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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
(Note: Each drug may have multiple generic products. This is not a comprehensive list of all available products on the Canadian market. Product availability may change over time)
Drug Name Brand Name Strength Dosage Form DIN
Azathioprine Imuran® 50 mg Tablet 00004596
Cyclophosphamide Procytox® 25 mg Tablet 02241795
Cytoxan® 50 mg Tablet 00344885
Procytox® 50 mg Tablet 02241796
Cyclosporine Neoral® 10 mg Capsule 02237671
Neoral® 25 mg Capsule 02150689
Neoral® 50 mg Capsule 02150662
Neoral® 100 mg Capsule 02150670
Neoral® 100 mg/ml Oral solution 02150697
Sandoz Cyclosporine 25 mg Capsule 02247073
Sandoz Cyclosporine 50 mg Capsule 02247074
Sandoz Cyclosporine 100 mg Capsule 02242821
Mycophenolate Mofetil CellCept® 250 mg Capsule 02192748
CellCept Oral Suspension® 200 mg/ml PD for Oral Susp-175 ml Pk 02242145
CellCept® 500 mg Tablet 02237484
Mycophenolate Sodium Myfortic® 180 mg Enteric coated table 02264560
Myfortic® 360 mg Enteric coated table 02264579
Apo-Mycophenolic acid 180 mg Enteric coated table 02372738
Apo-Mycophenolic acid 360 mg Enteric coated table 02372746
Prednisone Winpred® 1 mg Tablet 00271373
Apo-Prednisone 50 mg Tablet 00550957
Teva-Prednisone 50 mg Tablet 00232378
Apo-Prednisone 5 mg Tablet 00312770
Teva-Prednisone 5 mg Tablet 00021695
Rituximab Rituxan® 10 mg/ml Intravenous injection 02241927
Riximyo® 10 mg/ml Intravenous injection 02498316
RuxienceTM 10 mg/ml Intravenous injection 02495724
Truxima® 100mg/10ml Intravenous injection 02478382
Truxima® 500mg/50ml Intravenous injection 02478390
Tacrolimus immediate release Prograf® 0.5 mg Capsule 02243144
Sandoz Tacrolimus 0.5 mg Capsule 02416816
Prograf® 1 mg Capsule 02175991
Sandoz Tacrolimus 1 mg Capsule 02416824
Prograf® 5 mg Capsule 02175983
Sandoz Tacrolimus 5 mg Capsule 02416832
Tacrolimus extended release Advagraf® 0.5 mg Extended-release capsule 02296462
Advagraf® 1 mg Extended-release capsule 02296470
Advagraf® 3 mg Extended-release capsule 02331667
Advagraf® 5 mg Extended-release capsule 02296489
Tacrolimus prolonged release Envarsus PATM 0.75mg Prolonged-release tablets 02485877
Envarsus PATM 1mg Prolonged-release tablets 02485885
Envarsus PATM 4mg Prolonged-release tablets 02485893

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 deductible 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. Ontario Health (Ontario Renal Network) 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 Ontario Health (Ontario Renal Network). Please direct any inquiries to the applicable agency/entity who manages the drug funding option.