Vol. 6 No. 2 (2026)
Reimbursement Recommendations

Osilodrostat (Isturisa)

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Published February 11, 2026

Key Messages

  • Canada’s Drug Agency (CDA-AMC) recommends that Isturisa should be reimbursed by public drug plans for the treatment of adult patients with Cushing disease who have persistent or recurrent hypercortisolism after primary pituitary surgery and/or irradiation or for whom pituitary surgery is not an option if certain conditions are met.
  • Isturisa should only be covered for adults with Cushing disease who still have the disease after pituitary gland surgery or radiation or who cannot have surgery. These patients must have confirmed high cortisol levels, elevated adrenocorticotropic hormone (ACTH) levels, and a confirmed pituitary source of the excess ACTH.
  • Isturisa should only be reimbursed if it is prescribed by an endocrinologist or a clinician with expertise in managing Cushing disease and the cost of Isturisa does not exceed the drug program cost of treatment with the least costly alternative treatment reimbursed for the treatment of Cushing disease.