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LANTHANUM

All products: not a benefit

Other products in the same Health Canada class (V03AE) — coverage varies; not interchangeable

  • Polystyrene sulfonate (Solystat): general benefit, Not a benefit
  • Sevelamer carbonate (Renvela): not a benefit

Nat-Lanthanum · DIN 02498766 · 750mg · chewable tablet

Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-20
StatusOff-Formulary Interchangeable, not an ODB benefit
Write on scriptExceptional Access application required. For a drug to be considered for funding, the EAP reimbursement criteria must always be met and the request approved prior to the initiation of treatment with the drug being requested, unless otherwise specified within the criteria. (ontario.ca, Aug 31, 2026 ↗) Submit through SADIE: "The SADIE portal is available to authorized prescribers and their delegates and designates, enabling the creation, submission and tracking of web-based electronic requests directly to the Exceptional Access Program." (ontario.ca, Aug 31, 2026 ↗)
Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.

Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. Current criteria in SADIE

Coverage criteria
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive): Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange Lanthanum Brand(s): Fosrenol and Generics DOSAGE FORM/ STRENGTH: 250 mg, 500 mg, 750 mg, 1000 mg Chewable tablet Sevelamer Hydrochloride Brand(s): Renagel DOSAGE FORM/ STRENGTH: 800 mg tablet Sevelamer Carbonate Brand(s): Accel-Sevelamer DOSAGE FORM/ STRENGTH: 800 mg tablet Sevelamer Carbonate Brand(s): Renvela DOSAGE FORM/ STRENGTH: 800 mg tablet, 0.8 g powder sachet, 2.4 g powder sachet Updated: June 7, 2021 i) For the treatment of hyperphosphatemia associated with end-stage renal disease (ESRD) where patients are on dialysis and have a sustained serum phosphate > 1.8 mmol/L AND adjusted serum calcium > 2.65 mmol/L; OR ii) For dialysis patients experiencing hyperphosphatemia (sustained serum phosphate levels >1.8 mmol/L) who have calciphylaxis and/or evidence of coronary artery calcification. 466 Notes: 1. Calcium and phosphate levels provided to demonstrate sustained elevations should be at least 4 weeks apart. 2. Patients who demonstrate reduction of phosphate levels while on a calcium binder but who experience adjusted serum calcium > 2.65 mmol/L must provide supporting laboratory levels before treatment and while on treatment and should include the dose(s) of calcium-based binder used. Exclusion Criteria: Sevelamer will not be reimbursed in the following cases: Use in combination therapy with another funded non-calcium-based phosphate binder (e.g. lanthanum carbonate hydrate, sucroferric oxyhydroxide, other sevelamer formulations) Duration of approval: lifetime On a case-by-case basis, requests may be considered for sevelamer under the EAP for a patient with serum phosphate less than 1.8mmol/L and calcium values less than 2.65 mmol/L. EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 466, record 303, corpus 2025-01-01; name match only, not an eligibility decision
How long EAP takes
Turnaround times The Exceptional Access Program receives between 250 and 500 requests a day. Requests are categorized in order of priority based on how quickly a drug is needed, the type of drug, and the condition for which the drug is being used. Turnaround times begin on the business day on which the EAP receives a complete request from a physician or nurse practitioner. You may have to wait longer if the request is missing information or supporting documents required by the EAP criteria, if a request requires external review, or if documents are sent by fax or mail instead of submitted via SADIE. EAP Weekly Progress Report Date: September 15, 2026 Processing categories and examples | Target | Current | Priority 1 — for drugs such as antibiotics, cancer medications, and initial requests for pain medications | 3 business days | 2 business day | Priority 2 — for antiviral drugs to treat HIV, drugs for multiple sclerosis, and pulmonary hypertension | 5 business days | 3 business days | Biologics — for biologic drugs to treat rheumatoid arthritis, psoriatic arthritis, ulcerative colitis and Crohn’s disease | 10 business days | 4 business days | Chronic — for drugs used for chronic conditions such as migraines, chronic pain, Ménière's disease and symptoms of Parkinson’s disease. | 4 to 6 weeks | 11 business days | (ontario.ca, Updated September 15, 2026 ↗) For selected drugs, the Telephone Request Service is available to authorized prescribers or their delegates. In most cases, the funding decision is provided by the end of the call and processed within one business day. (ontario.ca, Updated September 15, 2026 ↗)
1 brand, same coverage
Nat-Lanthanum · DIN 02498766 Manufacturer: Natco Pharma (Canada) Inc.; listing date 2020-07-31 Health Canada: Marketed since 2020-07-21 · brand NAT-LANTHANUM · ATC V03AE03 LANTHANUM CARBONATE · form Tablet (chewable) · route Oral · ingredients LANTHANUM (LANTHANUM CARBONATE DIHYDRATE) 750 MG · company Natco pharma (canada) inc · schedule Prescription
Check this DIN again · Health Canada product record

Nat-Lanthanum: Formulary list price $3.6219/unit (unit not stated in source; not the patient's cost)

Ministry pays: $3.6219 per source unit.

Source explanation: The formulary price is what ODB pays; the cash price at the counter is set by the pharmacy.

Formulary data: Ontario extract of Aug 26, 2026 · Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=98845 · Verify on the e-Formulary ↗ (DIN 02498766)

Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02498766). DIN 02498766: Nat-Lanthanum Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y Item: 401800007; group id 550; item number 1484; lccId None; manufacturer id NAT Source form: Chew Tab; strength: 750mg Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed) Source prices (unrounded): $3.6219; ministry $3.6219 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02498766 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=98845
Interchangeable products
Fosrenol · DIN 02287161 · not recorded
Shortage status: not checked (no credentials)
Other drugs in the same formulary class (40:18 Potassium-Removing Resins) and how they are covered

Matched class: 40:18 Potassium-Removing Resins

Drug-class inventory only. Lists recorded Ontario formulary products, not every Canadian medication; does not recommend treatment. Some products covered without a code (check the product listing): POLYSTYRENE SODIUM SULFONATE 40:18 Potassium-Removing Resins

POLYSTYRENE SODIUM SULFONATE

· 6 products · Off-Formulary Interchangeable, not an ODB benefit (2), General benefit (4) · strengths: 250mg/mL, 1mEq/g · O/L, Oral Pd-454g Pk

SEVELAMER CARBONATE

· 2 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 800mg · Tab Source: formulary-ed43-front-matter.txt Part V; ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26; class 40:18
Full class listing Related classes: 40:12 Replacement Agents, 40:28 Diuretics, 40:40 Uricosuric Drugs Same formulary class, not same indication: class membership alone does not establish equivalent uses.
What the Health Canada label says it is for
1 INDICATIONS NAT-LANTHANUM (lanthanum carbonate dihydrate) is indicated as a phosphate binding agent in patients with end stage renal disease on dialysis. The use of lanthanum carbonate in controlled clinical studies beyond 2 years is limited. The risk versus benefit from administration beyond two years should be carefully considered. (see WARNINGS AND PRECAUTIONS, Bone, CLINICAL PHARMACOLOGY, Pharmacokinetics, Distribution, and CLINICAL TRIALS, Bone Safety) 1.1 Pediatrics Pediatrics (<18 years of age): No data are available to Health Canada; therefore, Health Canada has not authorized an indication for pediatric use. 1.2 Geriatrics Geriatrics (>65 years of age): Of the total number of patients in clinical studies of lanthanum carbonate, 32% (538) were ≥65 years of age while 9.3% (159) were ≥75 years of age. No overall differences in safety or efficacy were observed between patients ≥65 years of age and younger patients. https://pdf.hres.ca/dpd_pm/00072607.PDF PM date: August 24, 2023 Source product: NAT-LANTHANUM; DIN 02498731; fetched 2026-09-10 Product monograph posted by Health Canada; excerpt for lookup only.

Prepare an Exceptional Access request

SADIE has its own form for many drugs; this checklist prepares the answers; the ministry decides. Open SADIE

Use this text in SADIE’s free-text fields or read from it on a Telephone Request Service call. Review marks do not indicate eligibility. Evidence stays in this page until you copy it; nothing entered here is sent or saved. Do not enter patient identifiers.

EAP Telephone Request Service: The TRS can be accessed by calling toll-free at 1-866-811-9893 or 416-327-8109 (Toronto area) between 8:30 a.m. and 5:00 p.m. Monday through Friday (except holidays) and selecting the TRS option. Source; updated September 15, 2026

EAP fax: In Ontario: 1-866-811-9908 or 416-327-7526 (Toronto area). Outside Ontario: 1-833-905-4260. Source; updated September 15, 2026

Posted turnaround and Telephone Request Service scope
Turnaround times The Exceptional Access Program receives between 250 and 500 requests a day. Requests are categorized in order of priority based on how quickly a drug is needed, the type of drug, and the condition for which the drug is being used. Turnaround times begin on the business day on which the EAP receives a complete request from a physician or nurse practitioner. You may have to wait longer if the request is missing information or supporting documents required by the EAP criteria, if a request requires external review, or if documents are sent by fax or mail instead of submitted via SADIE. EAP Weekly Progress Report Date: September 15, 2026 Processing categories and examples | Target | Current | Priority 1 — for drugs such as antibiotics, cancer medications, and initial requests for pain medications | 3 business days | 2 business day | Priority 2 — for antiviral drugs to treat HIV, drugs for multiple sclerosis, and pulmonary hypertension | 5 business days | 3 business days | Biologics — for biologic drugs to treat rheumatoid arthritis, psoriatic arthritis, ulcerative colitis and Crohn’s disease | 10 business days | 4 business days | Chronic — for drugs used for chronic conditions such as migraines, chronic pain, Ménière's disease and symptoms of Parkinson’s disease. | 4 to 6 weeks | 11 business days |
For selected drugs, the Telephone Request Service is available to authorized prescribers or their delegates. In most cases, the funding decision is provided by the end of the call and processed within one business day.
Source; updated September 15, 2026

Lanthanum (Fosrenol and Generics)

Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. Current criteria in SADIE

Prepare answers: See the ministry wording below; no separate indication heading is held.

Ministry criteria corpus 2025-01-01; page 466

Lanthanum Brand(s): Fosrenol and Generics DOSAGE FORM/ STRENGTH: 250 mg, 500 mg, 750 mg, 1000 mg Chewable tablet
Sevelamer Hydrochloride Brand(s): Renagel DOSAGE FORM/ STRENGTH: 800 mg tablet
Sevelamer Carbonate Brand(s): Accel-Sevelamer DOSAGE FORM/ STRENGTH: 800 mg tablet
Sevelamer Carbonate Brand(s): Renvela DOSAGE FORM/ STRENGTH: 800 mg tablet, 0.8 g powder sachet, 2.4 g powder sachet Updated: June 7, 2021
i) For the treatment of hyperphosphatemia associated with end-stage renal disease (ESRD) where patients are on dialysis and have a sustained serum phosphate > 1.8 mmol/L AND adjusted serum calcium > 2.65 mmol/L; OR
ii) For dialysis patients experiencing hyperphosphatemia (sustained serum phosphate levels >1.8 mmol/L) who have calciphylaxis and/or evidence of coronary artery calcification.
466 Notes:
1. Calcium and phosphate levels provided to demonstrate sustained elevations should be at least 4 weeks apart.
2. Patients who demonstrate reduction of phosphate levels while on a calcium binder but who experience adjusted serum calcium > 2.65 mmol/L must provide supporting laboratory levels before treatment and while on treatment and should include the dose(s) of calcium-based binder used.
Exclusion Criteria: Sevelamer will not be reimbursed in the following cases: Use in combination therapy with another funded non-calcium-based phosphate binder (e.g. lanthanum carbonate hydrate, sucroferric oxyhydroxide, other sevelamer formulations)
Duration of approval: lifetime
On a case-by-case basis, requests may be considered for sevelamer under the EAP for a patient with serum phosphate less than 1.8mmol/L and calcium values less than 2.65 mmol/L.

Prepared from the ministry's published criteria; eligibility is decided by the Exceptional Access Program.