On January 25, 2018, the Canadian Agency for Drugs and Technologies in Health (CADTH) released a report recommending that apomorphine (MOVAPO) be considered for public coverage under provincial healthcare. 

CADTH is an independent, not-for-profit organization responsible for providing healthcare decision-makers with objective evidence to help make informed decisions about the optimal use of health technologies including drugs.

Apomorphine (MOVAPO) is an adjunctive therapy for patients who are receiving optimized PD therapy (levodopa and derivatives and domapminergic agonists) and are still experiencing "off" episodes. The therapy has already been used for a considerable period of time in the UK and Europe, while recently introduced in the USA. The drug manufacturer filed an application with Health Canada, and once it was reviewed as safe, they filed a further application with the national Common Drug Review process. 

To assist in achieving a positive recommendation, Parkinson Society British Columbia (PSBC) filed a patient evidence submission for the national review process on Apomorphine. We collected information from a clinical expert in the UK who has used this therapy extensively for many years, and collections of interviews with individuals using apomorphone from Parkinson's societies in the USA, UK and Europe.

The following is an excerpt from CADTH's report:

RECOMMENDATION:
The CADTH Canadian Drug Expert Committee (CDEC) recommends that apomorphine hydrochloride (apomorphine) be reimbursed for the acute, intermittent treatment of hypomobility “off” episodes (“end-of-dose wearing off” and unpredictable “on/off” episodes) in patients with advanced Parkinson’s disease (PD), if the following criterion and conditions are met:

Criterion:

• Apomorphine should only be used as adjunctive therapy in patients who are receiving optimized PD therapy (levodopa and derivatives and dopaminergic agonists) and still experiencing “off” episodes.

Conditions:

• Patients treated with apomorphine should be under the care of a physician with experience in the diagnosis and management of PD. 
• Reduction in price.

The recommendation from CADTH is a positive step towards obtaining public and equitable access to apomorphine; however, this is the beginning of the process. PSBC has filed patient input to BC PharmaCare recommending public coverage in BC. Further updates will be provided as they become available.