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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 6131R AAP-CYPROTERONE 50MG TAB (APO/COL) CYPROTERON CYPROTERONE AAP-CYPROTERONE 100'S A 52.68 0.53 TABLET 180 TAB APO APOTEX INC. COL COLLINS LTD B 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 6 ANTINEOPLASTICS
42 6131R AAP-CYPROTERONE 50MG TAB (APO) CYPROTERONE AAP-CYPROTERONE 100'S A 53.71 0.54 TAB 180 BOTT APO APOTEX INC. COL AVENTA BARBADOS B 1000 ANTINEOPLASTICS 2026-04-01 ORAL 6 ANTINEOPLASTICS
41 6131U AAP-CYPROTERONE 50MG TAB (APO) CYPR CYPROTERONE AAP-CYPROTERONE 100'S A 53.71 0.5371 TAB 180 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD B 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 ORAL 6 ANTINEOPLASTICS
40 61321 ANDROCUR 100MG TAB (BSP/AHI) CYPROTERONE CYPROTERONE ANDROCUR 30'S A 62.52 2.08 TABLET 90 TAB BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC B 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 6 ANTINEOPLASTICS
41 61321 ANDROCUR 100MG TAB (BSP) CYPROTERONE CYPROTERONE ANDROCUR 30'S A 62.52 2.084 TAB 90 BOX BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC B 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 ORAL 6 ANTINEOPLASTICS
40 61324 ANDROCUR 100MG TAB (BSP/COL) CYPROTERONE CYPROTERONE ANDROCUR 30'S A 62.52 2.08 TABLET 90 TAB BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD B 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 6 ANTINEOPLASTICS
41 61324 ANDROCUR 100MG TAB (BSP) CYPROTERONE CYPROTERONE ANDROCUR 30'S A 62.52 2.084 TAB 90 BOX BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD B 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 ORAL 6 ANTINEOPLASTICS
42 61324 ANDROCUR 100MG TAB (BSP) CYPROTERONE CYPROTERONE ANDROCUR 30'S C 62.52 2.08 TAB 90 BLIS BSP BAYER SCHERING PHARMA AG. COL AVENTA BARBADOS B 1000 ANTINEOPLASTICS 2026-04-01 ORAL 6 ANTINEOPLASTICS
41 6132D CYPROTERONE 100MG TAB (KWA) CYPROTERONE CYPROTERONE 30'S A 49.91 1.6636 TAB 90 BOTT KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD B 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 ORAL 6 ANTINEOPLASTICS
40 6132E CYPROTERONE 100MG TAB (LDP/AHI) CYPROTERONE CYPROTERONE 30'S A 44.85 1.50 TABLET 90 TAB LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC B 1000 ANTINEOPLASTICS 2022-04-01 2022-09-30 Oral 6 ANTINEOPLASTICS 2022-03-29
41 6132E CYPROTERONE 100MG TAB (LDP) CYPROTERONE CYPROTERONE 30'S A 38.98 1.2994 TAB 90 BOX LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC B 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 ORAL 6 ANTINEOPLASTICS
42 6132E CYPROTERONE 100MG TAB (LDP) CYPROTERONE CYPROTERONE 30'S A 40.34 1.34 TAB 90 BLIS LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC B 1000 ANTINEOPLASTICS 2026-04-01 ORAL 6 ANTINEOPLASTICS
42 6132K CYPROTERONE 100MG TAB (KWA) CYPROTERONE CYPROTERONE 30'S A 43.55 1.45 TAB 90 KWA KWALITY PHARMACEUTICALS STO BRYDEN STOKES LTD B 1000 ANTINEOPLASTICS 2026-04-01 Add to Contract as Cat A ORAL 6 ANTINEOPLASTICS 2026-03-02
40 6202T EPIRUBICIN 50MG INJ (INP/AHI) EPIRUBICIN EPIRUBICIN 25ML VIAL BQ 47.71 47.71 INJECTION 0 VIAL INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 6202W ZEPIRUBIN 2MG/ML INJ (ZUV) EPIRUBICIN (BQ) EPIRUBICIN ZEPIRUBIN 50MG VIAL BQ 36.29 36.2896 VIAL 50 VIAL ZUV ZUVIUS PHA PHARMACY SALES CARIBBEAN 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 6 ANTINEOPLASTICS
42 6202Y ZYRUBIN 2MG/ML INJ PWDR FOR SOLN (ZYD) EPIRUBICIN EPIRUBICIN ZYRUBIN 50ML VIAL BQ 38.17 38.17 VIAL 0 VIAL ZYD ZYDUS AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2026-04-01 IV 0 ANTINEOPLASTICS
41 62115 DORMICUM 5MG/ML INJ (ROC) MIDAZOLAM (B) MIDAZOLAM DORMICUM 5X3ML B 19.03 3.8057 AMP 0 BOX ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 282408 BENZODIAZEPINES (SEDATIVES) 2024-04-01 2026-03-31 INJ 0 BENZODIAZEPINES (SEDATIVES)
42 6211AA HYNOFAST 5MG/ML INJ (INC) MIDAZOLAM MIDAZOLAM HYNOFAST 3ML B 4.89 4.89 VIAL 0 VIAL INC INCEPTA PHARMACEUTICALS LIMITED AHI ARMSTRONG HEALTHCARE INC 282408 BENZODIAZEPINES (SEDATIVES) 2026-04-01 IM 0 BENZODIAZEPINES (SEDATIVES)
40 6211D MIDAZOLAM 5MG/ML INJ (RTM/PHA) MIDAZOLAM MIDAZOLAM 10X3ML B $36.50 2.62 INJECTION 0 AMP RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 282408 BENZODIAZEPINES (SEDATIVES) 2022-04-01 2024-03-31 PRICE CHANGE IV 0 CENTRAL NERVOUS SYSTEM DRUGS 0000-00-00
41 6211D MIDAZOLAM 5MG/ML INJ (RTM) (B) MIDAZOLAM MIDAZOLAM 10X3ML B 24.85 2.485 AMP 0 BOX RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 282408 BENZODIAZEPINES (SEDATIVES) 2024-04-01 2025-01-28 IV 0 BENZODIAZEPINES (SEDATIVES)