Ontario Drug Benefit Formulary/Comparative Drug Index
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1 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
2 Table of Contents New Single Source Products... 3 New Multi-Source Products... 4 New Off-Formulary Interchangeable (OFI) Products Drug Benefit Price (DBP) Changes Status Changes from Discontinued Drug to Not-A-Benefit Discontinued Products Delisted Products
3 New Single Source Products DIN/PIN PRODUCT NAME, STRENGTH & DOSAGE GENERIC NAME MFR DBP FORM Innohep 8000IU/0.4mL Inj Pref Syr TINZAPARIN SODIUM LEO Innohep 12000IU/0.6mL Inj Pref Syr TINZAPARIN SODIUM LEO Innohep 16000IU/0.8mL Inj Pref Syr TINZAPARIN SODIUM LEO Reason For Use Code and Clinical Criteria Code 186 For acute treatment of deep venous thrombosis (DVT), for a maximum of three weeks; Code 187 For DVT in pregnant or lactating females; Code 188 For DVT in patients whom treatment with warfarin is not tolerated, or contraindicated; Code 189 For DVT in patients who have failed treatment with warfarin. Code 323 For the acute treatment of pulmonary embolism, maximum of three weeks. 3
4 New Multi-Source Products Van-Alendronate 10mg Tab VAN Van-Alendronate 70mg Tab VAN (Interchangeable with Fosamax) Van-Amlodipine 5mg Tab VAN Van-Amlodipine 10mg Tab VAN (Interchangeable with Norvasc) Van-Anastrozole 1mg Tab VAN (Interchangeable with Arimidex) Reason For Use Code and Clinical Criteria Code 365 For the treatment of metastatic breast cancer in hormone receptor positive post-menopausal women. LU Authorization Period: Indefinite. Code 396 As an alternative to tamoxifen for the adjuvant treatment of postmenopausal women with hormone receptor positive breast cancer. LU Authorization Period: Indefinite. 4
5 New Multi-Source Products (Cont d...) Van-Bicalutamide 50mg Tab VAN (Interchangeable with Casodex) Ecl-Citalopram 20mg Tab ECL Ecl-Citalopram 40mg Tab ECL (Interchangeable with Celexa) Cyanocobalamin Injection USP 1mg/mL Inj Sol-10mL Pk MYL Jamp-Cyanocobalamin 1mg/mL Inj Sol-10mL Pk JPC (Interchangeable with Rubramin) Van-Finasteride 5mg Tab VAN (Interchangeable with Proscar PIN *) *New Proscar 5mg PIN created to serve as reference brand product for Van-Finasteride, which is interchangeable with Proscar for RFU Code 385 only. Continued on next page. 5
6 . Continued from previous page Reason For Use Code and Clinical Criteria Code 385 For monotherapy, as a second line agent in patients with symptomatic* Benign Prostatic Hyperplasia following treatment failure or intolerance to an alpha blocker. *Symptomatic is defined as having moderate (about half the time) to severe (almost always) symptoms related to the prostate in at least 4 of the following domains: 1. feeling of incomplete emptying of the bladder after voiding 2. needing to urinate again less than 2 hours after previous void 3. stopping and starting urine several times while voiding 4. difficulty postponing urination 5. weak urinary stream 6. pushing or straining to begin voiding 7. the need to get up to void at least 3 times in the night. LU Authorization Period: Indefinite. 6
7 New Multi-Source Products (Cont d...) Van-Gabapentin 100mg Cap VAN Van-Gabapentin 300mg Cap VAN Van-Gabapentin 400mg Cap VAN (Interchangeable with Neurontin) Van-Irbesartan 75mg Tab VAN Van-Irbesartan 150mg Tab VAN Van-Irbesartan 300mg Tab VAN (Interchangeable with Avapro) Van-Letrozole 2.5mg Tab VAN (Interchangeable with Femara) Reason For Use Code and Clinical Criteria Code 365 For the treatment of metastatic breast cancer in hormone receptor positive post-menopausal women. LU Authorization Period: Indefinite. Code 403 For the treatment of hormone receptor positive early breast cancer in postmenopausal women who have received 5 years of adjuvant tamoxifen therapy. LU Authorization Period: 5 years. Code 408 As an alternative to tamoxifen for the adjuvant treatment of post-menopausal women with hormone receptor positive early breast cancer for a maximum of five years. LU Authorization Period: 5 years. 7
8 New Multi-Source Products (Cont d...) Van-Losartan 25mg Tab VAN Van-Losartan 50mg Tab VAN Van-Losartan 100mg Tab VAN (Interchangeable with Cozaar) Van-Omeprazole 20mg DR Tab VAN (Interchangeable with Losec DIN ) Reason For Use Code and Clinical Criteria Code 293 Gastroesophageal Reflux Disease (GERD) For the treatment of erosive GERD or upper GI malignancy; OR For the treatment of non-erosive GERD after failure of H2-receptor antagonist therapy. Patients with GERD should be reassessed within 6 months after initial treatment with a PPI. The reassessment could include confirmation of need for PPI with endoscopy, a trial of PPI withdrawal, or step-down therapy to H2-receptor antagonist therapy. Note: There is a lack of published evidence to support double-dose PPI therapy in this setting. Code 297 Confirmed Peptic Ulcers or NSAID-induced Ulcer Prophylaxis: For the treatment of confirmed peptic ulcers and NSAID-induced ulcers; OR For the prophylaxis of NSAID-induced ulcers for patients at increased risk of GI bleeding. Note: There is a lack of published evidence to support double-dose PPI therapy in this setting. Code 401 Other Gastrointestinal Disorders: For the treatment of gastroduodenal Crohns disease, short-gut syndrome, scleroderma, or pancreatitis. Note: There is a lack of published evidence to support double-dose PPI therapy in these settings. Code 402 Severe Conditions: For the treatment of severe esophagitis, Zollinger-Ellison syndrome, esophageal stricture, persistent symptoms of GERD or persistent erosive esophagitis, or upon hospital discharge following a gastrointestinal bleed. For patients receiving double-dose therapy, the need to continue treatment at higher doses should be reassessed after eight weeks. For re-treatment at higher doses, a four-week period should have elapsed from the end of the previous treatment. Reassessment could include a procedural assessment of the condition or step-down therapy to lowerdose proton pump inhibitor (PPI) therapy. 8
9 New Multi-Source Products (Cont d...) Van-Omeprazole 20mg DR Tab VAN (Interchangeable with Losec PIN ) Reason For Use Code and Clinical Criteria Code 295 H. pylori-positive Peptic Ulcers For the treatment of H. pylori-positive peptic ulcers where H. pylori is documented, by serology, urea breath test or endoscopy, for a one-week course in combination with antimicrobial therapy. Retreatment of H. pyloripositive peptic ulcers must be documented by persistent H. pylori infection on urea breath test or endoscopy. Maximum duration: 7 days (for retreatment, a four-week period must elapse since the end of the previous treatment) Van-Sertraline 25mg Cap VAN Van-Sertraline 50mg Cap VAN Van-Sertraline 100mg Cap VAN (Interchangeable with Zoloft) 9
10 New Off-Formulary Interchangeable (OFI) Products DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR UNIT COST Vpi-Baclofen Intrathecal 0.05mg/mL Inj Sol-1mL Pk (No Preservative) Vpi-Baclofen Intrathecal 0.5mg/mL Inj Sol-20mL Pk (No Preservative) Vpi-Baclofen Intrathecal 2mg/mL Inj Sol-5mL Pk (No Preservative) (Interchangeable with Lioresal Intrathecal) VPI VPI VPI DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR UNIT COST Auro-Metformin 850mg Tab AUR (Interchangeable with Glucophage) 10
11 Drug Benefit Price (DBP) Changes Ezetrol 10mg Tab MFS Sandoz Rivastigmine 1.5mg Cap SDZ Sandoz Rivastigmine 3mg Cap SDZ Sandoz Rivastigmine 4.5mg Cap SDZ Sandoz Rivastigmine 6mg Cap SDZ Sandoz Sotalol 160mg Tab SDZ
12 Status Changes from Discontinued Drug to Not-A-Benefit* DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR Mylan-Valacyclovir 500mg Tab MYL PMS-Valacyclovir 500mg Tab PMS (*Due to supply depletion) 12
13 Discontinued Products (Some products will remain on Formulary for six months to facilitate depletion of supply) DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR Cordarone 200mg Tab PFI Novo-Clobetasol 0.05% Oint NOP Novo-Rivastigmine 1.5mg Cap NOP Novo-Rivastigmine 3mg Cap NOP Novo-Rivastigmine 6mg Cap NOP Novo-Fenofibrate Micronized 200mg Cap NOP Novo-Fluvoxamine 50mg Tab NOP Novo-Fluvoxamine 100mg Tab NOP Ratio-Azithromycin 250mg Tab RPH Ratio-Clonazepam 0.5mg Tab RPH Ratio-Fluvoxamine 100mg Tab RPH Vital HN Pd-79g Pk ABB 13
14 Delisted Products DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR AJ-Pip/Taz 2g & 250mg Inj Pd-Vial Pk AJC Apo-Cloxi 250mg Cap APX Apo-Cloxi 500mg Cap APX Apo-Cloxi 25mg/mL O/L APX Sandoz Lovastatin 40mg Tab SDZ Sandoz Paroxetine 10mg Tab SDZ Sandoz Terbinafine 250mg Tab SDZ Sandoz Ticlopidine 250mg Tab SDZ Sandoz Topiramate 200mg Tab SDZ 14
15 ISSN (PDF) August 2015 Queen s Printer for Ontario, 2015.
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 - November 2014 Effective November 27, 2014 Ministry of Health and Long-Term Care Table of Contents New Single Source
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
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
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
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 - October 2015 Effective October 29, 2015 Drug Program Services 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 June 2017 Effective June 29, 2017 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 July 2016 Effective July 28, 2016 Drug Programs Policy and Strategy Branch Ontario
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
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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 December 2018 Effective December 21, 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 October 2017 Effective October 30, 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 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 December 2017 Effective December 21, 2017 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 December 2016 Effective December 22, 2016 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 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 January 2018 Effective January 31, 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
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 C Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective November 04, 2008 SUMMARY OF CHANGES
UPDATE C Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective November 04, 2008 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 3 Exceptional
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
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
Ontario Drug Benefit Formulary/Comparative Drug Index Edition 42 Summary of Changes - January 2015 Effective January 28, 2015 Ministry of Health and Long-Term Care Table of Contents New Multi-Source Products...
Ontario Drug Benefit Formulary/Comparative Drug Index
Ontario Drug Benefit Formulary/Comparative Drug Index Edition 42 Summary of Changes - July 2015 Effective July 29, 2015 Ministry of Health and Long-Term Care Table of Contents New Single Source Products...
UPDATE AJ Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective July 27, 2012 SUMMARY OF CHANGES
UPDATE AJ Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective July 27, 2012 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 43 Summary of Changes April 2018 Effective April 30, 2018 Drug Programs Policy and Strategy Branch Ontario
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UPDATE AB Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective October 25, 2011 SUMMARY OF CHANGES
UPDATE AB Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective October 25, 2011 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 5 Off Formulary
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)
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)
BULLETIN # 84. Manitoba Drug Benefits and Interchangeability Formulary Amendments. The following amendments will take effect on October 22, 2015
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UPDATE F Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective 30 January, 2009 SUMMARY OF CHANGES
UPDATE F Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective 30 January, 2009 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 3 Manufacturer
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UPDATE B Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective October 01, 2008 SUMMARY OF CHANGES
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UPDATE AE Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective February 29, 2012 SUMMARY OF CHANGES
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