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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 5274AA LYRICA 150MG CAP (PFI) PREGABALIN PREGABALIN LYRICA 28'S C 102.40 3.66 CAP 120 BLIS PFI PFIZER CORPORATION COL AVENTA BARBADOS B 281292 ANTICONVULSANTS MISCELLANEOUS 2026-04-01 2028-03-31 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
41 5274N PREGASAFE 150MG CAP (MSN) PREGABALIN (B) PREGABALIN PREGASAFE 3X10 B 5.44 0.1812 CAP 120 BOX MSN MSN LABS ATB ANSA TRADING BARBADOS LTD B 281292 ANTICONVULSANTS MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
40 5274P PREGABALIN 150MG TAB (MCP/AHI) PREGABALIN PREGABALIN 3X10 B 5.57 0.19 TABLET 0 TAB MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 281292 ANTICONVULSANTS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
40 52761 LYRICA 300MG TAB (PFI/STO) PREGABALIN PREGABALIN LYRICA 28'S C 153.59 5.49 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 281292 ANTICONVULSANTS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 52761 LYRICA 300MG TAB (PFI) PREGABALIN (C) PREGABALIN LYRICA 28'S C 154.97 5.5347 TAB 60 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD B 281292 ANTICONVULSANTS MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
40 52763 LYRICA 300MG TAB (PFI/SBI) PREGABALIN PREGABALIN LYRICA 28'S C 153.59 5.49 TABLET 0 TAB PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 281292 ANTICONVULSANTS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 52763 LYRICA 300MG TAB (PFI) PREGABALIN (C) PREGABALIN LYRICA 28'S C 154.97 5.5347 TAB 60 BOX PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD B 281292 ANTICONVULSANTS MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
40 52764 APO-PREGABALIN 300MG CAP (APO/COL) PREGABALIN APO-PREGABALIN 100'S B 59.80 0.60 CAPSULE 0 CAP APO APOTEX INC. COL COLLINS LTD 281292 ANTICONVULSANTS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
41 52765 PMS-PREGABALIN 300MG CAP (PMS) (B) PREGABALIN PMS-PREGABALIN 100'S B 31.8 0.318 CAP 60 BOTT PMS PHARMASCIENCE COL COLLINS LTD B 281292 ANTICONVULSANTS MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
42 52765 PMS-PREGABALIN 300MG CAP (PMS) PREGABALIN PMS-PREGABALIN 100'S C 24.46 0.24 CAP 60 BOTT PMS PHARMASCIENCE COL AVENTA BARBADOS B 281292 ANTICONVULSANTS MISCELLANEOUS 2026-04-01 2028-03-31 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
40 52816 FUCITHALMIC 1% EYE DR (ANT/COL) FUSIDIC ACID FUSIDIC ACID FUCITHALMIC 5G A 14.95 14.95 EYE DROP 1 TUBE ANT CONCORDIA INTERNATIONAL COL COLLINS LTD 520404 EENT ANTIBACTERIALS 2022-04-01 2024-03-31 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS
42 52816 FUCITHALMIC 1% EYE DR (ANT) FUSIDIC ACID FUSIDIC ACID FUCITHALMIC 5G A 8.83 8.83 TUBE 1 BOX ANT CONCORDIA INTERNATIONAL COL AVENTA BARBADOS 520404 EENT ANTIBACTERIALS 2026-04-01 2028-03-31 OPHTHALMIC 0 EENT ANTIBACTERIALS
40 5281AA VISAG 0.1% EYE DR (LPO/COL) AZITHROMYCIN AZITHROMYCIN VISAG 2.5ML BQ 8.43 8.43 EYE DROP 0 BOTT LPO LABORATORIOS POEN S.A. COL COLLINS LTD 520404 EENT ANTIBACTERIALS 2022-04-01 2024-03-31 OPHTHALMIC 6 EYE, EAR, NOSE AND THROAT PREPARATIONS
41 5281AA VISAG 0.1% EYE DR (LPO) AZITHROMYCIN (BQ) AZITHROMYCIN VISAG 2.5ML BQ 8.43 8.4268 BOTT 1 BOTT LPO LABORATORIOS POEN S.A. COL COLLINS LTD 520404 EENT ANTIBACTERIALS 2024-04-01 2026-03-31 OPHTHALMIC 0 EENT ANTIBACTERIALS
42 5281AA VISAG 0.1% EYE DR (LPO) AZITHROMYCIN AZITHROMYCIN VISAG 2.5ML BQ 20.39 20.39 BOTT 1 BOTT LPO LABORATORIOS POEN S.A. COL AVENTA BARBADOS 520404 EENT ANTIBACTERIALS 2026-04-01 2028-03-31 OPHTHALMIC 0 EENT ANTIBACTERIALS
40 5281BB MOXICIP 0.5% EYE DR (CIP/AHI) MOXIFLOXACIN MOXIFLOXACIN MOXICIP 5ML BQ 10.60 10.60 EYE DROP 0 BOTT CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 520404 EENT ANTIBACTERIALS 2022-04-01 2022-09-30 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS 2022-03-29
40 5281BK GATIF FORTE 0.3% DROPS (LPO/COL) GATIFLOXACIN GATIFLOXACIN GATIF FORTE 5ML C 9.51 9.51 DROPS 0 BOTT LPO LABORATORIOS POEN S.A. COL COLLINS LTD 520404 EENT ANTIBACTERIALS 2022-04-01 2024-03-31 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS
41 5281BK GATIF FORTE 0.3% EYE DR (LPO) GATIFLOXACIN (C) GATIFLOXACIN GATIF FORTE 5ML C 10.47 10.4655 BOTT 0 BOTT LPO LABORATORIOS POEN S.A. COL COLLINS LTD 520404 EENT ANTIBACTERIALS 2024-04-01 2026-03-31 OPHTHALMIC 0 EENT ANTIBACTERIALS
42 5281BU CIPROFLOXACIN 0.3% EYE DR (CIP) CIPROFLOXACIN CIPROFLOXACIN 10ML BQ 1.25 1.25 BOTT 0 BOX CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 520404 EENT ANTIBACTERIALS 2026-04-01 2028-03-31 OPHTHALMIC 0 EENT ANTIBACTERIALS
40 5281BV APROCIN 0.3% EYE DR (ARP/AHI) CIPROFLOXACIN CIPROFLOXACIN APROCIN 10ML BH 8.15 8.15 EYE DROP 0 BOTT ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC 520404 EENT ANTIBACTERIALS 2022-04-01 2022-09-30 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS 2022-03-29