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 July 2016 Effective July 28, 2016 Drug Programs Policy and Strategy Branch Ontario Public Drug Programs Ministry of Health and Long-Term Care
2 Table of Contents New Single Source Product... 3 New Multi-Source Products... 4 New Off-Formulary Interchangeable (OFI) Products... 8 Status Change from Off-Formulary Interchangeable Products to Limited Use... 9 Off-Formulary Interchangeable Products Delisted Drug Benefit Price (DBP) Changes OFI Product Price Changes Product Manufacturer Name Changes Product Brand and Manufacturer Name Changes Discontinued Products Delisted Products
3 New Single Source Product DIN/PIN PRODUCT NAME,STRENGTH & DOSAGE FORM GENERIC NAME MFR DBP Humalog 200 units/ml INSULIN LISPRO LIL KwikPen 200U/mL Inj Sol-Pref Pen 5x3mL Pk Therapeutic Note: Note: For the treatment of patients with Type 1 diabetes mellitus. For the treatment of patients with Type 2 diabetes mellitus using insulin in an intensive regimen with 3 or more injections per day or an insulin pump. For the treatment of patients with Type 2 diabetes mellitus who are either experiencing recurrent hypoglycemia OR are unable to achieve adequate post-prandial glucose control while on less intensive regimen of regular insulin (1-2 injections per day). 3
4 New Multi-Source Products DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR DBP Amlodipine 5mg Tab SAI Amlodipine 10mg Tab SAI (Interchangeable with Norvasc) DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR DBP Act Bupropion XL 150mg ER Tab ACV Act Bupropion XL 300mg ER Tab ACV (Interchangeable with Wellbutrin XL) Reason For Use Code and Clinical Criteria Code 315 For the treatment of depression. LU Authorization Period: Indefinite. 4
5 New Multi-Source Products (Cont d...) DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR DBP Auro-Celecoxib 100mg Cap AUR Auro-Celecoxib 200mg Cap AUR (Interchangeable with Celebrex) Reason For Use Code and Clinical Criteria Osteoarthritis Code 316 For patients who have failed an adequate trial of acetaminophen (e.g. acetaminophen 1g QID for several weeks) and have had: History of a documented, clinically significant ulcer or GI bleed; or Failure or intolerance to at least three listed NSAIDS. NOTE: The maximum daily dose of celecoxib which will be reimbursed for the treatment of osteoarthritis is 200mg. LU Authorization Period: 1 year. Rheumatoid arthritis Code 317 For patients who have had: History of a documented, clinically significant ulcer or GI bleed; or Failure or intolerance to at least three listed NSAIDS. NOTE: The maximum daily dose of celecoxib which will be reimbursed for the treatment of rheumatoid arthritis is 400mg. LU Authorization Period: 1 year. DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR DBP Jamp-Duloxetine 30mg DR Cap JPC Jamp-Duloxetine 60mg DR Cap JPC (Interchangeable with Cymbalta) 5
6 New Multi-Source Products (Cont d...) DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR DBP Nat-Granisetron 1mg Tab NAT (Interchangeable with Kytril) Reason For Use Code and Clinical Criteria Code 91 For the treatment of emesis in cancer patients receiving highly emetogenic chemotherapy. LU Authorization Period: 1 year. Code 92 For patients receiving intravenous chemotherapy or radiation therapy who have not experienced adequate control with other available anti-emetics. LU Authorization Period: 1 year. Code 93 For patients receiving intravenous chemotherapy or radiation therapy who experience intolerable side effects with other anti- emetics. LU Authorization Period: 1 year. Code 326 For the treatment of emesis in patients receiving radiation therapy which consists of single fraction treatment to the abdominal cavity, hemi-body irradiation and total body irradiation. NOTE: The therapeutic value of GRANISETRON HCL more than 24 hours after the last dose of chemotherapy is unproven. LU Authorization Period: 1 year. Code 454 For the treatment of emesis in cancer patients receiving moderately emetogenic chemotherapy (MEC) regimens. LU Authorization Period: 1 year. 6
7 New Multi-Source Products (Cont d...) DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR DBP Sertraline 100mg Cap SAI (Interchangeable with Zoloft) DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR DBP Med-Solifenacin 5mg Tab GMP Med-Solifenacin 10mg Tab GMP (Interchangeable with Vesicare) Reason For Use Code and Clinical Criteria Code 290 For patients with urinary frequency, urgency or urge incontinence who have: Failed to respond to behavioral techniques AND an adequate trial of oxybutynin with gradual dose escalation has shown to be either ineffective or resulted in unacceptable side effects. NOTE: If after a trial of 2 weeks patients continue to experience similar side effects and no greater efficacy than oxybutynin, continued therapy with this more costly agent should be reassessed. Antimuscarinic agents should be used with caution in the elderly due to potentially serious adverse effects (e.g. confusion, psychosis, acute urinary retention, constipation). Antimuscarinic agents should be avoided in older adults with pre-existing cognitive impairment (e.g. dementia) and those who are already using other drugs with significant anticholinergic effects (e.g. tricyclic antidepressants) in order to avoid a high overall anticholinergic drug burden. LU Authorization Period: Indefinite. 7
8 New Off-Formulary Interchangeable (OFI) Products DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR UNIT COST Buspirone 10mg Tab SAI (Interchangeable with Buspar) DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR UNIT COST Teva-Rasagiline 0.5mg Tab TEV Teva-Rasagiline 1mg Tab TEV (Interchangeable with Azilect) 8
9 Status Change from Off-Formulary Interchangeable Products to Limited Use DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR DBP Act Levetiracetam 250mg Tab ACV Act Levetiracetam 500mg Tab ACV Act Levetiracetam 750mg Tab ACV Apo-Levetiracetam 250mg Tab APX Apo-Levetiracetam 500mg Tab APX Apo-Levetiracetam 750mg Tab APX Auro-Levetiracetam 250mg Tab AUR Auro-Levetiracetam 500mg Tab AUR Auro-Levetiracetam 750mg Tab AUR Jamp-Levetiracetam 250mg Tab JPC Jamp-Levetiracetam 500mg Tab JPC Jamp-Levetiracetam 750mg Tab JPC Nat-Levetiracetam 250mg Tab NAT Nat-Levetiracetam 500mg Tab NAT Nat-Levetiracetam 750mg Tab NAT Ran-Levetiracetam 250mg Tab RAN Ran-Levetiracetam 500mg Tab RAN Ran-Levetiracetam 750mg Tab RAN Keppra 250mg Tab UCB Keppra 500mg Tab UCB Keppra 750mg Tab UCB Reason For Use Code and Clinical Criteria Code 473 As adjunctive therapy in the management of patients with epilepsy who are not satisfactorily controlled by at least 2 other General Benefit anticonvulsant therapies (e.g., phenytoin, carbamazepine, gabapentin, lamotrigine, topiramate, etc.); AND patients are under the care of a physician experienced in the treatment of epilepsy. LU Authorization Period: Indefinite. 9
10 Off-Formulary Interchangeable Products Delisted DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR Levetiracetam Tablets 250mg Tab ACH Levetiracetam Tablets 500mg Tab ACH Levetiracetam Tablets 750mg Tab ACH PMS-Levetiracetam 250mg Tab PMS PMS-Levetiracetam 500mg Tab PMS PMS-Levetiracetam 750mg Tab PMS 10
11 Drug Benefit Price (DBP) Changes DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR DBP Granisetron 1mg Tab AAP Apo-Ticlopidine 250mg Tab APX Rocaltrol 0.25mcg Cap HLR Rocaltrol 0.5mcg Cap HLR Mylan-Bupropion XL 150mg ER Tab MYL Mylan-Bupropion XL 300mg ER Tab MYL
12 OFI Product Price Changes DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR UNIT COST Apo-Cinacalcet 30mg Tab APX Apo-Cinacalcet 60mg Tab APX Apo-Cinacalcet 90mg Tab APX
13 Product Manufacturer Name Changes DIN BRAND NAME STRENGTH DOSAGE FORM CURRENT MFR NEW MFR Keppra 250mg Tab VLH UCB Keppra 500mg Tab VLH UCB Keppra 750mg Tab VLH UCB 13
14 Product Brand and Manufacturer Name Changes DIN/PIN CURRENT BRAND NAME CURRENT MFR NEW BRAND NAME NEW MFR STRENGTH Co Levetiracetam COB Act Levetiracetam ACV 250mg Tab Co Levetiracetam COB Act Levetiracetam ACV 500mg Tab Co Levetiracetam COB Act Levetiracetam ACV 750mg Tab DOSAGE FORM 14
15 Discontinued Products DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR * Victrelis 200mg Cap MEK Mylan-Cimetidine 300mg Tab MYL Novo-Enalapril/HCTZ 5mg & 12.5mg Tab NOP Novo-Enalapril/HCTZ 10mg & 25mg Tab NOP Novo-Etidronatecal 400mg/500mg Tab-90 Tablets Kit NOP *Exceptional Access Program Product 15
16 Delisted Products DIN/PIN BRAND NAME STRENGTH DOSAGE FORM MFR Dovonex 50mcg/g Cr LEO Teva-Ticlopidine 250mg Tab TEV 16
17
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
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...
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
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
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 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 - 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
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
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 2016 Effective December 22, 2016 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 - 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
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
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
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 October 2018 Effective October 31, 2018 Drug Programs Policy and Strategy Branch
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 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 42 Summary of Changes October 2017 Effective October 30, 2017 Drug Programs Policy and Strategy Branch
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 April 2018 Effective April 30, 2018 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 December 2017 Effective December 21, 2017 Drug Programs Policy and Strategy Branch
Ontario Drug Benefit Formulary/Comparative Drug Index
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Ontario Drug Benefit Formulary/Comparative Drug Index
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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
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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
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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
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
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
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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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