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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
40 A831EW ETOVAN 60MG TAB (ARP/AHI) ETORICOXIB ETORICOXIB ETOVAN 3X10 C 14.33 0.48 TABLET 0 TAB ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC 28080408 CYCLOOXYGENASE-2 (COX2) INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
40 A831EX ETOVAN 90MG TAB (ARP/AHI) ETORICOXIB ETORICOXIB ETOVAN 2X15 C 11.04 0.37 TABLET 0 TAB ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC 28080408 CYCLOOXYGENASE-2 (COX2) INHIBITORS 2022-04-01 2022-07-13 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
40 A831EX ETOVAN 90MG TAB (ARP/AHI) ETORICOXIB ETORICOXIB ETOVAN 2X15 C 16.55 0.55 TABLET 0 TAB ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC 28080408 CYCLOOXYGENASE-2 (COX2) INHIBITORS 2022-07-14 2024-03-31 Price Change Oral 0 CENTRAL NERVOUS SYSTEM DRUGS 2022-07-13
40 A831EY ETOVAN 120MG TAB (ARP/AHI) ETORICOXIB ETORICOXIB ETOVAN 2X10 C 11.04 0.55 TABLET 0 TAB ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC 28080408 CYCLOOXYGENASE-2 (COX2) INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 A831FM APO-MELOXICAM 7.5MG TAB (APO) (C) MELOXICAM APO-MELOXICAM 100'S C 4.62 0.0462 TAB 0 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 ORAL 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
41 A831FN APO-MELOXICAM 15MG TAB (APO) (C) MELOXICAM APO-MELOXICAM 100'S C 7.77 0.0777 TAB 15 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 ORAL 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
41 A831FT CELECOXIB 200MG CAP (MCP) (C) CELECOXIB CELECOXIB 3X10 C 3.18 0.106 CAP 0 BOX MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 ORAL 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
41 A831FU ETORICOXIB 120MG CAP (MCP) (C) ETORICOXIB ETORICOXIB 3X10 C 11.06 0.3688 CAP 0 BOX MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 ORAL 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
41 A831FV ETORICOXIB 60MG CAP (MCP) (C) ETORICOXIB ETORICOXIB 3X10 C 4.27 0.1423 CAP 0 BOX MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 ORAL 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
41 A831FW ETORICOXIB 90MG CAP (MCP) (C) ETORICOXIB ETORICOXIB 3X10 C 5.63 0.1876 CAP 0 BOX MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 ORAL 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
40 A911K ZARZIO 300MCG INJ (BCH/COL) FILGRASTIM FILGRASTIM ZARZIO 5X300IU BQ 217.47 43.49 INJECTION 0 PFS BCH SANDOZ COL COLLINS LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 A911K ZARZIO 300MCG INJ (BCH) FILGRASTIM (BQ) FILGRASTIM ZARZIO 5X300IU BQ 217.47 43.4932 PFS 15 BOX BCH SANDOZ COL COLLINS LTD 2016 HEMATOPOIETIC 2024-04-01 2026-03-31 IV 0 HEMATOPOIETIC
40 A911S PEG-GRAFEEL 6MG INJ (DRL/AAL) PEGFILGRASTIM PEGFILGRASTIM PEG-GRAFEEL 1 DS SYRNG BQ 419.93 419.93 INJECTION 0 PFS DRL DR. REDDY'S LABORATORIES LTD AAL A. A. LAQUIS LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 A911S PEG-GRAFEEL 6MG INJ (DRL) PEGFILGRA (BQ) PEGFILGRASTIM PEG-GRAFEEL 1 DS SYRNG BQ 380.57 380.5654 PFS 0 BOX DRL DR. REDDY'S LABORATORIES LTD AAL A. A. LAQUIS LTD 2016 HEMATOPOIETIC 2024-04-01 2026-03-31 IV 0 HEMATOPOIETIC
40 A9416 FLOMAX MR 0.4MG TAB (BOE/STO) TAMSULOSIN MR TAMSULOSIN MR FLOMAX MR 30'S C 47.14 1.57 TABLET 0 TAB BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD 12160412 SELECTIVE ALPHA 1 ADRENERGIC BLOCKING AGENTS 2022-04-01 2024-03-31 Oral 0 AUTONOMIC DRUGS
41 A9416 FLOMAX 0.4MG MR TAB (BOE) TAMSULOSIN MR (C) TAMSULOSIN MR FLOMAX 30'S C 47.6 1.5866 TABMR 60 BOX BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD 12160412 SELECTIVE ALPHA 1 ADRENERGIC BLOCKING AGENTS 2024-04-01 2025-02-28 ORAL 6 SELECTIVE ALPHA 1 ADRENERGIC BLOCKING AGENT 2025-01-17
40 A941AP TAMSULOSIN MR 0.4MG TAB (HEA/RXP) TAMSULOSIN MR TAMSULOSIN MR 30'S C 7.56 0.25 TABLET 0 TAB HEA HEALTH 2000 INC RXP RX PRO INC 12160412 SELECTIVE ALPHA 1 ADRENERGIC BLOCKING AGENTS 2022-04-01 2024-03-31 Oral 0 AUTONOMIC DRUGS
40 A941AZ VELTAM MR 0.4MG TAB (INP/AAL) TAMSULOSIN MR TAMSULOSIN MR VELTAM MR 30'S A 3.26 0.11 TABLET 30 TAB INP INTAS PHARMACEUTICALS LTD AAL A. A. LAQUIS LTD 12160412 SELECTIVE ALPHA 1 ADRENERGIC BLOCKING AGENTS 2022-04-01 2024-03-31 Oral 6 AUTONOMIC DRUGS
41 A941AZ VELTAM 0.4MG MR TAB (INP) TAMSULOSIN MR TAMSULOSIN MR VELTAM 30'S A 1.2 0.0399 TABMR 60 BOX INP INTAS PHARMACEUTICALS LTD AAL A. A. LAQUIS LTD 12160412 SELECTIVE ALPHA 1 ADRENERGIC BLOCKING AGENTS 2024-04-01 2026-03-31 ORAL 6 SELECTIVE ALPHA 1 ADRENERGIC BLOCKING AGENT
40 A941BG TAMSULOSIN MR 0.4MG CAP (MCP/AHI) TAMSULOSIN MR TAMSULOSIN MR 3X10 A $2.65 0.08 CAPSULE 30 TAB MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 12160412 SELECTIVE ALPHA 1 ADRENERGIC BLOCKING AGENTS 2022-04-01 2024-03-31 PRICE CHANGE ORAL 6 AUTONOMIC DRUGS 0000-00-00