CADTH recommends that Opdivo should be reimbursed by public drug plans as a monotherapy for the adjuvant treatment of adult patients with urothelial carcinoma (UC) who are at high risk of recurrence after undergoing radical resection of UC. Opdivo should only be covered in patients with UC that spreads into the muscle layer, was removed by surgery, and is at high risk of coming back. Patients should have either received cisplatin-based neoadjuvant chemotherapy or not have received neoadjuvant

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... splatin-based chemotherapy and be ineligible or eligible for adjuvant cisplatin-based chemotherapy but decline to take it. Opdivo should only be reimbursed if prescribed by qualified practitioners with expertise in treating UC, systemic therapy delivery, and management of immunotherapy-related side effects, and if the cost of Opdivo is reduced. Patients should be in relatively good health (i.e., have a good performance status, as determined by a specialist).