Ministry of Health and Long-Term Care Ontario Drug Benefit Formulary/Comparative Drug Index Edition 43 Pan-Canadian Select Molecule Price Initiative for Generic Drugs Effective April 1, 2018 Drug Programs Policy and Strategy Branch Ontario Public Drug Programs Ministry of Health and Long-Term Care Visit Formulary Downloads: Edition 43
Table of Contents New Multi-Source Products... 3 Drug Benefit Price (DBP) Changes... 4 Delisted Products... 10 2
New Multi-Source Products DIN/PIN Brand Name Strength Dosage Form Mfr DBP 02466465 Atenolol 50mg Tab SAI 0.1107 02466473 Atenolol 100mg Tab SAI 0.1821 (Interchangeable with Tenormin) 3
Drug Benefit Price (DBP) Changes The Drug Benefit Prices (DBP) of the following 59 generic molecules on the Ontario Drug Benefit (ODB) Formulary will be reduced. The changes are listed by Generic Name, Strength, Dosage Form and DBP. For a list of price changes by individual DIN/PIN, please see the link on page 9. Generic Name Strength Dosage Form DBP Alendronate 70mg Tab 2.1014 Amiodarone HCl 200mg Tab 0.3706 Amlodipine 5mg Tab 0.1343 Amlodipine 10mg Tab 0.1993 Anastrozole 1mg Tab 0.9522 Atenolol 50mg Tab 0.1107 Atenolol 100mg Tab 0.1821 Atorvastatin Calcium 10mg Tab 0.1743 Atorvastatin Calcium 20mg Tab 0.2179 Atorvastatin Calcium 40mg Tab 0.2342 Atorvastatin Calcium 80mg Tab 0.2342 Azithromycin 250mg Tab 0.9410 Bicalutamide 50mg Tab 1.2690 Bisoprolol Fumarate 5mg Tab 0.0715 Bisoprolol Fumarate 10mg Tab 0.1044 Candesartan Cilexetil 8mg Tab 0.2281 Candesartan Cilexetil 16mg Tab 0.2281 Candesartan Cilexetil 32mg Tab 0.2281 Candesartan Cilexetil & Hydrochlorothiazide 16mg & 12.5mg Tab 0.2156 Candesartan Cilexetil & Hydrochlorothiazide 32mg & 12.5mg Tab 0.2156 Carvedilol 3.125mg Tab 0.2431 Carvedilol 6.25mg Tab 0.2431 Carvedilol 12.5mg Tab 0.2431 Carvedilol 25mg Tab 0.2431 4
Drug Benefit Price (DBP) Changes (Continued) Generic Name Strength Dosage Form DBP Celecoxib 100mg Cap 0.1279 Celecoxib 200mg Cap 0.2558 Ciprofloxacin 250mg Tab 0.4454 Ciprofloxacin 500mg Tab 0.5025 Ciprofloxacin 750mg Tab 0.9201 Citalopram Hydrobromide 20mg Tab 0.1332 Citalopram Hydrobromide 40mg Tab 0.1332 Clonazepam 0.5mg Tab 0.0418 Clonazepam 2mg Tab 0.0721 Clopidogrel Bisulfate 75mg Tab 0.2631 Domperidone Maleate 10mg Tab 0.0428 Donepezil HCl 5mg Tab 0.4586 Donepezil HCl 10mg Tab 0.4586 Dutasteride 0.5mg Cap 0.3027 Escitalopram 10mg Tab 0.3109 Escitalopram 20mg Tab 0.3310 Ezetimibe 10mg Tab 0.1811 Famciclovir 500mg Tab 1.3436 Finasteride 5mg Tab 0.4138 Fluoxetine HCl 20mg Cap 0.3311 Gabapentin 100mg Cap 0.0416 Gabapentin 300mg Cap 0.1012 Gabapentin 400mg Cap 0.1206 Imatinib Mesylate 100mg Tab 5.2079 Imatinib Mesylate 400mg Tab 20.8314 Irbesartan 75mg Tab 0.2281 Irbesartan 150mg Tab 0.2281 Irbesartan 300mg Tab 0.2281 Irbesartan & Hydrochlorothiazide 300mg & 25mg Tab 0.2184 Irbesartan & Hydrochlorothiazide 150mg & 12.5mg Tab 0.2281 Irbesartan & Hydrochlorothiazide 300mg & 12.5mg Tab 0.2281 5
Drug Benefit Price (DBP) Changes (Continued) Generic Name Strength Dosage Form DBP Lamotrigine 25mg Tab 0.0698 Lamotrigine 100mg Tab 0.2787 Lamotrigine 150mg Tab 0.4107 Levetiracetam 250mg Tab 0.3210 Levetiracetam 500mg Tab 0.3911 Levetiracetam 750mg Tab 0.5416 Metformin HCl 500mg Tab 0.0247 Montelukast Sodium 4mg Chew Tab 0.2758 Mycophenolate Mofetil 250mg Cap 0.3712 Mycophenolate Mofetil 500mg Tab 0.7423 Olanzapine 2.5mg Tab 0.1772 Olanzapine 5mg Tab 0.3544 Olanzapine 5mg Rapid Dissolve Tab 0.3574 Olanzapine 7.5mg Tab 0.5316 Olanzapine 10mg Tab 0.7088 Olanzapine 10mg Rapid Dissolve Tab 0.7143 Olanzapine 15mg Tab 1.0631 Olanzapine 15mg Rapid Dissolve Tab 1.0711 Omeprazole 20mg Cap/DR Cap/DR Tab 0.2287 Omeprazole 20mg Cap/DR Cap 0.2287 Omeprazole Magnesium 20mg DR Cap/DR Tab 0.2287 Pantoprazole Sodium 40mg Ent Tab 0.2016 Paroxetine HCl 20mg Tab 0.3250 Paroxetine HCl 30mg Tab 0.3453 Pramipexole Dihydrochloride Monohydrate 0.25mg Tab 0.1950 Pramipexole Dihydrochloride Monohydrate 1mg Tab 0.3901 Pramipexole Dihydrochloride Monohydrate 1.5mg Tab 0.3901 Pravastatin Sodium 10mg Tab 0.2916 Pravastatin Sodium 20mg Tab 0.3440 Pravastatin Sodium 40mg Tab 0.4143 6
Drug Benefit Price (DBP) Changes (Continued) Generic Name Strength Dosage Form DBP Pregabalin 25mg Cap 0.1481 Pregabalin 50mg Cap 0.2324 Pregabalin 75mg Cap 0.3007 Pregabalin 150mg Cap 0.4145 Pregabalin 300mg Cap 0.4145 Quetiapine 25mg Tab 0.0494 Quetiapine 100mg Tab 0.1318 Quetiapine 200mg Tab 0.2647 Quetiapine 300mg Tab 0.3863 Rabeprazole Sodium 10mg Tab 0.0669 Rabeprazole Sodium 20mg Tab 0.1338 Ramipril 1.25mg Cap 0.0708 Ramipril 2.5mg Cap 0.0817 Ramipril 5mg Cap 0.0817 Ramipril 10mg Cap 0.1034 Ranitidine HCl 150mg Tab 0.1197 Ranitidine HCl 300mg Tab 0.2253 Risedronate Sodium 35mg Tab 1.9787 Risperidone 0.25mg Tab 0.1036 Risperidone 0.5mg Tab 0.1735 Risperidone 1mg Tab 0.2397 Risperidone 2mg Tab 0.4795 Risperidone 3mg Tab 0.7180 Risperidone 4mg Tab 0.9574 Rosuvastatin Calcium 5mg Tab 0.1284 Rosuvastatin Calcium 10mg Tab 0.1354 Rosuvastatin Calcium 20mg Tab 0.1692 Rosuvastatin Calcium 40mg Tab 0.1990 Sertraline HCl 25mg Cap 0.1516 Sertraline HCl 50mg Cap 0.3032 Sertraline HCl 100mg Cap 0.3303 7
Drug Benefit Price (DBP) Changes (Continued) Generic Name Strength Dosage Form DBP Simvastatin 5mg Tab 0.1023 Simvastatin 10mg Tab 0.2023 Simvastatin 20mg Tab 0.2501 Simvastatin 40mg Tab 0.2501 Simvastatin 80mg Tab 0.2501 Solifenacin Succinate 5mg Tab 0.3041 Solifenacin Succinate 10mg Tab 0.3041 Telmisartan 40mg Tab 0.2161 Telmisartan 80mg Tab 0.2161 Telmisartan & Hydrochlorothiazide 80mg & 12.5mg Tab 0.2098 Telmisartan & Hydrochlorothiazide 80mg & 25mg Tab 0.2098 Topiramate 25mg Tab 0.2433 Topiramate 100mg Tab 0.4583 Topiramate 200mg Tab 0.6748 Valacyclovir 500mg Tab 0.6198 Valsartan 320mg Tab 0.2098 Valsartan 80mg Tab 0.2159 Valsartan 160mg Tab 0.2159 Valsartan & Hydrochlorothiazide 80mg & 12.5mg Tab 0.2213 Valsartan & Hydrochlorothiazide 320mg & 25mg Tab 0.2231 Valsartan & Hydrochlorothiazide 320mg & 12.5mg Tab 0.2235 Valsartan & Hydrochlorothiazide 160mg & 25mg Tab 0.2238 Valsartan & Hydrochlorothiazide 160mg & 12.5mg Tab 0.2240 Venlafaxine HCl 37.5mg ER Cap 0.0913 Venlafaxine HCl 75mg ER Cap 0.1825 Venlafaxine HCl 150mg ER Cap 0.1927 8
Drug Benefit Price (DBP) Changes (Continued) To view the DBP changes by DIN/PIN, the ministry has posted an Excel file with the details of the listing changes for download and review (Edition 43: Pan-Canadian Select Molecule Price Initiative for Generic Drugs Drug Benefit Price Changes April 2018). It is accessible from the ministry s website: http://www.health.gov.on.ca/en/pro/programs/drugs/edition_43.aspx. 9
Delisted Products DIN/PIN Brand Name Strength Dosage Form Mfr 02388650 Co Candesartan/HCT 16mg & 12.5mg Tab COB 02313561 Co Escitalopram 10mg Tab COB 02313588 Co Escitalopram 20mg Tab COB 02262762 Co Paroxetine 30mg Tab COB 02287765 Co Topiramate 25mg Tab COB 02287773 Co Topiramate 100mg Tab COB 02287781 Co Topiramate 200mg Tab COB 02421747 Ecl-Citalopram 20mg Tab ECL 02421755 Ecl-Citalopram 40mg Tab ECL 02421828 Ecl-Metformin 500mg Tab ECL 02274531 Gd-Azithromycin 250mg Tab GEM 02285827 Gd-Gabapentin 300mg Cap GEM 02360136 Gd-Pregabalin 25mg Cap GEM 02360144 Gd-Pregabalin 50mg Cap GEM 02360152 Gd-Pregabalin 75mg Cap GEM 02360179 Gd-Pregabalin 150mg Cap GEM 02360209 Gd-Pregabalin 300mg Cap GEM 02273683 Gd-Sertraline 25mg Cap GEM 02273691 Gd-Sertraline 50mg Cap GEM 02273705 Gd-Sertraline 100mg Cap GEM 02352850 Gd-Topiramate 25mg Tab GEM 02352877 Gd-Topiramate 100mg Tab GEM 02352885 Gd-Topiramate 200mg Tab GEM 02360020 Gd-Venlafaxine XR 37.5mg ER Cap GEM 02360039 Gd-Venlafaxine XR 75mg ER Cap GEM 02360047 Gd-Venlafaxine XR 150mg ER Cap GEM 10
Delisted Products (Continued) DIN/PIN Brand Name Strength Dosage Form Mfr 02357194 Jamp-Amlodipine 5mg Tab JPC 02313405 Jamp-Citalopram 20mg Tab JPC 02313413 Jamp-Citalopram 40mg Tab JPC 02380722 Jamp-Metformin Blackberry 500mg Tab JPC 02436019 Jamp-Pregabalin 300mg Cap JPC 02317427 Mint-Ciprofloxacin 250mg Tab MIN 02317435 Mint-Ciprofloxacin 500mg Tab MIN 02317443 Mint-Ciprofloxacin 750mg Tab MIN 02304686 Mint-Citalopram 20mg Tab MIN 02304694 Mint-Citalopram 40mg Tab MIN 02347512 Mylan-Carvedilol 3.125mg Tab MYL 02347520 Mylan-Carvedilol 6.25mg Tab MYL 02347555 Mylan-Carvedilol 12.5mg Tab MYL 02245649 Mylan-Ciprofloxacin 750mg Tab MYL 02230950 Mylan-Clonazepam 0.5mg Tab MYL 02248259 Mylan-Gabapentin 100mg Cap MYL 02248260 Mylan-Gabapentin 300mg Cap MYL 02248261 Mylan-Gabapentin 400mg Cap MYL 02347326 Mylan-Irbesartan 300mg Tab MYL 02380749 Mylan-Montelukast 4mg Chew Tab MYL 02257106 Mylan-Pravastatin 20mg Tab MYL 02408392 Mylan-Rabeprazole 10mg Tab MYL 02357984 Mylan-Risedronate 35mg Tab MYL 02282267 Mylan-Risperidone 1mg Tab MYL 02282275 Mylan-Risperidone 2mg Tab MYL 02282283 Mylan-Risperidone 3mg Tab MYL 02282291 Mylan-Risperidone 4mg Tab MYL 02383543 Mylan-Valsartan 160mg Tab MYL 02161745 Novo-Ciprofloxacin 500mg Tab NOP 02161753 Novo-Ciprofloxacin 750mg Tab NOP 11
Delisted Products (Continued) DIN/PIN Brand Name Strength Dosage Form Mfr 02238316 Phl-Atenolol 50mg Tab PHE 02238318 Phl-Atenolol 100mg Tab PHE 02248752 Phl-Carvedilol 3.125mg Tab PHE 02248753 Phl-Carvedilol 6.25mg Tab PHE 02248754 Phl-Carvedilol 12.5mg Tab PHE 02248755 Phl-Carvedilol 25mg Tab PHE 02302632 PMS-Bisoprolol 5mg Tab PMS 02302640 PMS-Bisoprolol 10mg Tab PMS 02313014 PMS-Valsartan 160mg Tab PMS 02344564 PMS-Valsartan 320mg Tab PMS 02433214 Telmisartan-HCTZ 80mg & 12.5mg Tab PMS 02433222 Telmisartan-HCTZ 80mg & 25mg Tab PMS 02384728 Ran-Alendronate 70mg Tab RAN 02371820 Ran-Finasteride 5mg Tab RAN 02396106 Ran-Levetiracetam 250mg Tab RAN 02396114 Ran-Levetiracetam 500mg Tab RAN 02396122 Ran-Levetiracetam 750mg Tab RAN 02402793 Ran-Montelukast 4mg Chew Tab RAN 02403064 Ran-Olanzapine 2.5mg Tab RAN 02403080 Ran-Olanzapine 7.5mg Tab RAN 02374870 Ran-Omeprazole DR Tab 20mg DR Tab RAN 02374552 Ran-Sertraline 25mg Cap RAN 02374560 Ran-Sertraline 50mg Cap RAN 02437996 Ran-Solifenacin 10mg Tab RAN 02291398 Sandoz Ramipril Tab 1.25mg Tab SDZ 02291401 Sandoz Ramipril Tab 2.5mg Tab SDZ 02291428 Sandoz Ramipril Tab 5mg Tab SDZ 02291436 Sandoz Ramipril Tab 10mg Tab SDZ 02326035 Zinda-Anastrozole 1mg Tab STA 12