Pharmacy Consultant, PEI Drug Programs Date : September 8, 2009 Tel / Tél : (902) Fax / Téléc : (902)
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1 To / Destinataire : All Retail Pharmacists and Staff From / Expéditeur : Patrick Crawford Pharmacy Consultant, PEI Drug Programs Date : September 8, 2009 Tel / Tél : (902) Fax / Téléc : (902) Subject / Objet : Revised September 2009 Update to the Interchangeable / Maximum Allowable Cost List / Courriel : pjcrawford@gov.pe.ca The September 2009 update to the PEI Drug Programs Interchangeable / Maximum Allowable Cost (MAC) List has been published. Changes in interchangeability will come into effect on 21 September 2009 Changes in pricing related to the addition of new interchangeable/mac categories will come into effect on 05 October Adobe Acrobat (pdf) and Excel versions of the complete list can be downloaded from the Government website at: All product availability and pricing has been confirmed with manufacturers prior to publication of this update. Please contact the Pharmacy Services Office at (Charlottetown) or (toll-free in PEI) if you are unable to access a copy of the list online. Please note that the Maximum Allowable Cost List also contains products that although not listed in the Drug Programs Formulary but may be available through the Special Authorization (Exceptional Drug Request) Process. Refer to the Formulary to determine coverage of products under specific drug programs. In addition, some of the Interchangeable / MAC Categories are only available through the Palliative Home Care Drug Pilot Project. NEW INTERCHANGEABLE / MAC CATEGORIES The following new categories have been added to the Maximum Allowable Cost List. CLINDAMYCIN PHOSPHATE DALACIN T PFI TARO-CLINDAMYCIN TAR FELODIPINE PLENDIL AZE N/A 2.5MG SUSTAINED RELEASE RENEDIL AVN MIRTAZAPINE REMERON RD SCH MG ORALLY DISINTEGRATING NOVO-MIRTAZAPINE OD NOP TABLET MIRTAZAPINE REMERON RD SCH MG ORALLY DISINTEGRATING NOVO-MIRTAZAPINE OD NOP TABLET September 2009 MAC List Update - 1
2 MIRTAZAPINE REMERON RD SCH MG ORALLY DISINTEGRATING NOVO-MIRTAZAPINE OD NOP TABLET RIVASTIGMINE EXELON NVR MG CAPSUEL PMS-RIVASTIGMINE PMS SANDOZ RIVASTIGMINE SDZ RIVASTIGMINE EXELON NVR MG CAPSUEL PMS-RIVASTIGMINE PMS SANDOZ RIVASTIGMINE SDZ RIVASTIGMINE EXELON NVR MG CAPSUEL PMS-RIVASTIGMINE PMS SANDOZ RIVASTIGMINE SDZ RIVASTIGMINE EXELON NVR MG CAPSUEL PMS-RIVASTIGMINE PMS SANDOZ RIVASTIGMINE SDZ PRODUCTS ADDED TO THE INTERCHANGEABLE / MAC LIST The following products have been added to existing interchangeable categories. BETALOC DURULES 200MG SUSTAINED RELEASE TABLET GEN-OMEPRAZPLE 20MG CAPSULE NOVO-DOCUSATE 100MG CAPSULE PMS-OXYCODONE-ACET 5MG & 325MG TABLET RAN-CITALOPRAM 20MG TABLET RAN-CITALOPRAM 40MG TABLET The following reimbursement prices have changed. CHANGES TO MAC PRICES The N/A notation appearing in some categories stands for not applicable and means that there is no MAC price set because the prices of the various brands in the category are the same or similar. Each brand within that category will be reimbursed as defined within the present pharmacy services agreement. BROMAZEPAM APO-BROMAZEPAM APX N/A 1.5MG TABLET GEN-BROMAZEPAM GPM CAPTOPRIL APO-CAPTO APX N/A 12.5 MG TABLET NU-CAPTO NXP NOVO-CAPTORIL NOP GEN-CAPTOPRIL GPM PMS-CAPTOPRIL PMS September 2009 MAC List Update - 2
3 CIPROFLOXACIN CIPRO BAY MG TABLET NOVO-CIPROFLOXACIN NOP APO-CIPROFLOX APX GEN-CIPROFLOXACIN GPM RATIO-CIPROFLOXACIN RPH CO CIPROFLOXACIN COB PMS-CIPROFLOXACIN PMS SANDOZ CIPROFLOXACIN SDZ TARO-CIPROFLOXACIN TAR RAN-CIPROFLOX RAN MINT-CIPROFLOXACIN MNT NABUMETONE APO-NABUMETONE APX N/A 500MG TABLET NOVO-NABUMETONE NOP GEN-NABUMETONE GPM PREDNISOLONE ACETATE PRED-FORTE ALL % OPH SUSPENSION RATIO-PREDNISOLONE RPH SANDOZ PREDNISOLONE SDZ DIOPRED SDZ TICLOPIDINE HCL NOVO-TICLOPIDINE NOP N/A 250MG TABLET NU-TICLOPIDINE NXP APO-TICLOPIDINE APX GEN-TICLOPIDINE GPM PMS-TICLOPIDINE PMS SANDOZ TICLOPIDINE SDZ TIMOLOL MALEATE APO-TIMOP APX N/A 0.25% OPH SOLUTION GEN-TIMOLOL GPM PMS-TIMOLOL PMS SANDOZ TIMOLOL SDZ DELETED INTERCHANGEABLE / MAC CATEGORIES The following categories have been removed from the Maximum Allowable Cost List due to the discontinuation of one of the brands by the manufacturer. The discontinued products will not appear in the next publication of the Drug Programs Formulary, but will remain as benefits for the next twelve months. The remaining product within that category will be reimbursed as defined within the current Pharmacy Services Agreement. CHLORPROPAMIDE NOVO-PROPAMIDE NOP (DISC) 250MG TABLET APO-CHLORPROPAMIDE APX CIMETIDINE NOVO-CIMETINE NOP (DISC) 800MG TABLET APO-CIMETIDINE APX DEXAMETHASONE DEXASONE VAL (DISC) 0.75MG TABLET PMS-DEXAMETHASONE PMS RATIO-DEXAMETHASONE RPH (DISC) DEXAMETHASONE SANDOZ DEXAMETHASONE SDZ 0.1% OPH/OTIC PMS-DEXAMETHASONE PMS (DISC) SOLUTION DIMENHYDRINATE GRAVOL CDC (DISC) 10MG/ML I/V INJ SOL DIMENHYDRINATE SDZ (5ML) September 2009 MAC List Update - 3
4 FLUNISOLIDE RATIO-FULNISOLIDE RPH (DISC) 0.025% NASAL SPRAY RHINARIS-F PMS (DISC) RHINALAR IVX (DISC) APO-FLUNISOLIDE APX HALOPERIDOL APO-HALOPERIDOL APX (DISC) 2MG/ML ORAL SOLUTION PMS-HALOPERIDOL PMS LABETALOL TRANDATE SQP 100MG TABLET APO-LABETALOL APX (DISC) LABETALOL TRANDATE SQP 200MG TABLET APO-LABETALOL APX (DISC) NAPROXEN APO-NAPROXEN APX 125MG TABLET NU-NAPROX NXP (DISC) NITROFURANTOIN MACRODANTIN ALZ (DISC) 100MG CAPSULE NOVO-FURANTOIN NOP (MACROCRYSTALS) PERGOLIDE PERMAX DRX (DISC) 0.05MG TABLET APO-PERGOLIDE APX (DISC) PERGOLIDE PERMAX DRX (DISC) 0.25MG TABLET APO-PERGOLIDE APX (DISC) PERGOLIDE PERMAX DRX (DISC) 1MG TABLET APO-PERGOLIDE APX (DISC) TRIAMCINOLONE ACETONIDE ORACORT TAR 0.1% ORAL TOP OINTMENT KENALOG-ORABASE WSD (DISC) DISCONTINUED PRODUCTS The following products have been removed from the Maximum Allowable Cost List. These products will not appear in the next publication of the Drug Programs Formulary, but will remain as benefits for the next twelve months. APO-KETOTIFEN 0.2MG/ML SYRUP APO-SALVENT IPRAVENT 1.0MG & 0.2MG PER ML NEBULE ENDANTADINE 100MG CAPSULE LECTOPAM 1.5MG TABLET LIN-BUSPIRONE 10MG TABLET LIN-FOSINOPRIL 10MG TABLET LIN-FOSINOPRIL 20MG TABLET M.O.S. 5MG/ML SOLUTION NOVO-BUPROPION SR 150MG SUSTAINED RELEASE TABLET NOVO-DIFLUNISAL 500MG TABLET NU-ALPRAZOLAM 0.25MG TABLET NU-ALPRAZOLAM 0.5MG TABLET September 2009 MAC List Update - 4
5 NU-BROMAZEPAM 1.5MG TABLET NU-BROMAZEPAM 3MG TABLET NU-BROMAZEPAM 6MG TABLET NU-KETOTIFEN 0.2MG/ML SYRUP NU-SALBUTAMOL 1MG/ML NEBULE NU-SALBUTAMOL 2MG/ML NEBULE NU-TEMAZEPAM 15MG CAPSULE NU-TEMAZEPAM 30MG CAPSULE PMS-CIMETIDINE 300MG TABLET PMS-CIMETIDINE 400MG TABLET PMS-CIMETIDINE 600MG TABLET PMS-FLAVOXATE 200MG TABLET PMS-GENTAMICIN 0.3% OPHTHALMIC SOLUTION PMS-PIROXICAM 10MG CAPSULE PMS-PIROXICAM 20MG CAPSULE PMS-TIAPROFENIC ACID 200MG TABLET RATIO-ALPRAZOLAM 0.25MG TABLET RATIO-ALPRAZOLAM 0.5MG TABLET RATIO-DESIPRAMINE 25MG TABLET RATIO-DESIPRAMINE 50MG TABLET RATIO-MPA 2.5MG TABLET RATIO-MPA 5MG TABLET RATIO-MPA 10MG TABLET RELAFEN 500MG TABLET SANDOZ NABUMETONE 500MG TABLET TICLID 250MG TABLET TIMOPTIC 0.25% OPHTHALMIC SOLUTION CHANGE IN MANUFACTURER DILAUDID 1MG/ML ORAL SOLUTION PFR DILAUDID 1MG TABLET PFR DILAUDID 2MG TABLET PFR DILAUDID 4MG TABLET PFR DILAUDID 8MG TABLET PFR DILAUDID 2MG/ML INJECTION PFR DILAUDID 10MG/ML INJECTION PFR DILAUDID 20MG/ML INJECTION PFR DILAUDID 50MG/ML INJECTION PFR September 2009 MAC List Update - 5
6 IMPORTANT NOTICES CHANGES TO PDINS (PSEUDO DRUG IDENTIFICATION NUMBERS) In order to eliminate overlap with existing DINs, the PDINs for the following products have been changed: ACETYLSALICYLIC ACID 325MG TABLET (UNCOATED) ASCORBIC ACID 500MG TABLET CALCIUM CARBONATE 250MG TABLETS USE OF PDINS (PSEUDO DRUG IDENTIFICATION NUMBERS) PDINs have been assigned to the following products since July 2006: ACETAMINOPHEN 32MG/ML ELIXIR ACETAMINOPHEN 80MG/ML DROPS ACETAMINOPHEN 325MG TABLET ACETAMINOPHEN 500MG TABLET ACETYLSALICYCLIC ACID 325MG TABLET (UNCOATED) ASCORBIC ACID 500MG TABLET CALAMINE LOTION CALCIUM CARBONATE 250MG TABLET CALCIUM CARBONATE 500MG TABLET FOLIC ACID 1MG TABLET NIACIN 100MG TABLET NIACIN 500MG TABLET VITAMIN E 200UNIT CAPSULE VITAMIN E 400UNIT CAPSULE VITAMIN D 1000UNIT TABLET PDINs mus be used when submitting claims for any of these products and the regular DINs for products such a Apo- Calcium and Apo-Acetaminophen will not be accepted by the adjudication system. September 2009 MAC List Update - 6
Manager, PEI Drug Programs Date : December 7, 2009 Tel / Tél : (902) Fax / Téléc : (902)
DRAFT To / Destinataire : All Retail Pharmacists and Staff From / Expéditeur : Faye Campbell Manager, PEI Drug Programs Date : December 7, 2009 Tel / Tél : (902) 368-6338 Fax / Téléc : (902) 368-4905 Subject
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