Prior authorization forms for prescription drugs A B C D E F G H I J K L M N O P Q R S T U V W X Y Z ACTEMRA (Tocilizumab) FV6861 - Rheumatoid Arthritis (PDF, 59 ko) FV6904 - General form (PDF, 53 ko) FV7047 - Giant cell arteritis (PDF, 104 ko) ADCIRCA (Tadalafil) FV6904 - General form (PDF, 53 ko) ADEMPAS (Riociguat) FV6904 - General form (PDF, 53 ko) AFINITOR (Évérolimus) FV6904 - General form (PDF, 53 ko) AIMOVIG (Erenumab) FV6850 - Migraines (PDF, 48 ko) ALECENSARO (Alectinib) FV6904 - General form (PDF, 53 ko) FV6968 - First-line treatment ALK+ locally advanced or metastatic non-small cell lung cancer (NSCLC) (PDF, 111 ko) ALUNBRIG (Brigatinib) FV6968 - First-line treatment ALK+ locally advanced or metastatic non-small cell lung cancer (NSCLC) (PDF, 111 ko) APTIOM (Eslicarbazepine acétate) FV6904 - General form (PDF, 53 ko) AUBAGIO (Tériflunomide) FV6904 - General form (PDF, 53 ko) Ouvrir ? BALVERSA (Erdafitinib) FV6904 - General form (PDF, 53 ko) STRIPS FV6946 - Authorization request to increase the number of blood glucose test strips eligible for reimbursement (PDF, 220 ko) BANZEL (Rufinamide) FV6904 - General form (PDF, 53 ko) BENLYSTA (Bélimumab) FV6904 - General form (PDF, 53 ko) BOSULIF (Bosutinib) FV6904 - General form (PDF, 53 ko) BOTOX (OnabotulinumtoxinA) FV6850 - Migraines (PDF, 48 ko) FV6904 - General form (PDF, 53 ko) FV7090 - Severe axillary hyperhidrosis in adults (PDF, 388 ko) BRENZYS (Etanercept) FV6861 - Rheumatoid Arthritis (PDF, 59 ko) FV6863 - Ankylosing Spondylitis (PDF, 48 ko) FV6904 - General form (PDF, 53 ko) BRIVLERA (Brivaracetam) FV6904 - General form (PDF, 53 ko) FV7024 - Refractory partial-onset seizure (PDF, 104 ko) CABOMETYX (Cabozantinib) FV6904 - General form (PDF, 53 ko) FV7114 - Locally advanced or metastatic renal adenocarcinoma (PDF, 214 ko) CALQUENCE (Acalabrutinib) FV6904 - General form (PDF, 53 ko) CANNABIS FV7001 - Medical use of Cannabis (PDF, 83 ko) CAPRELSA (Vandétanib) FV6904 - General form (PDF, 53 ko) CIALIS (Tadalafil) FV6904 - General form (PDF, 53 ko) CIMZIA (Certolizumab pégol) FV6856 - Psoriatic Arthritis (PDF, 55 ko) FV6861 - Rheumatoid Arthritis (PDF, 59 ko) FV6862 - Plaque psoriasis (PDF, 52 ko) FV6863 - Ankylosing Spondylitis (PDF, 48 ko) FV6904 - General form (PDF, 53 ko) CINQAIR (Reslizumab) FV6857 - Eosinophilic Asthma (PDF, 38 ko) FV6904 - General form (PDF, 53 ko) CONTRAVE (Naltrexone/Bupropion) FV6904 - General form (PDF, 53 ko) Ouvrir ? COPAXONE (Acetate de glatiramere) FV7003 - Remitting multiple sclerosis (PDF, 104 ko) COSENTYX (Secukinumab) FV6856 - Psoriatic Arthritis (PDF, 55 ko) FV6862 - Plaque psoriasis (PDF, 52 ko) FV6863 - Ankylosing Spondylitis (PDF, 48 ko) FV6904 - General form (PDF, 53 ko) COTELLIC (Cobimetinib) FV6904 - General form (PDF, 53 ko) FV6943 - Unresectable or metastatic melanoma (PDF, 115 ko) CRESEMBA (Isavuconazorium) FV6904 - General form (PDF, 53 ko) CRINONE (Progestérone) FV6904 - General form (PDF, 53 ko) CRYSVITA (Burosumab) FV6904 - General form (PDF, 53 ko) FV7097 - X-Linked Hypophosphatemia (XLH) (PDF, 843 ko) CYSTADROPS (Cystéamine) FV6904 - General form (PDF, 53 ko) DAKLINZA (Daclatasvir) FV6904 - General form (PDF, 53 ko) DIACOMIT (Stiripentol) FV6904 - General form (PDF, 53 ko) DUODOPA (Lévodopa / Carbidopa) FV6904 - General form (PDF, 53 ko) DUPIXENT (Dupilumab) FV6904 - General form (PDF, 53 ko) FV6969 – Refractory atopic dermatitis (PDF, 157 ko) DYSPORT (Toxine botulinique) FV6904 - General form (PDF, 53 ko) FV7076 - Severe spasticity conditions and cervicaldystonia (PDF, 382 ko) EGRIFTA (Tésamoréline) FV6904 - General form (PDF, 53 ko) EMGALITY (Galcanezumab) FV6850 - Migraines (PDF, 48 ko) ENBREL (Étanercept) FV6856 - Psoriatic Arthritis (PDF, 55 ko) FV6861 - Rheumatoid Arthritis (PDF, 59 ko) FV6862 - Plaque psoriasis (PDF, 52 ko) FV6863 - Ankylosing Spondylitis (PDF, 48 ko) FV6904 - General form (PDF, 53 ko) FV7036 - Juvenile idiopathic arthritis of polyarticular or systemic form (PDF, 387 ko) ENDOMETRIN (Progestérone) FV6904 - General form (PDF, 53 ko) ENTYVIO (Vedolizumab) FV6849 - Moderate to severe Crohn’s disease (PDF, 31 ko) FV6851 - Moderate to Severe Ulcerative Colitis (PDF, 57 ko) FV6904 - General form (PDF, 53 ko) EPCLUSA (Sofosbuvir/Velpatasvir) FV6904 - General form (PDF, 53 ko) ERELZI (Étanercept) FV6861 - Rheumatoid Arthritis (PDF, 59 ko) FV6863 - Ankylosing Spondylitis (PDF, 48 ko) FV6904 - General form (PDF, 53 ko) FV7036 - Juvenile idiopathic arthritis of polyarticular or systemic form (PDF, 387 ko) ERIVEDGE (Vismodégib) FV6904 - General form (PDF, 53 ko) FV6996 - Treatment of locally advanced or metastatic basal cell carcinoma (PDF, 105 ko) ERLEADA (Apalutamide) FV6904 - General form (PDF, 53 ko) FV7082 - Non-metastatic castration-resistant prostate cancer (PDF, 385 ko) ESBRIET (Pirfénidone) FV6904 - General form (PDF, 53 ko) FV6976 - Idiopathic pulmonary fibrosis (IPF) (PDF, 107 ko) EVENITY (Romosozumab) FV6904 - General form (PDF, 53 ko) EXJADE (Deferasirox) FV6904 - General form (PDF, 53 ko) Ouvrir ? EYLEA (Aflibercept) FV6852 - Neovascular (wet) age-related macular degeneration (PDF, 44 ko) FV6858 - Diabetic Macular Edema (DME) (PDF, 42 ko) FV6859 - Macular oedema secondary to retinal vein occlusion (RVO) (PDF, 43 ko) FV6860 - Visual impairment due to macular oedema following a central retinal vein occlusion (CRVO) (PDF, 43 ko) FV6904 - General form (PDF, 53 ko) FV6979 - Visual impairment due to a choroidal neovascularization subsequent to a pathologic myopia (PDF, 109 ko) FAMPYRA (Fampridine) FV6904 - General form (PDF, 53 ko) FASENRA (Benralizumab) FV6857 - Eosinophilic Asthma (PDF, 38 ko) FV6904 - General form (PDF, 53 ko) FENTORA (Fentanyl) FV6904 - General form (PDF, 53 ko) FIRAZYR (Icatibant) FV7080 - Hereditary angioedema (HAE) (PDF, 393 ko) FORTEO (Tériparatide) FV6904 - General form (PDF, 53 ko) FREESTYLE FV6941 - Authorization request form flash glucose monitoring system (PDF, 81 ko) FYCOMPA (Pérampanel) FV6904 - General form (PDF, 53 ko) FV7085 - Refactory partial epilepsy or refractory primary tonic-clonic generalized seizures (PDF, 387 ko) GALAFOLD (Migalast) FV7011 - Fabry disease in adults (PDF, 105 ko) GENOTROPIN (Somatropine) FV6904 - General form (PDF, 53 ko) GILENYA (Fingolimod) FV6904 - General form (PDF, 53 ko) GIOTRIF (Afatinib) FV6904 - General form (PDF, 53 ko) GLEEVEC (Imatinib) FV6904 - General form (PDF, 53 ko) FV6995 - Gastrointestinal stromal tumor (GIST) (PDF, 109 ko) HARVONI (Ledipasvir / Sofosbuvir ) FV6904 - General form (PDF, 53 ko) HCG (Gonadotrophine chorionique) FV6904 - General form (PDF, 53 ko) HUMATROPE (Somatotropine) FV6904 - General form (PDF, 53 ko) HUMIRA (Adalimumab) FV6849 - Moderate to severe Crohn’s disease (PDF, 31 ko) FV6851 - Moderate to Severe Ulcerative Colitis (PDF, 57 ko) FV6856 - Psoriatic Arthritis (PDF, 55 ko) FV6861 - Rheumatoid Arthritis (PDF, 59 ko) FV6862 - Plaque psoriasis (PDF, 52 ko) FV6863 - Ankylosing Spondylitis (PDF, 48 ko) FV6904 - General form (PDF, 53 ko) FV6942 - Non-infectious uveitis (PDF, 395 ko) FV7036 - Juvenile idiopathic arthritis of polyarticular or systemic form (PDF, 387 ko) FV7057 - Hidradenitis (PDF, 400 ko) IBAVYR (Ribavirine) FV6904 - General form (PDF, 53 ko) IBRANCE (Palbociclib) FV6854 - Advanced or metastatic breast cancer (PDF, 45 ko) FV6904 - General form (PDF, 53 ko) ICLUSIG (Chlorhydrate de ponitinib) FV6904 - General form (PDF, 53 ko) IDHIFA (Enasidenib) FV6904 - General form (PDF, 53 ko) ILARIS (Canakinumab) FV6904 - General form (PDF, 53 ko) IMBRUVICA (Ibrutinib) FV6904 - General form (PDF, 53 ko) FV7083 - Chronic Lymphoid Leukemia (PDF, 110 ko) FV7084 - Mantle-cell lymphoma (PDF, 109 ko) INFLECTRA (Infliximab) FV6849 - Moderate to severe Crohn’s disease (PDF, 31 ko) FV6851 - Moderate to Severe Ulcerative Colitis (PDF, 57 ko) FV6856 - Psoriatic Arthritis (PDF, 55 ko) FV6861 - Rheumatoid Arthritis (PDF, 59 ko) FV6862 - Plaque psoriasis (PDF, 52 ko) FV6863 - Ankylosing Spondylitis (PDF, 48 ko) FV6904 - General form (PDF, 53 ko) INLYTA (Axitinib) FV6904 - General form (PDF, 53 ko) IRESSA (Géfitinib) FV6904 - General form (PDF, 53 ko) JADENU (Deferasirox) FV6904 - General form (PDF, 53 ko) Ouvrir ? JAKAVI (Ruxolitinib) FV6944 - Polycythemia vera (PDF, 140 ko) FV7029 - Splenomegaly associated with primary myelofibrosis (PDF, 388 ko) JETREA (Ocriplasmine) FV6904 - General form (PDF, 53 ko) JINARC (Tolvaptan) FV6855 - Autosomal dominant polycystic kidney disease (ADPKD) (PDF, 41 ko) FV6904 - General form (PDF, 53 ko) JUXTAPID (Lomitapide) FV6904 - General form (PDF, 53 ko) KALYDECO (Ivacaftor) FV6904 - General form (PDF, 53 ko) KANUMA (Sebelipase alfa) FV6904 - General form (PDF, 53 ko) KETALAR (Kétamine) FV6904 - General form (PDF, 53 ko) KEVZARA (Sarilumab) FV6861 - Rheumatoid Arthritis (PDF, 59 ko) FV6904 - General form (PDF, 53 ko) KINERET (Anakinra) FV6861 - Rheumatoid Arthritis (PDF, 59 ko) FV6904 - General form (PDF, 53 ko) KISQALI (Ribociclib) FV6904 - General form (PDF, 53 ko) FV6984 - Advanced or metastasic breast cancer (PDF, 109 ko) KUVAN (Dichlorhydrate de saproptérine) FV6904 - General form (PDF, 53 ko) LANTUS (Insuline glargine) FV7004 - Diabetes (PDF, 103 ko) LEMTRADA (Alemtuzumab) FV6904 - General form (PDF, 53 ko) LENVIMA (Lenvatinib) FV6904 - General form (PDF, 53 ko) FV7105 - Unresectable hepatocellular carcinoma (PDF, 161 ko) LEVITRA (Vardénafil) FV6904 - General form (PDF, 53 ko) LOBRENA (Lorlatinib) FV6904 - General form (PDF, 53 ko) LONSURF (Trifluridine) FV6904 - General form (PDF, 53 ko) FV6970 - Metastatic colorectal cancer (PDF, 109 ko) LUCENTIS (Ranibizumab) FV6852 - Neovascular (wet) age-related macular degeneration (PDF, 44 ko) FV6858 - Diabetic Macular Edema (DME) (PDF, 42 ko) FV6860 - Visual impairment due to macular oedema following a central retinal vein occlusion (CRVO) (PDF, 43 ko) FV6904 - General form (PDF, 53 ko) FV6979 - Visual impairment due to a choroidal neovascularization subsequent to a pathologic myopia (PDF, 109 ko) LYNPARZA (Olaparib) FV6904 - General form (PDF, 53 ko) MATULANE (Procarbazine HCL) FV6904 - General form (PDF, 53 ko) Ouvrir ? MAVENCLAD (Cladribine) FV6904 - General form (PDF, 53 ko) MAVIRET (Glécaprévir/Pibrentasvir) FV7033 – Chronic hepatitis C (PDF, 106 ko) MEKINIST (Tramétinib) FV6904 - General form (PDF, 53 ko) MENOPUR (Ménotropines) FV6904 - General form (PDF, 53 ko) MOVAPO (Chlorhydrate d'apomorphine) FV6904 - General form (PDF, 53 ko) FV7067 - Advanced Parkinson’s disease (PDF, 104 ko) MYOZYME (Alglucosidase alfa) FV6904 - General form (PDF, 53 ko) NERLYNX (Neratinib) FV6904 - General form (PDF, 53 ko) NEULASTA (Pegfilgrastim) FV7079 - Neutropenia (PDF, 103 ko) NEUPOGEN (Filgrastim) FV6998 - Chronic or febrile neutropenia (PDF, 104 ko) NEXAVAR (Sorafénib) FV6904 - General form (PDF, 53 ko) FV7056 - Advanced-stage hepatocellular carcinoma (PDF, 408 ko) NINLARO (Ixazomib) FV6904 - General form (PDF, 53 ko) NORDITROPIN (Somatropin ) FV6904 - General form (PDF, 53 ko) NPLATE (Romiplostim) FV6904 - General form (PDF, 53 ko) NUCALA (Mepolizumab) FV6857 - Eosinophilic Asthma (PDF, 38 ko) FV6904 - General form (PDF, 53 ko) NUTROPIN (Somatropine) FV6904 - General form (PDF, 53 ko) OCALIVA (Acide obéticholique) FV6904 - General form (PDF, 53 ko) FV7017 – Primary biliary cholangitis (PDF, 392 ko) OCREVUS (Ocrélizumab) FV6904 - General form (PDF, 53 ko) FV6971 - Primary progressive multiple sclerosis (PPMS) (PDF, 192 ko) FV6972 – Relapsing-Remitting Multiple Sclerosis (RRMS) (PDF, 206 ko) OFEV (Nintédanib) FV6904 - General form (PDF, 53 ko) FV6976 - Idiopathic pulmonary fibrosis (IPF) (PDF, 107 ko) OLUMIANT (Baricitinib) FV6861 - Rheumatoid Arthritis (PDF, 59 ko) OMNITROPE (Somatropine) FV6904 - General form (PDF, 53 ko) ONPATTRO (Patisiran) FV6904 - General form (PDF, 53 ko) ORENCIA (Abatacept) FV6856 - Psoriatic Arthritis (PDF, 55 ko) FV6861 - Rheumatoid Arthritis (PDF, 59 ko) FV6863 - Ankylosing Spondylitis (PDF, 48 ko) FV6904 - General form (PDF, 53 ko) FV7036 - Juvenile idiopathic arthritis of polyarticular or systemic form (PDF, 387 ko) ORFADIN (Nitisinone) FV6904 - General form (PDF, 53 ko) ORKAMBI (Lumacaftor / Ivacaftor) FV6904 - General form (PDF, 53 ko) OTEZLA (Apremilast) FV6856 - Psoriatic Arthritis (PDF, 55 ko) FV6862 - Plaque psoriasis (PDF, 52 ko) FV6904 - General form (PDF, 53 ko) OZURDEX (Dexaméthasone) FV6904 - General form (PDF, 53 ko) PEGASYS ± RBV (Peginterféron alfa-2a ± ribavirine) FV6904 - General form (PDF, 53 ko) PEGETRON (Interféron alfa-2b péguylé / ribavirine) FV6904 - General form (PDF, 53 ko) PHEBURANE (Phénylbutyrate sodique) FV6904 - General form (PDF, 53 ko) POMALYST (Pomalidomide) FV6904 - General form (PDF, 53 ko) PRALUENT (Alirocumab) FV6853 - Hypercholesterolemia and clinically manifest atherosclerotic cardiovascular disease (PDF, 51 ko) FV6904 - General form (PDF, 53 ko) FV6973 - Heterozygous familial hypercholesterolemia (HeFH) (PDF, 112 ko) PREGNYL (Chorionic gonadotropin) FV6904 - General form (PDF, 53 ko) PREVYMIS (Letermovir) FV6904 - General form (PDF, 53 ko) PROCYSBI (Cystéamine ) FV6999 - Treatment of nephropathic cystinosis (PDF, 104 ko) PULMOZYME INHALATION (Dornase Alfa) FV6904 - General form (PDF, 53 ko) Ouvrir ? RADICAVA (Edaravone) FV6904 - General form (PDF, 53 ko) RAVICTI (Phénylbutyrate de glycérol) FV6904 - General form (PDF, 53 ko) FV7066 - Urea cycle disorder (PDF, 105 ko) REMICADE (Infliximab) FV6849 - Moderate to severe Crohn’s disease (PDF, 31 ko) FV6851 - Moderate to Severe Ulcerative Colitis (PDF, 57 ko) FV6856 - Psoriatic Arthritis (PDF, 55 ko) FV6861 - Rheumatoid Arthritis (PDF, 59 ko) FV6862 - Plaque psoriasis (PDF, 52 ko) FV6863 - Ankylosing Spondylitis (PDF, 48 ko) FV6904 - General form (PDF, 53 ko) FV7036 - Juvenile idiopathic arthritis of polyarticular or systemic form (PDF, 387 ko) RENFLEXIS (Infliximab) FV6849 - Moderate to severe Crohn’s disease (PDF, 31 ko) FV6851 - Moderate to Severe Ulcerative Colitis (PDF, 57 ko) FV6856 - Psoriatic Arthritis (PDF, 55 ko) FV6861 - Rheumatoid Arthritis (PDF, 59 ko) FV6862 - Plaque psoriasis (PDF, 52 ko) FV6863 - Ankylosing Spondylitis (PDF, 48 ko) FV6904 - General form (PDF, 53 ko) REPATHA (Évolocumab) FV6853 - Hypercholesterolemia and clinically manifest atherosclerotic cardiovascular disease (PDF, 51 ko) FV6904 - General form (PDF, 53 ko) FV6973 - Heterozygous familial hypercholesterolemia (HeFH) (PDF, 112 ko) REPRONEX (Ménotropines) FV6904 - General form (PDF, 53 ko) RETISERT (Acétonide de fluocinolone) FV6904 - General form (PDF, 53 ko) REVATIO (Sildénafil) FV6904 - General form (PDF, 53 ko) REVESTIVE (Teduglutide) FV6904 - General form (PDF, 53 ko) REVLIMID (Lénalidomide) FV6904 - General form (PDF, 53 ko) REVOLADE (Eltrombopag) FV6904 - General form (PDF, 53 ko) RINVOQ (Upadacitinib) FV6861 - Rheumatoid Arthritis (PDF, 59 ko) RITUXAN (Rituximab) FV6861 - Rheumatoid Arthritis (PDF, 59 ko) FV6904 - General form (PDF, 53 ko) RYDAPT (Midostaurine) FV6904 - General form (PDF, 53 ko) SAIZEN (Somatropine) FV6904 - General form (PDF, 53 ko) SAMSCA (Tolvaptan) FV6904 - General form (PDF, 53 ko) SANDOSTATIN (Octréotide) FV6904 - General form (PDF, 53 ko) Ouvrir ? SANDOSTATIN LAR (Octréotide) FV6904 - General form (PDF, 53 ko) Ouvrir ? SATIVEX (Cannabidiol/Delta-9-tétrahydrocannabinol) FV6904 - General form (PDF, 53 ko) SAXENDA (Liraglutide) FV6904 - General form (PDF, 53 ko) Ouvrir ? SEROSTIM (Somatropine) FV6904 - General form (PDF, 53 ko) SIGNIFOR (Pasiréotide) FV6904 - General form (PDF, 53 ko) SIGNIFOR LAR (Pasiréotide) FV6904 - General form (PDF, 53 ko) SILIQ (Brodulamab) FV6862 - Plaque psoriasis (PDF, 52 ko) FV6904 - General form (PDF, 53 ko) SIMPONI (Golimumab) FV6851 - Moderate to Severe Ulcerative Colitis (PDF, 57 ko) FV6856 - Psoriatic Arthritis (PDF, 55 ko) FV6861 - Rheumatoid Arthritis (PDF, 59 ko) FV6863 - Ankylosing Spondylitis (PDF, 48 ko) FV6904 - General form (PDF, 53 ko) SKYRIZI (Risankizumab) FV6862 - Plaque psoriasis (PDF, 52 ko) SOMAVERT (Pegvisomant) FV6904 - General form (PDF, 53 ko) SOVALDI (Sofosbuvir) FV6904 - General form (PDF, 53 ko) SPINRAZA (Nusinersen) FV6904 - General form (PDF, 53 ko) SPRYCEL (Dasatinib) FV6904 - General form (PDF, 53 ko) FV7059 - Acute myeloid leukemia (AML) in adults (PDF, 381 ko) FV7060 - Chronic myeloid leukemia (CML) in chronic or accelerated phase in adults (PDF, 383 ko) STAXYN (Vardénafil) FV6904 - General form (PDF, 53 ko) STELARA (Ustékinumab) FV6849 - Moderate to severe Crohn’s disease (PDF, 31 ko) FV6851 - Moderate to Severe Ulcerative Colitis (PDF, 57 ko) FV6856 - Psoriatic Arthritis (PDF, 55 ko) FV6862 - Plaque psoriasis (PDF, 52 ko) FV6904 - General form (PDF, 53 ko) STIVARGA (Régorafénib) FV6904 - General form (PDF, 53 ko) FV6970 - Metastatic colorectal cancer (PDF, 109 ko) FV7058 - Hepatocellular carcinoma (PDF, 396 ko) SUTENT (Sunitinib) FV6904 - General form (PDF, 53 ko) SYLVANT (Siltuximab) FV6904 - General form (PDF, 53 ko) SYMDEKO (Tezacaflor/Ivacaftor) FV6904 - General form (PDF, 53 ko) TAFINLAR (Dabrafénib) FV6904 - General form (PDF, 53 ko) TAGRISSO (Osimertinib) FV6904 - General form (PDF, 53 ko) TAKHZYRO (Lanadélumab) FV6904 - General form (PDF, 53 ko) TALTZ (Ixékizumab) FV6856 - Psoriatic Arthritis (PDF, 55 ko) FV6862 - Plaque psoriasis (PDF, 52 ko) FV6904 - General form (PDF, 53 ko) TARCEVA (Erlotinib) FV6904 - General form (PDF, 53 ko) TASIGNA (Nilotinib) FV6904 - General form (PDF, 53 ko) TECFIDERA (Dimethyl Fumarate) FV6904 - General form (PDF, 53 ko) Ouvrir ? TEGSEDI (Inotersen) FV6904 - General form (PDF, 53 ko) TEMODAL (Témozolomide) FV6904 - General form (PDF, 53 ko) THALOMID (Thalidomide) FV6904 - General form (PDF, 53 ko) THYROGEN (Thyrotropine alfa) FV6904 - General form (PDF, 53 ko) TOCTINO (Alitrétinoïne) FV6864 - Chronic hand eczema (PDF, 47 ko) FV6904 - General form (PDF, 53 ko) TRACLEER (Bosentan) FV6904 - General form (PDF, 53 ko) Ouvrir ? TREMFYA (Guselkumab) FV6862 - Plaque psoriasis (PDF, 52 ko) FV6904 - General form (PDF, 53 ko) TRUXIMA (Rituximab) FV6861 - Rheumatoid Arthritis (PDF, 59 ko) FV6904 - General form (PDF, 53 ko) TYKERB (Lapatinib) FV6904 - General form (PDF, 53 ko) TYSABRI (Natalizumab) FV7034 - Relapsing-Remitting Multiple Sclerosis (PDF, 386 ko) UPTRAVI (Selexipag) FV6904 - General form (PDF, 53 ko) Ouvrir ? VENCLEXTA (Venetoclax) FV6904 - General form (PDF, 53 ko) VERZENIO (Abemaciclib) FV7110 - Advanced or metastatic breast cancer (PDF, 196 ko) VIAGRA (Sildénafil) FV6904 - General form (PDF, 53 ko) VITRAKVI (Larotrectinib) FV6904 - General form (PDF, 53 ko) VIZIMPRO (Dacomitinib) FV6904 - General form (PDF, 53 ko) VOLIBRIS (Ambrisentan) FV6904 - General form (PDF, 53 ko) Ouvrir ? VOSEVI (Sofosbuvir/Velpatasvir/Voxilaprévir) FV6904 - General form (PDF, 53 ko) VOTRIENT (Pazopanib) FV6904 - General form (PDF, 53 ko) XALKORI (Crizotinib) FV6904 - General form (PDF, 53 ko) XELJANZ (Citrate de tofacitinib) FV6851 - Moderate to Severe Ulcerative Colitis (PDF, 57 ko) FV6856 - Psoriatic Arthritis (PDF, 55 ko) FV6861 - Rheumatoid Arthritis (PDF, 59 ko) FV6904 - General form (PDF, 53 ko) XENICAL (Orlistat) FV6904 - General form (PDF, 53 ko) Ouvrir ? XEOMIN (IncobotulinumtoxinA) FV6904 - General form (PDF, 53 ko) XERMELO (Telotristat etiprate) FV6904 - General form (PDF, 53 ko) XIAFLEX (Collagénase de Clostridium histolyticum) FV6904 - General form (PDF, 53 ko) Ouvrir ? XOLAIR (Omalizumab) FV6865 - Allergic asthma (PDF, 53 ko) FV6866 - Chronic idiopathic urticaria (PDF, 61 ko) FV6904 - General form (PDF, 53 ko) XOSPATA (Gilteritinib) FV6904 - General form (PDF, 53 ko) XTANDI (Enzalutamide) FV6904 - General form (PDF, 53 ko) XYREM (Oxybate de sodium) FV6904 - General form (PDF, 53 ko) ZAVESCA (Miglustat) FV6904 - General form (PDF, 53 ko) ZAXINE (Rifaximin) FV6904 - General form (PDF, 53 ko) FV7075 - Irritable Bowel Syndrome with Diarrhea (PDF, 108 ko) ZEJULA (Niraparib) FV6904 - General form (PDF, 53 ko) ZELBORAF (Vemurafénib) FV6904 - General form (PDF, 53 ko) ZEPATIER (Elbasvir / Grazoprévir) FV6904 - General form (PDF, 53 ko) ZOLINZA (Vorinostat) FV6904 - General form (PDF, 53 ko) ZYDELIG (Idélalisib) FV6904 - General form (PDF, 53 ko) ZYKADIA (Céritinib) FV6904 - General form (PDF, 53 ko) FV6968 - First-line treatment ALK+ locally advanced or metastatic non-small cell lung cancer (NSCLC) (PDF, 111 ko) ZYTIGA (Acétate d'abiratérone) FV6904 - General form (PDF, 53 ko) Fermer No pre-authorization required for our customers located in the province of Quebec Fermer Eligible only if under contract Fermer No pre-authorization required for our customers located in the province of Quebec Fermer No pre-authorization required for our customers located in the province of Quebec Fermer No pre-authorization required for our customers located in the province of Quebec Fermer No pre-authorization required for our customers located in the province of Quebec Fermer No pre-authorization required for our customers located in the province of Quebec Fermer No pre-authorization required for our customers located in the province of Quebec Fermer Eligible only if under contract Fermer No pre-authorization required for our customers located in the province of Quebec Fermer No pre-authorization required for our customers located in the province of Quebec Fermer No pre-authorization required for our customers located in the province of Quebec Fermer No pre-authorization required for our customers located in the province of Quebec Fermer Eligible only if under contract Fermer No pre-authorization required for women