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Medicine / Monoclonal antibodies / Arthritis / Disease-modifying antirheumatic drug / Rheumatoid arthritis / Leflunomide / Hydroxychloroquine / Biologic / Medical prescription / Immunosuppressants / Pharmacology / Immunology


SPECIAL AUTHORIZATION REQUEST FORM The Newfoundland and Labrador Prescription Drug Program (NLPDP) For INITIATION of Coverage of Restricted Rheumatoid Arthritis Medications Pharmaceutical Services Department of Health an
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Document Date: 2010-04-07 12:30:21


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Facility

Confederation Bldg. / Pharmacy Name / /

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Organization

Department of Health / /

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Position

Pharmacist / /

Product

Leflunomide / Cyclosporine / Azathioprine / /

ProvinceOrState

Newfoundland / /

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