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This version of the form is not currently in use and is provided for reference only. Download this version of
Form HLTH5393
for the current year.
Form HLTH5393 Pharmacare Special Authority Request - Rituximab for Granulomatosis With Polyangiitis or Microscopic Polyangiitis - British Columbia, Canada
Form HLTH5393 Pharmacare Special Authority Request - Rituximab for Granulomatosis With Polyangiitis or Microscopic Polyangiitis is used in British Columbia, Canada to request special authority coverage for the medication Rituximab. This form is specifically for individuals diagnosed with Granulomatosis With Polyangiitis or Microscopic Polyangiitis who require this medication as a part of their treatment.
The form HLTH5393 for Pharmacare Special Authority Request for Rituximab for Granulomatosis with Polyangiitis or Microscopic Polyangiitis in British Columbia, Canada is usually filed by the patient or their healthcare provider.
FAQ
Q: What is HLTH5393?
A: HLTH5393 is a form for requesting special authority for the use of rituximab in the treatment of Granulomatosis with Polyangiitis or Microscopic Polyangiitis in British Columbia, Canada.
Q: What is Rituximab?
A: Rituximab is a medication used in the treatment of certain autoimmune diseases, including Granulomatosis with Polyangiitis and Microscopic Polyangiitis.
Q: What is Granulomatosis with Polyangiitis?
A: Granulomatosis with Polyangiitis is a rare autoimmune disease that causes inflammation of blood vessels.
Q: What is Microscopic Polyangiitis?
A: Microscopic Polyangiitis is a rare autoimmune disease that causes inflammation of blood vessels.
Q: What is Special Authority?
A: Special Authority is a process in British Columbia, Canada, that allows for coverage of certain medications not normally covered by the provincial drug plan.
Q: How can I access the HLTH5393 form?
A: You can access the HLTH5393 form for requesting special authority for Rituximab in the treatment of Granulomatosis with Polyangiitis or Microscopic Polyangiitis in British Columbia, Canada.
Q: Who is eligible for the use of Rituximab under Special Authority?
A: Eligibility for the use of Rituximab under Special Authority is determined by the criteria outlined on the HLTH5393 form.
Q: Is Rituximab covered by the provincial drug plan in British Columbia?
A: Rituximab may not be covered by the provincial drug plan in British Columbia, but it can be requested through the Special Authority process.
Download Form HLTH5393 Pharmacare Special Authority Request - Rituximab for Granulomatosis With Polyangiitis or Microscopic Polyangiitis - British Columbia, Canada
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