JointHealth™ express   May 10, 2015

Common Drug Review recommendation for tofacitinib (Xeljanz®)

Good news for Canadians living with rheumatoid arthritis

On April 21, 2015, the Common Drug Review concluded its review of tofacitinib (Xeljanz®) and recommended to public formularies that it be listed for reimbursement in combination with methotrexate (MTX), for reducing the signs and symptoms of rheumatoid arthritis (RA) in adult patients with moderately to severely active RA or as a monotherapy in those who were intolerant to MTX. Click here to read the complete Common Drug Review recommendations.

Tofacitinib is an oral disease-modifying anti-rheumatic drug (DMARD) that was issued a Notice of Compliance (NOC) from Health Canada on April 17, 2014.

Tofacitinib (Xeljanz®) belongs to a new class of medications known as “targeted small molecule medications” (TSMM). It interferes with the process in rheumatoid arthritis that leads to joint damage by targeting JAK1 and JAK3 of the Janus family of kinases (enzymes). This disease modifying anti-rheumatic drug (DMARD) is not a biologic, which targets inflammation from the outside of cells. Instead, it prevents an inflammatory immune response from within cells. Tofacitinib is made in tablet form and taken by mouth twice daily.

In order for a patient to be eligible to receive tofacitinib, the following criterion and conditions must be met:
  • Inadequate response or intolerance to non-biologic disease-modifying antirheumatic drugs (DMARDs).
  • List in a similar manner to biologic DMARDs.
  • Daily dosage not to exceed 10 mg (i.e., 5 mg twice daily).
  • Drug plan cost for tofacitinib not to exceed the drug plan costs for the biologic DMARDs reimbursed.
This medication offers another important option for Canadians living with RA because each person living with the disease responds differently to available medications. In other words, no single treatment therapy is effective in everyone with RA. A rheumatologist and their patient must weigh the potential risks and benefits associated with each treatment therapy; therefore, it is important to have public formulary reimbursement for the full range of arthritis medications approved by Health Canada.