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Contract Number Brand Code Brand Name Active Ingredient Trade Name Package Size Formulary Category Pkg Price Unit Price Unit Description Max. Reimbursable Quantity / Month Package Description Manufacturer Code Manufacturer Name Agent Code Agent Name Benefit Therapeutic Code Therapeutic Desc Drug Contract Start Date Drug Contract End Date Status Description Default Route Max Repeats Therapeutic Head Amend Date
42 39216 PLAVIX 75MG TAB (SFA) CLOPIDOGREL CLOPIDOGREL PLAVIX 28'S C 81.55 2.91 TAB 30 BLIS SFA SANOFI COL AVENTA BARBADOS 201218 PLATELET AGGREGATION INHIBITORS 2026-04-01 2028-03-31 ORAL 6 PLATELET AGGREGATION INHIBITORS
40 3921BS CLOPIDOGREL 75MG TAB (KWA/ATB) CLOPIDOGREL CLOPIDOGREL 100'S A 8.07 0.08 TABLET 30 TAB KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 201218 PLATELET AGGREGATION INHIBITORS 2022-04-01 2024-03-31 Oral 6 BLOOD FORMATION, COAGULATION AND THROMBOSIS 2022-06-02
40 3921CH BRILINTA 90MG TAB (AZN/COL) TICAGRELOR TICAGRELOR BRILINTA 60'S C 122.32 2.04 TABLET 0 TAB AZN ASTRAZENECA AB COL COLLINS LTD 201218 PLATELET AGGREGATION INHIBITORS 2022-04-01 2024-03-31 Oral 0 BLOOD FORMATION, COAGULATION AND THROMBOSIS
41 3921CH BRILINTA 90MG TAB (AZN) TICAGRELOR (C) TICAGRELOR BRILINTA 60'S C 122.32 2.0387 TAB 60 BOX AZN ASTRAZENECA AB COL COLLINS LTD 201218 PLATELET AGGREGATION INHIBITORS 2024-04-01 2026-03-31 ORAL 0 PLATELET AGGREGATION INHIBITORS
42 3921CH BRILINTA 90MG TAB (AZN) TICAGRELOR TICAGRELOR BRILINTA 60'S C 121.54 2.03 TAB 60 BLIS AZN ASTRAZENECA AB COL AVENTA BARBADOS 201218 PLATELET AGGREGATION INHIBITORS 2026-04-01 2028-03-31 ORAL 0 PLATELET AGGREGATION INHIBITORS
40 3921CK PLASEP 75MG TAB (MSN/ATB) CLOPIDOGREL CLOPIDOGREL PLASEP 3X10 A 1.77 0.06 TABLET 30 TAB MSN MSN LABS ATB ANSA TRADING BARBADOS LTD 201218 PLATELET AGGREGATION INHIBITORS 2022-04-01 2022-07-26 Oral 6 BLOOD FORMATION, COAGULATION AND THROMBOSIS
40 3921CK PLASEP 75MG TAB (MSN/ATB) CLOPIDOGREL CLOPIDOGREL PLASEP 3X10 A 2.16 0.07 TABLET 30 TAB MSN MSN LABS ATB ANSA TRADING BARBADOS LTD 201218 PLATELET AGGREGATION INHIBITORS 2022-09-06 2024-03-31 Price Change Oral 6 BLOOD FORMATION, COAGULATION AND THROMBOSIS 2022-07-26
41 3921CK PLASEP 75MG TAB (MSN) CLOPIDOGREL CLOPIDOGREL PLASEP 3X10 A 2.64 0.0879 TAB 30 BOX MSN MSN LABS ATB ANSA TRADING BARBADOS LTD 201218 PLATELET AGGREGATION INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PLATELET AGGREGATION INHIBITORS
40 3921CM DIPYRIDAMOLE 50MG TAB (LDP/AHI) DIPYRIDAMOLE DIPYRIDAMOLE 100'S BQ 49.72 0.50 TABLET 120 TAB LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 201218 PLATELET AGGREGATION INHIBITORS 2022-04-01 2024-03-31 Add to Contract as Cat B Oral 6 BLOOD FORMATION, COAGULATION AND THROMBOSIS 2022-03-10
40 3921CQ DIPYRIDAMOLE 25MG TAB (LDP/AHI) DIPYRIDAMOLE DIPYRIDAMOLE 100'S BQ 49.72 0.50 TABLET 120 TAB LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 201218 PLATELET AGGREGATION INHIBITORS 2022-04-01 2024-03-31 Add to Contract as Cat B Oral 6 BLOOD FORMATION, COAGULATION AND THROMBOSIS 2022-03-10
40 3921CS DIPYRIDAMOLE 75MG TAB (LDP/AHI) DIPYRIDAMOLE DIPYRIDAMOLE 100'S BQ 49.72 0.50 TABLET 120 TAB LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 201218 PLATELET AGGREGATION INHIBITORS 2022-04-01 2024-03-31 Add to Contract as Cat B Oral 6 BLOOD FORMATION, COAGULATION AND THROMBOSIS 2022-03-10
41 3921DM CLOPIDOGREL 75MG TAB (MCP) CLOPIDOGREL CLOPIDOGREL 10X10 A 6.93 0.0693 TAB 30 BOX MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 201218 PLATELET AGGREGATION INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PLATELET AGGREGATION INHIBITORS
42 3921EA BRIREM 90MG TAB (REM) TICAGRELOR TICAGRELOR BRIREM 14X4 B 27.46 0.49 TAB 60 BLIS REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 201218 PLATELET AGGREGATION INHIBITORS 2026-04-01 2028-03-31 ORAL 0 PLATELET AGGREGATION INHIBITORS
42 3921ER PLASEP 75MG TAB (MSN) CLOPIDOGREL CLOPIDOGREL PLASEP 3X10 A 2.47 0.08 TAB 30 MSN MSN LABS STO BRYDEN STOKES LTD 201218 PLATELET AGGREGATION INHIBITORS 2026-04-01 2028-03-31 ORAL 6 PLATELET AGGREGATION INHIBITORS 2026-03-23
40 3921K ANTIPLAR 75MG TAB (EMC/COL) CLOPIDOGREL CLOPIDOGREL ANTIPLAR 100'S A 9.51 0.10 TABLET 30 TAB EMC EMCURE PHARMACEUTICALS LTD COL COLLINS LTD 201218 PLATELET AGGREGATION INHIBITORS 2022-05-31 2022-12-31 Oral 6 BLOOD FORMATION, COAGULATION AND THROMBOSIS 2022-05-31
41 3921K ANTIPLAR 75MG TAB (EMC) CLOPIDOGREL CLOPIDOGREL ANTIPLAR 100'S A 8.7 0.087 TAB 30 BOX EMC EMCURE PHARMACEUTICALS LTD COL COLLINS LTD 201218 PLATELET AGGREGATION INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PLATELET AGGREGATION INHIBITORS
42 3921K ANTIPLAR 75MG TAB (EMC) CLOPIDOGREL CLOPIDOGREL ANTIPLAR 100'S A 8.70 0.09 TAB 30 BLIS EMC EMCURE PHARMACEUTICALS LTD COL AVENTA BARBADOS 201218 PLATELET AGGREGATION INHIBITORS 2026-04-01 2028-03-31 ORAL 6 PLATELET AGGREGATION INHIBITORS
42 39612 APO-VALPROIC 250MG CAP (APO) VALPROIC ACID APO-VALPROIC 100'S A 38.06 0.38 CAP 90 BOTT APO APOTEX INC. COL AVENTA BARBADOS B 281292 ANTICONVULSANTS MISCELLANEOUS 2026-04-01 2028-03-31 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
40 3961AD DEPAKOTE ER 250MG TAB (ABB/PHA) VALPROIC ACID VALPROIC ACID DEPAKOTE ER 100'S A 71.36 0.71 TABLET 90 TAB ABB ABBOTT PHA PHARMACY SALES CARIBBEAN B 281292 ANTICONVULSANTS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
40 3961AD DEPAKOTE ER 250MG TAB (ABB/PHA) VALPROIC ACID VALPROIC ACID DEPAKOTE ER 100'S A 71.36 0.7136 TABLET IMMED ABB ABBOTT PHA PHARMACY SALES CARIBBEAN B 281292 ANTICONVULSANTS MISCELLANEOUS 2022-04-01 2023-03-31 Delete from contract Oral 6 ANTICONVULSANTS MISCELLANEOUS 2023-03-02