Reimbursement Recommendations
Key Messages
- CADTH recommends that Ultomiris be reimbursed by public drug plans for the treatment of adult and pediatric patients at least 1 month of age and older with atypical hemolytic uremic syndrome (aHUS) to inhibit complement-mediated thrombotic microangiopathy (TMA), if certain conditions are met.
- Ultomiris should only be covered to treat adults and children (aged 1 month or older) who: have aHUS, evidence of ongoing and progressing TMA (blood clots forming in small blood vessels), and evidence of at least 1 damaged or dysfunctional organ. Ultomiris may be funded for patients who had a kidney transplant, but not for those who have already tried ravulizumab and it did not work.
- Ultomiris should only be reimbursed if it is prescribed by or in consultation with a nephrologist or hematologist. Its cost should not be more than the least expensive complement inhibitor that is reimbursed for the treatment of aHUS.
