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 42 Summary of Changes October 2017 Effective October 30, 2017 Drug Programs Policy and Strategy Branch Ontario Public Drug Programs Ministry of Health and Long-Term Care Visit Summary of Changes: Edition 42 page
2 Table of Contents New Multi-Source Products... 2 New Off-Formulary Interchangeable (OFI) Products... 5 New Nutrition Product... 6 Drug Benefit Price (DBP) Changes... 7 Discontinued Products... 8 Delisted Products
3 New Multi-Source Products DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR DBP Mint-Clonidine 0.1mg Tab MIN Mint-Clonidine 0.2mg Tab MIN (Interchangeable with Catapres) Therapeutic Note Significant rebound hypertension can occur after missing even one or two doses; this drug should be avoided in patients with cardiovascular fragility or suspected problems with compliance. DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR DBP Mylan-Pregabalin 25mg Cap MYL Mylan-Pregabalin 50mg Cap MYL Mylan-Pregabalin 75mg Cap MYL Mylan-Pregabalin 150mg Cap MYL Mylan-Pregabalin 300mg Cap MYL (Interchangeable with Lyrica) 2
4 New Multi-Source Products (Continued) DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR DBP Taro-Capecitabine 150mg Tab TAR Taro-Capecitabine 500mg Tab TAR (Interchangeable with Xeloda) Reason For Use Code and Clinical Criteria Code 346 For the first-line treatment of patients with metastatic colorectal, small bowel and appendiceal adenocarcinomas in whom combination chemotherapy is not recommended. NOTE: Not to be used in patients who have failed 5-flurouracil. Code 360 For the treatment of metastatic breast cancer where patients have progressed after prior chemotherapy. Code 406 For adjuvant treatment of stage 3 or high risk stage 2* colon, small bowel or appendiceal adenocarcinomas in patients who have completed surgery (within three months), who would normally be candidates for adjuvant chemotherapy with 5FU/LV. *high risk stage 2 colon, small bowel or appendiceal adenocarcinomas is defined as one of the following: obstruction, perforation, poorly differentiated adenocarcinoma, inadequate lymph node sampling, T4 tumour. LU Authorization Period: 6 Months 3
5 New Multi-Source Products (Continued) Code 409 As part of the CAPOX (XELOX) regimen for the first-line and second-line treatment of metastatic colorectal, small bowel or appendiceal adenocarcinomas. Code 426 In combination with trastuzumab and cisplatin for the treatment of patients with HER2- positive metastatic adenocarcinoma of the stomach or gastro-esophageal junction who have not received prior anti-cancer treatment for their metastatic disease. Code 427 For the neo-adjuvant treatment of rectal cancer. Code 461 In combination with a platinum-containing product and epirubicin for the treatment of advanced (non-resectable; either locally advanced or metastatic) gastric or gastroesophageal junction cancer. Code 474 As part of the CAPOX (XELOX) regimen for the treatment of adjuvant stage III and high risk stage II colorectal, small bowel or appendiceal adenocarcinomas. 4
6 New Off-Formulary Interchangeable (OFI) Products DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR UNIT PRICE Jamp-Cetirizine 20mg Tab JPC (Interchangeable with Reactine) DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR UNIT PRICE Apo-Erlotinib 25mg Tab APX Apo-Erlotinib 100mg Tab APX Apo-Erlotinib 150mg Tab APX (Interchangeable with Tarceva) DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR UNIT PRICE Apo-Gefitinib 250mg Tab APX (Interchangeable with Iressa) 5
7 New Nutrition Product G.1 PEDIATRIC FORMULA, CHEMICALLY DEFINED OLIGOMERIC (SEMI- ELEMENTAL) BRAND NAME Similac Alimentum Omega-3 & Omega-6 STRENGTH, DOSAGE FORM, PACKAGE SIZE 5.17KCAL/G, PD-400G CAN PK PIN MFR COST ($) PER 1000 KCAL COST ($) PER PKG AMT ($) MOHLTC PAYS ABB AMT ($) PATIENT PAYS 6
8 Drug Benefit Price (DBP) Changes DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR DBP/ UNIT PRICE ** Aubagio 14mg Tab GZM Dantrium 25mg Cap JHP * Adcirca 20 mg Tab LIL Effient 10 mg Tab LIL Novo-Clonidine 0.1mg Tab NOP Novo-Clonidine 0.2mg Tab NOP Pms-Losartan 25mg Tab PMS Pms-Losartan 50mg Tab PMS Pms-Losartan 100mg Tab PMS Pms-Risedronate 35mg Tab PMS Pms-Salbutamol 2mg/mL Inh Sol - 2.5mL Pk PMS * Off-Formulary Interchangeable (OFI) Product ** Exceptional Access Program Product 7
9 Discontinued Products (Some products will remain on Formulary for six months to facilitate depletion of supply) DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR Mylan-Acebutolol (Type S) 200mg Tab MYL * Mylan-Alprazolam 1mg Tab MYL Mylan-Gabapentin 100mg Cap MYL Mylan-Gabapentin 300mg Cap MYL * Mylan-Gabapentin 600mg Tab MYL * Mylan-Gabapentin 800mg Tab MYL Mylan-Montelukast 4mg Tab MYL Mylan-Pravastatin 20mg Tab MYL Mylan-Risperidone 1mg Tab MYL * Off-Formulary Interchangeable (OFI) Product 8
10 Delisted Products DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR Zarah mg & 0.03mg Tab-21 Pk COB Zarah mg & 0.03mg Tab-28 Pk COB Pms-Carbamazepine 100mg Chew Tab PMS Pms-Carbamazepine 200mg Chew Tab PMS Sandoz Carbamazepine Chewtabs 200mg Chew Tab SDZ 9
11
Ontario Drug Benefit Formulary/Comparative Drug Index
Ministry of Health and Long-Term Care Ontario Drug Benefit Formulary/Comparative Drug Index Edition 42 Summary of Changes June 2017 Effective June 29, 2017 Drug Programs Policy and Strategy Branch Ontario
Ontario Drug Benefit Formulary/Comparative Drug Index
Ontario Drug Benefit Formulary/Comparative Drug Index Edition 42 Summary of Changes - December 2014 Effective December 18, 2014 Ministry of Health and Long-Term Care Table of Contents New Multi-Source
Ontario Drug Benefit Formulary/Comparative Drug Index
Ontario Drug Benefit Formulary/Comparative Drug Index Edition 42 Summary of Changes - February 2015 Effective February 26, 2015 Ministry of Health and Long-Term Care Table of Contents New Multi-Source
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
Ontario Drug Benefit Formulary/Comparative Drug Index
Ministry of Health and Long-Term Care Ontario Drug Benefit Formulary/Comparative Drug Index Edition 42 Summary of Changes July 2017 Effective July 31, 2017 Drug Programs Policy and Strategy Branch Ontario
UPDATE E Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective December 23, 2008 SUMMARY OF CHANGES
UPDATE E Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective December 23, 2008 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Multi-Source Drug(s) 2 New Drug Identification Number(s)
Ontario Drug Benefit Formulary/Comparative Drug Index
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 Drug Benefit Formulary/Comparative Drug Index
Ministry of Health and Long-Term Care Ontario Drug Benefit Formulary/Comparative Drug Index Edition 42 Summary of Changes September 2017 Effective September 28, 2017 Drug Programs Policy and Strategy Branch
Ontario Drug Benefit Formulary/Comparative Drug Index
Ontario Drug Benefit Formulary/Comparative Drug Index Edition 42 Summary of Changes - August 2015 Effective August 26, 2015 Ministry of Health and Long-Term Care Table of Contents New Single Source Products...
Ontario Drug Benefit Formulary/ Comparative Drug Index
Ontario Drug Benefit Formulary/ Comparative Drug Index Edition 42 Summary of Changes March 2014 Effective March 27, 2014 Ministry of Health and Long-Term Care Table of Contents Additions to Formulary...
Ontario Drug Benefit Formulary/Comparative Drug Index
Ontario Drug Benefit Formulary/Comparative Drug Index Edition 42 Summary of Changes - July 2014 Effective July 30, 2014 Ministry of Health and Long-Term Care Table of Contents New Single Source Products...
Ontario Drug Benefit Formulary/ Comparative Drug Index
Ontario Drug Benefit Formulary/ Comparative Drug Index Edition 42 Summary of Changes December 2013 Effective January 03, 2014 Ministry of Health and Long-Term Care Table of Contents Additions to Formulary...
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Ministry of Health and Long-Term Care Ontario Drug Benefit Formulary/Comparative Drug Index Edition 43 Summary of Changes February 2019 Effective February 28, 2019 Drug Programs Policy and Strategy Branch
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Ministry of Health and Long-Term Care Ontario Drug Benefit Formulary/Comparative Drug Index Edition 43 Summary of Changes December 2018 Effective December 21, 2018 Drug Programs Policy and Strategy Branch
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)
Ontario Drug Benefit Formulary/Comparative Drug Index
Ontario Drug Benefit Formulary/Comparative Drug Index Edition 42 Summary of Changes - November 2014 Effective November 27, 2014 Ministry of Health and Long-Term Care Table of Contents New Single Source
Ontario Drug Benefit Formulary/Comparative Drug Index
Ministry of Health and Long-Term Care Ontario Drug Benefit Formulary/Comparative Drug Index Edition 43 Summary of Changes April 2018 Effective April 30, 2018 Drug Programs Policy and Strategy Branch Ontario
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Ministry of Health and Long-Term Care Ontario Drug Benefit Formulary/Comparative Drug Index Edition 42 Summary of Changes December 2016 Effective December 22, 2016 Drug Programs Policy and Strategy Branch
Ontario Drug Benefit Formulary/Comparative Drug Index
Ministry of Health and Long-Term Care Ontario Drug Benefit Formulary/Comparative Drug Index Edition 42 Summary of Changes December 2017 Effective December 21, 2017 Drug Programs Policy and Strategy Branch
Ontario Drug Benefit Formulary/Comparative Drug Index
Ministry of Health and Long-Term Care Ontario Drug Benefit Formulary/Comparative Drug Index Edition 43 Summary of Changes June 2018 Effective June 29, 2018 Drug Programs Policy and Strategy Branch Ontario
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)
UPDATE AA Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective September 15, 2011 SUMMARY OF CHANGES
UPDATE AA Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective September 15, 2011 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 3 Off
Ontario Drug Benefit Formulary/Comparative Drug Index
Ministry of Health and Long-Term Care Ontario Drug Benefit Formulary/Comparative Drug Index Edition 43 Summary of Changes January 2018 Effective January 31, 2018 Drug Programs Policy and Strategy Branch
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Ministry of Health and Long-Term Care Ontario Drug Benefit Formulary/Comparative Drug Index Edition 42 Summary of Changes - October 2015 Effective October 29, 2015 Drug Program Services Branch/Ontario
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UPDATE AJ Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective July 27, 2012 SUMMARY OF CHANGES
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UPDATE AB Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective October 25, 2011 SUMMARY OF CHANGES
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UPDATE AX Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective August 29, 2013 SUMMARY OF CHANGES
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 B Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective October 01, 2008 SUMMARY OF CHANGES
UPDATE B Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective October 01, 2008 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Multi-Source Drug(s) 2 Manufacturer Requested Discontinued
UPDATE AE Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective February 29, 2012 SUMMARY OF CHANGES
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