Ontario Drug Benefit Formulary/Comparative Drug Index
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1 Ministry of Health and Long-Term Care Ontario Drug Benefit Formulary/Comparative Drug Index Edition 43 Summary of Changes August 2018 Effective August 30, 2018 Drug Programs Policy and Strategy Branch Ontario Public Drug Programs Ministry of Health and Long-Term Care Visit Formulary Downloads: Edition 43
2 Table of Contents New Single Source Products... 3 New Multi-Source Products... 4 New Off-Formulary Interchangeable (OFI) Products... 7 Manufacturer Name Changes... 8 Product Brand and Manufacturer Name Changes... 9 DIN/PIN to NPN Changes Drug Benefit Price (DBP) Changes Discontinued Products Delisted Products
3 New Single Source Products DIN/PIN Brand Name Strength Dosage Form Generic Name Mfr DBP Odefsey 200mg & Tab EMTRICITABINE & GIL mg & RILPIVIRINE HCL & 25mg TENOFOVIR ALAFENAMIDE HEMIFUMARATE Therapeutic Note As a complete regimen for the treatment of adults infected with HIV-1 with no known mutations associated with resistance to the non-nucleoside reverse-transcriptase inhibitor (NNRTI) class, tenofovir or emtricitabine (FTC), and with a viral load less than or equal to 100,000 copies/ml. For the treatment of HIV/AIDS. The prescriber must be approved for the Facilitated Access to HIV/AIDS Drug Products mechanism. DIN/PIN Brand Name Strength Dosage Form Generic Name Mfr DBP PDP- 1mg Tab BENZTROPINE PEN Benztropine MESYLATE 3
4 New Multi-Source Products DIN/PIN Brand Name Strength Dosage Form Mfr DBP Auro-Candesartan 4mg Tab AUR Auro-Candesartan 8mg Tab AUR (Interchangeable with Atacand) DIN/PIN Brand Name Strength Dosage Form Mfr DBP Mar-Diltiazem T 120mg SR Cap MAR Mar-Diltiazem T 180mg SR Cap MAR Mar-Diltiazem T 240mg SR Cap MAR Mar-Diltiazem T 300mg SR Cap MAR Mar-Diltiazem T 360mg SR Cap MAR (Interchangeable with Tiazac) DIN/PIN Brand Name Strength Dosage Form Mfr DBP Mar-Pravastatin 10mg Tab MAR Mar-Pravastatin 20mg Tab MAR Mar-Pravastatin 40mg Tab MAR (Interchangeable with Pravachol) DIN/PIN Brand Name Strength Dosage Form Mfr DBP Sandoz Pravastatin Tablets 10mg Tab SDZ Sandoz Pravastatin Tablets 20mg Tab SDZ Sandoz Pravastatin Tablets 40mg Tab SDZ (Interchangeable with Pravachol) 4
5 New Multi-Source Products (Continued) DIN/PIN Brand Name Strength Dosage Form Mfr DBP Apo-Quetiapine XR 50mg ER Tab APX Apo-Quetiapine XR 150mg ER Tab APX Apo-Quetiapine XR 200mg ER Tab APX Apo-Quetiapine XR 300mg ER Tab APX Apo-Quetiapine XR 400mg ER Tab APX (Interchangeable with Seroquel XR) DIN/PIN Brand Name Strength Dosage Form Mfr DBP Jamp-Entecavir 0.5mg Tab JPC (Interchangeable with Baraclude) Reason For Use Code and Clinical Criteria Code 505 Confirmed chronic Hepatitis B infection in persons with HBV DNA greater than or equal to 1000 IU/mL AND ALT levels greater than ULN OR Evidence of fibrosis OR Documented evidence of cirrhosis LU Authorization Period: 1 year 5
6 New Multi-Source Products (Continued) Code 506 For patients with chronic Hepatitis B infection who have a contraindication, intolerance or inadequate response to one or more of the following: lamivudine, tenofovir, adefovir or telbivudine. LU Authorization Period: 1 year Code 507 Patients with chronic Hepatitis B infection currently receiving treatment with entecavir and requires treatment continuation. LU Authorization Period: 1 year Code 508 Patients with chronic Hepatitis B infection who are scheduled to undergo chemotherapy or significant immunosuppressive treatment. LU Authorization Period: 1 year 6
7 New Off-Formulary Interchangeable (OFI) Products DIN/PIN Brand Name Strength Dosage Form Mfr Unit Price Apo-Cefepime 1g Inj Pd-Vial Pk APX Apo-Cefepime 2g Inj Pd-Vial Pk APX (Interchangeable with Maxipime) 7
8 Manufacturer Name Changes DIN/PIN Brand Name Strength Dosage Form Current Mfr New Mfr Biaxin BID 250mg Tab ABB BGP * Biaxin BID 500mg Tab ABB BGP Biaxin 125mg/5mL Ped Gran ABB BGP Biaxin 250mg/5mL Susp ABB BGP Biaxin XL 500mg ER Tab ABB BGP * Off-Formulary Interchangeable (OFI) Product 8
9 Product Brand and Manufacturer Name Changes DIN/PIN Current Brand Name Current Mfr New Brand Name New Mfr Strength Dosage Form Co Amlodipine COB Act Amlodipine TEV 5mg Tab Co Amlodipine COB Act Amlodipine TEV 10mg Tab 9
10 DIN/PIN to NPN Changes DIN/PIN Current Brand Name Strength New NPN Dosage Form Mfr Pedialyte Regular N/A O/L ABB Pedialyte Flavored N/A O/L ABB 10
11 Drug Benefit Price (DBP) Changes DIN/PIN/NPN Brand Name Strength Dosage Form Mfr DBP/ Unit Price Aventyl 10mg Cap AAP Aventyl 25mg Cap AAP Pedialyte Regular N/A O/L ABB Pedialyte Flavored N/A O/L ABB Flagyl 500mg Cap ODN PMS-Valproic Acid 250mg Cap PMS PMS-Valproic Acid 500mg Ent Cap PMS Sandoz Quetiapine XRT 50mg ER Tab SDZ Sandoz Quetiapine XRT 150mg ER Tab SDZ Sandoz Quetiapine XRT 200mg ER Tab SDZ Sandoz Quetiapine XRT 300mg ER Tab SDZ Sandoz Quetiapine XRT 400mg ER Tab SDZ Teva-Quetiapine XR 50mg ER Tab TEV Teva-Quetiapine XR 150mg ER Tab TEV Teva-Quetiapine XR 200mg ER Tab TEV Teva-Quetiapine XR 300mg ER Tab TEV Teva-Quetiapine XR 400mg ER Tab TEV
12 Discontinued Products (Some products will remain on Formulary for six months to facilitate depletion of supply) DIN/PIN Brand Name Strength Dosage Form Mfr * Pedialyte Regular N/A O/L ABB ** Pedialyte Flavored N/A O/L ABB Cardura-1 1mg Tab AZC Cardura-2 2mg Tab AZC Cardura-4 4mg Tab AZC *** Mylan-Cyclobenzaprine 10mg Tab MYL Mylan-Meloxicam 7.5mg Tab MYL Mylan-Meloxicam 15mg Tab MYL Frisium 10mg Tab OVA **** PMS-Repaglinide 0.5mg Tab PMS Zoledronic Acid Injection 5mg/100mL * DIN replaced by NPN (Natural Product Number) ** PIN replaced by NPN (Natural Product Number) *** Not-a-Benefit (NAB) Product **** Off-Formulary Interchangeable (OFI) Product Inj Sol-100mL Pk (Preservative-Free) TEV 12
13 Delisted Products DIN/PIN Brand Name Strength Dosage Form Mfr Tears Naturale 0.1%/0.3% Oph-Sol ALC * Cipralex MELTZ 10mg Orally Disintegrating Tab VLH * Cipralex MELTZ 20mg Orally Disintegrating Tab VLH * Remain on Formulary as Not-a-Benefit (NAB) to serve as a reference product in interchangeable group 13
14
Ontario Drug Benefit Formulary/Comparative Drug Index
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UPDATE AZ Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective October 31, 2013 SUMMARY OF CHANGES
UPDATE AZ Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective October 31, 2013 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 5 Off Formulary
UPDATE AF Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective March 26, 2012 SUMMARY OF CHANGES
UPDATE AF Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective March 26, 2012 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Multi-Source Drug(s) 2 Off Formulary Interchangeable Product(s)
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UPDATE AU Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective May 31, 2013 SUMMARY OF CHANGES
UPDATE AU Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective May 31, 2013 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Multi-Source Drug(s) 2 Off Formulary Interchangeable Product(s)
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UPDATE AX Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective August 29, 2013 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 4 Off Formulary
UPDATE AJ Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective July 27, 2012 SUMMARY OF CHANGES
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UPDATE F Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective 30 January, 2009 SUMMARY OF CHANGES
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UPDATE E Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective December 23, 2008 SUMMARY OF CHANGES
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