Exceptional Access Program (EAP)

EAP forms are to be completed when applying for MOH funding for drugs for rheumatological diseases through Ontario’s Exceptional Access Program (EAP).

Digital Ulcers

Criteria

Sildenafil

Brand(s)

  • Revatio and generics
  • Viagra and generics

Dosage Form/Strength

  • Revatio versions: 20 mg
  • Viagra versions: 25 mg, 50 mg, 100 mg

Effective Date

  • September 9, 2022

Indications for Treatment

For the treatment of severe Raynaud’s phenomenon (RP) and/or digital ulcers secondary to scleroderma (systemic sclerosis) or scleroderma-like disease:

  • After failure of at least one calcium channel blocker (CCB) OR without trial of a CCB in a patient who has experienced an emergency situation such as threatened ischemic digit(s) requiring hospitalization.
  • Must be prescribed by a specialist (i.e., rheumatologist, general internist, vascular surgeon).

Duration of Approval

  • Initial Approval: 6 months
  • Renewals:
    • Duration of Renewals: 1 year
    • Consideration: Renewals will be considered on a case-by-case basis for patients who demonstrate benefit from treatment (e.g., positive response in the duration, frequency, and/or severity of RP and/or improvement in the size or number of digital ulcers).

Renewal Criteria

  • Case-by-Case Basis: Renewals are considered for patients who demonstrate benefit from treatment, such as:
    • Positive response in the duration, frequency, and/or severity of Raynaud’s phenomenon (RP).
    • Improvement in the size or number of digital ulcers.
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