor is contraindicated, not tolerated or ineffective.
  • The maximum duration of each authorization is 12 months.
  • At the time of the first request to extend treatment, the physician is required to provide proof of benefit through a glycosylated hemoglobin (HbA1c) reduction of at least 0.5% or through the achievement of a target value of 7% or less.
  • Authorization is given for a maximum daily dose of 1.5 mg.
  • Inefficacy means non-achievement of an HbA1c value tailored to the patient.

BasaglarMC / Levemir® / Toujeo® / Tresiba®

For the treatment of diabetes when a prior trial with intermediate-acting insulin did not adequately control the glycemic profile without causing an episode of serious hypoglycemia or frequent episodes of hypoglycemia.


Degludec U100 et U200
Tresiba®
Detemir
Levemir®
Dulaglutide
Trulicity®
Glargine
BasaglarTM
Glargine U300
Toujeo®
Liraglutide
Victoza®
Semaglutide
Ozempic®

Strips

Reimbursement and Coding (FR) Update 2017 (2017-11-15) (FR)

Freestyle LibreTM

Autorisation of payment formulary RAMQ Eligibilty criteria et renewal

2020-04-04

CLASSES - GLP-1R


2020-03-09

Digital Applications


2020-03-04

Classes + Insulin

  • New indications for Fiasp® and Victoza® see product monograph Fiasp® / Victoza®

Coverage


2020-03-01

Classes


2020-02-09

Classes + Insulin

  • Adding of clinical trials

2020-01-15

Videos / Visual Tools / Applications


2019-12-26

Consultant

  • Jessie Haggai
    Proprietary Pharmacist - Diabetes Educator
    (see Contact us tab)

    Ms. Haggai joins the team as a consultant.

2019-12-25

Classes + Insulin


2019-12-21

Coverage


2019-11-30

Coverage

  • RAMQ Codes update (PDF)

2019-11-26

Classes + Insulin

  • The product monograph is now available

2019-11-16

Video


2019-11-14

GLP-1RA / Coverage


2019-11-10

Ressources


2019-11-03

Blood Glucose Monitoring


2019-10-27

Drug and Renal Function

Blood Glucose Monitoring

  • Freestyle LibreTM now working on Android


2019-10-10

Resources

Education

  • Nasal Glucagon BaqsimiTM - Health Canada Approval September 25 th
  • Nasal Glucagon BaqsimiTM - Information
  • Nasal Glucagon BaqsimiTM - Monograph

2019-10-03

Resources


2019-09-15

Blood Glucose Monitoring


2019-09-02

Education / Hypoglycemia / Glucagon


2019-08-15

Coverage

  • Glargine U300 Toujeo® now covered by the Quebec Health Insurance Board (RAMQ) according to certain criteria

2019-08-04

Blood Glucose Monitoring

  • Update of the Intercative Guide
  • Update of the Comparison Charts (PDF)

2019-07-19

Coverage

  • The FreeStyle LibreTM glucose monitoring flash system is now covered by the Quebec Health Insurance Board (RAMQ) according to certain criteria (see Coverage or Blood Glucose Monitoring tab)
  • RAMQ Codes update (PDF)

2019-06-20

GLP-1RA

  • Semaglutide Ozempic®
    New 4 mg flextouch maintenance pen. The 2 mg pen for the maintenance dose is no longer available

2019-05-31

Coverage

  • RAMQ Codes update (PDF)

2019-04-30

Drug and Renal Function

  • Update of the Renal Function Adjustment Chart

2019-04-11

Coverage

  • RAMQ Codes update (PDF)

2019-03-20

Blood Glucose Monitoring

  • New - Tab now completed

2019-03-07

Coverage

  • RAMQ Codes update (PDF)

2019-02-01

Coverage

  • RAMQ Codes update (PDF)

2018-12-19

Coverage

  • RAMQ Codes update (PDF)
  • SynjardyTM now code EN219

2018-11-23

Coverage

  • RAMQ Codes update (PDF)
  • Xigduo® and SynjardyTM now code EN150

2018-10-20

SGLT2

  • Adding - Ertugliflozin SteglatroTM
  • Adding - Ertugliflozin and Metformin SeglurometTM
  • Adding - Ertugliflozin and Sitagliptin SteglujanTM

Drug and Renal Function

  • New Chart Adjustment of the Medication with Renal Insufficiency

2018-10-01

Full update of the application

New

  • Addition of a search function
  • Overall improvement of performance and stability
  • Available soon for all Canadian provinces (in English only)

2018-09-27

Coverage

  • RAMQ Codes update (PDF) - Jardiance® now three codes EN148 - EN167 and EN179
  • Xigduo® and SynjardyTM now code EN199
  • Trajenta® now code EN148 and EN167
  • Degludec U100 and U200 now exception drugs (form)

2018-06-23

GLP-1RA

  • New document - Titration Protocol (Victoza® - Ozempic®- Trulicity® - AdlyxineTM)

2018-06-14

Drug and Renal Function

  • Update of the Renal Function Adjustment Chart

2018-05-26

Coverage

  • RAMQ Codes update (PDF) - Invokana® now three codes EN148, EN149 and EN167

2018-04-25

Lifestyle

  • New document - Meal and Physical Activity Log (PDF)

Insulin

  • New document - Basal Insulin Adjustments (PDF)

2018-04-15

Diabetes Canada

  • New Diabetes Canadian Guidelines as April 9, 2018

Drug and Renal function

  • New Chart Adjustment of the Medication with Renal Insufficiency

Classes

  • New Vascular Protection Data for SGLT2 and GLP-1RA classes