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Private Insurance

What is Covered

Plans vary depending on different insurance companies and individual plans.

To determine if the insurance company will cover these medications, the patient should provide their insurance company with the appropriate drug identification number(s) (DIN).

Open List of Drug Identification Numbers

Drug identification numbers for immunosuppressive medications
Drug Name Brand Name Strength Dosage Form DIN
Azathioprine Imuran® 50 mg Tablet 00004596
Cyclophosphamide Procytox® 25 mg Tablet 02241795
Cyclophosphamide Cytoxan® 50 mg Tablet 00344885
Cyclophosphamide Procytox 50 mg Tablet 02241796
Cyclosporine Neoral® 10 mg Capsule 02237671
Cyclosporine Neoral® 25 mg Capsule 02150689
Cyclosporine Neoral® 50 mg Capsule 02150662
Cyclosporine Neoral® 100 mg Capsule 02150670
Cyclosporine Neoral® 100 mg/ml Oral solution 02150697
Cyclosporine Sandoz Cyclosporine 25 mg Capsule 02247073
Cyclosporine Sandoz Cyclosporine 50 mg Capsule 02247074
Cyclosporine Sandoz Cyclosporine 100 mg Capsule 02242821
Cyclosporine Apo-Cyclosporine Oral Solution 100 mg/ml Oral solution 02244324
Mycophenolate Mofetil CellCept® 250 mg Capsule 02192748
Mycophenolate Mofetil CellCept Oral Suspension® 200 mg/ml PD for Oral Susp-175 ml Pk 02242145
Mycophenolate Mofetil CellCept 500 mg Tablet 02237484
Mycophenolate Sodium Myfortic® 180 mg Ent tablet 02264560
Mycophenolate Sodium Myfortic 360 mg Ent tablet 02264579
Mycophenolate Sodium Apo-Mycophenolic acid 180 mg Ent tablet 02372738
Mycophenolate Sodium Apo-Mycophenolic acid 360 mg Ent tablet 02372746
Prednisone Winpred® 1 mg Tablet 00271373
Prednisone Apo-Prednisone 50 mg Tablet 00550957
Prednisone Novo-Prednisone 50 mg Tablet 00232378
Prednisone Apo-Prednisone 5 mg Tablet 00312770
Prednisone Novo-Prednisone 5 mg Tablet 00021695
Rituximab Rituxan® 10 mg/ml Intravenous injection 02241927
Tacrolimus Prograf® 0.5 mg Capsule 02243144
Tacrolimus Sandoz Tacrolimus 0.5 mg Capsule 02416816
Tacrolimus Prograf 1 mg Capsule 02175991
Tacrolimus Sandoz Tacrolimus 1 mg Capsule 02416824
Tacrolimus Prograf 5 mg Capsule 02175983
Tacrolimus Sandoz Tacrolimus 5 mg Capsule 02416832
Tacrolimus Advagraf® 0.5 mg ER capsule 02296462
Tacrolimus Advagraf 1 mg ER capsule 02296470
Tacrolimus Advagraf 3 mg ER capsule 02331667
Tacrolimus Advagraf 5 mg ER capsule 02296489

Extent of Coverage

The extent of coverage for the cost of medications used in GN will be determined by the insurance company.

Generic versions are available for most medications. Generic alternatives are generally the lowest cost alternatives that are covered by insurance plans. Brand name versions may only be funded if no generic alternative is available.

Patients should check with the insurance company to see if there is a yearly maximum amount for drug coverage and/or a lifetime maximum for coverage and any deductable costs before starting medication therapy.

Special Authorization

In some cases, special authorization will be required by the private insurance company to obtain coverage of medications used for glomerular disease. In these cases, the kidney specialist must complete a special authorization form specific to the insurance company, detailing the diagnosis and explaining why the drug is needed. It is important to provide all clinical information so the private insurance company can make a decision about the drug coverage.

Patients should follow up directly with their private insurance program about response to special authorization requests and inform their medical team of the result, as the insurance company will directly contact the patient, not the care provider.

Disclaimer: The information contained herein (“Information”) is intended for informational purposes only, and no warranty as to its accuracy is provided or implied. The Information was collected from third party sources and is subject to change without notice. Cancer Care Ontario (CCO) makes no warranty that the Information is current. The Information is intended for use by healthcare professionals to advise patients of drug funding options that may be available to them. Do not act or rely upon the Information without exercising your independent judgment or seeking the advice of a qualified professional. Anyone using the Information does so at his or her own risk. The drug funding options described on this website are managed and funded by third parties, not by CCO. Please direct any inquiries to the applicable agency/entity who manages the drug funding option.