New Interchangeable Products Approved and Benefit Status Within the Nova Scotia Pharmacare Programs March 2016
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1 PAGE 1 OF 6 New Interchangeable Products Approved and Benefit Status Within the Nova Scotia Pharmacare Programs March New Categories A Maximum Reimbursable Price (MRP) or Pharmacare Reimbursement Price (PRP) has been established for the following products. Benefit status is effective March 7,. abacavir 300mg, lamivudine 150mg & zidovudine 300mg tab Apo-Abacavir-Lamivudine-Zidovudine 300/150/300mg Tab MARCH 28, Not Insured APX Trizivir 300/150/300mg Tab Not Insured VIV amphetamine 5mg XR cap ACT Amphetamine XR 5mg Cap Not Insured ATV Adderall XR 5mg Cap Not Insured SHI amphetamine 10mg XR cap ACT Amphetamine XR 10mg Cap Not Insured ATV Adderall XR 10mg Cap Not Insured SHI amphetamine 15mg XR cap ACT Amphetamine XR 15mg Cap Not Insured ATV Adderall XR 15mg Cap Not Insured SHI amphetamine 20mg XR cap ACT Amphetamine XR 20mg Cap Not Insured ATV Adderall XR 20mg Cap Not Insured SHI amphetamine 25mg XR cap ACT Amphetamine XR 25mg Cap Not Insured ATV Adderall XR 25mg Cap Not Insured SHI
2 PAGE 2 OF 6 New Categories Continued MARCH 28, amphetamine 30mg XR cap ACT Amphetamine XR 30mg Cap Not Insured ATV Adderall XR 30mg Cap Not Insured SHI naltrexone 50mg tab Apo-Naltrexone 50mg Tab DNP E (SF) APX ReVia 50mg Tab DNP E (SF) TEV rasagiline 0.5mg tab Apo-Rasagiline 0.5mg Tab Not Insured APX Azilect 0.5mg Tab Not Insured TMP rasagiline 1mg tab Apo-Rasagiline 1mg Tab Not Insured APX Azilect 1mg Tab Not Insured TMP Existing Categories Benefit status is effective March 7, and the existing MRP or PRP for each existing category will apply. acetaminophen 325mg & oxycodone 5mg tab Rivacocet 5/325mg Tab Not Insured RIV anastrozole 1mg tab Anastrozole 1mg Tab DNP SFC SAS atomoxetine 10mg cap Atomoxetine 10mg Cap Not Insured SIV atomoxetine 18mg cap Atomoxetine 18mg Cap Not Insured SIV
3 PAGE 3 OF 6 Existing Categories Continued atomoxetine 25mg cap Atomoxetine 25mg Cap Not Insured SIV atomoxetine 40mg cap Atomoxetine 40mg Cap Not Insured SIV atomoxetine 60mg cap Atomoxetine 60mg Cap Not Insured SIV celecoxib 100mg cap BIO-Celecoxib 100mg Cap DNP SF BMD celecoxib 200mg cap BIO-Celecoxib 200mg Cap DNP SF BMD Sandoz Celecoxib 200mg Cap DNP SF SDZ donepezil 5mg tab BIO-Donepezil 5mg Tab DNP E (SF) BMD donepezil 10mg tab BIO-Donepezil 10mg Tab DNP E (SF) BMD dorzolamide HCI 2% & timolol maleate 0.5% oph sol MINT-Dorzolamide/Timolol 2%/0.5% Oph Sol DNP SF MNT enalapril 2.5mg tab Enalapril 2.5mg Tab DNP SF SIV enalapril 5mg tab Enalapril 5mg Tab DNP SF SIV enalapril 10mg tab Enalapril 10mg Tab DNP SF SIV
4 PAGE 4 OF 6 Existing Categories Continued enalapril 20mg tab Enalapril 20mg Tab DNP SF SIV esomeprazole 20mg tab ACT Esomeprazole 20mg Tab Not Insured ATV esomeprazole 40mg cap/tab ACT Esomeprazole 40mg Tab Not Insured ATV fluoxetine 10mg cap BIO-Fluoxetine 10mg Cap Not Insured BMD fluoxetine 20mg Cap BIO-Fluoxetine 20mg Cap DNP SFC BMD gliclazide 30mg MR tab MYLAN-Gliclazide MR 30mg Tab DNP SFD MYL losartan 25mg tab BIO-Losartan 25mg Tab DNP SF BMD losartan 50mg tab BIO-Losartan 50mg Tab DNP SF BMD losartan 100mg tab BIO-Losartan 100mg Tab DNP SF BMD memantine 10mg tab Memantine 10mg Tab Not Insured SIV omeprazole 20mg cap/tab NAT-Omeprazole DR 20mg Tab DNP SFC NAT
5 PAGE 5 OF 6 Existing Categories Continued quetiapine 25mg tab BIO-Quetiapine 25mg Tab DNP SF BMD MINT-Quetiapine 25mg Tab DNP SF MNT quetiapine 100mg tab BIO-Quetiapine 100mg Tab DNP SF BMD MINT-Quetiapine 100mg Tab DNP SF MNT quetiapine 200mg tab BIO-Quetiapine 200mg Tab DNP SF BMD MINT-Quetiapine 200mg Tab DNP SF MNT quetiapine 300mg tab BIO-Quetiapine 300mg Tab DNP SF BMD MINT-Quetiapine 300mg Tab DNP SF MNT rizatriptan ODT 5mg tab Rizatriptan ODT 5mg Tab DNP SF SIV rizatriptan ODT 10mg tab Rizatriptan ODT 10mg Tab DNP SF SIV telmisartan 80mg & hydrochlorothiazide 25mg tab Telmisartan HCTZ 80/25mg Tab DNP SF PMS timolol maleate 0.5% oph sol Jamp-Timolol 0.5% Oph Sol DNP SF JPC zolmitriptan 2.5mg tab NAT-Zolmitriptan 2.5mg Tab DNP SF NAT zolmitriptan ODT 2.5mg tab AG-Zolmitriptan ODT 2.5mg Tab DNP SF AGP
6 PAGE 6 OF 6 Non-Interchangeable and Non-Insured The following product(s) were not recommended to list as insured benefits under the Nova Scotia Pharmacare Programs. pms-moxifloxacin 0.5% Oph Sol Not Insured PMS Price Changes Effective March 7,, a new MRP or PRP has been established for the following products. hydroxychloroquine 200mg tab Apo-Hydroxyquine 200mg Tab DNP SF APX MINT-Hydroxychloroquine 200mg Tab DNP SF MNT Plaquenil 200mg Tab DNP SF SAV
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00002234510 282 TABLET ORL TAB PPH TAB 0.0671 00002192691 3TC 10 MG/ML ORAL LIQUID ORL LIQ GSK ML 0.3330 00002192683 3TC 150 MG TABLET ORL TAB GSK TAB 5.1567 00002247825 3TC 300 MG TABLET ORL TAB GSK TAB
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00002234510 282 TABLET ORL TAB PPH TAB 0.0671 00002238645 292 TABLET ORL TAB PPH TAB 0.1872 00002192691 3TC 10 MG/ML ORAL LIQUID ORL LIQ GSK ML 0.3330 00002192683 3TC 150 MG TABLET ORL TAB GSK TAB 5.1567
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00002234510 282 TABLET ORL TAB PPH TAB 0.0671 00002238645 292 TABLET ORL TAB PPH TAB 0.1872 00002192691 3TC 10 MG/ML ORAL LIQUID ORL LIQ GSK ML 0.3307 00002192683 3TC 150 MG TABLET ORL TAB GSK TAB 5.0507
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