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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
41 5861D SPORANOX 100MG CAP (JAC) ITRACONAZOLE (C) ITRACONAZOLE SPORANOX 60'S C 186.88 3.1147 CAP 0 BOX JAC JANSSEN-CILAG STO BRYDEN STOKES LTD 081408 AZOLES 2024-04-01 2026-03-31 ORAL 0 AZOLES
42 5861D SPORANOX 100MG CAP (JAC) ITRACONAZOLE ITRACONAZOLE SPORANOX 60'S C 186.88 3.11 CAP 12 BLIS JAC JANSSEN-CILAG STO BRYDEN STOKES LTD 081408 AZOLES 2026-04-01 ORAL 0 AZOLES
40 5861EG FLUCESS 150MG CAP (BCH/COL) FLUCONAZOLE FLUCONAZOLE FLUCESS 10'S C 11.15 1.12 CAPSULE 0 CAP BCH SANDOZ COL COLLINS LTD 081408 AZOLES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 5861EH FLUCESS 200MG CAP (BCH/COL) FLUCONAZOLE FLUCONAZOLE FLUCESS 10'S C 21.01 2.10 CAPSULE 0 CAP BCH SANDOZ COL COLLINS LTD 081408 AZOLES 2022-04-01 2024-03-31 Price Change Oral 0 ANTI-INFECTIVE AGENTS 2022-01-18
40 5861ET FLUCONAZOLE 150MG CAP (HEA/RXP) FLUCONAZOLE FLUCONAZOLE 1'S A 0.46 0.46 CAPSULE 60 CAP HEA HEALTH 2000 INC RXP RX PRO INC 081408 AZOLES 2022-04-01 2024-03-31 Oral 6 ANTI-INFECTIVE AGENTS
40 5861EU APO-TERBINAFINE 250MG TAB (APO/COL) TERBINAFINE APO-TERBINAFINE 30'S A 9.98 0.33 TABLET 28 TAB APO APOTEX INC. COL COLLINS LTD 081404 ALLYAMINES 2022-04-01 2024-03-31 Oral 6 ANTI-INFECTIVE AGENTS
42 5861EU APO-TERBINAFINE 250MG TAB (APO) TERBINAFINE APO-TERBINAFINE 30'S A 10.30 0.34 TAB 28 BLIS APO APOTEX INC. COL AVENTA BARBADOS 081404 ALLYAMINES 2026-04-01 ORAL 6 ALLYAMINES
40 5861FQ FLUCONAZOLE 150MG CAP (HEA/ATB) FLUCONAZOLE FLUCONAZOLE 1'S A 0.46 0.46 CAPSULE HEA HEALTH 2000 INC ATB ANSA TRADING BARBADOS LTD 81408 AZOLES 2022-12-07 2024-03-31 Change Local Agent oral 6 AZOLES 2022-11-25
40 5861HB ITRACONAZOLE 100MG TAB (KWA/ATB) ITRACONAZOLE ITRACONAZOLE 10'S A 4.68 0.47 TABLET 60 TAB KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 081408 AZOLES 2022-04-01 2024-03-31 Oral 3 ANTI-INFECTIVE AGENTS
40 5861HC ITRACONAZOLE/SECNIDAZOLE 33.3/166.6 TAB (KWA/ ITRACONAZOLE|SECNIDAZOLE ITRACONAZOLE|SECNIDAZOLE 10'S C 20.39 2.04 TABLET 0 TAB KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 081408 AZOLES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
41 5861HF FLUCESS 150MG CAP (BCH) FLUCONAZOLE (C) FLUCONAZOLE FLUCESS 1'S C 6.9 6.9045 CAP 60 BOX BCH SANDOZ COL COLLINS LTD 081408 AZOLES 2024-04-01 2026-03-31 ORAL 6 AZOLES
42 5861HF FLUCESS 150MG CAP (BCH) FLUCONAZOLE FLUCONAZOLE FLUCESS 1'S C 21.91 21.91 CAP 60 BLIS BCH SANDOZ COL AVENTA BARBADOS 081408 AZOLES 2026-04-01 ORAL 6 AZOLES
41 5861JG FLUCONAZOLE 50MG TAB (LDP) FLUCONAZOLE FLUCONAZOLE 100'S A 12.23 0.1223 TAB 60 BOTT LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 081404 ALLYAMINES 2024-04-01 2026-03-31 ORAL 6 ALLYAMINES
40 5861JH FLUCONAZOLE 150MG TAB (LDP/AHI) FLUCONAZOLE FLUCONAZOLE 100'S A 23.79 0.24 TABLET 60 TAB LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 081408 AZOLES 2022-04-01 2024-03-31 Oral 6 ANTI-INFECTIVE AGENTS
40 5861JQ TERBINAFINE 250MG TAB (AUR/AHI) TERBINAFINE TERBINAFINE 50'S A 16.39 0.33 TABLET 28 TAB AUR AUROCHEM LABORATORIES AHI ARMSTRONG HEALTHCARE INC 081404 ALLYAMINES 2022-04-01 2024-03-31 Oral 6 ANTI-INFECTIVE AGENTS
40 5861JW FLUCONAZOLE 200MG TAB (FSB/ATB) FLUCONAZOLE FLUCONAZOLE 10'S A 3.64 0.36 TABLET 60 TAB FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 081408 AZOLES 2022-04-01 2024-03-31 Add to Contract as Cat A Oral 6 ANTI-INFECTIVE AGENTS 2021-12-03
41 5861KB APO-TERBINAFINE 250MG TAB (APO) TERBINAFINE APO-TERBINAFINE 30'S A 10.3 0.3434 TAB 28 BOX APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 081404 ALLYAMINES 2024-04-01 2026-03-31 ORAL 6 ALLYAMINES
41 5861KG ITRACONAZOLE 100MG CAP (RYV) ITRACONAZOLE ITRACONAZOLE 30'S A 13.51 0.4503 CAP 12 BOX RYV RYVIS PHARMA PVT. LTD ATB ANSA TRADING BARBADOS LTD 081408 AZOLES 2024-04-01 2026-03-31 ORAL AZOLES
41 5861KH FLUCONA-DENK 150MG CAP (EDK) FLUCONAZOLE FLUCONAZOLE FLUCONA-DENK 10'S A 2.04 0.2039 CAP 60 BOX EDK DENK PHARMA GMBH & CO. KG. SBI MASSY DISTRIBUTION (BDOS) LTD 081408 AZOLES 2024-04-01 2024-07-29 ORAL 6 AZOLES 2024-06-17
42 5861KK CANESORAL 150MG CAP (BSP) FLUCONAZ (C) FLUCONAZOLE CANESORAL 1'S C 4.89 4.89 CAP 60 BOX BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 081408 AZOLES 2026-04-01 Add to Contract as Cat C ORAL 6 AZOLES 2026-02-11