Look up one drug

Ontario coverage, price, criteria word for word, Health Canada status and shortages for one product

Patient plan: look up a medication list

SAPROPTERIN DIHYDROCHLORIDE

All products: not a benefit

Other products in the same Health Canada class (A16A, A16AX) — coverage varies; not interchangeable

  • Miglustat (Zavesca): not a benefit
  • Levocarnitine (Carnitor): not a benefit

Kuvan · DIN 02482207 · 100mg · Pd for Sol (Sachet Pk)

Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-02
StatusOff-Formulary Interchangeable, not an ODB benefit
Write on scriptExceptional Access application required. For a drug to be considered for funding, the EAP reimbursement criteria must always be met and the request approved prior to the initiation of treatment with the drug being requested, unless otherwise specified within the criteria. (ontario.ca, Aug 31, 2026 ↗) Submit through SADIE: "The SADIE portal is available to authorized prescribers and their delegates and designates, enabling the creation, submission and tracking of web-based electronic requests directly to the Exceptional Access Program." (ontario.ca, Aug 31, 2026 ↗)
Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.

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

Coverage criteria
Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive): Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange Sapropterin Brand(s): Kuvan DOSAGE FORM/ STRENGTH: 100 mg tablet Effective date: February 20, 2013; Updated December 2, 2020 Ongoing funding of sapropterin (Kuvan) will be considered through the EAP for non-pregnant patients and patients actively planning pregnancy who have a diagnosis of Phenylketonuria(PKU) and who have demonstrated a response to the initial 6 month trial of sapropterin [generally reimbursed through the Biomarin, the manufacturer of Kuvan]. Initial Criteria for the Trial Period ( First 6 months) For the management of patients with the diagnosis of hyperphenylalaninemia (HPA) due to tetrahydrobiopterin (BH4)-responsive phenylketonuria (PKU) who meet ALL of the following criteria: 1. Diagnosis of PKU confirmed through an approved test. 2. Compliance with low protein diet and formulas. 3. Documented baseline blood phenylalanine (Phe) levels, which have been measured at least twice during a 3 to 6 month period, are greater than 360 μmol/L despite compliance with a low protein diet; 4. Baseline protein intake assessment by a dietitian. Ability to comply with their medication regimen 5. Managed by a prescriber specialized in metabolic/ biochemical diseases. 6. the Patient’s blood Phe tolerance levels will be documented at months 1 to 2 and 4 to 6 during the Trial Period. Modified Criteria for Pregnant Patients during the 6 month trial period: 1. Patient has a diagnosis of PKU confirmed through an approved test 2. Patient’s treatment is being managed by a prescriber specialized in metabolic/biochemical diseases; and 3. Patient’s baseline blood Phe level is greater than 360 μmol/L despite compliance with all recommendations for dietary intervention and monitoring or compliance with a low protein diet. In the case of Patients who are eligible for but do not utilize the Patient support program for a 185-day or 6-month trial. Executive Officer will approve a request to reimburse claims for Kuvan at a dosage of up to 20mg/kg per day for the trial period of up to 6 months provided that the above conditions are met. 193 Sapropterin Brand(s): Kuvan DOSAGE FORM/ STRENGTH: 100 mg tablet Approval Duration: 6 months Funding Criteria for Kuvan in the Post Trial Period: Patients must have demonstrated the response as per the trial criteria to be funded following the 6 month trial period. Initial Criteria Post Trial: For the management of patients with the diagnosis of hyperphenylalaninemia (HPA) due to tetrahydrobiopterin (BH4)-responsive phenylketonuria (PKU) who meet ALL of the following criteria: 1. Compliance with low protein diet, formulas, and Kuvan; AND 2. During the 6 month trial period under EAP or PSP patient has achieved one of more of the following: i) a demonstrated response to the Kuvan responsiveness test or PKU clinical protocol, based on the following information: ii) the clinic’s definition for response; and iii) all relevant laboratory results used to determine that the Patient was a responder to Kuvan 3. Patient meets one of the following: i) normal sustained Blood Phe levels [ > 120 μmol/L and < 360 μmol/L] (At least 2 levels measured at least 1 month apart); OR ii) sustained blood Phe reduction of at least 30% (At least 2 levels measured at least 1 month apart)compared to baseline if the Phe baseline level is < 1200 μmol/L; OR iii) sustained blood Phe reduction of at least 50% (At least 2 levels measured at least 1 month apart) compared to baseline if the Phe baseline level is > 1200 μmol/L; 4. Demonstrated an increase in dietary protein tolerance based on targets set between the clinician and patient 5. Managed by a prescriber specialized in metabolic/ biochemical diseases. Dosage: Up to a maximum of 20 mg/kg per day Approval Duration: 1 year 194 Sapropterin Brand(s): Kuvan DOSAGE FORM/ STRENGTH: 100 mg tablet Renewal Criteria: Renewals will be considered for patients meeting the following criteria: 1. Demonstrates ongoing response to treatment; AND 2. Complies with and will continue to comply with a low protein diet, formulas, and treatment with Kuvan; AND 3. the request for extended coverage includes a recent follow-up from a prescriber specialized in metabolic/biochemical diseases. Exclusion Criteria for both Initial (Trial and Post Trial period) and Renewal criteria: (Patients meeting any of the following criteria will not be funded) • the Patient is not on a low protein diet or is not compliant with their low protein diet; or • the Patient has a baseline blood PHe level less than 360 μmol/L prior to initiating therapy with Kuvan. Dosage: Up to a maximum of 20 mg/kg per day Approval Duration: 1 year 195 EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 193, record 111, 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
Kuvan · DIN 02482207 Manufacturer: BioMarin International Ltd.; listing date 2024-01-31 Health Canada: Marketed since 2019-12-05 · brand KUVAN · ATC A16AX07 SAPROPTERIN · form Powder · route Oral · ingredients SAPROPTERIN DIHYDROCHLORIDE 100 MG/SACHET · company Biomarin international limited · schedule Prescription
Check this DIN again · Health Canada product record

Kuvan: Formulary list price not recorded/unit (unit not stated in source; not the patient's cost)

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=97268 · Verify on the e-Formulary ↗ (DIN 02482207)

Source record
DIN 02482207: Kuvan Raw flags: notABenefit=Y, sec3=Y, sec3b=Y Item: 920000778; group id 954; item number 2267; lccId None; manufacturer id BIM Source form: Pd for Sol (Sachet Pk); strength: 100mg Recorded listing: Off-Formulary Interchangeable, not an ODB benefit Source prices (unrounded): not recorded; ministry not recorded Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02482207 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=97268
Interchangeable products
Reddy-Sapropterin · DIN 02534533 · not recorded
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=02482207
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Reddy-Sapropterin · DIN 02534533 · 100mg · Pd for Sol (Sachet Pk)

Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-02
StatusOff-Formulary Interchangeable, not an ODB benefit
Write on scriptnot a benefit; no Exceptional Access criteria on record; see alternatives
Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.

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

Coverage criteria
Exceptional Access criteria on record are for Brand(s): Kuvan; DOSAGE FORM/ STRENGTH: 100 mg tablet — 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 Sapropterin Brand(s): Kuvan DOSAGE FORM/ STRENGTH: 100 mg tablet Effective date: February 20, 2013; Updated December 2, 2020 Ongoing funding of sapropterin (Kuvan) will be considered through the EAP for non-pregnant patients and patients actively planning pregnancy who have a diagnosis of Phenylketonuria(PKU) and who have demonstrated a response to the initial 6 month trial of sapropterin [generally reimbursed through the Biomarin, the manufacturer of Kuvan]. Initial Criteria for the Trial Period ( First 6 months) For the management of patients with the diagnosis of hyperphenylalaninemia (HPA) due to tetrahydrobiopterin (BH4)-responsive phenylketonuria (PKU) who meet ALL of the following criteria: 1. Diagnosis of PKU confirmed through an approved test. 2. Compliance with low protein diet and formulas. 3. Documented baseline blood phenylalanine (Phe) levels, which have been measured at least twice during a 3 to 6 month period, are greater than 360 μmol/L despite compliance with a low protein diet; 4. Baseline protein intake assessment by a dietitian. Ability to comply with their medication regimen 5. Managed by a prescriber specialized in metabolic/ biochemical diseases. 6. the Patient’s blood Phe tolerance levels will be documented at months 1 to 2 and 4 to 6 during the Trial Period. Modified Criteria for Pregnant Patients during the 6 month trial period: 1. Patient has a diagnosis of PKU confirmed through an approved test 2. Patient’s treatment is being managed by a prescriber specialized in metabolic/biochemical diseases; and 3. Patient’s baseline blood Phe level is greater than 360 μmol/L despite compliance with all recommendations for dietary intervention and monitoring or compliance with a low protein diet. In the case of Patients who are eligible for but do not utilize the Patient support program for a 185-day or 6-month trial. Executive Officer will approve a request to reimburse claims for Kuvan at a dosage of up to 20mg/kg per day for the trial period of up to 6 months provided that the above conditions are met. 193 Sapropterin Brand(s): Kuvan DOSAGE FORM/ STRENGTH: 100 mg tablet Approval Duration: 6 months Funding Criteria for Kuvan in the Post Trial Period: Patients must have demonstrated the response as per the trial criteria to be funded following the 6 month trial period. Initial Criteria Post Trial: For the management of patients with the diagnosis of hyperphenylalaninemia (HPA) due to tetrahydrobiopterin (BH4)-responsive phenylketonuria (PKU) who meet ALL of the following criteria: 1. Compliance with low protein diet, formulas, and Kuvan; AND 2. During the 6 month trial period under EAP or PSP patient has achieved one of more of the following: i) a demonstrated response to the Kuvan responsiveness test or PKU clinical protocol, based on the following information: ii) the clinic’s definition for response; and iii) all relevant laboratory results used to determine that the Patient was a responder to Kuvan 3. Patient meets one of the following: i) normal sustained Blood Phe levels [ > 120 μmol/L and < 360 μmol/L] (At least 2 levels measured at least 1 month apart); OR ii) sustained blood Phe reduction of at least 30% (At least 2 levels measured at least 1 month apart)compared to baseline if the Phe baseline level is < 1200 μmol/L; OR iii) sustained blood Phe reduction of at least 50% (At least 2 levels measured at least 1 month apart) compared to baseline if the Phe baseline level is > 1200 μmol/L; 4. Demonstrated an increase in dietary protein tolerance based on targets set between the clinician and patient 5. Managed by a prescriber specialized in metabolic/ biochemical diseases. Dosage: Up to a maximum of 20 mg/kg per day Approval Duration: 1 year 194 Sapropterin Brand(s): Kuvan DOSAGE FORM/ STRENGTH: 100 mg tablet Renewal Criteria: Renewals will be considered for patients meeting the following criteria: 1. Demonstrates ongoing response to treatment; AND 2. Complies with and will continue to comply with a low protein diet, formulas, and treatment with Kuvan; AND 3. the request for extended coverage includes a recent follow-up from a prescriber specialized in metabolic/biochemical diseases. Exclusion Criteria for both Initial (Trial and Post Trial period) and Renewal criteria: (Patients meeting any of the following criteria will not be funded) • the Patient is not on a low protein diet or is not compliant with their low protein diet; or • the Patient has a baseline blood PHe level less than 360 μmol/L prior to initiating therapy with Kuvan. Dosage: Up to a maximum of 20 mg/kg per day Approval Duration: 1 year 195 EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 193, record 111, corpus 2025-01-01; name match only, not an eligibility decision
1 brand, same coverage
Reddy-Sapropterin · DIN 02534533 Manufacturer: Dr. Reddy's Laboratories Inc.; listing date 2024-01-31 Health Canada: Marketed since 2023-12-11 · brand REDDY-SAPROPTERIN · ATC A16AX07 SAPROPTERIN · form Powder for solution · route Oral · ingredients SAPROPTERIN DIHYDROCHLORIDE 100 MG/SACHET · company Dr reddy's laboratories ltd · schedule Prescription
Check this DIN again · Health Canada product record

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=102345 · Verify on the e-Formulary ↗ (DIN 02534533)

Source record
DIN 02534533: Reddy-Sapropterin Raw flags: notABenefit=Y, sec3=Y, sec3b=Y Item: 920000778; group id 954; item number 2267; lccId None; manufacturer id DRR Source form: Pd for Sol (Sachet Pk); strength: 100mg Recorded listing: Off-Formulary Interchangeable, not an ODB benefit Source prices (unrounded): $24.7500; ministry not recorded Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02534533 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=102345
Interchangeable products
Kuvan · DIN 02482207 · not recorded
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=02534533
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Reddy-Sapropterin · DIN 02535610 · 500mg · Pd for Sol (Sachet Pk)

Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-02
StatusOff-Formulary Interchangeable, not an ODB benefit
Write on scriptnot a benefit; no Exceptional Access criteria on record; see alternatives
Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.

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

Coverage criteria
Exceptional Access criteria on record are for Brand(s): Kuvan; DOSAGE FORM/ STRENGTH: 100 mg tablet — 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 Sapropterin Brand(s): Kuvan DOSAGE FORM/ STRENGTH: 100 mg tablet Effective date: February 20, 2013; Updated December 2, 2020 Ongoing funding of sapropterin (Kuvan) will be considered through the EAP for non-pregnant patients and patients actively planning pregnancy who have a diagnosis of Phenylketonuria(PKU) and who have demonstrated a response to the initial 6 month trial of sapropterin [generally reimbursed through the Biomarin, the manufacturer of Kuvan]. Initial Criteria for the Trial Period ( First 6 months) For the management of patients with the diagnosis of hyperphenylalaninemia (HPA) due to tetrahydrobiopterin (BH4)-responsive phenylketonuria (PKU) who meet ALL of the following criteria: 1. Diagnosis of PKU confirmed through an approved test. 2. Compliance with low protein diet and formulas. 3. Documented baseline blood phenylalanine (Phe) levels, which have been measured at least twice during a 3 to 6 month period, are greater than 360 μmol/L despite compliance with a low protein diet; 4. Baseline protein intake assessment by a dietitian. Ability to comply with their medication regimen 5. Managed by a prescriber specialized in metabolic/ biochemical diseases. 6. the Patient’s blood Phe tolerance levels will be documented at months 1 to 2 and 4 to 6 during the Trial Period. Modified Criteria for Pregnant Patients during the 6 month trial period: 1. Patient has a diagnosis of PKU confirmed through an approved test 2. Patient’s treatment is being managed by a prescriber specialized in metabolic/biochemical diseases; and 3. Patient’s baseline blood Phe level is greater than 360 μmol/L despite compliance with all recommendations for dietary intervention and monitoring or compliance with a low protein diet. In the case of Patients who are eligible for but do not utilize the Patient support program for a 185-day or 6-month trial. Executive Officer will approve a request to reimburse claims for Kuvan at a dosage of up to 20mg/kg per day for the trial period of up to 6 months provided that the above conditions are met. 193 Sapropterin Brand(s): Kuvan DOSAGE FORM/ STRENGTH: 100 mg tablet Approval Duration: 6 months Funding Criteria for Kuvan in the Post Trial Period: Patients must have demonstrated the response as per the trial criteria to be funded following the 6 month trial period. Initial Criteria Post Trial: For the management of patients with the diagnosis of hyperphenylalaninemia (HPA) due to tetrahydrobiopterin (BH4)-responsive phenylketonuria (PKU) who meet ALL of the following criteria: 1. Compliance with low protein diet, formulas, and Kuvan; AND 2. During the 6 month trial period under EAP or PSP patient has achieved one of more of the following: i) a demonstrated response to the Kuvan responsiveness test or PKU clinical protocol, based on the following information: ii) the clinic’s definition for response; and iii) all relevant laboratory results used to determine that the Patient was a responder to Kuvan 3. Patient meets one of the following: i) normal sustained Blood Phe levels [ > 120 μmol/L and < 360 μmol/L] (At least 2 levels measured at least 1 month apart); OR ii) sustained blood Phe reduction of at least 30% (At least 2 levels measured at least 1 month apart)compared to baseline if the Phe baseline level is < 1200 μmol/L; OR iii) sustained blood Phe reduction of at least 50% (At least 2 levels measured at least 1 month apart) compared to baseline if the Phe baseline level is > 1200 μmol/L; 4. Demonstrated an increase in dietary protein tolerance based on targets set between the clinician and patient 5. Managed by a prescriber specialized in metabolic/ biochemical diseases. Dosage: Up to a maximum of 20 mg/kg per day Approval Duration: 1 year 194 Sapropterin Brand(s): Kuvan DOSAGE FORM/ STRENGTH: 100 mg tablet Renewal Criteria: Renewals will be considered for patients meeting the following criteria: 1. Demonstrates ongoing response to treatment; AND 2. Complies with and will continue to comply with a low protein diet, formulas, and treatment with Kuvan; AND 3. the request for extended coverage includes a recent follow-up from a prescriber specialized in metabolic/biochemical diseases. Exclusion Criteria for both Initial (Trial and Post Trial period) and Renewal criteria: (Patients meeting any of the following criteria will not be funded) • the Patient is not on a low protein diet or is not compliant with their low protein diet; or • the Patient has a baseline blood PHe level less than 360 μmol/L prior to initiating therapy with Kuvan. Dosage: Up to a maximum of 20 mg/kg per day Approval Duration: 1 year 195 EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 193, record 111, corpus 2025-01-01; name match only, not an eligibility decision
1 brand, same coverage
Reddy-Sapropterin · DIN 02535610 Manufacturer: Dr. Reddy's Laboratories Inc.; listing date 2024-01-31 Health Canada: Marketed since 2023-12-19 · brand REDDY-SAPROPTERIN · ATC A16AX07 SAPROPTERIN · form Powder for solution · route Oral · ingredients SAPROPTERIN DIHYDROCHLORIDE 500 MG/SACHET · company Dr reddy's laboratories ltd · schedule Prescription
Check this DIN again · Health Canada product record

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=102445 · Verify on the e-Formulary ↗ (DIN 02535610)

Source record
DIN 02535610: Reddy-Sapropterin Raw flags: notABenefit=Y, sec3=Y, sec3b=Y Item: 920000779; group id 954; item number 2268; lccId None; manufacturer id DRR Source form: Pd for Sol (Sachet Pk); strength: 500mg Recorded listing: Off-Formulary Interchangeable, not an ODB benefit Source prices (unrounded): $123.7500; ministry not recorded Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02535610 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=102445
Interchangeable products
Kuvan · DIN 02482215 · not recorded
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=02535610
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Kuvan · DIN 02482215 · 500mg · Pd for Sol (Sachet Pk)

Off-Formulary Interchangeable, not an ODB benefit; Health Canada lists this DIN as Cancelled post market since 2025-08-15 — choose a marketed DIN from the same-category list.Discontinued 2025-08-15 · checked 2026-09-02
StatusOff-Formulary Interchangeable, not an ODB benefit; Health Canada lists this DIN as Cancelled post market since 2025-08-15 — choose a marketed DIN from the same-category list.
Write on scriptnot a benefit; no Exceptional Access criteria on record; see alternatives; Health Canada lists this DIN as Cancelled post market since 2025-08-15 — choose a marketed DIN from the same-category list.
Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.

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

Coverage criteria
Exceptional Access criteria on record are for Brand(s): Kuvan; DOSAGE FORM/ STRENGTH: 100 mg tablet — 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 Sapropterin Brand(s): Kuvan DOSAGE FORM/ STRENGTH: 100 mg tablet Effective date: February 20, 2013; Updated December 2, 2020 Ongoing funding of sapropterin (Kuvan) will be considered through the EAP for non-pregnant patients and patients actively planning pregnancy who have a diagnosis of Phenylketonuria(PKU) and who have demonstrated a response to the initial 6 month trial of sapropterin [generally reimbursed through the Biomarin, the manufacturer of Kuvan]. Initial Criteria for the Trial Period ( First 6 months) For the management of patients with the diagnosis of hyperphenylalaninemia (HPA) due to tetrahydrobiopterin (BH4)-responsive phenylketonuria (PKU) who meet ALL of the following criteria: 1. Diagnosis of PKU confirmed through an approved test. 2. Compliance with low protein diet and formulas. 3. Documented baseline blood phenylalanine (Phe) levels, which have been measured at least twice during a 3 to 6 month period, are greater than 360 μmol/L despite compliance with a low protein diet; 4. Baseline protein intake assessment by a dietitian. Ability to comply with their medication regimen 5. Managed by a prescriber specialized in metabolic/ biochemical diseases. 6. the Patient’s blood Phe tolerance levels will be documented at months 1 to 2 and 4 to 6 during the Trial Period. Modified Criteria for Pregnant Patients during the 6 month trial period: 1. Patient has a diagnosis of PKU confirmed through an approved test 2. Patient’s treatment is being managed by a prescriber specialized in metabolic/biochemical diseases; and 3. Patient’s baseline blood Phe level is greater than 360 μmol/L despite compliance with all recommendations for dietary intervention and monitoring or compliance with a low protein diet. In the case of Patients who are eligible for but do not utilize the Patient support program for a 185-day or 6-month trial. Executive Officer will approve a request to reimburse claims for Kuvan at a dosage of up to 20mg/kg per day for the trial period of up to 6 months provided that the above conditions are met. 193 Sapropterin Brand(s): Kuvan DOSAGE FORM/ STRENGTH: 100 mg tablet Approval Duration: 6 months Funding Criteria for Kuvan in the Post Trial Period: Patients must have demonstrated the response as per the trial criteria to be funded following the 6 month trial period. Initial Criteria Post Trial: For the management of patients with the diagnosis of hyperphenylalaninemia (HPA) due to tetrahydrobiopterin (BH4)-responsive phenylketonuria (PKU) who meet ALL of the following criteria: 1. Compliance with low protein diet, formulas, and Kuvan; AND 2. During the 6 month trial period under EAP or PSP patient has achieved one of more of the following: i) a demonstrated response to the Kuvan responsiveness test or PKU clinical protocol, based on the following information: ii) the clinic’s definition for response; and iii) all relevant laboratory results used to determine that the Patient was a responder to Kuvan 3. Patient meets one of the following: i) normal sustained Blood Phe levels [ > 120 μmol/L and < 360 μmol/L] (At least 2 levels measured at least 1 month apart); OR ii) sustained blood Phe reduction of at least 30% (At least 2 levels measured at least 1 month apart)compared to baseline if the Phe baseline level is < 1200 μmol/L; OR iii) sustained blood Phe reduction of at least 50% (At least 2 levels measured at least 1 month apart) compared to baseline if the Phe baseline level is > 1200 μmol/L; 4. Demonstrated an increase in dietary protein tolerance based on targets set between the clinician and patient 5. Managed by a prescriber specialized in metabolic/ biochemical diseases. Dosage: Up to a maximum of 20 mg/kg per day Approval Duration: 1 year 194 Sapropterin Brand(s): Kuvan DOSAGE FORM/ STRENGTH: 100 mg tablet Renewal Criteria: Renewals will be considered for patients meeting the following criteria: 1. Demonstrates ongoing response to treatment; AND 2. Complies with and will continue to comply with a low protein diet, formulas, and treatment with Kuvan; AND 3. the request for extended coverage includes a recent follow-up from a prescriber specialized in metabolic/biochemical diseases. Exclusion Criteria for both Initial (Trial and Post Trial period) and Renewal criteria: (Patients meeting any of the following criteria will not be funded) • the Patient is not on a low protein diet or is not compliant with their low protein diet; or • the Patient has a baseline blood PHe level less than 360 μmol/L prior to initiating therapy with Kuvan. Dosage: Up to a maximum of 20 mg/kg per day Approval Duration: 1 year 195 EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 193, record 111, corpus 2025-01-01; name match only, not an eligibility decision
1 brand, same coverage
Kuvan · DIN 02482215 Manufacturer: BioMarin International Ltd.; listing date 2024-01-31 Health Canada: Cancelled post market since 2025-08-15 · brand KUVAN · ATC A16AX07 SAPROPTERIN · form Powder · route Oral · ingredients SAPROPTERIN DIHYDROCHLORIDE 500 MG/SACHET · company Biomarin international limited · schedule Prescription
Check this DIN again · Health Canada product record

Kuvan: Formulary list price not recorded/unit (unit not stated in source; not the patient's cost)

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=97269 · Verify on the e-Formulary ↗ (DIN 02482215)

Source record
DIN 02482215: Kuvan Raw flags: notABenefit=Y, sec3=Y, sec3b=Y Item: 920000779; group id 954; item number 2268; lccId None; manufacturer id BIM Source form: Pd for Sol (Sachet Pk); strength: 500mg Recorded listing: Off-Formulary Interchangeable, not an ODB benefit Source prices (unrounded): not recorded; ministry not recorded Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02482215 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=97269
Interchangeable products
Reddy-Sapropterin · DIN 02535610 · not recorded
Shortage status: discontinued (2025-08-15, reported by BIOMARIN INTERNATIONAL LIMITED); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02482215
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Health Canada lists this DIN as Cancelled post market since 2025-08-15 — choose a marketed DIN from the same-category list.
Other drugs in the same formulary class (92:00 UNCLASSIFIED THERAPEUTIC AGENTS) and how they are covered

Matched class: 92:00 UNCLASSIFIED THERAPEUTIC 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: ALENDRONATE & CHOLECALCIFEROL, AZATHIOPRINE, CYCLOSPORINE, GLUCAGON RDNA ORIGIN, LANREOTIDE ACETATE, LEFLUNOMIDE, LEVODOPA & BENSERAZIDE, MYCOPHENOLATE SODIUM Some products covered without a code (check the product listing): ALENDRONATE, ALLOPURINOL, AMANTADINE HCL, BROMOCRIPTINE, CLOPIDOGREL BISULFATE, LEVODOPA & CARBIDOPA, MYCOPHENOLATE MOFETIL, OCTREOTIDE, RISEDRONATE SODIUM, ROPINIROLE, SELEGILINE HCL, TAMSULOSIN HCL 92:00 UNCLASSIFIED THERAPEUTIC AGENTS

MIGLUSTAT

· 2 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 100mg · Cap

LEVOCARNITINE

· 2 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 100mg/mL · Oral Sol (with preservative)

ALENDRONATE

· 28 products · Off-Formulary Interchangeable, not an ODB benefit (4), Listed, not a benefit (1), General benefit (23) · strengths: 5mg, 10mg, 70mg · Tab

ALENDRONATE & CHOLECALCIFEROL

· 6 products · General benefit · strengths: 70mg & 70mcg, 70mg & 140mcg · Tab

ALLOPURINOL

· 10 products · General benefit (6), Listed, not a benefit (4) · strengths: 100mg, 200mg, 300mg · Tab

AMANTADINE HCL

· 5 products · Listed, not a benefit (2), General benefit (3) · strengths: 100mg, 10mg/mL · Cap, O/L

AZATHIOPRINE

· 3 products · General benefit · strengths: 50mg · Tab

BROMOCRIPTINE

· 4 products · Listed, not a benefit (2), General benefit (2) · strengths: 5mg, 2.5mg · Cap, Tab

CLOPIDOGREL BISULFATE

· 19 products · General benefit (16), Off-Formulary Interchangeable, not an ODB benefit (3) · strengths: 75mg, 300mg · Tab

CYCLOSPORINE

· 8 products · General benefit · strengths: 10mg, 25mg, 50mg, 100mg, 100mg/mL · Cap, O/L

GLUCAGON RDNA ORIGIN

· 2 products · General benefit · strengths: 1mg/Vial · Inj Pd-Syr Pk, Inj Pd-Vial Pk

LANREOTIDE ACETATE

· 6 products · General benefit · strengths: 60mg/Syr, 90mg/Syr, 120mg/Syr · ER Pref Syr Pk Source: formulary-ed43-front-matter.txt Part V; ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26; class 92:00 and 75 more
Full class listing Related classes: Same formulary class, not same indication: class membership alone does not establish equivalent uses.
What the Health Canada label says it is for
1 INDICATIONS Kuvan® (sapropterin dihydrochloride tablets and powder for oral solution) is indicated in conjunction with a phenylalanine (Phe)-restricted diet for: • the reduction of blood Phe levels in patients with hyperphenylalaninemia (HPA) due to tetrahydrobiopterin-(BH4)-responsive Phenylketonuria (PKU). 1.1 Pediatrics Pediatrics (ages 1 month to 16 years): Based on the data submitted and reviewed by Health Canada, the safety and efficacy of Kuvan in pediatric patients has been established. Therefore, Health Canada has authorized an indication for pediatric use in patients older than 1 month. Pediatric patients with PKU, ages 1 month to 16 years, have been treated with Kuvan in clinical studies [see 14.1 Clinical Trials in Phenylketonuria]. Pediatrics (less than 1 month of age): The efficacy and safety of Kuvan have not been established in infants less than 1 month of age; therefore, Health Canada has not authorized an indication for Kuvan use in this population. 1.2 Geriatrics Geriatrics: No data are available to Health Canada; therefore, Health Canada has… https://pdf.hres.ca/dpd_pm/00085030.PDF PM date: 2026-06-16 Source product: KUVAN; DIN 02482207; fetched 2026-09-10 Product monograph posted by Health Canada; excerpt for lookup only.

Availability

Kuvan · DIN 02482215 Shortage status: discontinued (2025-08-15, reported by BIOMARIN INTERNATIONAL LIMITED); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02482215

Check this DIN again

Prepare an Exceptional Access request

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

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

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

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

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

Sapropterin (Kuvan)

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

Prepare answers: For the management of patients with the diagnosis of hyperphenylalaninemia (HPA) due to tetrahydrobiopterin (BH4)-responsive phenylketonuria (PKU) who meet ALL of the following criteria:

Ministry criteria corpus 2025-01-01; page 193

Sapropterin Brand(s): Kuvan DOSAGE FORM/ STRENGTH: 100 mg tablet Effective date: February 20, 2013; Updated December 2, 2020
Ongoing funding of sapropterin (Kuvan) will be considered through the EAP for non-pregnant patients and patients actively planning pregnancy who have a diagnosis of Phenylketonuria(PKU) and who have demonstrated a response to the initial 6 month trial of sapropterin [generally reimbursed through the Biomarin, the manufacturer of Kuvan].
Initial Criteria for the Trial Period ( First 6 months)
For the management of patients with the diagnosis of hyperphenylalaninemia (HPA) due to tetrahydrobiopterin (BH4)-responsive phenylketonuria (PKU) who meet ALL of the following criteria:
1. Diagnosis of PKU confirmed through an approved test.
2. Compliance with low protein diet and formulas.
3. Documented baseline blood phenylalanine (Phe) levels, which have been measured at least twice during a 3 to 6 month period, are greater than 360 μmol/L despite compliance with a low protein diet;
4. Baseline protein intake assessment by a dietitian. Ability to comply with their medication regimen
5. Managed by a prescriber specialized in metabolic/ biochemical diseases.
6. the Patient’s blood Phe tolerance levels will be documented at months 1 to 2 and 4 to 6 during the Trial Period.
Modified Criteria for Pregnant Patients during the 6 month trial period:
1. Patient has a diagnosis of PKU confirmed through an approved test
2. Patient’s treatment is being managed by a prescriber specialized in metabolic/biochemical diseases; and
3. Patient’s baseline blood Phe level is greater than 360 μmol/L despite compliance with all recommendations for dietary intervention and monitoring or compliance with a low protein diet.
In the case of Patients who are eligible for but do not utilize the Patient support program for a 185-day or 6-month trial. Executive Officer will approve a request to reimburse claims for Kuvan at a dosage of up to 20mg/kg per day for the trial period of up to 6 months provided that the above conditions are met.
193 Sapropterin Brand(s): Kuvan DOSAGE FORM/ STRENGTH: 100 mg tablet
Approval Duration: 6 months
Funding Criteria for Kuvan in the Post Trial Period: Patients must have demonstrated the response as per the trial criteria to be funded following the 6 month trial period.
Initial Criteria Post Trial:
For the management of patients with the diagnosis of hyperphenylalaninemia (HPA) due to tetrahydrobiopterin (BH4)-responsive phenylketonuria (PKU) who meet ALL of the following criteria:
1. Compliance with low protein diet, formulas, and Kuvan; AND
2. During the 6 month trial period under EAP or PSP patient has achieved one of more of the following:
i) a demonstrated response to the Kuvan responsiveness test or PKU clinical protocol, based on the following information:
ii) the clinic’s definition for response; and
iii) all relevant laboratory results used to determine that the Patient was a responder to Kuvan
3. Patient meets one of the following:
i) normal sustained Blood Phe levels [ > 120 μmol/L and < 360 μmol/L] (At least 2 levels measured at least 1 month apart); OR ii) sustained blood Phe reduction of at least 30% (At least 2 levels measured at least 1 month apart)compared to baseline if the Phe baseline level is < 1200 μmol/L; OR iii) sustained blood Phe reduction of at least 50% (At least 2 levels measured at least 1 month apart) compared to baseline if the Phe baseline level is > 1200 μmol/L;
4. Demonstrated an increase in dietary protein tolerance based on targets set between the clinician and patient
5. Managed by a prescriber specialized in metabolic/ biochemical diseases.
Dosage: Up to a maximum of 20 mg/kg per day
Approval Duration: 1 year
194 Sapropterin Brand(s): Kuvan DOSAGE FORM/ STRENGTH: 100 mg tablet
Renewal Criteria:
Renewals will be considered for patients meeting the following criteria:
1. Demonstrates ongoing response to treatment; AND
2. Complies with and will continue to comply with a low protein diet, formulas, and treatment with Kuvan; AND
3. the request for extended coverage includes a recent follow-up from a prescriber specialized in metabolic/biochemical diseases.
Exclusion Criteria for both Initial (Trial and Post Trial period) and Renewal criteria: (Patients meeting any of the following criteria will not be funded)
• the Patient is not on a low protein diet or is not compliant with their low protein diet; or
• the Patient has a baseline blood PHe level less than 360 μmol/L prior to initiating therapy with Kuvan.
Dosage: Up to a maximum of 20 mg/kg per day
Approval Duration: 1 year
195

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

Other review policies

For Reddy-Sapropterin, Kuvan: no applicable EAP criteria are held and no ODB benefit is established. These policies do not establish coverage.

For rare, immediately life-, limb- or organ-threatening circumstances, the Compassionate Review Policy may consider an unfunded drug or indication, subject to its criteria and without bypassing the drug review process. Compassionate Review Policy

Compassionate Review Policy: source quote
Where there are rare clinical circumstances in immediately life, limb, or organ-threatening conditions, the Executive Officer will also consider requests for drugs or indications in situations where there has not been a decision by the Executive Officer to provide funding of the drug or indication as part of the Ontario Drug Benefit program (and the EAP), and the drug or indication requested would not circumvent the established review process for new drugs or indications as part of the drug submission process for listing within the Ontario Drug Benefit program. Requests must meet the criteria for the Compassionate Review Policy.

Ontario source; updated September 15, 2026

For cancer drugs, Case-by-Case Review considers rare, immediately life-threatening circumstances when no satisfactory funded treatment exists; its criteria and application process apply. Case-by-Case Review (cancer drugs)

Case-by-Case Review (cancer drugs): source quote
Note: Requests for cancer drugs are considered under the Case-by-Case Review Program (CBCRP) which is administered by Ontario Health (Cancer Care Ontario) on behalf of the Ministry of Health. The CBCRP considers funding requests for drugs (both oral therapies and injectable drugs) for the treatment of cancer in patients who have a rare clinical circumstance that is immediately life-threatening (death is likely within a matter of months) and who require treatment with an unfunded drug, because there is no other satisfactory and funded treatment. Please refer to the Ontario Health website for information on the application process, FAQs, eligibility criteria and program policies.

Ontario source; updated September 15, 2026