Manager, PEI Drug Programs Date : December 7, 2009 Tel / Tél : (902) Fax / Téléc : (902)
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1 DRAFT To / Destinataire : All Retail Pharmacists and Staff From / Expéditeur : Faye Campbell Manager, PEI Drug Programs Date : December 7, 2009 Tel / Tél : (902) Fax / Téléc : (902) Subject / Objet : December 2009 Update to the Interchangeable / Maximum Allowable Cost List / Courriel : fecampbell@gov.pe.ca The December 2009 update to the PEI Drug Programs Interchangeable / Maximum Allowable Cost (MAC) List has been st published. Changes in interchangeability will come into effect on 21 December Changes in pricing related to the th addition of new interchangeable/mac categories will come into effect on 4 January 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 No new interchangeable categories PRODUCTS ADDED TO THE INTERCHANGEABLE / MAC LIST The following products have been added to existing interchangeable categories. CO-OLANZAPINE ODT 5 MG TABLETS CO-OLANZAPINE ODT 10 MG TABLETS CO-OLANZAPINE ODT 15 MG TABLETS December 2009 MAC List Update Page- 1
2 NOVO-LANSOPRAZOLE DR 15 MG CAPSULES NOVO-LANSPPRAZOLE DR 30 MG CAPSULES PHL-ALENDRONATE-FC 70 MG TABLETS PHL-AMLODIPINE 5 MG TABLETS PHL-AMLODIPINE 10 MG TABLETS PHL-ATENOLOL 25 MG TABLETS PHL-ATENOLOL 50 MG TABLETS PHL-ATENOLOL 100 MG TABLETS PHL-AZITHROMYCON 250 MG TABLETS PHL-BACLOFEN 10 MG TABLETS PHL-BACLOFEN 20 MG TABLETS PHL-CARVEDILOL MG TABLETS PHL-CARVEDILOL 6.25 MG TABLETS PHL-CARVEDILOL 12.5 MG TABLETS PHL-CARVEDILOL 25 MG TABLETS PHL-CITALOPRAM 10 MG TABLETS PHL-CITALOPRAM 20 MG TABLETS PHL-CITALOPRAM 40 MG TABLETS PHL-CLONAZEPAM 0.5 MG TABLETS PHL-CLONAZEPAM 1 MG TABLETS PHL-CLONAZEPAM 2 MG TABLETS PHL-CYCLOBENZAPRINE 10 MG TABLETS PHL-FLUOXETINE 10 MG CAPSULES PHL-FLUOXETINE 20 MG CAPSULES PHL-GABAPENTIN 100 MG CAPSULES PHL-GABAPENTIN 300 MG CAPSULES PHL-GABAPENTIN 400 MG CAPSULES PHL-MIRTAZAPINE 15 MG TABLETS PHL-MIRTAZAPINE 30 MG TABLETS PHL-ONDANSETRON 4 MG TABLETS PHL-ONDANSETRON 8 MG TABLETS PHL-PANTOPRAZOLE 40 MG TABLETS PHL-PAROXETINE 20 MG TABLETS PHL-PAROXETINE 30 MG TABLETS PHL-PIOGLITAZONE 15 MG TABLETS PHL-PIOGLITAZONE 30 MG TABLETS PHL-PIOGLITAZONE 45 MG TABLETS PHL-PRAVASTATIN 10 MG TABLETS PHL-PRAVASTATIN 20 MG TABLETS PHL-PRAVASTATIN 40 MG TABLETS PHL-RISPERIDONE 0.25 MG TABLETS PHL-RISPERIDONE 0.5 MG TABLETS December 2009 MAC List Update Page- 2
3 PHL-RISPERIDONE 1 MG TABLETS PHL-RISPERIDONE 2 MG TABLETS PHL-RISPERIDONE 3 MG TABLETS PHL-RISPERIDONE 4 MG TABLETS PHL-SERTRALINE 25 MG CAPSULES PHL-SERTRALINE 50 MG CAPSULES PHL-SERTRALINE 100 MG CAPSULES PHL-SIMVASTATIN 5 MG TABLETS PHL-SIMVASTATIN 10 MG TABLETS PHL-SIMVASTATIN 20 MG TABLETS PHL-SIMVASTATIN 40 MG TABLETS PHL-SIMVASTATIN 80 MG TABLETS PHL-TOPIRAMATE 25 MG TABLETS PHL-TOPIRAMATE 100 MG TABLETS PHL-TOPIRAMATE 200 MG TABLETS PHL-ZOPICLONE 5 MG TABLETS PHL-ZOPICLONE 7.5 MG TABLETS RAN-FENTAYL MTX PATCHES 12 UG/HR RAN-FENTAYL MTX PATCHES 25 UG/HR RAN-FENTAYL MTX PATCHES 50 UG/HR RAN-FENTAYL MTX PATCHES 75 UG/HR RAN-FENTAYL MTX PATCHES 100 UG/HR The following reimbursement prices have changed. CHANGES TO MAC PRICES AZITHROMYCIN ZITHROMAX PFI MG TABLET APO-AZITHROMYCIN APX CO AZITHROMYCIN COB PMS-AZITHROMYCIN PMS SANDOZ AZITHROMYCIN SDZ NOVO-AZITHROMYCIN NOP RATIO-AZITHROMYCIN RPH GEN-AZITHROMYCIN GPM PHL-AZITHROMYCIN PHL CETIRIZINE REACTINE PFI MG TABLET APO-CETIRIZINE APX OLANZAPINE ZYPREXA LIL MG TABLET NOVO-OLANZAPINE NOP APO-OLANZAPINE APO PMS-OLANZAPINE PMS CO-OLANZAPINE COB December 2009 MAC List Update Page- 3
4 OLANZAPINE ZYPREXA LIL MG TABLET NOVO-OLANZAPINE NOP APO-OLANZAPINE APO PMS-OLANZAPINE PMS CO-OLANZAPINE COB OLANZAPINE ZYPREXA LIL MG TABLET NOVO-OLANZAPINE NOP APO-OLANZAPINE APO PMS-OLANZAPINE PMS CO-OLANZAPINE COB OLANZAPINE ZYPREXA LIL MG TABLET NOVO-OLANZAPINE NOP APO-OLANZAPINE APO PMS-OLANZAPINE PMS CO-OLANZAPINE COB OLANZAPINE ZYPREXA LIL MG TABLET NOVO-OLANZAPINE NOP APO-OLANZAPINE APO PMS-OLANZAPINE PMS CO-OLANZAPINE COB ONDANSETRON HCL ZOFRAN GSK MG TABLET PMS-ONDANSETRON PMS NOVO-ONDANSETRON NOP SANDOZ ONDANSETRON SDZ RATIO-ONDANSETRON RPH PHL-ONDANSETRON PHL APO-ONDANSETRON APX CO ONDANSETRON COB GEN-ONDANSETRON GPM MINT-ONDANSETRON MNT ODANSETRON-ODAN ODN RAN-ONDANSETRON RAN JAMP-ONDANSETRON JPC No deleted categories at this time. DELETED INTERCHANGEABLE / MAC CATEGORIES December 2009 MAC List Update Page- 4
5 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. CO-GLIMEPIRIDE 1 MG TABLETS CO-GLIMEPIRIDE 2 MG TABLETS CO-GLIMEPIRIDE 4 MG TABLETS MOS CONCENTRATE 20MG/ML PMS-MEFENAMIC ACID 250 MG CAPSULES ZADITEN 1 MG TABLETS No changes CHANGE IN MANUFACTURER IMPORTANT NOTICES The PEI Drug Programs Management and Staff would like to wish you a very Merry Christmas! December 2009 MAC List Update Page- 5
Pharmacy Consultant, PEI Drug Programs Date : September 8, 2009 Tel / Tél : (902) Fax / Téléc : (902)
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AMANTADINE ER. Products Affected Step 2: OSMOLEX ER 129 MG TABLET, EXTENDED RELEASE OSMOLEX ER 193 MG TABLET, Details
AMANTADINE ER OSMOLEX ER 129 MG TABLET, EXTENDED RELEASE OSMOLEX ER 193 MG TABLET, EXTENDED RELEASE OSMOLEX ER 258 MG TABLET, PRIOR CLAIM FOR AMANTADINE HCL IMMEDIATE RELEASE WITHIN THE PAST 120 DAYS.
Riesbeck's Pharmacy Reward Club Generic Medication List February 2018 $4 30 Day Supply
Allergy, Cold & Flu Antibiotic Treatments Arthritis & Pain Benzonatate 100mg cap 14 42 Diphenhydramine HCl Cap 50 MG 30 90 Diphenhydramine HCl Inj 50MG/ML 1 3 Diphenhydramine HCl Liquid 12.5 MG/5ML 720ml
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 March 2019 Effective March 28, 2019 Drug Programs Policy and Strategy Branch Drugs
SASKATCHEWAN FORMULARY COMMITTEE UPDATE BULLETIN 52nd Edition
Saskatchewan Health Drug Plan and Extended Benefits Branch April, 2003 Bulletin #94 ISSN 0708-3246 SASKATCHEWAN FORMULARY COMMITTEE UPDATE BULLETIN 52nd Edition NEW EXCEPTION DRUG STATUS AGENTS Effective
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
New Interchangeable Products Approved and Benefit Status Within the Nova Scotia Pharmacare Programs March 2016
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
Nova Scotia Pharmacare Programs Interchangeable Product Updates November 13, 2018 New Categories
PAGE 1 OF 7 Nova Scotia Pharmacare Programs Interchangeable Product Updates November 13, New Categories A Maximum Reimbursable Price (MRP) or Pharmacare Reimbursement Price (PRP) has been established for
Riesbeck's Pharmacy Reward Club Generic Medication List October 2017
Allergy, Cold & Flu Antibiotic Treatments Arthritis & Pain Benzonatate 100mg cap 14 42 Diphenhydramine HCl Cap 50 MG 30 90 Diphenhydramine HCl Inj 50MG/ML 1 3 Diphenhydramine HCl Liquid 12.5 MG/5ML 720ml
SASKATCHEWAN FORMULARY COMMITTEE BULLETIN 55th EDITION
Saskatchewan Health Drug Plan and Extended Benefits Branch July 2005 Bulletin #103 ISSN 0708-3246 SASKATCHEWAN FORMULARY COMMITTEE BULLETIN 55th EDITION All listings are effective July 1, 2005 NEW FULL
Pharma X Consultancy Inc. Inventory List
Pharma X Consultancy Inc. Inventory List Location: Pharma X Consultancy Inc 2 Aceclofenac 100mg Tablets 60S 1205 ID Aciclovir 200mg Tablets 25S 1213 Aciclovir 400mg Tablets 56S 1214 Aciclovir 5% Cream
SASKATCHEWAN FORMULARY COMMITTEE BULLETIN UPDATE TO THE 54th EDITION
Saskatchewan Health Drug Plan and Extended Benefits Branch January 2005 Bulletin #101 ISSN 0708-3246 SASKATCHEWAN FORMULARY COMMITTEE BULLETIN UPDATE TO THE 54th EDITION NEW FULL FORMULARY LISTING: The
Riesbeck's Pharmacy Reward Club Generic Medication List September 2017
Drug Category Allergy, Cold & Flu Antibiotic Treatments Arthritis & Pain Riesbeck's Benzonatate 100mg cap 14 42 Diphenhydramine HCl Cap 50 MG 30 90 Diphenhydramine HCl Liquid 12.5 MG/5ML 720ml 2160ml Hydroxyzine
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
Drug Regimen Optimization
Texas Prior Authorization Program Clinical Edit Criteria Drug/Drug Class Clinical Edit Information Included in this Document Excluding Valsartan / Ramipril Prior authorization criteria logic: a description
Updates to the Alberta Drug Benefit List. Effective June 1, 2018
Updates to the Alberta Drug Benefit List Effective June 1, 2018 Inquiries should be directed to: Pharmacy Services Alberta Blue Cross 10009 108 Street NW Edmonton AB T5J 3C5 Telephone Number: (780) 498-8370
Updates to the Alberta Drug Benefit List. Effective December 1, 2018
Updates to the Alberta Drug Benefit List Effective December 1, 2018 Inquiries should be directed to: Pharmacy Services Alberta Blue Cross 10009 108 Street NW Edmonton AB T5J 3C5 Telephone Number: (780)
CRITERIA Trial of two generic formulary products from the following: atomoxetine or ADHD stimulant medication.
ADHD STIMULANTS ATOMOXETINE HCL, DEXEDRINE 10 MG TABLET, DEXEDRINE 5 MG TABLET, DEXMETHYLPHENIDATE HCL, DEXMETHYLPHENIDATE HCL ER, DEXTROAMPHETAMINE 10 MG TAB, DEXTROAMPHETAMINE 5 MG TAB, DEXTROAMPHETAMINE