Chronic inflammatory demyelinating polyneuropathy: all criteria

Every recorded criterion by drug and payer. Evaluated criteria drive the eligibility tool. Narrative requirements are shown but not evaluated. Last content update 2026-10-20.

Drug	Payer	Pathway	Evaluated criteria	Also required / notes	Sources and verification
immune globulin intravenous (IVIG)	All payers	Blood product	Active disease (progressing or relapsing) is yes	Funded provincially as a blood product through Canadian Blood Services and AHS Transfusion Medicine. Not dependent on the patient's drug plan. Prairie immune globulin guideline: first-line therapy, started when progression is rapid, walking is compromised, or there is significant functional impairment. Diagnosis made or reviewed by a neurologist with neuromuscular expertise. Induction 2 g/kg adjusted body weight over 2 to 5 days; maintenance about 1 g/kg every 3 to 4 weeks, titrated to the lowest effective dose. Continuation requires objective measures of effectiveness defined at the start of treatment; allow 3 to 6 months to judge response. Periodic trials of dose reduction or withdrawal are expected.	Criteria for the Clinical Use of Immune Globulin, Prairie provinces, 2nd edition 2022 Draft 2026-10-20 Confirm this is the current edition and add the AHS request form link.
immune globulin subcutaneous (SCIG) Hizentra, Cuvitru and others	All payers	Blood product	Active disease (progressing or relapsing) is yes	Funded provincially as a blood product through Canadian Blood Services. Not dependent on the patient's drug plan. Prairie immune globulin guideline positions SCIG as a maintenance alternative once the patient is stabilized on IVIG, at an equivalent monthly dose. Requires enrolment in a home infusion training program and the same objective response measures as IVIG.	Criteria for the Clinical Use of Immune Globulin, Prairie provinces, 2nd edition 2022 Draft 2026-10-20 Confirm whether de novo SCIG without prior IVIG stabilization is accepted in Alberta.
prednisone	All payers	Regular benefit	None	Regular benefit. First-line option alongside immune globulin; pulsed dexamethasone or methylprednisolone regimens are also used.	Alberta Drug Benefit List Draft 2026-10-20
plasma exchange (PLEX)	All payers	Hospital procedure	None	Hospital-administered procedure funded through AHS. Not dependent on the patient's drug plan. Usually reserved for patients who do not respond to immune globulin or corticosteroids, or for rapid deterioration.	Draft 2026-10-20
azathioprine Imuran	All payers	Regular benefit	None	Regular benefit. Used as a steroid-sparing or immune globulin-sparing agent; evidence of benefit in CIDP is limited. Consider TPMT testing before initiation.	Alberta Drug Benefit List Draft 2026-10-20
mycophenolate mofetil CellCept	All payers	STEDT approval	None	Requires approval through the AHS Short Term Exceptional Drug Therapy (STEDT) program for the CIDP indication. Funding is through AHS and does not depend on the patient's insurer.	AHS STEDT program (locate current request form) Draft 2026-10-20 Add direct STEDT form link and any documented prerequisite therapies.
rituximab Rituxan and biosimilars	All payers	STEDT approval	None	Requires approval through the AHS Short Term Exceptional Drug Therapy (STEDT) program. Funding is through AHS and does not depend on the patient's insurer. Preferred therapy for autoimmune nodopathy (paranodal antibody positive disease), which typically responds poorly to immune globulin. Also considered for CIDP refractory to first-line therapy.	AHS STEDT program (locate current request form) Draft 2026-10-20 Add direct STEDT form link and documented prerequisites.
efgartigimod alfa and hyaluronidase Vyvgart SC (Vyvgart Hytrulo in the US)	Alberta government plan	Not yet listed Not yet listed in Alberta. CDA-AMC recommended public reimbursement with conditions on 12 January 2026; pan-Canadian negotiation and provincial listing are pending. The patient meets the anticipated criteria. Until listing, access is through the manufacturer's patient support program or private coverage.	Diagnostic certainty is one of Definite or probable CIDP, electrodiagnostically confirmed, Possible CIDP with at least 2 supportive criteria Paranodal or nodal antibody positive (NF155, CNTN1, CASPR1, NF186) is no Active disease (progressing or relapsing) is yes Any of: myelopathy history, central demyelination, anti-MAG neuropathy, pure sensory CIDP, or another cause better explaining the neuropathy is no	Monotherapy for active CIDP in adults; the Health Canada indication is monotherapy. Prescribed by, or in consultation with, a neurologist or neuromuscular specialist. Continuation after the first 6 months requires clinical stability on at least one accepted assessment tool, with review every 12 months thereafter. CDA-AMC requires that the total cost not exceed that of IVIG; a price reduction is expected before listing. Health Canada approved the CIDP indication on 3 November 2025. The European indication specifies prior treatment with corticosteroids or immunoglobulins; whether Alberta will require prior therapy is not yet known (verify when the Section 3 text is published). Dose 1,000 mg subcutaneously once weekly.	CDA-AMC reimbursement recommendation SR0894 (efgartigimod alfa SC, CIDP), January 2026 CDA-AMC SR0894 supplemental material CDA-AMC project page ADHERE trial, Lancet Neurology 2024 Draft 2026-10-20 Conditions derived from the CDA-AMC recommendation summary. Verify against the full recommendation text and replace with Alberta Section 3 wording once listed. The paranodal antibody condition is an inference from the diagnostic criteria, not an explicit CDA-AMC exclusion.
	Alberta Blue Cross (private), Manulife, Canada Life, Sun Life, GreenShield, Desjardins, Other private	Not published	This insurer does not publish its prior authorization criteria. The CIDP indication was approved in November 2025; expect prior authorization with criteria tracking the CDA-AMC recommendation, and some plans may not have added the indication yet.	Submit the insurer's own prior authorization form. The manufacturer patient support program can usually confirm plan-specific status.	Draft 2026-10-20
	NIHB, VAC	Not published	Federal program listing status for the CIDP indication not confirmed.		Draft 2026-10-20
	No coverage	Not published	No drug plan on file and no public listing yet in Alberta, so Non-Group Coverage enrolment would not currently provide access. The manufacturer patient support program is the only route until listing.		Draft 2026-10-20

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