Limited coverage criteria – deferasirox
Last updated on March 3, 2025
Return to Special Authority drug list
Generic name |
deferasirox |
Strength & form |
Tablet, dispersible: 125 mg, 250 mg, 500 mg Tablet, oral: 90 mg, 180 mg, 360 mg |
Special Authority criteria |
Approval period |
|
Treatment of transfusion-dependent conditions where iron chelation therapy is required, according to established criteria*, and when a Special Authority request is submitted by a hematologist. |
Initial request: 1 year |
Practitioner exemptions
- None
Special notes
- None
Special Authority request form(s)
* Click on the Special Authority Form below for full criteria: