New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch...

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Page 1 of 3 New Interchangeable Products New Interchangeable Products Approved and Benefit Status within the Nova Scotia Pharmacare Programs January 2013 New Categories: A Maximum Reimbursable Price (MRP) or Pharmacare Reimbursement Price (PRP) has been established for the following products. Benefit status is effective January 7, 2013. PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS JANUARY 7, 2013 MRP/PRP* JANUARY 28, 2013 MFR atovaquone 250mg & proguanil hydrochloride 100mg tab Teva-Atovaquone Proguanil 250/100mg Tab 02380927 Not Insured TEV Malarone 250/100mg Tab 02238151 Not Insured GSK clopidogrel 300mg tab Teva-Clopidogrel 300mg Tab 02388065 Not Insured TEV Plavix 300mg Tab 02330555 Not Insured SAV polymyxin B 10,000unit/mL & trimethoprim 1mg/mL oph sol Sandoz Polytrimethoprim Oph Sol 02239234 Not Insured SDZ Polytrim Oph Sol 02011956 Not Insured ALL Existing Categories: Benefit status is effective January 7, 2013 and the existing MRP or PRP for each existing category will apply. PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS JANUARY 7, 2013 MRP/PRP* JANUARY 7, 2013 MFR alendronate 5mg tab RAN-Alendronate 5mg Tab 02384698 Not Insured RAN alendronate 10mg tab RAN-Alendronate 10mg Tab 02384701 DNP E (SFC) 0.6981 RAN alendronate 70mg tab RAN-Alendronate 70mg Tab 02384728 DNP E (SFC) 3.5201 RAN bisoprolol 5mg tab Bisoprolol 5mg Tab 02391589 DNP SF 0.1391 SAS

Transcript of New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch...

Page 1: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 1 of 3 New Interchangeable Products

New Interchangeable Products Approved and Benefit Status within the Nova Scotia Pharmacare Programs January 2013

New Categories: A Maximum Reimbursable Price (MRP) or Pharmacare Reimbursement Price (PRP) has

been established for the following products. Benefit status is effective January 7, 2013.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS

JANUARY 7, 2013

MRP/PRP*

JANUARY 28, 2013 MFR

atovaquone 250mg & proguanil hydrochloride 100mg tab

Teva-Atovaquone Proguanil 250/100mg Tab

02380927 Not Insured TEV

Malarone 250/100mg Tab 02238151 Not Insured GSK

clopidogrel 300mg tab

Teva-Clopidogrel 300mg Tab 02388065 Not Insured TEV

Plavix 300mg Tab 02330555 Not Insured SAV

polymyxin B 10,000unit/mL & trimethoprim 1mg/mL oph sol

Sandoz Polytrimethoprim Oph Sol

02239234 Not Insured SDZ

Polytrim Oph Sol 02011956 Not Insured ALL

Existing Categories: Benefit status is effective January 7, 2013 and the existing MRP or PRP for each existing

category will apply.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS

JANUARY 7, 2013

MRP/PRP*

JANUARY 7, 2013 MFR

alendronate 5mg tab

RAN-Alendronate 5mg Tab 02384698 Not Insured RAN

alendronate 10mg tab

RAN-Alendronate 10mg Tab 02384701 DNP E (SFC) 0.6981 RAN

alendronate 70mg tab

RAN-Alendronate 70mg Tab 02384728 DNP E (SFC) 3.5201 RAN

bisoprolol 5mg tab

Bisoprolol 5mg Tab 02391589 DNP SF 0.1391 SAS

Page 2: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 2 of 3 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS

JANUARY 7, 2013

MRP/PRP*

JANUARY 7, 2013 MFR

bisoprolol 10mg tab

Bisoprolol 10mg Tab 02391597 DNP SF 0.2030 SAS

bupropion 100mg SR tab

Bupropion SR 100mg Tab 02391562 DNP SFC 0.2167 SAS

bupropion 150mg SR tab

Bupropion SR 150mg Tab 02391570 DNP SFC 0.3236 SAS

candesartan 32mg tab

Sandoz Candesartan 32mg Tab 02392267 DNP SF 0.4193 SDZ

ciprofloxacin 0.3% oph sol

Sandoz Ciprofloxacin 0.3% Oph Sol

02387131 DNPO E (SF) 0.7920 SDZ

cyproterone 50mg tab

MED-Cyproterone 50mg Tab 02390760 DNP SFC 1.5283 GMP

esomeprazole 20mg tab

MYLAN-Esomeprazole 20mg Tab

02383039 Not Insured MYL

losartan 50mg & hydrochlorothiazide 12.5mg tab

CO Losartan/HCT 50/12.5mg Tab

02388251 DNP SF 0.4407 COB

losartan 100mg & hydrochlorothiazide 12.5mg tab

CO Losartan/HCT 100/12.5mg Tab

02388278 DNP SF 0.4314 COB

losartan 100mg & hydrochlorothiazide 25mg tab

CO Losartan/HCT 100/25mg Tab

02388286 DNP SF 0.4407 COB

ropinirole 0.25mg tab

Jamp-Ropinirole 0.25mg Tab 02352338 DNP SF 0.0993 JPC

RAN-Ropinirole 0.25mg Tab 02314037 DNP SF 0.0993 RAN

Page 3: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 3 of 3 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS

JANUARY 7, 2013

MRP/PRP*

JANUARY 7, 2013 MFR

ropinirole 1mg tab

Jamp-Ropinirole 1mg Tab 02352346 DNP SF 0.3974 JPC

RAN-Ropinirole 1mg Tab 02314053 DNP SF 0.3974 RAN

ropinirole 2mg tab

Jamp-Ropinirole 2mg Tab 02352354 DNP SF 0.4371 JPC

RAN-Ropinirole 2mg Tab 02314061 DNP SF 0.4371 RAN

ropinirole 5mg tab

Jamp-Ropinirole 5mg Tab 02352362 DNP SF 1.2034 JPC

RAN-Ropinirole 5mg Tab 02314088 DNP SF 1.2034 RAN

simvastatin 10mg tab

Jamp-Simvastatin 10mg Tab 02375605 DNP SF 0.7081 JPC

tramadol 37.5mg & acetaminophen 325mg tab

Mint-Tramadol/Acet 37.5/325mg Tab

02389800 Not Insured MNT

Page 4: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 1 of 3 New Interchangeable Products

New Interchangeable Products Approved and Benefit Status within the Nova

Scotia Pharmacare Programs February 2013

New Categories: A Maximum Reimbursable Price (MRP) or Pharmacare Reimbursement Price (PRP) has been established for the following products. Benefit status is effective February 11, 2013.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS FEBRUARY 11, 2013

MRP/PRP* MARCH 4, 2013

MFR

clarithromycin 25mg/mL o/l Accel-Clarithromycin 125mg/5mL O/L 02390442 DNP E (SFC) 0.2047 ACC

Biaxin 125mg/5mL O/L 02146908 DNP E (SFC) 0.2047 ABB

clarithromycin 50mg/mL o/l Accel-Clarithromycin 250mg/5mL O/L 02390450 DNP E (SFC) 0.3998 ACC

Biaxin 250mg/5mL O/L 02244641 DNP E (SFC) 0.3998 ABB

entecavir 0.5mg tab

Apo-Entecavir 0.5mg Tab 02396955 Under Review APX

Baraclude 0.5mg Tab 02282224 DNP E (SF) BRI

fluvastatin 20mg cap

Teva-Fluvastatin 20mg Cap 02299224 Under Review TEV

Lescol 20mg Cap 02061562 DNP SF NVR

fluvastatin 40mg cap

Teva-Fluvastatin 40mg Cap 02299232 Under Review TEV

Lescol 40mg Cap 02061570 DNP SF NVR Existing Categories: Benefit status is effective February 11, 2013 and the existing MRP or PRP for each existing category will apply.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS FEBRUARY 11, 2013

MRP/PRP* FEBRUARY 11, 2013

MFR

entacapone 200mg tab

MYLAN-Entacapone 200mg Tab 02390337 DNP E (SF) 0.5687 MYL fluorometholone 0.1% oph susp

Sandoz Fluorometholone 0.1% Oph Susp 00432814 DNPO SF 1.7880 SDZ

Page 5: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 2 of 3 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS FEBRUARY 11, 2013

MRP/PRP* FEBRUARY 11, 2013

MFR

hydromorphone HCl 1mg tab

Apo-Hydromorphone 1mg Tab 02364115 D SFC 0.0959 APX

hydromorphone HCl 2mg tab

Apo-Hydromorphone 2mg Tab 02364123 D SFC 0.1417 APX

hydromorphone HCl 4mg tab

Apo-Hydromorphone 4mg Tab 02364131 D SFC 0.2240 APX

hydromorphone HCl 8mg tab

Apo-Hydromorphone 8mg Tab 02364158 D SFC 0.3528 APX

montelukast 10mg tab

Jamp-Montelukast 10mg Tab 02391422 DNP E (SF) 0.8276 JPC

nabilone 0.5mg cap

CO Nabilone 0.5mg Cap 02393581 D E (SFC) 1.0859 COB

nabilone 1mg cap

CO Nabilone 1mg Cap 02393603 D E (SFC) 2.1718 COB

olanzapine 2.5mg tab

CO Olanzapine 2.5mg Tab 02325659 DNP E (SF) 0.6290 COB

olanzapine 5mg tab

CO Olanzapine 5mg Tab 02325667 DNP E (SF) 1.2580 COB

olanzapine 7.5mg tab

CO Olanzapine 7.5mg Tab 02325675 DNP E (SF) 1.8871 COB

olanzapine 10mg tab

CO Olanzapine 10mg Tab 02325683 DNP E (SF) 2.5161 COB

olanzapine 15mg tab

CO Olanzapine 15mg Tab 02325691 DNP E (SF) 3.7741 COB

Page 6: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 3 of 3 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS FEBRUARY 11, 2013

MRP/PRP* FEBRUARY 11, 2013

MFR

olanzapine 20mg tab

CO Olanzapine 20mg Tab 02325713 Not Insured COB

telmisartan 40mg tab

CO Telmisartan 40mg Tab 02393247 DNP SF 0.3954 COB

telmisartan 80mg tab

CO Telmisartan 80mg Tab 02393255 DNP SF 0.3954 COB telmisartan 80mg & hydrochlorothiazide 12.5mg tab

Telmisartan/HCTZ 80/12.5mg Tab 02395355 DNP SF 0.3954 SAS telmisartan 80mg & hydrochlorothiazide 25mg tab

Telmisartan/HCTZ 80/25mg Tab 02395363 DNP SF 0.3954 SAS

zopiclone 5mg tab

MINT-Zopiclone 5mg Tab 02391716 DNP SFC 0.2231 MNT

Changes to Benefit Status: The following product will no longer be an eligible benefit as of February 11, 2013

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS FEBRUARY 11, 2013

MRP/PRP* FEBRUARY 11, 2013

MFR

fluorometholone 0.1% oph susp pms-Fluorometholone 0.1% Oph Susp 02238568 Not Insured PMS

Page 7: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 1 of 6 New Interchangeable Products

New Interchangeable Products Approved and Benefit Status within the Nova

Scotia Pharmacare Programs March 2013

New Categories: A Maximum Reimbursable Price (MRP) or Pharmacare Reimbursement Price (PRP) has been established for the following products. Benefit status is effective March 11, 2013.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS MARCH 11, 2013

MRP/PRP* APRIL 1, 2013

MFR

pregabalin 25mg cap

GD-Pregabalin 25mg Cap 02360136 Not Insured GMD

pms-Pregabalin 25mg Cap 02359596 Not Insured PMS

Teva-Pregabalin 25mg Cap 02361159 Not Insured TEV

Lyrica 25mg Cap 02268418 Not Insured PFI

pregabalin 50mg cap

GD-Pregabalin 50mg Cap 02360144 Not Insured GMD

pms-Pregabalin 50mg Cap 02359618 Not Insured PMS

Teva-Pregabalin 50mg Cap 02361175 Not Insured TEV

Lyrica 50mg Cap 02268426 Not Insured PFI

pregabalin 75mg cap

GD-Pregabalin 75mg Cap 02360152 Not Insured GMD

pms-Pregablin 75mg Cap 02359626 Not Insured PMS

Teva-Pregabalin 75mg Cap 02361183 Not Insured TEV

Lyrica 75mg Cap 02268434 Not Insured PFI

pregabalin 150mg cap

GD-Pregabalin 150mg Cap 02360179 Not Insured GMD

pms-Pregabalin 150mg Cap 02359634 Not Insured PMS

Teva-Pregablin 150mg Cap 02361205 Not Insured TEV

Lyrica 150mg Cap 02268450 Not Insured PFI

pregabalin 225mg cap

GD-Pregabalin 225mg Cap 02360195 Not Insured GMD

Page 8: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 2 of 6 New Interchangeable Products

New Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS MARCH 11, 2013

MRP/PRP* APRIL 1, 2013

MFR

pms-Pregabalin 225mg Cap 02398079 Not Insured PMS

Teva-Pregabalin 225mg Cap 02361221 Not Insured TEV

Lyrica 225mg Cap 02268477 Not Insured PFI

pregablin 300mg cap

GD-Pregabalin 300mg Cap 02360209 Not Insured GMD

pms-Pregabalin 300mg Cap 02359642 Not Insured PMS

Teva-Pregabalin 300mg Cap 02361248 Not Insured TEV

Lyrica 300mg Cap 02268485 Not Insured PFI

tetrabenazine 25mg tab

pms-Tetrabenazine 25mg Tab 02402424 DNP SF 4.8551 PMS

Nitoman 25mg Tab 02199270 DNP SF 4.8551 BVL

Existing Categories: Benefit status is effective March 11, 2013 and the existing MRP or PRP for each existing category will apply.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS MARCH 11, 2013

MRP/PRP* MARCH 11, 2013

MFR

anastrozole 1mg tab

MINT-Anastrozole 1mg Tab 02393573 DNP SFC 1.7821 MNT candesartan 16mg & hydrochlorothiazide 12.5mg tab

Candesartan/HCTZ 16/12.5mg Tab 02394804 DNP SF 0.4193 SAS

ciprofloxacin 250mg tab

Auro-Ciprofloxacin 250mg Tab 02381907 DNP E (SFC) 0.8660 ARO

ciprofloxacin 500mg tab

Auro-Ciprofloxacin 500mg Tab 02381923 DNP E (SFC) 0.9770 ARO

ciprofloxacin 750mg tab

Auro-Ciprofloxacin 750mg Tab 02381931 DNP E (SFC) 1.7891 ARO

Page 9: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 3 of 6 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS MARCH 11, 2013

MRP/PRP* MARCH 11, 2013

MFR

clarithromycin 250mg tab

Teva-Clarithromycin 250mg Tab 02248804 DNP E (SFC) 0.5770 TEV

clarithromycin 500mg tab

Teva-Clarithromycin 500mg Tab 02248805 DNP E (SFC) 1.6293 TEV

fentanyl 12mcg/hr patch MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL

fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr Patch 02396718 D E (SFC) 4.0236 MYL

fentanyl 50mcg/hr patch MYLAN-Fentanyl Matrix 50mcg/hr Patch 02396726 D E (SFC) 7.5719 MYL

fentanyl 75mcg/hr patch MYLAN-Fentanyl Matrix 75mcg/hr Patch 02396734 D E (SFC) 10.6498 MYL

fentanyl 100mcg/hr patch MYLAN-Fentanyl Matrix 100mcg/hr Patch 02396742 D E (SFC) 13.2559 MYL

fluoxetine 10mg cap

Auro-Fluoxetine 10mg Cap 02385627 DNP SFC 0.8650 ARO

fluoxetine 20mg cap

Auro-Fluoxetine 20mg Cap 02385635 DNP SFC 0.6438 ARO

lamotrigine 25mg tab

Auro-Lamotrigine 25mg Tab 02381354 DNP SF 0.1310 ARO

lamotrigine 100mg tab

Auro-Lamotrigine 100mg Tab 02381362 DNP SF 0.5229 ARO

lamotrigine 150mg tab

Auro-Lamotrigine 150mg Tab 02381370 DNP SF 0.7706 ARO

Page 10: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 4 of 6 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS MARCH 11, 2013

MRP/PRP* MARCH 11, 2013

MFR

montelukast 4mg chewtab

Apo-Montelukast 4mg Chewtab 02377608 DNP E (SF) 0.5104 APX

montelukast 5mg chewtab

Apo-Montelukast 5mg Chewtab 02377616 DNP E (SF) 0.5635 APX

ofloxacin 0.3% oph sol

Sandoz Ofloxacin 0.3% Oph Sol 02247189 DNPO E (SF) 0.8561 SDZ

ondansetron 4mg tab

Septa-Ondansetron 4mg Tab 02376091 DNP E (SFC) 3.5778* SPT

ondansetron 8mg tab

Septa-Ondansetron 8mg Tab 02376105 DNP E (SFC) 7.1555 SPT

paroxetine 20mg tab

Auro-Paroxetine 20mg Tab 02383284 DNP SFC 0.6320 ARO

paroxetine 30mg tab

Auro-Paroxetine 30mg Tab 02383292 DNP SFC 0.6714 ARO

pioglitazone 15mg tab

Auro-Pioglitazone 15mg Tab 02384906 DNP E (SFD) 0.8324 ARO

pioglitazone 30mg tab

Auro-Pioglitazone 30mg Tab 02384914 DNP E (SFD) 1.1662 ARO

pioglitazone 45mg tab

Auro-Pioglitazone 45mg Tab 02384922 DNP E (SFD) 1.7535 ARO

ramipril 1.25mg cap/tab

RAN-Ramipril 1.25mg Cap 02310503 DNP SF 0.2427 RAN

ramipril 2.5mg cap/tab

RAN-Ramipril 2.5mg Cap 02310511 DNP SF 0.2800 RAN

Page 11: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 5 of 6 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS MARCH 11, 2013

MRP/PRP* MARCH 11, 2013

MFR

ramipril 5mg cap/tab

RAN-Ramipril 5mg Cap 02310538 DNP SF 0.2800 RAN

ramipril 10mg cap/tab

RAN-Ramipril 10mg Cap 02310546 DNP SF 0.3546 RAN

rosuvastatin 5mg tab

Jamp-Rosuvastatin 5mg Tab 02391252 Not Insured JPC

rosuvastatin 10mg tab

Jamp-Rosuvastatin 10mg Tab 02391260 DNP SF 0.4760 JPC

rosuvastatin 20mg tab

Jamp-Rosuvastatin 20mg Tab 02391279 DNP SF 0.5950 JPC

rosuvastatin 40mg tab

Jamp-Rosuvastatin 40mg Tab 02391287 DNP SF 0.6965 JPC

sildenafil 25mg tab

Myl-Sildenafil 25mg Tab 02392577 Not Insured MYL

RAN-Sildenafil 25mg Tab 02383101 Not Insured RAN

sildenafil 50mg tab

Myl-Sildenafil 50mg Tab 02392585 Not Insured MYL

RAN-Sildenafil 50mg Tab 02383128 Not Insured RAN

sildenafil 100mg tab

Myl-Sildenafil 100mg Tab 02392593 Not Insured MYL

RAN-Sildenafil 100mg Tab 02383136 Not Insured RAN

simvastatin 5mg tab

Jamp-Simvastatin 5mg tab 02375591 DNP SF 0.3600 JPC

Page 12: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 6 of 6 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS MARCH 11, 2013

MRP/PRP* MARCH 11, 2013

MFR

telmisartan 80mg & hydrochlorothiazide 12.5mg tab

CO Telmisartan/HCT 80/12.5mg Tab 02393263 DNP SF 0.3954 COB telmisartan 80mg & hydrochlorothiazide 25mg tab CO Telmisartan/HCT 80/25mg Tab 02393271 DNP SF 0.3954 COB

zopiclone 7.5mg tab

MINT-Zopiclone 7.5mg Tab 02391724 Not Insured MNT Changes to Benefit Status: As a result of recent pricing changes, the following product(s) will be eligible benefits as of March 11, 2013.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS MARCH 11, 2013

MRP/PRP* APRIL 1, 2013

MFR

entecavir 0.5mg tab

Apo-Entecavir 0.5mg Tab 02396955 DNP E (SF) 16.5000 APX

Baraclude 0.5mg Tab 02282224 DNP E (SF) 16.5000 BRI

fluvastatin 20mg cap

Teva-Fluvastatin 20mg Cap 02299224 DNP SF 0.7048 TEV

Lescol 20mg Cap 02061562 DNP SF 0.7048 NVR

fluvastatin 40mg cap

Teva-Fluvastatin 40mg Cap 02299232 DNP SF 0.9896 TEV

Lescol 40mg Cap 02061570 DNP SF 0.9896 NVR

Page 13: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 1 of 4 New Interchangeable Products

New Interchangeable Products Approved and Benefit Status within the Nova

Scotia Pharmacare Programs April 2013

New Categories: A Maximum Reimbursable Price (MRP) or Pharmacare Reimbursement Price (PRP) has been established for the following products. Benefit status is effective April 8, 2013.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS APRIL 8, 2013

MRP/PRP* APRIL 29, 2013

MFR

candesartan 32mg & hydrochlorothiazide 12.5mg tab

Apo-Candesartan/HCTZ 32/12.5mg Tab 02395126 DNP SF 0.8985 APX

Atacand Plus 32/12.5mg Tab 02332922 DNP SF 0.8985 AZE candesartan 32mg & hydrochlorothiazide 25mg tab Apo-Candesartan/HCTZ 32/25mg Tab 02395134 DNP SF 0.8985 APX

Atacand Plus 32/25mg Tab 02332957 DNP SF 0.8985 AZE

quetiapine 50mg ER tab

Teva-Quetiapine XR 50mg Tab 02395444 Not Insured TEV

Seroquel XR 50mg Tab 02300184 Not Insured AZE

quetiapine 150mg ER tab

Teva-Quetiapine XR 150mg Tab 02395452 Not Insured TEV

Seroquel XR 150mg Tab 02321513 Not Insured AZE

quetiapine 200mg ER tab

Teva-Quetiapine XR 200mg Tab 02395460 Not Insured TEV

Seroquel XR 200mg Tab 02300192 Not Insured AZE

quetiapine 300mg ER tab

Teva-Quetiapine XR 300mg Tab 02395479 Not Insured TEV

Seroquel XR 300mg Tab 02300206 Not Insured AZE

quetiapine 400mg ER tab

Teva-Quetiapine XR 400mg Tab 02395487 Not Insured TEV

Seroquel XR 400mg Tab 02300214 Not Insured AZE

Page 14: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 2 of 4 New Interchangeable Products

Existing Categories: Benefit status is effective April 8, 2013 and the existing MRP or PRP for each existing

category will apply.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS APRIL 8, 2013

MRP/PRP* APRIL 8, 2013

MFR

fluoxetine 10mg cap

Mar-Fluoxetine 10mg Cap 02392909 DNP SFC 0.8650 MAR

fluoxetine 20mg cap

Mar-Fluoxetine 20mg Cap 02392917 DNP SFC 0.6438 MAR

irbesartan 150mg & hydrochlorothiazide 12.5mg tab

Apo-Irbesartan-HCTZ 150/12.5mg Tab 02387646 DNP SF 0.4234 APX irbesartan 300mg & hydrochlorothiazide 12.5mg tab

Apo-Irbesartan-HCTZ 300/12.5mg Tab 02387654 DNP SF 0.4234 APX irbesartan 300mg & hydrochlorothiazide 25mg tab

Apo-Irbesartan-HCTZ 300/25mg Tab 02387662 DNP SF 0.4206 APX

olanzapine ODT 5mg tab

Mar-Olanzapine ODT 5mg Tab 02389088 DNP E (SF) 1.2511 MAR

olanzapine ODT 10mg tab

Mar-Olanzapine ODT 10mg Tab 02389096 DNP E (SF) 2.5000 MAR

olanzapine ODT 15mg tab

Mar-Olanzapine ODT 15mg Tab 02389118 DNP E (SF) 3.7489 MAR

olanzapine ODT 20mg tab

Mar-Olanzapine ODT 20mg Tab 02389126 DNP E (SF) 5.9376 MAR

sildenafil 25mg tab

Sandoz Sildenafil 25mg Tab 02318806 Not Insured SDZ

sildenafil 50mg tab

Sandoz Sildenafil 50mg Tab 02318814 Not Insured SDZ

Page 15: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 3 of 4 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS APRIL 8, 2013

MRP/PRP* APRIL 8, 2013

MFR

sildenafil 100mg tab

Sandoz Sildenafil 100mg Tab 02318822 Not Insured SDZ

simvastatin 5mg tab

Simvastatin-ODAN 5mg Tab 02378884 DNP SF 0.3600 ODN

simvastatin 10mg tab

Simvastatin-ODAN 10mg Tab 02378892 DNP SF 0.7081 ODN

simvastatin 20mg tab

Simvastatin-ODAN 20mg Tab 02378906 DNP SF 0.8751 ODN

simvastatin 40mg tab

Simvastatin-ODAN 40mg Tab 02378914 DNP SF 0.8751 ODN

simvastatin 80mg tab

Simvastatin-ODAN 80mg Tab 02378922 DNP SF 0.8751 ODN

terazosin 1mg tab

MYLAN-Terazosin 1mg Tab 02396289 DNP SF 0.2616 MYL

terazosin 2mg tab

MYLAN-Terazosin 2mg Tab 02396297 DNP SF 0.3325 MYL

terazosin 5mg tab

MYLAN-Terazosin 5mg Tab 02396300 DNP SF 0.4515 MYL

terazosin 10mg tab

MYLAN-Terazosin 10mg Tab 02396319 DNP SF 0.6609 MYL

zopiclone 5mg tab

Mar-Zopiclone 5mg Tab 02386771 DNP SFC 0.2231 MAR

Septa-Zopiclone 5mg Tab 02386909 DNP SFC 0.2231 SPT

Page 16: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 4 of 4 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS APRIL 8, 2013

MRP/PRP* APRIL 8, 2013

MFR

zopiclone 7.5mg tab

Mar-Zopiclone 7.5mg Tab 02386798 Not Insured MAR

Septa-Zopiclone 7.5mg Tab 02386917 Not Insured SPT

Page 17: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

9 Full benefit for children aged 3 to 11 years.

Page 1 of 3 New Interchangeable Products

New Interchangeable Products Approved and Benefit Status within the Nova Scotia Pharmacare Programs May 2013

New Categories: A Maximum Reimbursable Price (MRP) or Pharmacare Reimbursement Price (PRP) has been established for the following products. Benefit status is effective May 6, 2013.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS MAY 6, 2013

MRP/PRP* MAY 27, 2013

MFR

mometasone 50mcg/mL nasal spray Apo-Mometasone 0.05% Nasal Spray 02403587 DNP F9 0.1549 APX

Nasonex 0.05% Nasal Spray 02238465 DNP F9 0.1549 SCH

tranexamic acid 500mg tab

Tranexamic Acid 500mg Tab 02401231 DNP SF 0.8757 STR

Cyklokapron 500mg Tab 02064405 DNP SF 0.8757 PFI Existing Categories: Benefit status is effective May 6, 2013 and the existing MRP or PRP for each existing category will apply.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS MAY 6, 2013

MRP/PRP* MAY 6, 2013

MFR

clopidogrel 300mg tab

Apo-Clopidogrel 300mg Tab 02398591 Not Insured APX

fentanyl 25mcg/hr patch

CO Fentanyl 25mcg/hr Patch 02386852 D E 4.0236 COB

fentanyl 50mcg/hr patch

CO Fentanyl 50mcg/hr Patch 02386879 D E 7.5719 COB

fentanyl 75mcg/hr patch

CO Fentanyl 75mcg/hr Patch 02386887 D E 10.6498 COB

fentanyl 100mcg/hr patch

CO Fentanyl 100mcg/hr Patch 02386895 D E 13.2559 COB

fluoxetine 10mg cap

Fluoxetine BP 10mg Cap 02393441 DNP SFC 0.8650 AHI

Page 18: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 2 of 4 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS MAY 6, 2013

MRP/PRP* MAY 6, 2013

MFR

gabapentin 600mg tab

Gabapentin 600mg Tab 02392526 DNP SFC 0.6350 AHI

MYLAN-Gabapentin 600mg Tab 02397471 DNP SFC 0.6350 MYL

gabapentin 800mg tab

Gabapentin 800mg Tab 02392534 DNP SFC 0.8467 AHI

MYLAN-Gabapentin 800mg Tab 02397498 DNP SFC 0.8467 MYL

pioglitazone 15mg tab

Pioglitazone 15mg Tab 02391600 DNP E 0.8324 AHI

pregabalin 25mg cap

CO Pregabalin 25mg Cap 02402912 Not Insured COB

RAN-Pregabalin 25mg Cap 02392801 Not Insured RAN

Sandoz Pregabalin 25mg Cap 02390817 Not Insured SDZ

pregabalin 50mg cap

CO Pregabalin 50mg Cap 02402920 Not Insured COB

RAN-Pregabalin 50mg Cap 02392828 Not Insured RAN

Sandoz Pregabalin 50mg Cap 02390825 Not Insured SDZ

pregabalin 75mg cap

CO Pregabalin 75mg Cap 02402939 Not Insured COB

RAN-Pregabalin 75mg Cap 02392836 Not Insured RAN

Sandoz Pregabalin 75mg Cap 02390833 Not Insured SDZ

pregabalin 150mg cap

CO Pregabalin 150mg Cap 02402955 Not Insured COB

RAN-Pregabalin 150mg Cap 02392844 Not Insured RAN

Sandoz Pregabalin 150mg Cap 02390841 Not Insured SDZ

Page 19: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 3 of 4 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS MAY 6, 2013

MRP/PRP* MAY 6, 2013

MFR

pregabalin 225mg cap

CO Pregabalin 225mg Cap 02402971 Not Insured COB

RAN-Pregabalin 225mg Cap 02392852 Not Insured RAN

pregabalin 300mg cap

CO Pregabalin 300mg Cap 02402998 Not Insured COB

RAN-Pregabalin 300mg Cap 02392860 Not Insured RAN

Sandoz Pregabalin 300mg Cap 02390868 Not Insured SDZ ramipril 2.5mg & hydrochlorothiazide 12.5mg tab

Teva-Ramipril/HCTZ 2.5/12.5mg Tab 02388332 DNP SF 0.2093 TEV ramipril 5mg & hydrochlorothiazide 12.5mg tab

Teva-Ramipril/HCTZ 5/12.5mg Tab 02388340 DNP SF 0.2069 TEV ramipril 5mg & hydrochlorothiazide 25mg tab Teva-Ramipril/HCTZ 5/25mg Tab 02388367 DNP SF 0.2069 TEV ramipril 10mg & hydrochlorothiazide 12.5mg tab

Teva-Ramipril/HCTZ 10/12.5mg Tab 02388359 DNP SF 0.2633 TEV ramipril 10mg & hydrochlorothiazide 25mg tab Teva-Ramipril/HCTZ 10/25mg Tab 02388375 DNP SF 0.2633 TEV

rizatriptan 5mg tab

Apo-Rizatriptan 5mg Tab 02393468 DNP E 5.1870 APX

rizatriptan 10mg tab

Apo-Rizatriptan 10mg Tab 02393476 DNP E 5.1870 APX

Page 20: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 4 of 4 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS MAY 6, 2013

MRP/PRP* MAY 6, 2013

MFR

telmisartan 80mg & hydrochlorothiazide 12.5mg tab

pms-Telmisartan-HCTZ 80/12.5mg Tab 02401665 DNP SF 0.3954 PMS telmisartan 80mg & hydrochlorothiazide 25mg tab pms-Telmisartan-HCTZ 80/25mg Tab 02401673 DNP SF 0.3954 PMS

Page 21: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 1 of 3 New Interchangeable Products

New Interchangeable Products Approved and Benefit Status within the Nova Scotia Pharmacare Programs June 2013

New Categories: A Maximum Reimbursable Price (MRP) or Pharmacare Reimbursement Price (PRP) has been established for the following products. Benefit status is effective June 10, 2013.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS JUNE 10, 2013

MRP/PRP* JULY 1, 2013

MFR

colchicine 0.6mg tab

pms-Colchicine 0.6mg Tab 02402181 DNP SF 0.2565 PMS

Colchicine 0.6mg Tab 00572349 DNP SF 0.2565 ODN

desogestrel 150mcg and ethiny estradiol 30mcg tab (21)

Freya Tab 21 Day 02396491 DNP F 0.5032 MYL

Marvelon Tab 21 Day 02042487 DNP F 0.5032 SCH

desogestrel 150mcg and ethiny estradiol 30mcg tab (28)

Freya Tab 28 Day 02396610 DNP F 0.3774 MYL

Marvelon Tab 28 Day 02042479 DNP F 0.3774 SCH

latanoprost 50mcg/mL & timolol maleate 5mg/mL oph sol

Sandoz Latanoprost/Timolol 50mcg/5mg/mL Oph Sol

02394685 DNP SF 4.4280 SDZ

Xalacom Oph Sol 02246619 DNP SF 4.4280 ALC

nabilone 0.25mg cap

Teva-Nabilone 0.25mg Cap 02392925 D E 1.1634 TEV

Cesamet 0.25mg Cap 02312263 D E 1.1634 VLN

olopatadine 0.1% oph sol

Apo-Olopatadine 0.1% Oph Sol 02305054 Not Insured APX

Patanol 0.1% Oph Sol 02233143 Not Insured ALC

Page 22: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 2 of 3 New Interchangeable Products

Existing Categories: Benefit status is effective June 10, 2013 and the existing MRP or PRP for each existing category will apply.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS JUNE 10, 2013

MRP/PRP* JUNE 10, 2013

MFR

allopurinol 100mg tab

Apo-Allopurinol 100mg Tab 02402769 DNP SFC 0.0780 APX

Mar-Allopurinol 100mg Tab 02396327 DNP SFC 0.0780 MAR

allopurinol 200mg tab

Apo-Allopurinol 200mg Tab 02402777 DNP SFC 0.1300 APX

Mar-Allopurinol 200mg Tab 02396335 DNP SFC 0.1300 MAR

allopurinol 300mg tab

Apo-Allopurinol 300mg Tab 02402785 DNP SFC 0.2125 APX

Mar-Allopurinol 300mg Tab 02396343 DNP SFC 0.2125 MAR

clindamycin 150mg cap

Clindamycin 150mg Cap 02400529 DNPM SFC 0.3294 SAS

clindamycin 300mg cap

Clindamycin 300mg Cap 02400537 DNPM SFC 0.6588 SAS

clopidogrel 75mg tab

Clopidogrel 75mg Tab 02400553 DNP E 0.9206 SAS

irebesartan 150mg & hydrochlorothiazide 12.5mg tab

MINT-Irbesartan/HCTZ 150/12.5mg Tab

02392992 DNP SF 0.4234 MNT

irbesartan 300mg & hydrochlorothiazide 12.5mg tab

MINT-Irbesartan/HCTZ 300/12.5mg Tab

02393018 DNP SF 0.4234 MNT

irbesartan 300mg & hydrochlorothiazide 25mg tab

MINT-Irbesartan/HCTZ 300/25mg Tab

02393026 DNP SF 0.4206 MNT

Page 23: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 3 of 3 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS JUNE 10, 2013

MRP/PRP* JUNE 10, 2013

MFR

losartan 50mg & hydrochlorothiazide 12.5mg tab

MINT-Losartan/HCTZ 50/12.5mg Tab

02389657 DNP SF 0.4407 MNT

losartan 100mg & hydrochlorothiazide 12.5mg tab

MINT-Losartan/HCTZ 100/12.5mg Tab

02389665 DNP SF 0.4314 MNT

losartan 100mg & hydrochlorothiazide 25mg tab

MINT-Losartan/HCTZ DS 100/25mg Tab

02389673 DNP SF 0.4407 MNT

tramadol 37.5mg & acetaminophen 325mg tab

pms-Tramadol/Acet 37.5/325mg Tab

02401657 Not Insured PMS

Page 24: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 1 of 3 New Interchangeable Products

New Interchangeable Products Approved and Benefit Status within the Nova

Scotia Pharmacare Programs July

New Categories: A Maximum Reimbursable Price (MRP) or Pharmacare Reimbursement Price (PRP) has been established for the following products. Benefit status is effective July 8, 2013.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS JULY 8, 2013

MRP/PRP* JULY 29, 2013

MFR

fenofibrate 48mg tab

Sandoz Fenofibrate E 48mg Tab 02390698 Not Insured SDZ

Lipidil EZ 48mg Tab 02269074 Not Insured ABB

fenofibrate 145mg tab Sandoz Fenofibrate E 145mg Tab 02390701 Not Insured SDZ

Lipidil EZ 145mg Tab 02269082 Not Insured ABB Existing Categories: Benefit status is effective July 8, 2013 and the existing MRP or PRP for each existing category will apply.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS JULY 8, 2013

MRP/PRP* JULY 8, 2013

MFR

atorvastatin 10mg tab

pms-Atorvastatin 10mg Tab 02399377 DNP SF 0.3138 PMS

atorvastatin 20mg tab

pms-Atorvastatin 20mg Tab 02399385 DNP SF 0.3922 PMS

atorvastatin 40mg tab

pms-Atorvastatin 40mg Tab 02399393 DNP SF 0.4216 PMS

atorvastatin 80mg tab

pms-Atorvastatin 80mg Tab 02399407 DNP SF 0.4216 PMS

diltiazem 120mg CD cap

Diltiazem CD 120mg Cap 02400421 DNP SF 0.5174 SAS

diltiazem 180mg CD cap

Diltiazem CD 180mg Cap 02400448 DNP SF 0.6869 SAS

Page 25: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 2 of 3 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS JULY 8, 2013

MRP/PRP* JULY 8, 2013

MFR

diltiazem 240mg CD cap

Diltiazem CD 240mg Cap 02400456 DNP SF 0.9111 SAS

diltiazem 300mg CD cap

Diltiazem CD 300mg Cap 02400464 DNP SF 1.1388 SAS

divalproex sodium 125mg tab

Divalproex 125mg Tab 02400499 DNP SF 0.1032 SAS

divalproex sodium 250mg tab

Divalproex 250mg Tab 02400502 DNP SF 0.1855 SAS

divalproex sodium 500mg tab

Divalproex 500mg Tab 02400510 DNP SF 0.3711 SAS

enalapril 2.5mg tab

Enalapril 2.5mg Tab 02400650 DNP SF 0.2737 SAS

enalapril 5mg tab

Enalapril 5mg Tab 02400669 DNP SF 0.3239 SAS

enalapril 10mg tab

Enalapril 10mg Tab 02400677 DNP SF 0.3891 SAS

enalapril 20mg tab

Enalapril 20mg Tab 02400685 DNP SF 0.4696 SAS

fluvastatin 20mg cap

Sandoz Fluvastatin 20mg Cap 02400235 DNP SF 0.3155 SDZ

fluvastatin 40mg cap

Sandoz Fluvastatin 40mg Cap 02400243 DNP SF 0.4433 SDZ latanoprost 50mcg/mL & timolol maleate 5mg/mL oph sol

GD-Latanoprost/Timolol 50mcg/5mg/mL Oph Sol 02373068 DNP SF 4.4280 GMD

Page 26: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 3 of 3 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS JULY 8, 2013

MRP/PRP* JULY 8, 2013

MFR

pregabalin 25mg cap

Apo-Pregabalin 25mg Cap 02394235 Not Insured APX

pregabalin 50mg cap

Apo-Pregabalin 50mg Cap 02394243 Not Insured APX

pregabalin 75mg cap

Apo-Pregabalin 75mg Cap 02394251 Not Insured APX

pregabalin 150mg cap

Apo-Pregabalin 150mg Cap 02394278 Not Insured APX

pregabalin 300mg cap

Apo-Pregabalin 300mg Cap 02394294 Not Insured APX

Page 27: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 1 of 3 New Interchangeable Products

New Interchangeable Products Approved and Benefit Status within the Nova

Scotia Pharmacare Programs August 2013

New Categories: A Maximum Reimbursable Price (MRP) or Pharmacare Reimbursement Price (PRP) has been established for the following products. Benefit status is effective August 12, 2013.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS AUGUST 12, 2013

MRP/PRP* SEPTEMBER 2, 2013

MFR

drospirenone 3mg & ethinyl estradiol 0.03mg tab (28)

Zarah Tab 28 Day 02385066 DNP F 0.3220 COB

Yasmin Tab 28 Day 02261731 DNP F 0.3220 BAY

ketotifen 0.25% oph sol

Ketotifen 0.25% Oph Sol 02400871 Not Insured STR

Zaditor 0.25% Oph Sol 02242324 Not Insured NVO

ondansetron OD 4mg tab/film

Ondissolve ODF 4mg Film 02389983 DNP E 3.5778* TAK

Zofran 4mg ODT Tab 02239372 DNP E 3.5778* GSK

ondansetron OD 8mg tab/film

Ondissolve ODF 8mg Film 02389991 DNP E 6.9900 TAK

Zofran 8mg ODT Tab 02239373 DNP E 6.9900 GSK

pilocarpine 5mg tab

Pilocarpine 5mg Tab 02402483 DNP E 0.7805 STR

Salagen 5mg Tab 02216345 DNP E 0.7805 PFI

quinapril 5mg tab

Apo-Quinapril 5mg Tab 02248499 DNP SF 0.6867 APX

Accupril 5mg Tab 01947664 DNP SF 0.6867 PFI

quinapril 10mg tab

Apo-Quinapril 10mg Tab 02248500 DNP SF 0.6867 APX

Accupril 10mg Tab 01947672 DPN SF 0.6867 PFI

Page 28: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 2 of 3 New Interchangeable Products

New Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS AUGUST 12, 2013

MRP/PRP* SEPTEMBER 2, 2013

MFR

quinapril 20mg tab

Apo-Quinapril 20mg Tab 02248501 DNP SF 0.6867 APX

Accupril 20mg Tab 01947680 DNP SF 0.6867 PFI

quinapril 40mg tab

Apo-Quinapril 40mg Tab 02248502 DNP SF 0.6867 APX

Accupril 40mg Tab 01947699 DNP SF 0.6867 PFI

valganciclovir 450mg tab

Apo-Valganciclovir 450mg Tab 02393824 DNP E 19.7305 APX

Valcyte 450mg Tab 02245777 DNP E 19.7305 HLR Existing Categories: Benefit status is effective August 12, 2013 and the existing MRP or PRP for each existing category will apply.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS AUGUST 12, 2013

MRP/PRP* AUGUST 12, 2013

MFR

amitriptyline 10mg tab

Apo-Amitriptyline 10mg Tab 02403137 DNP SFC 0.0664 APX

amitriptyline 25mg tab

Apo-Amitriptyline 25mg Tab 02403145 DNP SFC 0.1211 APX

amitriptyline 50mg tab

Apo-Amitriptyline 50mg Tab 02403153 DNP SFC 0.2347 APX

amitriptyline 75mg tab

Apo-Amitriptyline 75mg Tab 02403161 DNP SFC 0.3634 APX

candesartan 32mg tab

Apo-Candesartan 32mg Tab 02399105 DNP SF 0.4193 APX

ceftriaxone 1g/vial inj

Ceftriaxone 1g/vial Inj 02287633 DNP SFC 12.4950 TEV

Page 29: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 3 of 3 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS AUGUST 12, 2013

MRP/PRP* AUGUST 12, 2013

MFR

dorzolamide HCl 2% & timolol maleate 0.5% oph sol CO DorzoTimolol 2%/0.5% Oph Sol 02404389 DNP SF 2.0097 COB

galantamine 8mg ER cap

pms-Galantamine ER 8mg Cap 02398370 DNP E 1.7451 PMS

galantamine 16mg ER cap

pms-Galantamine ER 16mg Cap 02398389 DNP E 1.7451 PMS

galantamine 24mg ER cap

pms-Galantamine ER 24mg Cap 02398397 DNP E 1.7451 PMS

lansoprazole 15mg cap

pms-Lansoprazole 15mg Cap 02395258 DNP E 0.3500* PMS

lansoprazole 30mg cap pms-Lansoprazole 30mg DR Cap 02395266 DNP E 0.7000 PMS

nevirapine 200mg tab

pms-Nevirapine 200mg Tab 02405776 Not Insured PMS piperacillin sodium & enzyme inhibitor 4g/vial inj

AJ-Pip/Taz 4g/vial Inj 02395146 Not Insured AJP

pregabalin 225mg cap

Apo-Pregabalin 225mg Cap 02394286 Not Insured APX

Page 30: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 1 of 2 New Interchangeable Products

New Interchangeable Products Approved and Benefit Status within the Nova Scotia Pharmacare Programs September 2013

New Categories: A Maximum Reimbursable Price (MRP) or Pharmacare Reimbursement Price (PRP) has been established for the following products. Benefit status is effective September 9, 2013.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS SEPTEMBER 9, 2013

MRP/PRP* SEPTEMBER 30, 2013

MFR

diclofenac 50mg & misoprostol 200mcg tab

CO Diclo-Miso 50mg Tab 02397145 DNP SF 0.4541 COB

Arthrotec 50mg Tab 01917056 DNP SF 0.4541 PFI

diclofenac 75mg & misoprostol 200mcg tab

CO Diclo-Miso 75mg Tab 02397153 DNP SF 0.6179 COB

Arthrotec 75mg Tab 02229837 DNP SF 0.6179 PFI

imatinib 100mg tab

Apo-Imatinib 100mg Tab 02355337 DNP E 9.5460 APX

Teva-Imatinib 100mg Tab 02399806 DNP E 9.5460 TEV

Gleevec 100mg Tab 02253275 DNP E 9.5460 NVR

imatinib 400mg tab

Apo-Imatinib 400mg Tab 02355345 DNP E 39.1840 APX

Teva-Imatinib 400mg Tab 02399814 DNP E 39.1840 TEV

Gleevec 400mg Tab 02253283 DNP E 39.1840 NVR

levonorgestrel 0.75mg tab

Next Choice 0.75mg Tab 02364905 DNP F 7.7400 COB

Plan B 0.75mg Tab 02241674 DNP F 7.7400 PAL

Existing Categories: Benefit status is effective September 9, 2013 and the existing MRP or PRP for each existing category will apply.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS SEPTEMBER 9, 2013

MRP/PRP* SEPTEMBER 9, 2013

MFR

candesartan 4mg tab

RAN-Candesartan 4mg Tab 02380684 Not Insured RAN

Page 31: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 2 of 2 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS SEPTEMBER 9, 2013

MRP/PRP* SEPTEMBER 9, 2013

MFR

candesartan 8mg tab

RAN-Candesartan 8mg Tab 02380692 DNP SF 0.4100 RAN

candesartan 16mg tab

RAN-Candesartan 16mg Tab 02380706 DNP SF 0.4100 RAN

cilazapril 2.5mg tab

CO Cilazapril 2.5mg Tab 02285215 DNP SF 0.2513 COB

cilazapril 5mg tab

CO Cilazapril 5mg Tab 02285223 DNP SF 0.2919 COB

fentanyl 12mcg/hr patch

CO Fentanyl 12mcg/hr Patch 02386844 D E 2.2300 COB

levonorgestrel 0.15mg & ethinyl estradiol 0.03mg tab (21)

Ovima Tab 21 Day 02387085 DNP F 0.5075 APX

levonorgestrel 0.15mg & ethinyl estradiol 0.03mg tab (28)

Ovima Tab 28 Day 02387093 DNP F 0.3806 APX

montelukast 10mg tab

RAN-Montelukast 10mg Tab 02389517 DNP E 0.8276 RAN

nabilone 0.25mg cap

RAN-Nabilone 0.25mg Cap 02358077 Not Insured RAN

olopatadine 0.1% oph sol

Sandoz Olopatadine 0.1% Oph Sol

02358913 Not Insured SDZ

simvastatin 80mg tab

MINT-Simvastatin 80mg Tab 02372975 DNP SF 0.8751 MNT

Page 32: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 1 of 6 New Interchangeable Products

New Interchangeable Products Approved and Benefit Status within the Nova

Scotia Pharmacare Programs October 2013

New Categories: A Maximum Reimbursable Price (MRP) or Pharmacare Reimbursement Price (PRP) has been established for the following products. Benefit status is effective October 7, 2013.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS OCTOBER 7, 2013

MRP/PRP* OCTOBER 28, 2013

MFR

efavirenz 600mg tab

MYLAN-Efavirenz 600mg Tab 02381524 Not Insured MYL

Teva-Efavirenz 600mg Tab 02389762 Not Insured TEV

Sustiva 600mg Tab 02246045 Not Insured BRI gemcitabine hydrochloride 200mg/vial Inj

Gemcitabine 38mg/mL Inj (200mg Vial) 02402831 Not Insured

HOS

Gemzar 38mg/mL Inj (200mg Vial) 02230308 Not Insured LIL

temozolomide 20mg cap

CO Temozolomide 20mg Cap 02395274 DNP E 22.7194 COB

Temodal 20mg Cap 02241094 DNP E 22.7194 FRS

temozolomide 100mg cap

CO Temozolomide 100mg Cap 02395282 DNP E 113.5966 COB

Temodal 100mg Cap 02241095 DNP E 113.5966 FRS

temozolomide 140mg cap

CO Temozolomide 140mg Cap 02395290 DNP E 159.0358 COB

Temodal 140mg Cap 02312794 DNP E 159.0358 FRS

temozolomide 250mg cap

CO Temozolomide 250mg Cap 02395312 DNP E 283.9834 COB

Temodal 250mg Cap 02241096 DNP E 283.9834 FRS

Page 33: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 2 of 6 New Interchangeable Products

Existing Categories: Benefit status is effective October 7, 2013 and the existing MRP or PRP for each existing category will apply.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS OCTOBER 7, 2013

MRP/PRP* OCTOBER 7, 2013

MFR

gemcitabine hydrochloride 1g/vial Inj

Gemcitabine 38mg/mL Inj (1g Vial) 02402831 Not Insured HOS

amitriptyline 10mg tab

pms-Amitriptyline 10mg Tab 00654523 DNP SFC 0.0664 PMS

amitriptyline 25mg tab

pms-Amitriptyline 25mg Tab 00654515 DNP SFC 0.1211 PMS

amitriptyline 50mg tab

pms-Amitriptyline 50mg Tab 00654507 DNP SFC 0.2347 PMS

amlodipine 5mg & atorvastatin 10mg tab

pms-Amlodipine/Atorvastatin 5/10mg Tab 02404222 DNP SF 1.0310 PMS

amlodipine 5mg & atorvastatin 20mg tab

pms-Amlodipine/Atorvastatin 5/20mg Tab 02404230 DNP SF 1.1766 PMS

amlodipine 10mg & atorvastatin 10mg tab

pms-Amlodipine/Atorvastatin 10/10mg Tab 02404249 DNP SF 1.2483 PMS

amlodipine 10mg & atorvastatin 20mg tab

pms-Amlodipine/Atorvastatin 10/20mg Tab 02404257 DNP SF 1.3939 PMS

amoxicillin 250mg cap

Auro-Amoxicillin 250mg Cap 02388073 DNP SFC 0.1750 ARO

amoxicillin 500mg cap

Auro-Amoxicillin 500mg Cap 02388081 DNP SFC 0.3417 ARO

Page 34: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 3 of 6 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS OCTOBER 7, 2013

MRP/PRP* OCTOBER 7, 2013

MFR

lansoprazole 15mg cap

RAN-Lansoprazole 15mg Cap 02402610 DNP E 0.3500* RAN

lansoprazole 30mg cap

RAN-Lansoprazole 30mg Cap 02402629 DNP E 0.7000 RAN

letrozole 2.5mg tab

Teva-Letrozole 2.5mg Tab 02343657 DNP SFC 2.0662 TEV Levonorgestrel 0.10mg & ethinyl estradiol 0.02mg tab(28)

Lutera Tab 28 Day 02401207 DNP F 0.3477 COB

losartan 25mg tab

RAN-Losartan 25mg Tab 02404451 DNP SF 0.4407 RAN

losartan 50mg tab

RAN-Losartan 50mg Tab 02404478 DNP SF 0.4407 RAN

losartan 100mg tab

RAN-Losartan 100mg Tab 02404486 DNP SF 0.4407 RAN

midazolam 1mg/mL inj

Midazolam 1mg/mL Inj 02382873 D E 0.7800 SDZ

midazolam 5mg/mL inj

Midazolam 5mg/mL Inj 02382903 D E 4.1000 SDZ

montelukast 4mg chewtab

RAN-Montelukast 4mg Chewtab 02402793 DNP E 0.5104 RAN

Montelukast 5mg chewtab

RAN-Montelukast 5mg Chewtab 02402807 DNP E 0.5635 RAN

Page 35: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 4 of 6 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS OCTOBER 7, 2013

MRP/PRP* OCTOBER 7, 2013

MFR

olanzapine 2.5mg tab

RAN-Olanzapine 2.5mg Tab 02403064 DNP E 0.6290 RAN

olanzapine 5mg tab

RAN-Olanzapine 5mg Tab 02403072 DNP E 1.2580 RAN

olanzapine 7.5mg tab

RAN-Olanzapine 7.5mg Tab 02403080 DNP E 1.8871 RAN

olanzapine 10mg tab

RAN-Olanzapine 10mg Tab 02403099 DNP E 2.5161 RAN

omeprazole 20mg cap

RAN-Omeprazole 20mg Cap 02403617 DNP SFC* 0.4117 RAN

pregabalin 25mg cap

Pregabalin 25mg Cap 02405539 Not Insured SAS

pregabalin 50mg cap

Pregabalin 50mg Cap 02405547 Not Insured SAS

pregabalin 75mg cap

Pregabalin 75mg Cap 02405555 Not Insured SAS

pregabalin 150mg cap

Pregabalin 150mg Cap 02405563 Not Insured SAS

pregabalin 300mg cap

Pregabalin 300mg Cap 02405598 Not Insured SAS

quetiapine 25mg tab

RAN-Quetiapine 25mg Tab 02397099 DNP SF 0.1779 RAN

quetiapine 100mg tab

RAN-Quetiapine 100mg Tab 02397102 DNP SF 0.4746 RAN

Page 36: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 5 of 6 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS OCTOBER 7, 2013

MRP/PRP* OCTOBER 7, 2013

MFR

quetiapine 200mg tab

RAN-Quetiapine 200mg Tab 02397110 DNP SF 0.9530 RAN

quetiapine 300mg tab

RAN-Quetiapine 300mg Tab 02397129 DNP SF 1.3906 RAN

rosuvastatin 5mg tab

Rosuvastatin 5mg Tab 02405628 Not Insured SAS

rosuvastatin 10mg tab

Rosuvastatin 10mg Tab 02405636 DNP SF 0.4760 SAS

rosuvastatin 20mg tab

Rosuvastatin 20mg Tab 02405644 DNP SF 0.5950 SAS

rosuvastatin 40mg tab

Rosuvastatin 40mg Tab 02405652 DNP SF 0.6965 SAS

sildenafil 25mg tab

MINT-Sildenafil 25mg Tab 02393069 Not Insured MINT

sildenafil 50mg tab

MINT-Sildenafil 50mg Tab 02393077 Not Insured MINT

Sildenafil 50mg Tab 02406152 Not Insured SAS

sildenafil 100mg tab

MINT-Sildenafil 100mg Tab 02393085 Not Insured MINT

Sildenafil 100mg Tab 02406160 Not Insured SAS

Page 37: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 6 of 6 New Interchangeable Products

Non-Interchangeable and Non-Insured: The following product(s) were not recommended to list as insured benefits under the Nova Scotia Pharmacare Programs.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS MRP/PRP* MFR drospirenone 3mg & ethinyl estradiol 0.03mg Tab(21)

Zarah Tab 21 Day 02385058 Not Insured COB

candesartan 32mg tab

RAN-Candesartan 32mg Tab 02380714 Not Insured RAN leveonorgestrel 0.10mg & ethinyl estradiol 0.02mg tab(21)

Lutera Tab 21 Day 02401185 Not Insured COB

olanzapine 15mg tab

RAN-Olanzapine 15mg Tab 02403102 Not Insured RAN

Page 38: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 1 of 3 New Interchangeable Products

New Interchangeable Products Approved and Benefit Status within the Nova Scotia Pharmacare Programs November 2013

New Categories: A Maximum Reimbursable Price (MRP) or Pharmacare Reimbursement Price (PRP) has been established for the following products. Benefit status is effective November 12, 2013.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS NOVEMBER 12, 2013

MRP/PRP* DECEMBER 3, 2013

MFR

almotriptan 6.25mg tab

MYLAN-Almotriptan 6.25mg Tab 02398435 DNP E 7.0434 MYL

Axert 6.25mg Tab 02248128 DNP E 7.0434 JNJ

almotriptan 12.5mg tab

MYLAN-Almotriptan 12.5mg Tab 02398443 DNP E 7.0434 MYL

Sandoz Almotriptan 12.5mg Tab 02405334 DNP E 7.0434 SDZ

Axert 12.5mg Tab 02248129 DNP E 7.0434 JNJ

capecitabine 150mg tab

Teva-Capecitabine 150mg Tab 02400022 DNP E 1.3725 TEV

Xeloda 150mg Tab 02238453 DNP E 1.3725 HLR

capecitabine 500mg tab

Teva-Capecitabine 500mg Tab 02400030 DNP E 4.5750 TEV

Xeloda 500mg Tab 02238454 DNP E 4.5750 HLR

quinapril 10mg & hydrochlorothiazide 12.5mg tab

Apo-Quinapril/HCTZ 10/12.5mg Tab

02408767 DNP SF 0.6865 APX

Accuretic 10/12.5mg Tab 02237367 DNP SF 0.6865 PFI

quinapril 20mg & hydrochlorothiazide 12.5mg tab

Apo-Quinapril/HCTZ 20/12.5mg Tab

02408775 DNP SF 0.6865 APX

Accuretic 20/12.5mg Tab 02237368 DNP SF 0.6865 PFI

Page 39: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 2 of 3 New Interchangeable Products

New Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS NOVEMBER 12, 2013

MRP/PRP* DECEMBER 3, 2013

MFR

quinapril 20mg & hydrochlorothiazide 25mg tab

Apo-Quinapril/HCTZ 20/25mg Tab

02408783 DNP SF 0.6512 APX

Accuretic 20/25mg Tab 02237369 DNP SF 0.6512 PFI

Existing Categories: Benefit status is effective November 12, 2013 and the existing MRP or PRP for each existing category will apply.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS NOVEMBER 12, 2013

MRP/PRP* NOVEMBER 12, 2013

MFR

alendronate 10mg tab

MINT-Alendronate 10mg Tab 02394863 DNP E 0.6981 MNT

alendronate 70mg tab

MINT-Alendronate 70mg Tab 02394871 DNP E 3.5201 MNT

levetiracetam 250mg tab

RAN-Levetiracetam 250mg Tab 02396106 DNP E 0.8000 RAN

levetiracetam 500mg tab

RAN-Levetiracetam 500mg Tab 02396114 DNP E 0.9750 RAN

levetiracetam 750mg tab

RAN-Levetiracetam 750mg Tab 02396122 DNP E 1.3500 RAN

quetiapine 50mg ER tab

Sandoz Quetiapine XRT 50mg Tab

02407671 Not Insured SDZ

quetiapine 150mg ER tab

Sandoz Quetiapine XRT 150mg Tab

02407698 Not Insured SDZ

quetiapine 200mg ER tab

Sandoz Quetiapine XRT 200mg Tab

02407701 Not Insured SDZ

quetiapine 300mg ER tab

Sandoz Quetiapine XRT 300mg Tab

02407728 Not Insured SDZ

Page 40: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 3 of 3 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS NOVEMBER 12, 2013

MRP/PRP* NOVEMBER 12, 2013

MFR

quetiapine 400 ER tab

Sandoz Quetiapine XRT 400mg Tab

02407736 Not Insured SDZ

rabeprazole 10mg EC tab

MYLAN-Rabeprazole 10mg Tab 02408392 DNP SFC 0.1204 MYL

rabeprazole 20mg EC tab

MYLAN-Rabeprazole 20mg Tab 02408406 DNP SFC 0.2408 MYL

risedronate 150mg tab

MYLAN-Risedronate 150mg Tab 02397773 Not Insured MYL

rosuvastatin 5mg tab

MINT-Rosuvastatin 5mg Tab 02397781 Not Insured MNT

rosuvastatin 10mg tab

MINT-Rosuvastatin 10mg Tab 02397803 DNP SF 0.4760 MNT

rosuvastatin 20mg tab

MINT-Rosuvastatin 20mg Tab 02397811 DNP SF 0.5950 MNT

rosuvastatin 40mg tab

MINT-Rosuvastatin 40mg Tab 02397838 DNP SF 0.6965 MNT

tetrabenazine 25mg tab

Tetrabenazine 25mg Tab 02401338 DNP SF 3.3746 STR

Page 41: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 1 of 6 New Interchangeable Products

New Interchangeable Products Approved and Benefit Status within the Nova

Scotia Pharmacare Programs December 2013

New Categories: A Maximum Reimbursable Price (MRP) or Pharmacare Reimbursement Price (PRP) has been established for the following products. Benefit status is effective December 9, 2013.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS DECEMBER 9, 2013

MRP/PRP* DECEMBER 30, 2013

MFR

alendronic acid 70mg & cholecalciferol 2800 IU tab Teva-Alendronate/Cholecalciferol 70mg/2800 IU Tab

02403633 Not Insured TEV

Fosavance 70mg/2800 IU Tab 02276429 Not Insured FRS

alendronic acid 70mg & cholecalciferol 5600 IU tab

Teva-Alendronate/Cholecalciferol 70mg/5600 Tab

02403641 DNP E 2.7975 TEV

Fosavance 70mg/5600 IU Tab 02314940 DNP E 2.7975 FRS

bupropion 150mg XL tab MYLAN-Bupropion XL 150mg Tab 02382075 DNP SFC 0.3982 MYL

Wellbutrin XL 150mg Tab 02275090 DNP SFC 0.3982 VLN

bupropion 300mg XL tab MYLAN-Bupropion XL 300mg Tab 02382083 DNP SFC 0.7963 MYL

Wellbutrin XL 300mg Tab 02275104 DNP SFC 0.7963 VLN

cetirizine 20mg tab

pms-Cetirizine 20mg Tab 02315963 Not Insured PMS

Reactine 20mg Tab 01900978 Not Insured JNJ

nitroglycerin 0.2mg/hr patch

MYLAN-Nitro 0.2mg/hr Patch 02407442 DNPM SF 0.4463 MYL

Nitro-Dur 0.2mg/hr Patch 01911910 DNPM SF 0.4463 FRS

Page 42: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 2 of 6 New Interchangeable Products

New Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS DECEMBER 9, 2013

MRP/PRP* DECEMBER 30, 2013

MFR

nitroglycerin 0.4mg/hr patch

MYLAN-Nitro 0.4mg/hr Patch 02407450 DNPM SF 0.4704 MYL

Nitro-Dur 0.4mg/hr Patch 01911902 DNPM SF 0.4704 FRS

nitroglycerin 0.6mg/hr patch

MYLAN-Nitro 0.6mg/hr Patch 02407469 DNPM SF 0.4704 MYL

Nitro-Dur 0.6mg/hr Patch 01911929 DNPM SF 0.4704 FRS

nitroglycerin 0.8mg/hr patch

MYLAN-Nitro 0.8mg/hr Patch 02407477 DNPM SF 0.8743 MYL

Nitro-Dur 0.8mg/hr Patch 02011271 DNPM SF 0.8743 FRS Existing Categories: Benefit status is effective December 9, 2013 and the existing MRP or PRP for each existing category will apply.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS DECEMBER 9, 2013

MRP/PRP* DECEMBER 9, 2013

MFR

alendronate 5mg tab

Alendronate Sodium 5mg Tab 02381478 Not Insured AHI

alendronate 10mg tab

Alendronate Sodium 10mg Tab 02381486 DNP E 0.6981 AHI

alendronate 70mg tab

Alendronate Sodium 70mg Tab 02381494 DNP E 3.5201 AHI

amlodipine 5mg tab

Auro-Amlodipine 5mg Tab 02397072 DNP SF 0.2417 ARO

amlodipine 10mg tab

Auro-Amlodipine 10mg Tab 02397080 DNP SF 0.3587 ARO

anastrozole 1mg tab

Anastrozole 1mg Tab 02351218 DNP SFC 1.7821 AHI

Page 43: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 3 of 6 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS DECEMBER 9, 2013

MRP/PRP* DECEMBER 9, 2013

MFR

candesartan 16mg & hydrochlorothiazide 12.5mg tab

Teva-Candesartan/HCTZ 16/12.5mg Tab 02395541 DNP SF 0.4193 TEV candesartan 32mg & hdyrochlorothiazide 12.5mg tab

Teva-Candesartan/HCTZ 32/12.5mg Tab 02395568 DNP SF 0.5990 TEV

clarithromycin 25mg/mL o/l

Clarithromycin 125mg/mL O/L 02408988 DNP SFC 0.2047 SAS

clarithromycin 50mg/mL o/l

Clarithromycin 250mg/mL O/L 02408996 DNP SFC 0.3998 SAS

clopidogrel 75mg tab

MINT-Clopidogrel 75mg Tab 02408910 DNP E 0.9206 MNT

fluoxetine 10mg cap

Jamp-Fluoxetine 10mg Cap 02401894 DNP SFC 0.8650 JPC

RAN-Fluoxetine 10mg Cap 02405695 DNP SFC 0.8650 RAN

fluoxetine 20mg cap

RAN-Fluoxetine 20mg Cap 02405709 DNP SFC 0.6438 RAN

irbesartan 75mg tab

Auro-Irbesartan 75mg Tab 02406098 DNP SF 0.4234 ARO

RAN-Irbesartan 75mg Tab 02406810 DNP SF 0.4234 RAN

irbesartan 150mg tab

Auro-Irbesartan 150mg Tab 02406101 DNP SF 0.4234 ARO

RAN-Irbesartan 150mg Tab 02406829 DNP SF 0.4234 RAN

Page 44: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 4 of 6 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS DECEMBER 9, 2013

MRP/PRP* DECEMBER 9, 2013

MFR

irbesartan 300mg tab

Auro-Irbesartan 300mg Tab 02406128 DNP SF 0.4234 ARO

RAN-Irbesartan 300mg Tab 02406837 DNP SF 0.4234 ARO

lisinopril 5mg tab

Auro-Lisinopril 5mg Tab 02394472 DNP SF 0.2100 ARO

lisinopril 10mg tab

Auro-Lisinopril 10mg Tab 02394480 DNP SF 0.2522 ARO

lisinopril 20mg tab

Auro-Lisinopril 20mg Tab 02394499 DNP SF 0.3032 ARO

meloxicam 7.5mg tab

Auro-Meloxicam 7.5mg Tab 02390884 DNP SF 0.2804 ARO

meloxicam 15mg tab

Auro-Meloxicam 15mg Tab 02390892 DNP SF 0.3235 ARO

montelukast 10mg tab

Auro-Montelukast 10mg Tab 02401274 DNP E 0.8276 ARO

pioglitazone 15mg tab

Jamp-Pioglitazone 15mg Tab 02397307 DNP E 0.8324 JPC

quetiapine 25mg tab

Auro-Quetiapine 25mg Tab 02390205 DNP SF 0.1779 ARO

quetiapine 100mg tab

Auro-Quetiapine 100mg Tab 02390213 DNP SF 0.4746 ARO

quetiapine 200mg tab

Auro-Quetiapine 200mg Tab 02390248 DNP SF 0.9530 ARO

Page 45: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 5 of 6 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS DECEMBER 9, 2013

MRP/PRP* DECEMBER 9, 2013

MFR

quetiapine 300mg tab

Auro-Quetiapine 300mg Tab 02390256 DNP SF 1.3906 ARO

ramipril 1.25mg cap/tab

Auro-Ramipril 1.25mg Cap 02387387 DNP SF 0.1274 ARO

ramipril 2.5mg cap/tab

Auro-Ramipril 2.5mg Cap 02387395 DNP SF 0.1470 ARO

ramipril 5mg cap/tab

Auro-Ramipril 5mg Cap 02387409 DNP SF 0.1470 ARO

ramipril 10mg cap/tab

Auro-Ramipril 10mg Cap 02387417 DNP SF 0.1862 ARO

sertraline 25mg cap

Auro-Sertraline 25mg Cap 02390906 DNP SFC 0.2814 ARO

sertraline 50mg cap

Auro-Sertraline 50mg Cap 02390914 DNP SFC 0.5628 ARO

sertraline 100mg cap

Auro-Sertraline 100mg Cap 02390922 DNP SFC 0.5898 ARO

sildenafil 25mg tab

pms-Sildenafil 25mg Tab 02317559 Not Insured PMS

sildenafil 50mg tab

pms-Sildenafil 50mg Tab 02317575 Not Insured PMS

sildenafil 100mg tab

pms-Sildenafil 100mg Tab 02317583 Not Insured PMS tamsulosin 0.4mg sustained release cap/tab

Teva-Tamsulosin CR 0.4mg Tab 02368242 DNP SF 0.2168 TEV

Page 46: New Interchangeable Products Approved and Benefit Status ......MYLAN-Fentanyl Matrix 12mcg/hr Patch 02396696 D E (SFC) 2.2300 MYL fentanyl 25mcg/hr patch MYLAN-Fentanyl Matrix 25mcg/hr

Page 6 of 6 New Interchangeable Products

Existing Categories Continued…

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS DECEMBER 9, 2013

MRP/PRP* DECEMBER 9, 2013

MFR

tetrabenazine 25mg tab

Apo-Tetrabenazine 25mg Tab 02407590 Not Insured APX

valacyclovir 500mg tab

Auro-Valacyclovir 500mg Tab 02405040 DNPM SFC 1.1874 ARO

zopiclone 5mg tab

Jamp-Zopiclone 5mg Tab 02406969 DNP SFC 0.2231 JPC

Changes to Benefit Status: As a result of recent pricing changes, the following product will no longer be eligible benefits as of December 9, 2013.

PRODUCT DIN/PIN PRESCRIBER BENEFIT STATUS DECEMBER 9, 2013

MRP/PRP* DECEMBER 9, 2013

MFR

tetrabenazine 25mg tab

Tetrabenazine 25mg Tab 02410338 Not Insured STR