NB Drug Plans Formulary Update

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Bulletin #984 October 31, 2018 NB Drug Formulary Update Drug product updates included in this bulletin: Drug product additions - New generic products will be reimbursed up to the category Maximum Allowable Price () effective October 31, 2018. - The original brand product will be reimbursed at the new category effective November 21, 2018. Prior to November 21, 2018, the original brand product will be reimbursed up to the higher indicated on the attached list. Drug price changes - Products listed on the NB Drug Formulary prior to October 31, 2018 will be reimbursed up to the new category effective November 21, 2018. Prior to November 21, 2018, products in the category will be reimbursed up to the previous. Drug category changes - Products in categories where there is no longer a generic brand will be moved to the Manufacturer List Price (MLP) List effective November 21, 2018. Delisted drug products - Manufacturers who did not confirm prices to the new lower will have impacted products removed from the NB Drug Formulary effective November 21, 2018. If you have any questions, please contact our office at 1-800-332-3691. The Formulary Updates are available online: www.gnb.ca/0212/benefitupdates-e.asp. To unsubscribe from the NB Drug emailed announcements, please send a message to info@nbdrugs-medicamentsnb.ca. Administered by Medavie Blue Cross on behalf of the Government of New Brunswick

Drug Product Additions DIN MFR Aripiprazole Tab Orl 2 mg Teva-Aripiprazole 2464144 TEV 0.8092 5 mg Teva-Aripiprazole 2464152 TEV 0.9046 10 mg Teva-Aripiprazole 2464160 TEV 1.0754 30 mg Teva-Aripiprazole 2464195 TEV 1.0017 Tab Orl 250 mg Auro- 2470578 ARO 0.0866 500 mg Auro- 2470586 ARO 0.1731 Dutasteride Cap Orl 0.5 mg Auro-Dutasteride 2469308 ARO 0.3027 Efavirenz / Emtricitabine / Tenofovir Tab Orl 600 mg / 200 mg / 300 mg Apo-Efavirenz-Emtricitabine-Tenofovir 2468247 APX DU 11.3300 Tab Orl 20 mg Mint- 2466759 MNT W 0.0219 40 mg Mint- 2466767 MNT W 0.0327 Lacosamide Tab Orl 50 mg Vimpat 2357615 UCB 2.5000 Auro-Lacosamide 2475332 ARO pharma-lacosamide 2478196 PMS Sandoz Lacosamide 2474670 SDZ 0.6313 Teva-Lacosamide 2472902 TEV 100 mg Vimpat 2357623 UCB 3.4793 Auro-Lacosamide 2475340 ARO pharma-lacosamide 2478218 PMS Sandoz Lacosamide 2474689 SDZ 0.8750 Teva-Lacosamide 2472910 TEV 150 mg Vimpat 2357631 UCB 4.6600 Auro-Lacosamide 2475359 ARO pharma-lacosamide 2478226 PMS Sandoz Lacosamide 2474697 SDZ 1.1763 Teva-Lacosamide 2472929 TEV 200 mg Vimpat 2357658 UCB 5.7500 Auro-Lacosamide 2475367 ARO pharma-lacosamide 2478234 PMS Sandoz Lacosamide 2474700 SDZ 1.4500 Teva-Lacosamide 2472937 TEV Paroxetine Tab Orl 10 mg Teva-Paroxetine 2248556 TEV 0.3046 New Brunswick Drug 2 October 2018

Drug Product Additions DIN MFR Pinaverium Tab Orl 50 mg Dicetel 1950592 ABB 0.3607 Apo-Pinaverium 2469677 PMS 0.3066 100 mg Dicetel 2230684 ABB 0.6289 Apo-Pinaverium 2469685 PMS 0.5346 Quetiapine ERT Orl 50 mg Quetiapine XR 2417359 SIV W 0.2501 150 mg Quetiapine XR 2417367 SIV W 0.4926 200 mg Quetiapine XR 2417375 SIV W 0.6661 300 mg Quetiapine XR 2417383 SIV W 0.9776 400 mg Quetiapine XR 2417391 SIV W 1.3270 Solifenacin Tab Orl 5 mg Apo-Solifenacin 2423375 APX 0.3041 10 mg Apo-Solifenacin 2423383 APX 0.3041 Trandolapril Cap Orl 0.5 mg Auro-Trandolapril 2471868 ARO Teva-Trandolapril 2415429 TEV Drug Price Changes 1 mg Auro-Trandolapril 2471876 ARO Teva-Trandolapril 2415437 TEV 2 mg Auro-Trandolapril 2471884 ARO Teva-Trandolapril 2415445 TEV 4 mg Auro-Trandolapril 2471892 ARO Teva-Trandolapril 2415453 TEV 0.0698 0.1762 0.2025 0.2498 DIN MFR Tab Orl 250 mg Teva- 583413 TEV 0.0866 500 mg Teva- 583421 TEV 0.1731 Efavirenz / Emtricitabine / Tenofovir Tab Orl 600 mg / 200 mg / 300 mg Mylan-Efavirenz/Emtricitabine/Tenofovir 2461412 MYL Teva- Efavirenz/Emtricitabine/Tenofovir 2393549 TEV DU 11.3300 Tab Orl 20 mg Teva- 337730 TEV W 0.0219 40 mg Teva- 337749 TEV W 0.0327 New Brunswick Drug 3 October 2018

Drug Price Changes DIN MFR Nitroglycerin Aem Slg 0.4 mg Mylan-Nitro SL 2243588 MYL Rho-Nitro 2238998 SDZ W 0.0421 Pindolol Tab Orl 5 mg Apo-Pindol 755877 APX Teva-Pindolol 869007 TEV 0.1361 10 mg Apo-Pindol 755885 APX Teva-Pindolol 869015 TEV 15 mg Apo-Pindol 755893 APX Teva-Pindolol 869023 TEV 0.2323 0.3370 Piroxicam Cap Orl 10 mg Teva-Piroxicam 695718 TEV 0.2213 Polystyrene Sulfonate Sus Orl 250 mg/ml Solystat 769541 PDP 0.1566 Prazosin Tab Orl 1 mg Teva-Prazosin 1934198 TEV 0.1371 2 mg Teva-Prazosin 1934201 TEV 0.1862 5 mg Teva-Prazosin 1934228 TEV 0.2560 Trandolapril Cap Orl 0.5 mg pms-trandolapril 2357755 PMS Sandoz Trandolapril 2325721 SDZ Drug Category Changes 1 mg pms-trandolapril 2357763 PMS Sandoz Trandolapril 2325748 SDZ 2 mg pms-trandolapril 2357771 PMS Sandoz Trandolapril 2325756 SDZ 4 mg pms-trandolapril 2357798 PMS Sandoz Trandolapril 2325764 SDZ 0.0698 0.1762 0.2025 0.2498 DIN MFR Calcitonin Liq Inj 200 U/mL Calcimar 1926691 SAV Dexamethasone / Framycetin / Gramicidin Dps Oph 0.5 mg / 5 mg / 0.05 mg Sofracort E/E 2224623 SAV Erythromycin ECC Orl 250 mg Eryc 607142 PFI 333 mg Eryc 873454 PFI New Brunswick Drug 4 October 2018

Drug Category Changes DIN MFR Flupenthixol Liq Inj 100 mg/ml Fluanoxol Depot 2156040 VLH Fluphenazine Liq Inj 100 mg/ml Modecate Concentrate 755575 BRI Levobunolol Liq Oph 0.5% Betagan 637661 ALL Sodium Aurothiomalate Liq Inj 10 mg/ml Myochrysine 1927620 SAV 25 mg/ml Myochrysine 1927612 SAV Delisted Drug Products DIN MFR Tab Orl 250 mg Apo-Cephalex 768723 APX 500 mg Apo-Cephalex 768715 APX Tab Orl 20 mg Apo- 396788 APX 2351420 SAS pms- 2247493 PMS 40 mg Apo- 362166 APX 2351439 SAS pms- 2247494 PMS W W Nitroglycerin Aem Slg 0.4 mg Apo-Nitroglycerin 2393433 APX W New Brunswick Drug 5 October 2018