PALBOCICLIB
All strengths: Off-Formulary Interchangeable, not an ODB benefit; same patient cost rules
Shared coverage and patient cost rules
StatusOff-Formulary Interchangeable, not an ODB benefit
Patient paysPatient pays: program not supplied; amount cannot be determined.
Other products in the same Health Canada class (L01E) — coverage varies; not interchangeable
- Imatinib (Gleevec): general benefit
- Afatinib (Giotrif): not a benefit
- Bosutinib (Bosulif): not a benefit
- Dasatinib (Sprycel): not a benefit
- Erlotinib (Tarceva): not a benefit
- Gefitinib (Iressa): not a benefit
2 more in the class list below
Ibrance · DIN 02493535 · 75mg · tablet
Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-02
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 ↗) 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
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablet or capsules
Updated December 4, 2020
Initial Criteria
For the treatment of patients with estrogen receptor(ER)-positive, human epidermal growth
factor receptor 2 (HER 2)-negative; unresectable locally advanced breast cancer or
metastatic breast cancer in patients who meet the following criteria;
1. Palbociclib is being used as combination therapy in one of the following treatment
regimens1;
i) As first line therapy in combination with an aromatase inhibitor (i.e. letrozole,
anastrozole, or exemestane) or fulvestrant in a patient who has not progressed on
a prior systemic treatment (i.e. chemotherapy, immunotherapy, or endocrine
therapy) for their unresectable locally advanced or metastatic disease; OR
ii) As second line therapy in combination with an aromatase inhibitor (i.e. letrozole,
anastrozole, or exemestane) or fulvestrant after progression on a chemotherapy
for unresectable locally advanced or metastatic disease; OR
iii) As a second or subsequent line therapy in combination with fulvestrant after
progression on any number of endocrine monotherapies with the exception of
progression during prior fulvestrant therapy.
1Note: EAP funding will be considered for only one CDK 4/6 inhibitor regimen (i.e.
Palbociclib or Ribociclib) OR Everolimus based regimen for the treatment of
unresectable locally advanced or metastatic disease. No funding for sequential
treatment regimens involving palbociclib or ribociclib or everolimus will be considered.
AND
2. Patients who received anastrozole or letrozole in the neo-adjuvant or adjuvant setting,
must demonstrate a minimum disease free interval of twelve (12) months after
stopping therapy to qualify for funding of palbociclib in combination with anastrozole or
letrozole. (Note: This does not apply to patients receiving tamoxifen or exemestane in
the neoadjuvant or adjuvant setting who progress or relapse early on those
treatments.)
3. Patient has good performance status defined as an Eastern Cooperative Oncology
Group (ECOG) score of 0 to 2; AND
4. Patient does not have active or uncontrolled metastases to the central nervous
system; AND
348
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablets or capsules
5. In the case of a Patient who is pre-menopausal or peri-menopausal, the Patient is
receiving a luteinizing hormone-releasing hormone (LHRH) agonist to achieve
chemically-induced menopause (Note: Women who have had an oophorectomy are
considered to be post-menopausal); AND
6. The Patient has not experienced disease progression on any of the following regimens
for locally advanced or metastatic breast cancer:
(i) a palbociclib or ribociclib regimen;
(ii) an everolimus regimen; or
(iii) another CDK 4/6 regimen that has been publicly funded.
Renewal Criteria:
Renewals will be considered in patients who have not demonstrated evidence of disease
progression or development of unacceptable toxicity requiring discontinuation while on
palbociclib.
Exclusion Criteria (Note that exclusion criteria apply to both Initial eligibility criteria and
renewal criteria.) Patients meeting the following criteria will not be funded.
i) Patient is using palbociclib as retreatment after disease progression on a prior
palbociclib-based regimen in advanced breast cancer.
ii) Patient is using palbociclib with other drugs or in combinations other than those
situations mentioned in 1 i), ii), iii) of the eligibility criteria.
iii) Patient is using palbociclib in combination with letrozole or anastrozole in the
metastatic setting but has experienced progression in the neoadjuvant or adjuvant
setting occurring during treatment or within 12 months of stopping treatment with
letrozole or anastrozole;
iv) Patient is pre- or peri-menopausal who is not being treated with a luteinizing hormone-
releasing hormone (LHRH) agonist.
v) Patient who is intending to use palbociclib with fulvestrant who has progressed on
prior fulvestrant used as monotherapy or as part of another regimen.
vi) Patient whose disease has progressed during treatment with a ribociclib regimen, an
everolimus regimen, or another CDK 4/6 inhibitor regimen used for advanced,
metastatic breast cancer, unless that use was through a clinical trial.
vii) Patient who has active or uncontrolled central nervous system (CNS) metastases.
viii) The Patient is requesting Ibrance for use with fulvestrant and has extensive,
symptomatic, potentially life-threatening visceral metastases.
349
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablets or capsules
On a time-limited basis, funding will be considered for the following on a case-by-case
basis:
1. Patients who missed the opportunity to use palbociclib in the advanced setting in
patients started on first-line, monotherapy with an aromatase inhibitor (AI) (e.g.
letrozole, anastrozole, exemestane) AND who have not have not experienced disease
progression with current AI therapy AND who meet the disease-free time requirement
if anastrozole or letrozole was used previously in the adjuvant or neoadjuvant setting
and the EAP request is submitted between the dates of December 4, 2020 to March 4,
2021.
2. Addition of palbociclib for patients already on fulvestrant in first, second or subsequent
line who has not experienced disease progression on fulvestrant and who are CDK 4/6
inhibitor naïve and otherwise eligible for this therapy if the EAP request is submitted
between the dates of December 4, 2020 to March 4, 2021.
3. A switch to palbociclib + fulvestrant at progression for patients already on
endocrine/hormonal therapy other than fulvestrant and who are CDK4/6 naïve and
otherwise meet the eligibility requirements for this therapy.
4. A switch to palbociclib + fulvestrant at progression for patients already on and
benefitting from everolimus + exemestane, provided that the start of everolimus +
exemestane was prior to December 4, 2020. Patients must be CDK 4/6 inhibitor naïve
and otherwise eligible for this therapy.
Dosing:
Palbociclib (Ibrance) 125mg orally once a day for 21 consecutive days, followed by 7 days
off treatment, in a combination regimen with one of the following:
• A continuous daily aromatase inhibitor or
• Fulvestrant 500mg administered intramuscularly on days 1 and 15 of cycle 1 and
tehn on day 1 of each subsequent 28-day cycle.
350
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 348, record 202, 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
Ibrance · DIN 02493535
Manufacturer: Pfizer Canada Inc.; listing date 2024-11-29
Health Canada: Marketed since 2020-09-21 · brand IBRANCE · ATC L01EF01 PALBOCICLIB · form Tablet · route Oral · ingredients PALBOCICLIB 75 MG · company Pfizer canada ulc · schedule Prescription
Check this DIN again · Health Canada product recordMinistry pays: $126.9562 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=98354 · Verify on the e-Formulary ↗ (DIN 02493535)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02493535).
DIN 02493535: Ibrance
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 100000317; group id 178; item number 0321; lccId None; manufacturer id PFI
Source form: Tab; strength: 75mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $253.9123; ministry $126.9562
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02493535
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=98354
Interchangeable products
PMS-Palbociclib · DIN 02552124 · $126.9562
Taro-Palbociclib · DIN 02547635 · $126.9562
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02493535
Shortage record checked 2026-09-13T08:10:21.292534+00:00
PMS-Palbociclib · DIN 02552124 · 75mg · tablet
Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-02
Write on scriptnot a benefit; no Exceptional Access criteria on record; see alternatives
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 criteria on record are for Brand(s): Ibrance; DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablet or capsules — not this product; no criteria on record for this product in this block.
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
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablet or capsules
Updated December 4, 2020
Initial Criteria
For the treatment of patients with estrogen receptor(ER)-positive, human epidermal growth
factor receptor 2 (HER 2)-negative; unresectable locally advanced breast cancer or
metastatic breast cancer in patients who meet the following criteria;
1. Palbociclib is being used as combination therapy in one of the following treatment
regimens1;
i) As first line therapy in combination with an aromatase inhibitor (i.e. letrozole,
anastrozole, or exemestane) or fulvestrant in a patient who has not progressed on
a prior systemic treatment (i.e. chemotherapy, immunotherapy, or endocrine
therapy) for their unresectable locally advanced or metastatic disease; OR
ii) As second line therapy in combination with an aromatase inhibitor (i.e. letrozole,
anastrozole, or exemestane) or fulvestrant after progression on a chemotherapy
for unresectable locally advanced or metastatic disease; OR
iii) As a second or subsequent line therapy in combination with fulvestrant after
progression on any number of endocrine monotherapies with the exception of
progression during prior fulvestrant therapy.
1Note: EAP funding will be considered for only one CDK 4/6 inhibitor regimen (i.e.
Palbociclib or Ribociclib) OR Everolimus based regimen for the treatment of
unresectable locally advanced or metastatic disease. No funding for sequential
treatment regimens involving palbociclib or ribociclib or everolimus will be considered.
AND
2. Patients who received anastrozole or letrozole in the neo-adjuvant or adjuvant setting,
must demonstrate a minimum disease free interval of twelve (12) months after
stopping therapy to qualify for funding of palbociclib in combination with anastrozole or
letrozole. (Note: This does not apply to patients receiving tamoxifen or exemestane in
the neoadjuvant or adjuvant setting who progress or relapse early on those
treatments.)
3. Patient has good performance status defined as an Eastern Cooperative Oncology
Group (ECOG) score of 0 to 2; AND
4. Patient does not have active or uncontrolled metastases to the central nervous
system; AND
348
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablets or capsules
5. In the case of a Patient who is pre-menopausal or peri-menopausal, the Patient is
receiving a luteinizing hormone-releasing hormone (LHRH) agonist to achieve
chemically-induced menopause (Note: Women who have had an oophorectomy are
considered to be post-menopausal); AND
6. The Patient has not experienced disease progression on any of the following regimens
for locally advanced or metastatic breast cancer:
(i) a palbociclib or ribociclib regimen;
(ii) an everolimus regimen; or
(iii) another CDK 4/6 regimen that has been publicly funded.
Renewal Criteria:
Renewals will be considered in patients who have not demonstrated evidence of disease
progression or development of unacceptable toxicity requiring discontinuation while on
palbociclib.
Exclusion Criteria (Note that exclusion criteria apply to both Initial eligibility criteria and
renewal criteria.) Patients meeting the following criteria will not be funded.
i) Patient is using palbociclib as retreatment after disease progression on a prior
palbociclib-based regimen in advanced breast cancer.
ii) Patient is using palbociclib with other drugs or in combinations other than those
situations mentioned in 1 i), ii), iii) of the eligibility criteria.
iii) Patient is using palbociclib in combination with letrozole or anastrozole in the
metastatic setting but has experienced progression in the neoadjuvant or adjuvant
setting occurring during treatment or within 12 months of stopping treatment with
letrozole or anastrozole;
iv) Patient is pre- or peri-menopausal who is not being treated with a luteinizing hormone-
releasing hormone (LHRH) agonist.
v) Patient who is intending to use palbociclib with fulvestrant who has progressed on
prior fulvestrant used as monotherapy or as part of another regimen.
vi) Patient whose disease has progressed during treatment with a ribociclib regimen, an
everolimus regimen, or another CDK 4/6 inhibitor regimen used for advanced,
metastatic breast cancer, unless that use was through a clinical trial.
vii) Patient who has active or uncontrolled central nervous system (CNS) metastases.
viii) The Patient is requesting Ibrance for use with fulvestrant and has extensive,
symptomatic, potentially life-threatening visceral metastases.
349
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablets or capsules
On a time-limited basis, funding will be considered for the following on a case-by-case
basis:
1. Patients who missed the opportunity to use palbociclib in the advanced setting in
patients started on first-line, monotherapy with an aromatase inhibitor (AI) (e.g.
letrozole, anastrozole, exemestane) AND who have not have not experienced disease
progression with current AI therapy AND who meet the disease-free time requirement
if anastrozole or letrozole was used previously in the adjuvant or neoadjuvant setting
and the EAP request is submitted between the dates of December 4, 2020 to March 4,
2021.
2. Addition of palbociclib for patients already on fulvestrant in first, second or subsequent
line who has not experienced disease progression on fulvestrant and who are CDK 4/6
inhibitor naïve and otherwise eligible for this therapy if the EAP request is submitted
between the dates of December 4, 2020 to March 4, 2021.
3. A switch to palbociclib + fulvestrant at progression for patients already on
endocrine/hormonal therapy other than fulvestrant and who are CDK4/6 naïve and
otherwise meet the eligibility requirements for this therapy.
4. A switch to palbociclib + fulvestrant at progression for patients already on and
benefitting from everolimus + exemestane, provided that the start of everolimus +
exemestane was prior to December 4, 2020. Patients must be CDK 4/6 inhibitor naïve
and otherwise eligible for this therapy.
Dosing:
Palbociclib (Ibrance) 125mg orally once a day for 21 consecutive days, followed by 7 days
off treatment, in a combination regimen with one of the following:
• A continuous daily aromatase inhibitor or
• Fulvestrant 500mg administered intramuscularly on days 1 and 15 of cycle 1 and
tehn on day 1 of each subsequent 28-day cycle.
350
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 348, record 202, corpus 2025-01-01; name match only, not an eligibility decision
Brand vs generic price
Lowest DBP recovery rule under medically necessary no-substitution claims:
6.2 Medically Necessary "No Substitution" Claims
The Side Effect Reporting Form will not have to be renewed. However, the
pharmacy must maintain a copy of the prescription that contains a direction that
there be no substitution and the required Health Canada Side Effect Reporting Form
(completed and signed by the prescriber). The prescriber must write “No
Substitution” or “No Sub” on renewal or subsequent new written prescriptions, and
indicate “No Substitution” on subsequent new oral prescriptions. The dispenser will
be reimbursed the DBP plus a mark-up and the lesser of the posted usual and
customary fee or the ODB dispensing fee minus the applicable ODB co-payment
amount. Where a completed Side Effect Reporting Form is not available at the
pharmacy during an inspection, the difference between the cost of the higher-cost
product and the lowest DBP listed for the interchangeable category will be
recovered.
(ontario.ca, Revision #17; 2026-08-03 ↗)
6.2 Medically Necessary "No Substitution" Claims
The Ministry will provide reimbursement of a higher-cost interchangeable product in
medically necessary circumstances where a patient has experienced a significant
adverse reaction with two (2) lower-cost interchangeable drug products, where
available. When a prescriber identifies a patient for which it is medically necessary
that a higher cost interchangeable product be provided, the prescriber must:
• Complete, sign and forward to the pharmacist a copy of the Health Canada
side effect reporting form for each lower-cost interchangeable drug product
trialed (Side Effect Reporting Form[s]); and
• Write “No Substitution” or “No Sub” on a written prescription or indicate “No
Substitution” to the pharmacist in the case of a verbal prescription.
The prescriber should keep a copy of the completed form in the patient’s record for
future use and reference.
In the case of a written prescription, when the pharmacist or dispensing physician
receives a prescription with the written notation “No Substitution” or “No Sub”,
reimbursement will be provided for the higher-cost interchangeable product only if
the prescription is accompanied by a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed.
This form must be completely filled out noting the details of the adverse reaction
and signed by the prescriber.
In the case of a verbal prescription, the prescriber must satisfy the operator of the
pharmacy or dispensing physician that a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed
has been completed and signed by the prescriber. A written record of this verbal
prescription and the completed Health Canada Side Effect Reporting Form must be
received by the pharmacy prior to claim submission.
Upon receipt, the pharmacist must:
• Fax, submit online or mail the completed and signed form to Health Canada’s
Canada Vigilance Program; and
• Retain his or her copy of the completed and signed Side Effect Reporting
Form.
(ontario.ca, Revision #17; 2026-08-03 ↗)1 brand, same coverage
PMS-Palbociclib · DIN 02552124
Manufacturer: Pharmascience Inc.; listing date 2024-11-29
Health Canada: Marketed since 2024-09-27 · brand PMS-PALBOCICLIB · ATC L01EF01 PALBOCICLIB · form Tablet · route Oral · ingredients PALBOCICLIB 75 MG · company Pharmascience inc · schedule Prescription
Check this DIN again · Health Canada product recordPMS-Palbociclib: Formulary list price $126.9562/unit (unit not stated in source; not the patient's cost)
Ministry pays: $126.9562 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=104081 · Verify on the e-Formulary ↗ (DIN 02552124)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02552124).
DIN 02552124: PMS-Palbociclib
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 100000317; group id 178; item number 0321; lccId None; manufacturer id PMS
Source form: Tab; strength: 75mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $126.9562; ministry $126.9562
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02552124
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=104081
Interchangeable products
Ibrance · DIN 02493535 · $126.9562
Taro-Palbociclib · DIN 02547635 · $126.9562
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02552124
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Taro-Palbociclib · DIN 02547635 · 75mg · tablet
Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-02
Write on scriptnot a benefit; no Exceptional Access criteria on record; see alternatives
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 criteria on record are for Brand(s): Ibrance; DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablet or capsules — not this product; no criteria on record for this product in this block.
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
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablet or capsules
Updated December 4, 2020
Initial Criteria
For the treatment of patients with estrogen receptor(ER)-positive, human epidermal growth
factor receptor 2 (HER 2)-negative; unresectable locally advanced breast cancer or
metastatic breast cancer in patients who meet the following criteria;
1. Palbociclib is being used as combination therapy in one of the following treatment
regimens1;
i) As first line therapy in combination with an aromatase inhibitor (i.e. letrozole,
anastrozole, or exemestane) or fulvestrant in a patient who has not progressed on
a prior systemic treatment (i.e. chemotherapy, immunotherapy, or endocrine
therapy) for their unresectable locally advanced or metastatic disease; OR
ii) As second line therapy in combination with an aromatase inhibitor (i.e. letrozole,
anastrozole, or exemestane) or fulvestrant after progression on a chemotherapy
for unresectable locally advanced or metastatic disease; OR
iii) As a second or subsequent line therapy in combination with fulvestrant after
progression on any number of endocrine monotherapies with the exception of
progression during prior fulvestrant therapy.
1Note: EAP funding will be considered for only one CDK 4/6 inhibitor regimen (i.e.
Palbociclib or Ribociclib) OR Everolimus based regimen for the treatment of
unresectable locally advanced or metastatic disease. No funding for sequential
treatment regimens involving palbociclib or ribociclib or everolimus will be considered.
AND
2. Patients who received anastrozole or letrozole in the neo-adjuvant or adjuvant setting,
must demonstrate a minimum disease free interval of twelve (12) months after
stopping therapy to qualify for funding of palbociclib in combination with anastrozole or
letrozole. (Note: This does not apply to patients receiving tamoxifen or exemestane in
the neoadjuvant or adjuvant setting who progress or relapse early on those
treatments.)
3. Patient has good performance status defined as an Eastern Cooperative Oncology
Group (ECOG) score of 0 to 2; AND
4. Patient does not have active or uncontrolled metastases to the central nervous
system; AND
348
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablets or capsules
5. In the case of a Patient who is pre-menopausal or peri-menopausal, the Patient is
receiving a luteinizing hormone-releasing hormone (LHRH) agonist to achieve
chemically-induced menopause (Note: Women who have had an oophorectomy are
considered to be post-menopausal); AND
6. The Patient has not experienced disease progression on any of the following regimens
for locally advanced or metastatic breast cancer:
(i) a palbociclib or ribociclib regimen;
(ii) an everolimus regimen; or
(iii) another CDK 4/6 regimen that has been publicly funded.
Renewal Criteria:
Renewals will be considered in patients who have not demonstrated evidence of disease
progression or development of unacceptable toxicity requiring discontinuation while on
palbociclib.
Exclusion Criteria (Note that exclusion criteria apply to both Initial eligibility criteria and
renewal criteria.) Patients meeting the following criteria will not be funded.
i) Patient is using palbociclib as retreatment after disease progression on a prior
palbociclib-based regimen in advanced breast cancer.
ii) Patient is using palbociclib with other drugs or in combinations other than those
situations mentioned in 1 i), ii), iii) of the eligibility criteria.
iii) Patient is using palbociclib in combination with letrozole or anastrozole in the
metastatic setting but has experienced progression in the neoadjuvant or adjuvant
setting occurring during treatment or within 12 months of stopping treatment with
letrozole or anastrozole;
iv) Patient is pre- or peri-menopausal who is not being treated with a luteinizing hormone-
releasing hormone (LHRH) agonist.
v) Patient who is intending to use palbociclib with fulvestrant who has progressed on
prior fulvestrant used as monotherapy or as part of another regimen.
vi) Patient whose disease has progressed during treatment with a ribociclib regimen, an
everolimus regimen, or another CDK 4/6 inhibitor regimen used for advanced,
metastatic breast cancer, unless that use was through a clinical trial.
vii) Patient who has active or uncontrolled central nervous system (CNS) metastases.
viii) The Patient is requesting Ibrance for use with fulvestrant and has extensive,
symptomatic, potentially life-threatening visceral metastases.
349
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablets or capsules
On a time-limited basis, funding will be considered for the following on a case-by-case
basis:
1. Patients who missed the opportunity to use palbociclib in the advanced setting in
patients started on first-line, monotherapy with an aromatase inhibitor (AI) (e.g.
letrozole, anastrozole, exemestane) AND who have not have not experienced disease
progression with current AI therapy AND who meet the disease-free time requirement
if anastrozole or letrozole was used previously in the adjuvant or neoadjuvant setting
and the EAP request is submitted between the dates of December 4, 2020 to March 4,
2021.
2. Addition of palbociclib for patients already on fulvestrant in first, second or subsequent
line who has not experienced disease progression on fulvestrant and who are CDK 4/6
inhibitor naïve and otherwise eligible for this therapy if the EAP request is submitted
between the dates of December 4, 2020 to March 4, 2021.
3. A switch to palbociclib + fulvestrant at progression for patients already on
endocrine/hormonal therapy other than fulvestrant and who are CDK4/6 naïve and
otherwise meet the eligibility requirements for this therapy.
4. A switch to palbociclib + fulvestrant at progression for patients already on and
benefitting from everolimus + exemestane, provided that the start of everolimus +
exemestane was prior to December 4, 2020. Patients must be CDK 4/6 inhibitor naïve
and otherwise eligible for this therapy.
Dosing:
Palbociclib (Ibrance) 125mg orally once a day for 21 consecutive days, followed by 7 days
off treatment, in a combination regimen with one of the following:
• A continuous daily aromatase inhibitor or
• Fulvestrant 500mg administered intramuscularly on days 1 and 15 of cycle 1 and
tehn on day 1 of each subsequent 28-day cycle.
350
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 348, record 202, corpus 2025-01-01; name match only, not an eligibility decision
Brand vs generic price
Lowest DBP recovery rule under medically necessary no-substitution claims:
6.2 Medically Necessary "No Substitution" Claims
The Side Effect Reporting Form will not have to be renewed. However, the
pharmacy must maintain a copy of the prescription that contains a direction that
there be no substitution and the required Health Canada Side Effect Reporting Form
(completed and signed by the prescriber). The prescriber must write “No
Substitution” or “No Sub” on renewal or subsequent new written prescriptions, and
indicate “No Substitution” on subsequent new oral prescriptions. The dispenser will
be reimbursed the DBP plus a mark-up and the lesser of the posted usual and
customary fee or the ODB dispensing fee minus the applicable ODB co-payment
amount. Where a completed Side Effect Reporting Form is not available at the
pharmacy during an inspection, the difference between the cost of the higher-cost
product and the lowest DBP listed for the interchangeable category will be
recovered.
(ontario.ca, Revision #17; 2026-08-03 ↗)
6.2 Medically Necessary "No Substitution" Claims
The Ministry will provide reimbursement of a higher-cost interchangeable product in
medically necessary circumstances where a patient has experienced a significant
adverse reaction with two (2) lower-cost interchangeable drug products, where
available. When a prescriber identifies a patient for which it is medically necessary
that a higher cost interchangeable product be provided, the prescriber must:
• Complete, sign and forward to the pharmacist a copy of the Health Canada
side effect reporting form for each lower-cost interchangeable drug product
trialed (Side Effect Reporting Form[s]); and
• Write “No Substitution” or “No Sub” on a written prescription or indicate “No
Substitution” to the pharmacist in the case of a verbal prescription.
The prescriber should keep a copy of the completed form in the patient’s record for
future use and reference.
In the case of a written prescription, when the pharmacist or dispensing physician
receives a prescription with the written notation “No Substitution” or “No Sub”,
reimbursement will be provided for the higher-cost interchangeable product only if
the prescription is accompanied by a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed.
This form must be completely filled out noting the details of the adverse reaction
and signed by the prescriber.
In the case of a verbal prescription, the prescriber must satisfy the operator of the
pharmacy or dispensing physician that a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed
has been completed and signed by the prescriber. A written record of this verbal
prescription and the completed Health Canada Side Effect Reporting Form must be
received by the pharmacy prior to claim submission.
Upon receipt, the pharmacist must:
• Fax, submit online or mail the completed and signed form to Health Canada’s
Canada Vigilance Program; and
• Retain his or her copy of the completed and signed Side Effect Reporting
Form.
(ontario.ca, Revision #17; 2026-08-03 ↗)1 brand, same coverage
Taro-Palbociclib · DIN 02547635
Manufacturer: Taro Pharmaceuticals Inc.; listing date 2024-11-29
Health Canada: Marketed since 2024-09-17 · brand TARO-PALBOCICLIB · ATC L01EF01 PALBOCICLIB · form Tablet · route Oral · ingredients PALBOCICLIB 75 MG · company Taro pharmaceuticals inc · schedule Prescription
Check this DIN again · Health Canada product recordTaro-Palbociclib: Formulary list price $126.9562/unit (unit not stated in source; not the patient's cost)
Ministry pays: $126.9562 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=103657 · Verify on the e-Formulary ↗ (DIN 02547635)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02547635).
DIN 02547635: Taro-Palbociclib
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 100000317; group id 178; item number 0321; lccId None; manufacturer id TAR
Source form: Tab; strength: 75mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $126.9562; ministry $126.9562
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02547635
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=103657
Interchangeable products
Ibrance · DIN 02493535 · $126.9562
PMS-Palbociclib · DIN 02552124 · $126.9562
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02547635
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Ibrance · DIN 02493543 · 100mg · tablet
Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-02
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 ↗) 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
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablet or capsules
Updated December 4, 2020
Initial Criteria
For the treatment of patients with estrogen receptor(ER)-positive, human epidermal growth
factor receptor 2 (HER 2)-negative; unresectable locally advanced breast cancer or
metastatic breast cancer in patients who meet the following criteria;
1. Palbociclib is being used as combination therapy in one of the following treatment
regimens1;
i) As first line therapy in combination with an aromatase inhibitor (i.e. letrozole,
anastrozole, or exemestane) or fulvestrant in a patient who has not progressed on
a prior systemic treatment (i.e. chemotherapy, immunotherapy, or endocrine
therapy) for their unresectable locally advanced or metastatic disease; OR
ii) As second line therapy in combination with an aromatase inhibitor (i.e. letrozole,
anastrozole, or exemestane) or fulvestrant after progression on a chemotherapy
for unresectable locally advanced or metastatic disease; OR
iii) As a second or subsequent line therapy in combination with fulvestrant after
progression on any number of endocrine monotherapies with the exception of
progression during prior fulvestrant therapy.
1Note: EAP funding will be considered for only one CDK 4/6 inhibitor regimen (i.e.
Palbociclib or Ribociclib) OR Everolimus based regimen for the treatment of
unresectable locally advanced or metastatic disease. No funding for sequential
treatment regimens involving palbociclib or ribociclib or everolimus will be considered.
AND
2. Patients who received anastrozole or letrozole in the neo-adjuvant or adjuvant setting,
must demonstrate a minimum disease free interval of twelve (12) months after
stopping therapy to qualify for funding of palbociclib in combination with anastrozole or
letrozole. (Note: This does not apply to patients receiving tamoxifen or exemestane in
the neoadjuvant or adjuvant setting who progress or relapse early on those
treatments.)
3. Patient has good performance status defined as an Eastern Cooperative Oncology
Group (ECOG) score of 0 to 2; AND
4. Patient does not have active or uncontrolled metastases to the central nervous
system; AND
348
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablets or capsules
5. In the case of a Patient who is pre-menopausal or peri-menopausal, the Patient is
receiving a luteinizing hormone-releasing hormone (LHRH) agonist to achieve
chemically-induced menopause (Note: Women who have had an oophorectomy are
considered to be post-menopausal); AND
6. The Patient has not experienced disease progression on any of the following regimens
for locally advanced or metastatic breast cancer:
(i) a palbociclib or ribociclib regimen;
(ii) an everolimus regimen; or
(iii) another CDK 4/6 regimen that has been publicly funded.
Renewal Criteria:
Renewals will be considered in patients who have not demonstrated evidence of disease
progression or development of unacceptable toxicity requiring discontinuation while on
palbociclib.
Exclusion Criteria (Note that exclusion criteria apply to both Initial eligibility criteria and
renewal criteria.) Patients meeting the following criteria will not be funded.
i) Patient is using palbociclib as retreatment after disease progression on a prior
palbociclib-based regimen in advanced breast cancer.
ii) Patient is using palbociclib with other drugs or in combinations other than those
situations mentioned in 1 i), ii), iii) of the eligibility criteria.
iii) Patient is using palbociclib in combination with letrozole or anastrozole in the
metastatic setting but has experienced progression in the neoadjuvant or adjuvant
setting occurring during treatment or within 12 months of stopping treatment with
letrozole or anastrozole;
iv) Patient is pre- or peri-menopausal who is not being treated with a luteinizing hormone-
releasing hormone (LHRH) agonist.
v) Patient who is intending to use palbociclib with fulvestrant who has progressed on
prior fulvestrant used as monotherapy or as part of another regimen.
vi) Patient whose disease has progressed during treatment with a ribociclib regimen, an
everolimus regimen, or another CDK 4/6 inhibitor regimen used for advanced,
metastatic breast cancer, unless that use was through a clinical trial.
vii) Patient who has active or uncontrolled central nervous system (CNS) metastases.
viii) The Patient is requesting Ibrance for use with fulvestrant and has extensive,
symptomatic, potentially life-threatening visceral metastases.
349
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablets or capsules
On a time-limited basis, funding will be considered for the following on a case-by-case
basis:
1. Patients who missed the opportunity to use palbociclib in the advanced setting in
patients started on first-line, monotherapy with an aromatase inhibitor (AI) (e.g.
letrozole, anastrozole, exemestane) AND who have not have not experienced disease
progression with current AI therapy AND who meet the disease-free time requirement
if anastrozole or letrozole was used previously in the adjuvant or neoadjuvant setting
and the EAP request is submitted between the dates of December 4, 2020 to March 4,
2021.
2. Addition of palbociclib for patients already on fulvestrant in first, second or subsequent
line who has not experienced disease progression on fulvestrant and who are CDK 4/6
inhibitor naïve and otherwise eligible for this therapy if the EAP request is submitted
between the dates of December 4, 2020 to March 4, 2021.
3. A switch to palbociclib + fulvestrant at progression for patients already on
endocrine/hormonal therapy other than fulvestrant and who are CDK4/6 naïve and
otherwise meet the eligibility requirements for this therapy.
4. A switch to palbociclib + fulvestrant at progression for patients already on and
benefitting from everolimus + exemestane, provided that the start of everolimus +
exemestane was prior to December 4, 2020. Patients must be CDK 4/6 inhibitor naïve
and otherwise eligible for this therapy.
Dosing:
Palbociclib (Ibrance) 125mg orally once a day for 21 consecutive days, followed by 7 days
off treatment, in a combination regimen with one of the following:
• A continuous daily aromatase inhibitor or
• Fulvestrant 500mg administered intramuscularly on days 1 and 15 of cycle 1 and
tehn on day 1 of each subsequent 28-day cycle.
350
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 348, record 202, 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
Ibrance · DIN 02493543
Manufacturer: Pfizer Canada Inc.; listing date 2024-11-29
Health Canada: Marketed since 2020-09-21 · brand IBRANCE · ATC L01EF01 PALBOCICLIB · form Tablet · route Oral · ingredients PALBOCICLIB 100 MG · company Pfizer canada ulc · schedule Prescription
Check this DIN again · Health Canada product recordMinistry pays: $126.9562 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=98355 · Verify on the e-Formulary ↗ (DIN 02493543)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02493543).
DIN 02493543: Ibrance
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 100000318; group id 178; item number 0322; lccId None; manufacturer id PFI
Source form: Tab; strength: 100mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $253.9123; ministry $126.9562
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02493543
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=98355
Interchangeable products
PMS-Palbociclib · DIN 02552132 · $126.9562
Taro-Palbociclib · DIN 02547643 · $126.9562
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02493543
Shortage record checked 2026-09-13T08:10:21.292534+00:00
PMS-Palbociclib · DIN 02552132 · 100mg · tablet
Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-02
Write on scriptnot a benefit; no Exceptional Access criteria on record; see alternatives
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 criteria on record are for Brand(s): Ibrance; DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablet or capsules — not this product; no criteria on record for this product in this block.
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
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablet or capsules
Updated December 4, 2020
Initial Criteria
For the treatment of patients with estrogen receptor(ER)-positive, human epidermal growth
factor receptor 2 (HER 2)-negative; unresectable locally advanced breast cancer or
metastatic breast cancer in patients who meet the following criteria;
1. Palbociclib is being used as combination therapy in one of the following treatment
regimens1;
i) As first line therapy in combination with an aromatase inhibitor (i.e. letrozole,
anastrozole, or exemestane) or fulvestrant in a patient who has not progressed on
a prior systemic treatment (i.e. chemotherapy, immunotherapy, or endocrine
therapy) for their unresectable locally advanced or metastatic disease; OR
ii) As second line therapy in combination with an aromatase inhibitor (i.e. letrozole,
anastrozole, or exemestane) or fulvestrant after progression on a chemotherapy
for unresectable locally advanced or metastatic disease; OR
iii) As a second or subsequent line therapy in combination with fulvestrant after
progression on any number of endocrine monotherapies with the exception of
progression during prior fulvestrant therapy.
1Note: EAP funding will be considered for only one CDK 4/6 inhibitor regimen (i.e.
Palbociclib or Ribociclib) OR Everolimus based regimen for the treatment of
unresectable locally advanced or metastatic disease. No funding for sequential
treatment regimens involving palbociclib or ribociclib or everolimus will be considered.
AND
2. Patients who received anastrozole or letrozole in the neo-adjuvant or adjuvant setting,
must demonstrate a minimum disease free interval of twelve (12) months after
stopping therapy to qualify for funding of palbociclib in combination with anastrozole or
letrozole. (Note: This does not apply to patients receiving tamoxifen or exemestane in
the neoadjuvant or adjuvant setting who progress or relapse early on those
treatments.)
3. Patient has good performance status defined as an Eastern Cooperative Oncology
Group (ECOG) score of 0 to 2; AND
4. Patient does not have active or uncontrolled metastases to the central nervous
system; AND
348
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablets or capsules
5. In the case of a Patient who is pre-menopausal or peri-menopausal, the Patient is
receiving a luteinizing hormone-releasing hormone (LHRH) agonist to achieve
chemically-induced menopause (Note: Women who have had an oophorectomy are
considered to be post-menopausal); AND
6. The Patient has not experienced disease progression on any of the following regimens
for locally advanced or metastatic breast cancer:
(i) a palbociclib or ribociclib regimen;
(ii) an everolimus regimen; or
(iii) another CDK 4/6 regimen that has been publicly funded.
Renewal Criteria:
Renewals will be considered in patients who have not demonstrated evidence of disease
progression or development of unacceptable toxicity requiring discontinuation while on
palbociclib.
Exclusion Criteria (Note that exclusion criteria apply to both Initial eligibility criteria and
renewal criteria.) Patients meeting the following criteria will not be funded.
i) Patient is using palbociclib as retreatment after disease progression on a prior
palbociclib-based regimen in advanced breast cancer.
ii) Patient is using palbociclib with other drugs or in combinations other than those
situations mentioned in 1 i), ii), iii) of the eligibility criteria.
iii) Patient is using palbociclib in combination with letrozole or anastrozole in the
metastatic setting but has experienced progression in the neoadjuvant or adjuvant
setting occurring during treatment or within 12 months of stopping treatment with
letrozole or anastrozole;
iv) Patient is pre- or peri-menopausal who is not being treated with a luteinizing hormone-
releasing hormone (LHRH) agonist.
v) Patient who is intending to use palbociclib with fulvestrant who has progressed on
prior fulvestrant used as monotherapy or as part of another regimen.
vi) Patient whose disease has progressed during treatment with a ribociclib regimen, an
everolimus regimen, or another CDK 4/6 inhibitor regimen used for advanced,
metastatic breast cancer, unless that use was through a clinical trial.
vii) Patient who has active or uncontrolled central nervous system (CNS) metastases.
viii) The Patient is requesting Ibrance for use with fulvestrant and has extensive,
symptomatic, potentially life-threatening visceral metastases.
349
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablets or capsules
On a time-limited basis, funding will be considered for the following on a case-by-case
basis:
1. Patients who missed the opportunity to use palbociclib in the advanced setting in
patients started on first-line, monotherapy with an aromatase inhibitor (AI) (e.g.
letrozole, anastrozole, exemestane) AND who have not have not experienced disease
progression with current AI therapy AND who meet the disease-free time requirement
if anastrozole or letrozole was used previously in the adjuvant or neoadjuvant setting
and the EAP request is submitted between the dates of December 4, 2020 to March 4,
2021.
2. Addition of palbociclib for patients already on fulvestrant in first, second or subsequent
line who has not experienced disease progression on fulvestrant and who are CDK 4/6
inhibitor naïve and otherwise eligible for this therapy if the EAP request is submitted
between the dates of December 4, 2020 to March 4, 2021.
3. A switch to palbociclib + fulvestrant at progression for patients already on
endocrine/hormonal therapy other than fulvestrant and who are CDK4/6 naïve and
otherwise meet the eligibility requirements for this therapy.
4. A switch to palbociclib + fulvestrant at progression for patients already on and
benefitting from everolimus + exemestane, provided that the start of everolimus +
exemestane was prior to December 4, 2020. Patients must be CDK 4/6 inhibitor naïve
and otherwise eligible for this therapy.
Dosing:
Palbociclib (Ibrance) 125mg orally once a day for 21 consecutive days, followed by 7 days
off treatment, in a combination regimen with one of the following:
• A continuous daily aromatase inhibitor or
• Fulvestrant 500mg administered intramuscularly on days 1 and 15 of cycle 1 and
tehn on day 1 of each subsequent 28-day cycle.
350
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 348, record 202, corpus 2025-01-01; name match only, not an eligibility decision
Brand vs generic price
Lowest DBP recovery rule under medically necessary no-substitution claims:
6.2 Medically Necessary "No Substitution" Claims
The Side Effect Reporting Form will not have to be renewed. However, the
pharmacy must maintain a copy of the prescription that contains a direction that
there be no substitution and the required Health Canada Side Effect Reporting Form
(completed and signed by the prescriber). The prescriber must write “No
Substitution” or “No Sub” on renewal or subsequent new written prescriptions, and
indicate “No Substitution” on subsequent new oral prescriptions. The dispenser will
be reimbursed the DBP plus a mark-up and the lesser of the posted usual and
customary fee or the ODB dispensing fee minus the applicable ODB co-payment
amount. Where a completed Side Effect Reporting Form is not available at the
pharmacy during an inspection, the difference between the cost of the higher-cost
product and the lowest DBP listed for the interchangeable category will be
recovered.
(ontario.ca, Revision #17; 2026-08-03 ↗)
6.2 Medically Necessary "No Substitution" Claims
The Ministry will provide reimbursement of a higher-cost interchangeable product in
medically necessary circumstances where a patient has experienced a significant
adverse reaction with two (2) lower-cost interchangeable drug products, where
available. When a prescriber identifies a patient for which it is medically necessary
that a higher cost interchangeable product be provided, the prescriber must:
• Complete, sign and forward to the pharmacist a copy of the Health Canada
side effect reporting form for each lower-cost interchangeable drug product
trialed (Side Effect Reporting Form[s]); and
• Write “No Substitution” or “No Sub” on a written prescription or indicate “No
Substitution” to the pharmacist in the case of a verbal prescription.
The prescriber should keep a copy of the completed form in the patient’s record for
future use and reference.
In the case of a written prescription, when the pharmacist or dispensing physician
receives a prescription with the written notation “No Substitution” or “No Sub”,
reimbursement will be provided for the higher-cost interchangeable product only if
the prescription is accompanied by a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed.
This form must be completely filled out noting the details of the adverse reaction
and signed by the prescriber.
In the case of a verbal prescription, the prescriber must satisfy the operator of the
pharmacy or dispensing physician that a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed
has been completed and signed by the prescriber. A written record of this verbal
prescription and the completed Health Canada Side Effect Reporting Form must be
received by the pharmacy prior to claim submission.
Upon receipt, the pharmacist must:
• Fax, submit online or mail the completed and signed form to Health Canada’s
Canada Vigilance Program; and
• Retain his or her copy of the completed and signed Side Effect Reporting
Form.
(ontario.ca, Revision #17; 2026-08-03 ↗)1 brand, same coverage
PMS-Palbociclib · DIN 02552132
Manufacturer: Pharmascience Inc.; listing date 2024-11-29
Health Canada: Marketed since 2024-09-27 · brand PMS-PALBOCICLIB · ATC L01EF01 PALBOCICLIB · form Tablet · route Oral · ingredients PALBOCICLIB 100 MG · company Pharmascience inc · schedule Prescription
Check this DIN again · Health Canada product recordPMS-Palbociclib: Formulary list price $126.9562/unit (unit not stated in source; not the patient's cost)
Ministry pays: $126.9562 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=104082 · Verify on the e-Formulary ↗ (DIN 02552132)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02552132).
DIN 02552132: PMS-Palbociclib
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 100000318; group id 178; item number 0322; lccId None; manufacturer id PMS
Source form: Tab; strength: 100mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $126.9562; ministry $126.9562
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02552132
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=104082
Interchangeable products
Ibrance · DIN 02493543 · $126.9562
Taro-Palbociclib · DIN 02547643 · $126.9562
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02552132
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Taro-Palbociclib · DIN 02547643 · 100mg · tablet
Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-02
Write on scriptnot a benefit; no Exceptional Access criteria on record; see alternatives
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 criteria on record are for Brand(s): Ibrance; DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablet or capsules — not this product; no criteria on record for this product in this block.
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
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablet or capsules
Updated December 4, 2020
Initial Criteria
For the treatment of patients with estrogen receptor(ER)-positive, human epidermal growth
factor receptor 2 (HER 2)-negative; unresectable locally advanced breast cancer or
metastatic breast cancer in patients who meet the following criteria;
1. Palbociclib is being used as combination therapy in one of the following treatment
regimens1;
i) As first line therapy in combination with an aromatase inhibitor (i.e. letrozole,
anastrozole, or exemestane) or fulvestrant in a patient who has not progressed on
a prior systemic treatment (i.e. chemotherapy, immunotherapy, or endocrine
therapy) for their unresectable locally advanced or metastatic disease; OR
ii) As second line therapy in combination with an aromatase inhibitor (i.e. letrozole,
anastrozole, or exemestane) or fulvestrant after progression on a chemotherapy
for unresectable locally advanced or metastatic disease; OR
iii) As a second or subsequent line therapy in combination with fulvestrant after
progression on any number of endocrine monotherapies with the exception of
progression during prior fulvestrant therapy.
1Note: EAP funding will be considered for only one CDK 4/6 inhibitor regimen (i.e.
Palbociclib or Ribociclib) OR Everolimus based regimen for the treatment of
unresectable locally advanced or metastatic disease. No funding for sequential
treatment regimens involving palbociclib or ribociclib or everolimus will be considered.
AND
2. Patients who received anastrozole or letrozole in the neo-adjuvant or adjuvant setting,
must demonstrate a minimum disease free interval of twelve (12) months after
stopping therapy to qualify for funding of palbociclib in combination with anastrozole or
letrozole. (Note: This does not apply to patients receiving tamoxifen or exemestane in
the neoadjuvant or adjuvant setting who progress or relapse early on those
treatments.)
3. Patient has good performance status defined as an Eastern Cooperative Oncology
Group (ECOG) score of 0 to 2; AND
4. Patient does not have active or uncontrolled metastases to the central nervous
system; AND
348
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablets or capsules
5. In the case of a Patient who is pre-menopausal or peri-menopausal, the Patient is
receiving a luteinizing hormone-releasing hormone (LHRH) agonist to achieve
chemically-induced menopause (Note: Women who have had an oophorectomy are
considered to be post-menopausal); AND
6. The Patient has not experienced disease progression on any of the following regimens
for locally advanced or metastatic breast cancer:
(i) a palbociclib or ribociclib regimen;
(ii) an everolimus regimen; or
(iii) another CDK 4/6 regimen that has been publicly funded.
Renewal Criteria:
Renewals will be considered in patients who have not demonstrated evidence of disease
progression or development of unacceptable toxicity requiring discontinuation while on
palbociclib.
Exclusion Criteria (Note that exclusion criteria apply to both Initial eligibility criteria and
renewal criteria.) Patients meeting the following criteria will not be funded.
i) Patient is using palbociclib as retreatment after disease progression on a prior
palbociclib-based regimen in advanced breast cancer.
ii) Patient is using palbociclib with other drugs or in combinations other than those
situations mentioned in 1 i), ii), iii) of the eligibility criteria.
iii) Patient is using palbociclib in combination with letrozole or anastrozole in the
metastatic setting but has experienced progression in the neoadjuvant or adjuvant
setting occurring during treatment or within 12 months of stopping treatment with
letrozole or anastrozole;
iv) Patient is pre- or peri-menopausal who is not being treated with a luteinizing hormone-
releasing hormone (LHRH) agonist.
v) Patient who is intending to use palbociclib with fulvestrant who has progressed on
prior fulvestrant used as monotherapy or as part of another regimen.
vi) Patient whose disease has progressed during treatment with a ribociclib regimen, an
everolimus regimen, or another CDK 4/6 inhibitor regimen used for advanced,
metastatic breast cancer, unless that use was through a clinical trial.
vii) Patient who has active or uncontrolled central nervous system (CNS) metastases.
viii) The Patient is requesting Ibrance for use with fulvestrant and has extensive,
symptomatic, potentially life-threatening visceral metastases.
349
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablets or capsules
On a time-limited basis, funding will be considered for the following on a case-by-case
basis:
1. Patients who missed the opportunity to use palbociclib in the advanced setting in
patients started on first-line, monotherapy with an aromatase inhibitor (AI) (e.g.
letrozole, anastrozole, exemestane) AND who have not have not experienced disease
progression with current AI therapy AND who meet the disease-free time requirement
if anastrozole or letrozole was used previously in the adjuvant or neoadjuvant setting
and the EAP request is submitted between the dates of December 4, 2020 to March 4,
2021.
2. Addition of palbociclib for patients already on fulvestrant in first, second or subsequent
line who has not experienced disease progression on fulvestrant and who are CDK 4/6
inhibitor naïve and otherwise eligible for this therapy if the EAP request is submitted
between the dates of December 4, 2020 to March 4, 2021.
3. A switch to palbociclib + fulvestrant at progression for patients already on
endocrine/hormonal therapy other than fulvestrant and who are CDK4/6 naïve and
otherwise meet the eligibility requirements for this therapy.
4. A switch to palbociclib + fulvestrant at progression for patients already on and
benefitting from everolimus + exemestane, provided that the start of everolimus +
exemestane was prior to December 4, 2020. Patients must be CDK 4/6 inhibitor naïve
and otherwise eligible for this therapy.
Dosing:
Palbociclib (Ibrance) 125mg orally once a day for 21 consecutive days, followed by 7 days
off treatment, in a combination regimen with one of the following:
• A continuous daily aromatase inhibitor or
• Fulvestrant 500mg administered intramuscularly on days 1 and 15 of cycle 1 and
tehn on day 1 of each subsequent 28-day cycle.
350
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 348, record 202, corpus 2025-01-01; name match only, not an eligibility decision
Brand vs generic price
Lowest DBP recovery rule under medically necessary no-substitution claims:
6.2 Medically Necessary "No Substitution" Claims
The Side Effect Reporting Form will not have to be renewed. However, the
pharmacy must maintain a copy of the prescription that contains a direction that
there be no substitution and the required Health Canada Side Effect Reporting Form
(completed and signed by the prescriber). The prescriber must write “No
Substitution” or “No Sub” on renewal or subsequent new written prescriptions, and
indicate “No Substitution” on subsequent new oral prescriptions. The dispenser will
be reimbursed the DBP plus a mark-up and the lesser of the posted usual and
customary fee or the ODB dispensing fee minus the applicable ODB co-payment
amount. Where a completed Side Effect Reporting Form is not available at the
pharmacy during an inspection, the difference between the cost of the higher-cost
product and the lowest DBP listed for the interchangeable category will be
recovered.
(ontario.ca, Revision #17; 2026-08-03 ↗)
6.2 Medically Necessary "No Substitution" Claims
The Ministry will provide reimbursement of a higher-cost interchangeable product in
medically necessary circumstances where a patient has experienced a significant
adverse reaction with two (2) lower-cost interchangeable drug products, where
available. When a prescriber identifies a patient for which it is medically necessary
that a higher cost interchangeable product be provided, the prescriber must:
• Complete, sign and forward to the pharmacist a copy of the Health Canada
side effect reporting form for each lower-cost interchangeable drug product
trialed (Side Effect Reporting Form[s]); and
• Write “No Substitution” or “No Sub” on a written prescription or indicate “No
Substitution” to the pharmacist in the case of a verbal prescription.
The prescriber should keep a copy of the completed form in the patient’s record for
future use and reference.
In the case of a written prescription, when the pharmacist or dispensing physician
receives a prescription with the written notation “No Substitution” or “No Sub”,
reimbursement will be provided for the higher-cost interchangeable product only if
the prescription is accompanied by a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed.
This form must be completely filled out noting the details of the adverse reaction
and signed by the prescriber.
In the case of a verbal prescription, the prescriber must satisfy the operator of the
pharmacy or dispensing physician that a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed
has been completed and signed by the prescriber. A written record of this verbal
prescription and the completed Health Canada Side Effect Reporting Form must be
received by the pharmacy prior to claim submission.
Upon receipt, the pharmacist must:
• Fax, submit online or mail the completed and signed form to Health Canada’s
Canada Vigilance Program; and
• Retain his or her copy of the completed and signed Side Effect Reporting
Form.
(ontario.ca, Revision #17; 2026-08-03 ↗)1 brand, same coverage
Taro-Palbociclib · DIN 02547643
Manufacturer: Taro Pharmaceuticals Inc.; listing date 2024-11-29
Health Canada: Marketed since 2024-09-17 · brand TARO-PALBOCICLIB · ATC L01EF01 PALBOCICLIB · form Tablet · route Oral · ingredients PALBOCICLIB 100 MG · company Taro pharmaceuticals inc · schedule Prescription
Check this DIN again · Health Canada product recordTaro-Palbociclib: Formulary list price $126.9562/unit (unit not stated in source; not the patient's cost)
Ministry pays: $126.9562 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=103658 · Verify on the e-Formulary ↗ (DIN 02547643)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02547643).
DIN 02547643: Taro-Palbociclib
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 100000318; group id 178; item number 0322; lccId None; manufacturer id TAR
Source form: Tab; strength: 100mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $126.9562; ministry $126.9562
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02547643
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=103658
Interchangeable products
Ibrance · DIN 02493543 · $126.9562
PMS-Palbociclib · DIN 02552132 · $126.9562
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02547643
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Ibrance · DIN 02493551 · 125mg · tablet
Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-02
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 ↗) 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
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablet or capsules
Updated December 4, 2020
Initial Criteria
For the treatment of patients with estrogen receptor(ER)-positive, human epidermal growth
factor receptor 2 (HER 2)-negative; unresectable locally advanced breast cancer or
metastatic breast cancer in patients who meet the following criteria;
1. Palbociclib is being used as combination therapy in one of the following treatment
regimens1;
i) As first line therapy in combination with an aromatase inhibitor (i.e. letrozole,
anastrozole, or exemestane) or fulvestrant in a patient who has not progressed on
a prior systemic treatment (i.e. chemotherapy, immunotherapy, or endocrine
therapy) for their unresectable locally advanced or metastatic disease; OR
ii) As second line therapy in combination with an aromatase inhibitor (i.e. letrozole,
anastrozole, or exemestane) or fulvestrant after progression on a chemotherapy
for unresectable locally advanced or metastatic disease; OR
iii) As a second or subsequent line therapy in combination with fulvestrant after
progression on any number of endocrine monotherapies with the exception of
progression during prior fulvestrant therapy.
1Note: EAP funding will be considered for only one CDK 4/6 inhibitor regimen (i.e.
Palbociclib or Ribociclib) OR Everolimus based regimen for the treatment of
unresectable locally advanced or metastatic disease. No funding for sequential
treatment regimens involving palbociclib or ribociclib or everolimus will be considered.
AND
2. Patients who received anastrozole or letrozole in the neo-adjuvant or adjuvant setting,
must demonstrate a minimum disease free interval of twelve (12) months after
stopping therapy to qualify for funding of palbociclib in combination with anastrozole or
letrozole. (Note: This does not apply to patients receiving tamoxifen or exemestane in
the neoadjuvant or adjuvant setting who progress or relapse early on those
treatments.)
3. Patient has good performance status defined as an Eastern Cooperative Oncology
Group (ECOG) score of 0 to 2; AND
4. Patient does not have active or uncontrolled metastases to the central nervous
system; AND
348
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablets or capsules
5. In the case of a Patient who is pre-menopausal or peri-menopausal, the Patient is
receiving a luteinizing hormone-releasing hormone (LHRH) agonist to achieve
chemically-induced menopause (Note: Women who have had an oophorectomy are
considered to be post-menopausal); AND
6. The Patient has not experienced disease progression on any of the following regimens
for locally advanced or metastatic breast cancer:
(i) a palbociclib or ribociclib regimen;
(ii) an everolimus regimen; or
(iii) another CDK 4/6 regimen that has been publicly funded.
Renewal Criteria:
Renewals will be considered in patients who have not demonstrated evidence of disease
progression or development of unacceptable toxicity requiring discontinuation while on
palbociclib.
Exclusion Criteria (Note that exclusion criteria apply to both Initial eligibility criteria and
renewal criteria.) Patients meeting the following criteria will not be funded.
i) Patient is using palbociclib as retreatment after disease progression on a prior
palbociclib-based regimen in advanced breast cancer.
ii) Patient is using palbociclib with other drugs or in combinations other than those
situations mentioned in 1 i), ii), iii) of the eligibility criteria.
iii) Patient is using palbociclib in combination with letrozole or anastrozole in the
metastatic setting but has experienced progression in the neoadjuvant or adjuvant
setting occurring during treatment or within 12 months of stopping treatment with
letrozole or anastrozole;
iv) Patient is pre- or peri-menopausal who is not being treated with a luteinizing hormone-
releasing hormone (LHRH) agonist.
v) Patient who is intending to use palbociclib with fulvestrant who has progressed on
prior fulvestrant used as monotherapy or as part of another regimen.
vi) Patient whose disease has progressed during treatment with a ribociclib regimen, an
everolimus regimen, or another CDK 4/6 inhibitor regimen used for advanced,
metastatic breast cancer, unless that use was through a clinical trial.
vii) Patient who has active or uncontrolled central nervous system (CNS) metastases.
viii) The Patient is requesting Ibrance for use with fulvestrant and has extensive,
symptomatic, potentially life-threatening visceral metastases.
349
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablets or capsules
On a time-limited basis, funding will be considered for the following on a case-by-case
basis:
1. Patients who missed the opportunity to use palbociclib in the advanced setting in
patients started on first-line, monotherapy with an aromatase inhibitor (AI) (e.g.
letrozole, anastrozole, exemestane) AND who have not have not experienced disease
progression with current AI therapy AND who meet the disease-free time requirement
if anastrozole or letrozole was used previously in the adjuvant or neoadjuvant setting
and the EAP request is submitted between the dates of December 4, 2020 to March 4,
2021.
2. Addition of palbociclib for patients already on fulvestrant in first, second or subsequent
line who has not experienced disease progression on fulvestrant and who are CDK 4/6
inhibitor naïve and otherwise eligible for this therapy if the EAP request is submitted
between the dates of December 4, 2020 to March 4, 2021.
3. A switch to palbociclib + fulvestrant at progression for patients already on
endocrine/hormonal therapy other than fulvestrant and who are CDK4/6 naïve and
otherwise meet the eligibility requirements for this therapy.
4. A switch to palbociclib + fulvestrant at progression for patients already on and
benefitting from everolimus + exemestane, provided that the start of everolimus +
exemestane was prior to December 4, 2020. Patients must be CDK 4/6 inhibitor naïve
and otherwise eligible for this therapy.
Dosing:
Palbociclib (Ibrance) 125mg orally once a day for 21 consecutive days, followed by 7 days
off treatment, in a combination regimen with one of the following:
• A continuous daily aromatase inhibitor or
• Fulvestrant 500mg administered intramuscularly on days 1 and 15 of cycle 1 and
tehn on day 1 of each subsequent 28-day cycle.
350
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 348, record 202, 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
Ibrance · DIN 02493551
Manufacturer: Pfizer Canada Inc.; listing date 2024-11-29
Health Canada: Marketed since 2020-09-21 · brand IBRANCE · ATC L01EF01 PALBOCICLIB · form Tablet · route Oral · ingredients PALBOCICLIB 125 MG · company Pfizer canada ulc · schedule Prescription
Check this DIN again · Health Canada product recordMinistry pays: $126.9562 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=98356 · Verify on the e-Formulary ↗ (DIN 02493551)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02493551).
DIN 02493551: Ibrance
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 100000319; group id 178; item number 0323; lccId None; manufacturer id PFI
Source form: Tab; strength: 125mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $253.9123; ministry $126.9562
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02493551
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=98356
Interchangeable products
PMS-Palbociclib · DIN 02552140 · $126.9562
Taro-Palbociclib · DIN 02547651 · $126.9562
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02493551
Shortage record checked 2026-09-13T08:10:21.292534+00:00
PMS-Palbociclib · DIN 02552140 · 125mg · tablet
Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-02
Write on scriptnot a benefit; no Exceptional Access criteria on record; see alternatives
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 criteria on record are for Brand(s): Ibrance; DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablet or capsules — not this product; no criteria on record for this product in this block.
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
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablet or capsules
Updated December 4, 2020
Initial Criteria
For the treatment of patients with estrogen receptor(ER)-positive, human epidermal growth
factor receptor 2 (HER 2)-negative; unresectable locally advanced breast cancer or
metastatic breast cancer in patients who meet the following criteria;
1. Palbociclib is being used as combination therapy in one of the following treatment
regimens1;
i) As first line therapy in combination with an aromatase inhibitor (i.e. letrozole,
anastrozole, or exemestane) or fulvestrant in a patient who has not progressed on
a prior systemic treatment (i.e. chemotherapy, immunotherapy, or endocrine
therapy) for their unresectable locally advanced or metastatic disease; OR
ii) As second line therapy in combination with an aromatase inhibitor (i.e. letrozole,
anastrozole, or exemestane) or fulvestrant after progression on a chemotherapy
for unresectable locally advanced or metastatic disease; OR
iii) As a second or subsequent line therapy in combination with fulvestrant after
progression on any number of endocrine monotherapies with the exception of
progression during prior fulvestrant therapy.
1Note: EAP funding will be considered for only one CDK 4/6 inhibitor regimen (i.e.
Palbociclib or Ribociclib) OR Everolimus based regimen for the treatment of
unresectable locally advanced or metastatic disease. No funding for sequential
treatment regimens involving palbociclib or ribociclib or everolimus will be considered.
AND
2. Patients who received anastrozole or letrozole in the neo-adjuvant or adjuvant setting,
must demonstrate a minimum disease free interval of twelve (12) months after
stopping therapy to qualify for funding of palbociclib in combination with anastrozole or
letrozole. (Note: This does not apply to patients receiving tamoxifen or exemestane in
the neoadjuvant or adjuvant setting who progress or relapse early on those
treatments.)
3. Patient has good performance status defined as an Eastern Cooperative Oncology
Group (ECOG) score of 0 to 2; AND
4. Patient does not have active or uncontrolled metastases to the central nervous
system; AND
348
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablets or capsules
5. In the case of a Patient who is pre-menopausal or peri-menopausal, the Patient is
receiving a luteinizing hormone-releasing hormone (LHRH) agonist to achieve
chemically-induced menopause (Note: Women who have had an oophorectomy are
considered to be post-menopausal); AND
6. The Patient has not experienced disease progression on any of the following regimens
for locally advanced or metastatic breast cancer:
(i) a palbociclib or ribociclib regimen;
(ii) an everolimus regimen; or
(iii) another CDK 4/6 regimen that has been publicly funded.
Renewal Criteria:
Renewals will be considered in patients who have not demonstrated evidence of disease
progression or development of unacceptable toxicity requiring discontinuation while on
palbociclib.
Exclusion Criteria (Note that exclusion criteria apply to both Initial eligibility criteria and
renewal criteria.) Patients meeting the following criteria will not be funded.
i) Patient is using palbociclib as retreatment after disease progression on a prior
palbociclib-based regimen in advanced breast cancer.
ii) Patient is using palbociclib with other drugs or in combinations other than those
situations mentioned in 1 i), ii), iii) of the eligibility criteria.
iii) Patient is using palbociclib in combination with letrozole or anastrozole in the
metastatic setting but has experienced progression in the neoadjuvant or adjuvant
setting occurring during treatment or within 12 months of stopping treatment with
letrozole or anastrozole;
iv) Patient is pre- or peri-menopausal who is not being treated with a luteinizing hormone-
releasing hormone (LHRH) agonist.
v) Patient who is intending to use palbociclib with fulvestrant who has progressed on
prior fulvestrant used as monotherapy or as part of another regimen.
vi) Patient whose disease has progressed during treatment with a ribociclib regimen, an
everolimus regimen, or another CDK 4/6 inhibitor regimen used for advanced,
metastatic breast cancer, unless that use was through a clinical trial.
vii) Patient who has active or uncontrolled central nervous system (CNS) metastases.
viii) The Patient is requesting Ibrance for use with fulvestrant and has extensive,
symptomatic, potentially life-threatening visceral metastases.
349
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablets or capsules
On a time-limited basis, funding will be considered for the following on a case-by-case
basis:
1. Patients who missed the opportunity to use palbociclib in the advanced setting in
patients started on first-line, monotherapy with an aromatase inhibitor (AI) (e.g.
letrozole, anastrozole, exemestane) AND who have not have not experienced disease
progression with current AI therapy AND who meet the disease-free time requirement
if anastrozole or letrozole was used previously in the adjuvant or neoadjuvant setting
and the EAP request is submitted between the dates of December 4, 2020 to March 4,
2021.
2. Addition of palbociclib for patients already on fulvestrant in first, second or subsequent
line who has not experienced disease progression on fulvestrant and who are CDK 4/6
inhibitor naïve and otherwise eligible for this therapy if the EAP request is submitted
between the dates of December 4, 2020 to March 4, 2021.
3. A switch to palbociclib + fulvestrant at progression for patients already on
endocrine/hormonal therapy other than fulvestrant and who are CDK4/6 naïve and
otherwise meet the eligibility requirements for this therapy.
4. A switch to palbociclib + fulvestrant at progression for patients already on and
benefitting from everolimus + exemestane, provided that the start of everolimus +
exemestane was prior to December 4, 2020. Patients must be CDK 4/6 inhibitor naïve
and otherwise eligible for this therapy.
Dosing:
Palbociclib (Ibrance) 125mg orally once a day for 21 consecutive days, followed by 7 days
off treatment, in a combination regimen with one of the following:
• A continuous daily aromatase inhibitor or
• Fulvestrant 500mg administered intramuscularly on days 1 and 15 of cycle 1 and
tehn on day 1 of each subsequent 28-day cycle.
350
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 348, record 202, corpus 2025-01-01; name match only, not an eligibility decision
Brand vs generic price
Lowest DBP recovery rule under medically necessary no-substitution claims:
6.2 Medically Necessary "No Substitution" Claims
The Side Effect Reporting Form will not have to be renewed. However, the
pharmacy must maintain a copy of the prescription that contains a direction that
there be no substitution and the required Health Canada Side Effect Reporting Form
(completed and signed by the prescriber). The prescriber must write “No
Substitution” or “No Sub” on renewal or subsequent new written prescriptions, and
indicate “No Substitution” on subsequent new oral prescriptions. The dispenser will
be reimbursed the DBP plus a mark-up and the lesser of the posted usual and
customary fee or the ODB dispensing fee minus the applicable ODB co-payment
amount. Where a completed Side Effect Reporting Form is not available at the
pharmacy during an inspection, the difference between the cost of the higher-cost
product and the lowest DBP listed for the interchangeable category will be
recovered.
(ontario.ca, Revision #17; 2026-08-03 ↗)
6.2 Medically Necessary "No Substitution" Claims
The Ministry will provide reimbursement of a higher-cost interchangeable product in
medically necessary circumstances where a patient has experienced a significant
adverse reaction with two (2) lower-cost interchangeable drug products, where
available. When a prescriber identifies a patient for which it is medically necessary
that a higher cost interchangeable product be provided, the prescriber must:
• Complete, sign and forward to the pharmacist a copy of the Health Canada
side effect reporting form for each lower-cost interchangeable drug product
trialed (Side Effect Reporting Form[s]); and
• Write “No Substitution” or “No Sub” on a written prescription or indicate “No
Substitution” to the pharmacist in the case of a verbal prescription.
The prescriber should keep a copy of the completed form in the patient’s record for
future use and reference.
In the case of a written prescription, when the pharmacist or dispensing physician
receives a prescription with the written notation “No Substitution” or “No Sub”,
reimbursement will be provided for the higher-cost interchangeable product only if
the prescription is accompanied by a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed.
This form must be completely filled out noting the details of the adverse reaction
and signed by the prescriber.
In the case of a verbal prescription, the prescriber must satisfy the operator of the
pharmacy or dispensing physician that a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed
has been completed and signed by the prescriber. A written record of this verbal
prescription and the completed Health Canada Side Effect Reporting Form must be
received by the pharmacy prior to claim submission.
Upon receipt, the pharmacist must:
• Fax, submit online or mail the completed and signed form to Health Canada’s
Canada Vigilance Program; and
• Retain his or her copy of the completed and signed Side Effect Reporting
Form.
(ontario.ca, Revision #17; 2026-08-03 ↗)1 brand, same coverage
PMS-Palbociclib · DIN 02552140
Manufacturer: Pharmascience Inc.; listing date 2024-11-29
Health Canada: Marketed since 2024-09-27 · brand PMS-PALBOCICLIB · ATC L01EF01 PALBOCICLIB · form Tablet · route Oral · ingredients PALBOCICLIB 125 MG · company Pharmascience inc · schedule Prescription
Check this DIN again · Health Canada product recordPMS-Palbociclib: Formulary list price $126.9562/unit (unit not stated in source; not the patient's cost)
Ministry pays: $126.9562 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=104083 · Verify on the e-Formulary ↗ (DIN 02552140)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02552140).
DIN 02552140: PMS-Palbociclib
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 100000319; group id 178; item number 0323; lccId None; manufacturer id PMS
Source form: Tab; strength: 125mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $126.9562; ministry $126.9562
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02552140
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=104083
Interchangeable products
Ibrance · DIN 02493551 · $126.9562
Taro-Palbociclib · DIN 02547651 · $126.9562
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02552140
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Taro-Palbociclib · DIN 02547651 · 125mg · tablet
Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-02
Write on scriptnot a benefit; no Exceptional Access criteria on record; see alternatives
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 criteria on record are for Brand(s): Ibrance; DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablet or capsules — not this product; no criteria on record for this product in this block.
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
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablet or capsules
Updated December 4, 2020
Initial Criteria
For the treatment of patients with estrogen receptor(ER)-positive, human epidermal growth
factor receptor 2 (HER 2)-negative; unresectable locally advanced breast cancer or
metastatic breast cancer in patients who meet the following criteria;
1. Palbociclib is being used as combination therapy in one of the following treatment
regimens1;
i) As first line therapy in combination with an aromatase inhibitor (i.e. letrozole,
anastrozole, or exemestane) or fulvestrant in a patient who has not progressed on
a prior systemic treatment (i.e. chemotherapy, immunotherapy, or endocrine
therapy) for their unresectable locally advanced or metastatic disease; OR
ii) As second line therapy in combination with an aromatase inhibitor (i.e. letrozole,
anastrozole, or exemestane) or fulvestrant after progression on a chemotherapy
for unresectable locally advanced or metastatic disease; OR
iii) As a second or subsequent line therapy in combination with fulvestrant after
progression on any number of endocrine monotherapies with the exception of
progression during prior fulvestrant therapy.
1Note: EAP funding will be considered for only one CDK 4/6 inhibitor regimen (i.e.
Palbociclib or Ribociclib) OR Everolimus based regimen for the treatment of
unresectable locally advanced or metastatic disease. No funding for sequential
treatment regimens involving palbociclib or ribociclib or everolimus will be considered.
AND
2. Patients who received anastrozole or letrozole in the neo-adjuvant or adjuvant setting,
must demonstrate a minimum disease free interval of twelve (12) months after
stopping therapy to qualify for funding of palbociclib in combination with anastrozole or
letrozole. (Note: This does not apply to patients receiving tamoxifen or exemestane in
the neoadjuvant or adjuvant setting who progress or relapse early on those
treatments.)
3. Patient has good performance status defined as an Eastern Cooperative Oncology
Group (ECOG) score of 0 to 2; AND
4. Patient does not have active or uncontrolled metastases to the central nervous
system; AND
348
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablets or capsules
5. In the case of a Patient who is pre-menopausal or peri-menopausal, the Patient is
receiving a luteinizing hormone-releasing hormone (LHRH) agonist to achieve
chemically-induced menopause (Note: Women who have had an oophorectomy are
considered to be post-menopausal); AND
6. The Patient has not experienced disease progression on any of the following regimens
for locally advanced or metastatic breast cancer:
(i) a palbociclib or ribociclib regimen;
(ii) an everolimus regimen; or
(iii) another CDK 4/6 regimen that has been publicly funded.
Renewal Criteria:
Renewals will be considered in patients who have not demonstrated evidence of disease
progression or development of unacceptable toxicity requiring discontinuation while on
palbociclib.
Exclusion Criteria (Note that exclusion criteria apply to both Initial eligibility criteria and
renewal criteria.) Patients meeting the following criteria will not be funded.
i) Patient is using palbociclib as retreatment after disease progression on a prior
palbociclib-based regimen in advanced breast cancer.
ii) Patient is using palbociclib with other drugs or in combinations other than those
situations mentioned in 1 i), ii), iii) of the eligibility criteria.
iii) Patient is using palbociclib in combination with letrozole or anastrozole in the
metastatic setting but has experienced progression in the neoadjuvant or adjuvant
setting occurring during treatment or within 12 months of stopping treatment with
letrozole or anastrozole;
iv) Patient is pre- or peri-menopausal who is not being treated with a luteinizing hormone-
releasing hormone (LHRH) agonist.
v) Patient who is intending to use palbociclib with fulvestrant who has progressed on
prior fulvestrant used as monotherapy or as part of another regimen.
vi) Patient whose disease has progressed during treatment with a ribociclib regimen, an
everolimus regimen, or another CDK 4/6 inhibitor regimen used for advanced,
metastatic breast cancer, unless that use was through a clinical trial.
vii) Patient who has active or uncontrolled central nervous system (CNS) metastases.
viii) The Patient is requesting Ibrance for use with fulvestrant and has extensive,
symptomatic, potentially life-threatening visceral metastases.
349
Palbociclib
Brand(s): Ibrance
DOSAGE FORM/ STRENGTH: 75 mg, 100 mg, 125 mg tablets or capsules
On a time-limited basis, funding will be considered for the following on a case-by-case
basis:
1. Patients who missed the opportunity to use palbociclib in the advanced setting in
patients started on first-line, monotherapy with an aromatase inhibitor (AI) (e.g.
letrozole, anastrozole, exemestane) AND who have not have not experienced disease
progression with current AI therapy AND who meet the disease-free time requirement
if anastrozole or letrozole was used previously in the adjuvant or neoadjuvant setting
and the EAP request is submitted between the dates of December 4, 2020 to March 4,
2021.
2. Addition of palbociclib for patients already on fulvestrant in first, second or subsequent
line who has not experienced disease progression on fulvestrant and who are CDK 4/6
inhibitor naïve and otherwise eligible for this therapy if the EAP request is submitted
between the dates of December 4, 2020 to March 4, 2021.
3. A switch to palbociclib + fulvestrant at progression for patients already on
endocrine/hormonal therapy other than fulvestrant and who are CDK4/6 naïve and
otherwise meet the eligibility requirements for this therapy.
4. A switch to palbociclib + fulvestrant at progression for patients already on and
benefitting from everolimus + exemestane, provided that the start of everolimus +
exemestane was prior to December 4, 2020. Patients must be CDK 4/6 inhibitor naïve
and otherwise eligible for this therapy.
Dosing:
Palbociclib (Ibrance) 125mg orally once a day for 21 consecutive days, followed by 7 days
off treatment, in a combination regimen with one of the following:
• A continuous daily aromatase inhibitor or
• Fulvestrant 500mg administered intramuscularly on days 1 and 15 of cycle 1 and
tehn on day 1 of each subsequent 28-day cycle.
350
EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 348, record 202, corpus 2025-01-01; name match only, not an eligibility decision
Brand vs generic price
Lowest DBP recovery rule under medically necessary no-substitution claims:
6.2 Medically Necessary "No Substitution" Claims
The Side Effect Reporting Form will not have to be renewed. However, the
pharmacy must maintain a copy of the prescription that contains a direction that
there be no substitution and the required Health Canada Side Effect Reporting Form
(completed and signed by the prescriber). The prescriber must write “No
Substitution” or “No Sub” on renewal or subsequent new written prescriptions, and
indicate “No Substitution” on subsequent new oral prescriptions. The dispenser will
be reimbursed the DBP plus a mark-up and the lesser of the posted usual and
customary fee or the ODB dispensing fee minus the applicable ODB co-payment
amount. Where a completed Side Effect Reporting Form is not available at the
pharmacy during an inspection, the difference between the cost of the higher-cost
product and the lowest DBP listed for the interchangeable category will be
recovered.
(ontario.ca, Revision #17; 2026-08-03 ↗)
6.2 Medically Necessary "No Substitution" Claims
The Ministry will provide reimbursement of a higher-cost interchangeable product in
medically necessary circumstances where a patient has experienced a significant
adverse reaction with two (2) lower-cost interchangeable drug products, where
available. When a prescriber identifies a patient for which it is medically necessary
that a higher cost interchangeable product be provided, the prescriber must:
• Complete, sign and forward to the pharmacist a copy of the Health Canada
side effect reporting form for each lower-cost interchangeable drug product
trialed (Side Effect Reporting Form[s]); and
• Write “No Substitution” or “No Sub” on a written prescription or indicate “No
Substitution” to the pharmacist in the case of a verbal prescription.
The prescriber should keep a copy of the completed form in the patient’s record for
future use and reference.
In the case of a written prescription, when the pharmacist or dispensing physician
receives a prescription with the written notation “No Substitution” or “No Sub”,
reimbursement will be provided for the higher-cost interchangeable product only if
the prescription is accompanied by a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed.
This form must be completely filled out noting the details of the adverse reaction
and signed by the prescriber.
In the case of a verbal prescription, the prescriber must satisfy the operator of the
pharmacy or dispensing physician that a completed Health Canada Side Effect
Reporting Form for each of the lower-cost interchangeable drug products trialed
has been completed and signed by the prescriber. A written record of this verbal
prescription and the completed Health Canada Side Effect Reporting Form must be
received by the pharmacy prior to claim submission.
Upon receipt, the pharmacist must:
• Fax, submit online or mail the completed and signed form to Health Canada’s
Canada Vigilance Program; and
• Retain his or her copy of the completed and signed Side Effect Reporting
Form.
(ontario.ca, Revision #17; 2026-08-03 ↗)1 brand, same coverage
Taro-Palbociclib · DIN 02547651
Manufacturer: Taro Pharmaceuticals Inc.; listing date 2024-11-29
Health Canada: Marketed since 2024-09-17 · brand TARO-PALBOCICLIB · ATC L01EF01 PALBOCICLIB · form Tablet · route Oral · ingredients PALBOCICLIB 125 MG · company Taro pharmaceuticals inc · schedule Prescription
Check this DIN again · Health Canada product recordTaro-Palbociclib: Formulary list price $126.9562/unit (unit not stated in source; not the patient's cost)
Ministry pays: $126.9562 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=103659 · Verify on the e-Formulary ↗ (DIN 02547651)
Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02547651).
DIN 02547651: Taro-Palbociclib
Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y
Item: 100000319; group id 178; item number 0323; lccId None; manufacturer id TAR
Source form: Tab; strength: 125mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed)
Source prices (unrounded): $126.9562; ministry $126.9562
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02547651
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=103659
Interchangeable products
Ibrance · DIN 02493551 · $126.9562
PMS-Palbociclib · DIN 02552140 · $126.9562
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02547651
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Other drugs in the same formulary class (10:00 ANTINEOPLASTIC AGENTS) and how they are covered
Matched class: 10:00 ANTINEOPLASTIC AGENTS
Drug-class inventory only. Lists recorded Ontario formulary products, not every Canadian medication; does not recommend treatment.
Covered without a code on the Ontario formulary: ABIRATERONE ACETATE, ALTRETAMINE, ANASTROZOLE, BUSERELIN ACETATE, BUSULFAN, CAPECITABINE, CHLORAMBUCIL, CYPROTERONE ACETATE, DAUNORUBICIN, DEGARELIX ACETATE, ETOPOSIDE, EXEMESTANE, FLUOROURACIL & SALICYLIC ACID, FULVESTRANT, GOSERELIN ACETATE, HYDROXYUREA, IMATINIB MESYLATE, LETROZOLE, LEUPROLIDE ACETATE, MELPHALAN, MERCAPTOPURINE, MITOTANE, PROCARBAZINE HCL, TEMOZOLOMIDE, THIOGUANINE, TRIPTORELIN PAMOATE
Some products covered without a code (check the product listing): BICALUTAMIDE, CYCLOPHOSPHAMIDE, FLUTAMIDE, LOMUSTINE (CCNU), MEGESTROL ACETATE, METHOTREXATE, TAMOXIFEN CITRATE, VINCRISTINE SULFATE
10:00 ANTINEOPLASTIC AGENTS
· 20 products · General benefit · strengths: 100mg, 400mg · Tab
· 9 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 20mg, 30mg, 40mg · Tab
· 4 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 100mg, 500mg · Tab
· 33 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 20mg, 50mg, 70mg, 80mg, 100mg, 140mg · Tab
· 14 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 25mg, 100mg, 150mg · Tab
· 5 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 250mg · Tab
· 6 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 150mg, 200mg · Cap
· 3 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 200mg · Tab
· 18 products · General benefit · strengths: 250mg, 500mg · Tab
· 1 products · General benefit · strengths: 50mg · Cap
· 17 products · General benefit · strengths: 1mg · Tab
· 9 products · Listed, not a benefit (1), General benefit (8) · strengths: 50mg · Tab
Source: formulary-ed43-front-matter.txt Part V; ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26; class 10:00
and 34 more
Full class listing
Related classes:
Same formulary class, not same indication: class membership alone does not establish equivalent uses.