Rituximab (Rituxan ®) is prescribed in three ways and it is not consistent throughout the country. Here is a fact sheet that outlines what provinces fund rituximab (Rituxan ®) therapy.

Rituximab (Rituxan ®) was the first monoclonal antibody approved for use (1997 in the United States, 2000 in Canada). It is widely used in combination with traditional chemotherapy for most types of lymphoma. Table 1 outlines the three main ways rituximab (Rituxan ®) is used in Canada and for what types of lymphoma.

Please note that each case of lymphoma is unique, and as such, we strongly recommend you always consult your physician with any question you may have about these treatments.

Table 1: Overview of Rituximab (Rituxan®) Use in Canada

Rituximab (Rituxan®) First-line Rituximab (Rituxan®) Maintenance Rituximab (Rituxan®) Retreatment
A first-line treatment is recommended for the initial treatment of lymphoma.
The combination of rituximab (Rituxan®) with chemotherapy has shown to prolong remission in many types of lymphoma, and in patients with diffuse large B-cell lymphoma, it has shown to improve survival.		 Maintenance treatment refers to therapy used within the first six months following initial treatment in an attempt to keep lymphoma from progressing or recurring. Data has shown that relapses can be delayed, or even prevented, by continuing or ‘maintaining’ treatment with rituximab (Rituxan®) while patients are in remission. The goal of maintenance therapy is to prevent those patients who have responded to initial treatment from relapsing while ultimately improving overall survival. Retreatment refers to a second course of rituximab (Rituxan®) after a patient has relapsed. Retreatment therapy is funded in only some provinces in Canada. It is used in many other developed countries.
Used for the following lymphomas:

  • Patients with relapsed or refractory* low-grade or follicular, CD20 positive, B-cell non-Hodgkin lymphoma
  • Patients with CD20 positive, diffuse large B-cell non-Hodgkin lymphoma in combination with CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisone)
  • Patients with previously untreated Stage III/IV follicular, CD20 positive, B-cell non-Hodgkin lymphoma in combination with CVP (cyclophosphamide, vincristine and prednisone) chemotherapy
  • The treatment of patients with previously untreated B-cell chronic lymphocytic leukemia (BCLL), stage B or C, in combination with fludarabine and cyclophosphamide.
 Used for the following lymphomas:

  • Patients with follicular lymphoma or other indolent B-cell lymphomas
  • Patients with follicular non-Hodgkin lymphoma who have responded to induction therapy with either CHOP or CHOP plus rituximab and it must be administered within six months of their initial treatment.
 Used for the following lymphomas:

  • Patients with follicular non-Hodgkin lymphoma who have responded to induction therapy with either CHOP or CHOP plus rituximab (Rituxan®)
  • Patients with CD20 positive relapsed or refractory*, low grade, follicular, or transformed non-Hodgkin lymphoma, including patients with rituximab (Rituxan®)-refractory* NHL.
Rituximab (Rituxan®) first-line is approved for funding in all provinces for all indications. EXCEPT for previously untreated CLL.§

§Previously untreated CLL is approved for funding in only British Columbia, Manitoba and Ontario. Québec, New Brunswick and Prince Edward Island evaluate funding rituximab (Rituxan®) use for previously untreated CLL on a case by case basis.

 Approved for funding in all provinces. See funding breakdown in Table 2.

*Refractory means resistant to treatment or not yielding to treatment.

Table 2: Rituximab (Rituxan®) Retreatment Funding – Provincial Breakdown as of January 2010

Diffuse Large B-Cell Lymphoma

Approved: Case by Case: Not Approved:
Nova Scotia
Newfoundland		 British Columbia
Alberta
Manitoba
Québec
New Brunswick
Prince Edward Island		 Saskatchewan
Ontario

Indolent Lymphoma

Approved: Case by Case: Not Approved:
Nova Scotia
Newfoundland
Alberta
Manitoba		 British Columbia
Québec
New Brunswick
Prince Edward Island		 Saskatchewan
Ontario

Remember, every patient has the right to ask about their type of lymphoma and the prescribed treatment plan.

If you would like information on possible financial support for therapies that may not be covered in your province, please click here. If you would like a sample letter to send to your provincial government click here. To get the contact information for your provincial government click here.

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