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 the following products. Benefit status is effective November 13,. hydromorphone HCl 3mg CR cap Apo-HYDROmorphone CR 3mg Cap 02476614 DN SFC 0.6023 APX Hydromorph Contin 3mg Cap 02125323 DN SFC 0.6023 PFR hydromorphone HCl 4.5mg CR cap Apo-HYDROmorphone CR 4.5mg Cap 02476622 DN SFC 0.7275 APX Hydromorph Contin 4.5mg Cap 02359502 DN SFC 0.7275 PFR hydromorphone HCl 6mg CR cap Apo-HYDROmorphone CR 6mg Cap 02476630 DN SFC 0.9030 APX Hydromorph Contin 6mg Cap 02125331 DN SFC 0.9030 PFR hydromorphone HCl 9mg CR cap Apo-HYDROmorphone CR 9mg Cap 02476649 DN SFC 1.1925 APX Hydromorph Contin 9mg Cap 02359510 DN SFC 1.1925 PFR hydromorphone HCl 18mg CR cap Apo-HYDROmorphone CR 18mg Cap 02476665 DN SFC 2.2590 APX Hydromorph Contin 18mg Cap 02243562 DN SFC 2.2590 PFR hydromorphone HCl 24mg CR cap Apo-HYDROmorphone CR 24mg Cap 02476673 DN SFC 2.6138 APX Hydromorph Contin 24mg Cap 02125382 DN SFC 2.6138 PFR hydromorphone HCl 30mg CR cap Apo-HYDROmorphone CR 30mg Cap 02476681 DN SFC 3.1309 APX Hydromorph Contin 30mg Cap 02125390 DN SFC 3.1309 PFR
PAGE 2 OF 7 New Categories Continued lacosamide 50mg tab Auro-Lacosamide 50mg Tab 02475332 DNP E(SF) 0.6313 ARO Pharma-Lacosamide 50mg Tab 02478196 DNP E(SF) 0.6313 PMS Sandoz Lacosamide 50mg Tab 02474670 DNP E(SF) 0.6313 SDZ Teva-Lacosamide 50mg Tab 02472902 DNP E(SF) 0.6313 TEV Vimpat 50mg Tab 02357615 DNP E(SF) 0.6313 UCB lacosamide 100mg tab Auro-Lacosamide 100mg Tab 02475340 DNP E(SF) 0.8750 ARO Pharma-Lacosamide 100mg Tab 02478218 DNP E(SF) 0.8750 PMS Sandoz Lacosamide 100mg Tab 02474689 DNP E(SF) 0.8750 SDZ Teva-Lacosamide 100mg Tab 02472910 DNP E(SF) 0.8750 TEV Vimpat 100mg Tab 02357623 DNP E(SF) 0.8750 UCB lacosamide 150mg tab Auro-Lacosamide 150mg Tab 02475359 DNP E(SF) 1.1763 ARO Pharma-Lacosamide 150mg Tab 02478226 DNP E(SF) 1.1763 PMS Sandoz Lacosamide 150mg Tab 02474697 DNP E(SF) 1.1763 SDZ Teva-Lacosamide 150mg Tab 02472929 DNP E(SF) 1.1763 TEV Vimpat 150mg Tab 02357631 DNP E(SF) 1.1763 UCB lacosamide 200mg tab Auro-Lacosamide 200mg Tab 02475367 DNP E(SF) 1.4500 ARO Pharma-Lacosamide 200mg Tab 02478234 DNP E(SF) 1.4500 PMS Sandoz Lacosamide 200mg Tab 02474700 DNP E(SF) 1.4500 SDZ Teva-Lacosamide 200mg Tab 02472937 DNP E(SF) 1.4500 TEV Vimpat 200mg Tab 02357658 DNP E(SF) 1.4500 UCB
PAGE 3 OF 7 New Categories Continued pinaverium bromide 50mg tab Apo-Pinaverium 50mg Tab 02469677 DNP SFC 0.3066 APX Dicetel 50mg Tab 01950592 DNP SFC 0.3066 ABB pinaverium bromide 100mg tab Apo-Pinaverium 100mg Tab 02469685 DNP SFC 0.5346 APX Dicetel 100mg Tab 02230684 DNP SFC 0.5346 ABB trandolapril 0.5mg cap Auro-Trandolapril 0.5mg Cap 02471868 DNP SF 0.0698 ARO pms-trandolapril 0.5mg Cap 02357755 DNP SF 0.0698 PMS Sandoz Trandolapril 0.5mg Cap 02325721 DNP SF 0.0698 SDZ Teva-Trandolapril 0.5mg Cap 02415429 DNP SF 0.0698 TEV Mavik 0.5mg Cap 02231457 DNP SF 0.0698 BGP trandolapril 1mg cap Auro-Trandolapril 1mg Cap 02471876 DNP SF 0.1762 ARO pms-trandolapril 1mg Cap 02357763 DNP SF 0.1762 PMS Sandoz Trandolapril 1mg Cap 02325748 DNP SF 0.1762 SDZ Teva-Trandolapril 1mg Cap 02415437 DNP SF 0.1762 TEV Mavik 1mg Cap 02231459 DNP SF 0.1762 BGP trandolapril 2mg cap Auro-Trandolapril 2mg Cap 02471884 DNP SF 0.2025 ARO pms-trandolapril 2mg Cap 02357771 DNP SF 0.2025 PMS Sandoz Trandolapril 2mg Cap 02325756 DNP SF 0.2025 SDZ Teva-Trandolapril 2mg Cap 02415445 DNP SF 0.2025 TEV Mavik 2mg Cap 02231460 DNP SF 0.2025 BGP
PAGE 4 OF 7 New Categories Continued trandolapril 4mg cap Auro-Trandolapril 4mg Cap 02471892 DNP SF 0.2498 ARO pms-trandolapril 4mg Cap 02357798 DNP SF 0.2498 PMS Sandoz Trandolapril 4mg Cap 02325764 DNP SF 0.2498 SDZ Teva-Trandolapril 4mg Cap 02415453 DNP SF 0.2498 TEV Mavik 4mg Cap 02239267 DNP SF 0.2498 BGP Existing Categories Benefit status is effective November 13, and the established MRP or PRP for each existing category will apply. 13, aripiprazole 2mg tab Teva-Aripiprazole 2mg Tab 02464144 DNP E(SF) 0.8092 TEV aripiprazole 5mg tab Teva-Aripiprazole 5mg Tab 02464152 DNP E(SF) 0.9046 TEV aripiprazole 10mg tab Teva-Aripiprazole 10mg Tab 02464160 DNP E(SF) 1.0754 TEV aripiprazole 30mg tab Teva-Aripiprazole 30mg Tab 02464195 DNP E(SF) 1.0017 TEV cephalexin monohydrate 250mg tab Auro-Cephalexin 250mg Tab 02470578 DNPM SFC 0.0866 ARO cephalexin monohydrate 500mg tab Auro-Cephalexin 500mg Tab 02470586 DNPM SFC 0.1731 ARO diltiazem 120mg ER cap Mar-Diltiazem T 120mg Cap 02465353 DNP SF 0.2134 MAR
PAGE 5 OF 7 Existing Categories Continued 13, diltiazem 180mg ER cap Mar-Diltiazem T 180mg Cap 02465361 DNP SF 0.2889 MAR diltiazem 240mg ER cap Mar-Diltiazem T 240mg Cap 02465388 DNP SF 0.3832 MAR diltiazem 300mg ER cap Mar-Diltiazem T 300mg Cap 02465396 DNP SF 0.4719 MAR diltiazem 360mg ER cap Mar-Diltiazem T 360mg Cap 02465418 DNP SF 0.5778 MAR efavirenz 600mg, emtricitabine 200mg & tenofovir disoproxil 300mg tab Apo-Efavirenz-Emtricitabine-Tenofovir 600mg/200mg/300mg Tab 02468247 Not Insured APX midodrine 2.5mg tab Mar-Midodrine 2.5mg Tab 02473984 DNP SF 0.2305 MAR midodrine 5mg tab Mar-Midodrine 5mg Tab 02473992 DNP SF 0.3842 MAR progesterone 100mg cap pms-progesterone 100mg Cap 02476576 Not Insured PMS ursodiol 250mg tab Jamp-Ursodiol 250mg Tab 02472392 DN E(SF) 0.3818 JPC ursodiol 500mg tab Jamp-Ursodiol 500mg Tab 02472406 DN E(SF) 0.7242 JPC
PAGE 6 OF 7 Price Changes Effective November 13,, a new MRP or PRP has been established for the following products. 13, cephalexin monohydrate 250mg tab Novo-Lexin 250mg Tab 00583413 DNPM SFC 0.0866 TEV Apo-Cephalex 250mg Tab 00768723 DNPM SFC 0.0866 APX cephalexin monohydrate 500mg tab Novo-Lexin 500mg Tab 00583421 DNPM SFC 0.1731 TEV Apo-Cephalex 500mg Tab 00768715 DNPM SFC 0.1731 APX midodrine 2.5mg tab Midodrine 2.5mg Tab 02278677 DNP SF 0.2305 AAP midodrine 5mg tab Midodrine 5mg Tab 02278685 DNP SF 0.3842 AAP ursodiol 250mg tab Pms-Ursodiol C 250mg Tab 02273497 DN E(SF) 0.3818 PMS Ursodiol 250mg Tab 02426900 DN E(SF) 0.3818 GLM Urso 250mg Tab 02238984 DN E(SF) 0.3818 AXC ursodiol 500mg tab pms-ursodiol 250mg tab 02273500 DN E(SF) 0.7242 PMS Ursodiol 500mg Tab 02426919 DN E(SF) 0.7242 GLM Urso DS 500mg Tab 02245894 DN E(SF) 0.7242 AXC
PAGE 7 OF 7 Changes to Benefit Status The following products will be eligible benefits as of November 13,. 13, Apo-Ranitidine 15mg/mL O/L 02280833 DNP SFC 0.1480 APX RAN-Solifenacin 10mg Tab 02437996 DNP SF 0.3041 RAN