Form HLTH5469 Special Authority Request - Dalteparin / Tinzaparin / Enoxaparin (Biosimilar) for Treatment of Venous Thromboembolism in Cancer Patients - British Columbia, Canada

Form HLTH5469, Special Authority Request - Dalteparin/Tinzaparin/Enoxaparin (Biosimilar) for Treatment of Venous Thromboembolism in Cancer Patients, is a document utilized in British Columbia, Canada. This form is used by healthcare professionals to request special authority from the British Columbia Ministry of Health for coverage of the specific medications Dalteparin, Tinzaparin, and Enoxaparin (Biosimilar). These drugs are used for the treatment of Venous Thromboembolism in cancer patients. Venous Thromboembolism is a condition involving blood clot formation in the veins, which can be serious if not adequately treated, especially for patients dealing with cancer. The special authority request form seeks to gain financial coverage for these medications for eligible patients.

The Form HLTH5469 Special Authority Request - Dalteparin/Tinzaparin/Enoxaparin (Biosimilar) for Treatment of Venous Thromboembolism in Cancer Patients is filed by healthcare professionals or medical practitioners in British Columbia, Canada. This form is used to apply for coverage for these specific medications on behalf of their patients. Generally, it's the responsibility of the prescribing physician or a nurse working under their supervision to complete and submit this form to British Columbia's PharmaCare program.

FAQ

Q: What is form HLTH5469 used for in British Columbia, Canada?
A: Form HLTH5469 is a Special Authority Request form used in British Columbia, Canada. It is specifically for requesting special permission to prescribe Dalteparin/Tinzaparin/Enoxaparin (Biosimilar), which are treatments for venous thromboembolism in cancer patients.

Q: What medications are requested through form HLTH5469?
A: The medications requested through form HLTH5469 are Dalteparin, Tinzaparin, and Enoxaparin, which are biosimilar drugs often used to treat venous thromboembolism in cancer patients.

Q: Who fills out the Special Authority Request form HLTH5469?
A: Form HLTH5469 is filled out by a licensed healthcare provider who believes that the allocation of the drugs Dalteparin, Tinzaparin, or Enoxaparin is necessary for the treatment of venous thromboembolism in a cancer patient.

Q: Who can use the medications requested via form HLTH5469?
A: The medications listed on form HLTH5469, Dalteparin, Tinzaparin, and Enoxaparin, are intended for the treatment of venous thromboembolism in individuals diagnosed with cancer.

Q: What condition are the drugs Dalteparin, Tinzaparin, and Enoxaparin used to treat?
A: Dalteparin, Tinzaparin, and Enoxaparin are most often used to treat venous thromboembolism, a condition which causes blood clots in the veins. This can be a common complication in cancer patients.