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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 A3223 PAXIL 20MG TAB (GSK/COL) PAROXETINE PAROXETINE PAXIL 30'S C 91.39 3.05 TABLET 0 TAB GSK GLAXOSMITHKLINE COL COLLINS LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 A3223 PAXIL 20MG TAB (GSK) PAROXETINE (C) PAROXETINE PAXIL 30'S C 100.5 3.3499 TAB 42 BOX GSK GLAXOSMITHKLINE COL COLLINS LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
42 A3223 PAXIL 20MG TAB (GSK) PAROXETINE PAROXETINE PAXIL 30'S C 105.55 3.52 TAB 42 BLIS GSK GLAXOSMITHKLINE COL AVENTA BARBADOS 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2026-04-01 2028-03-31 ORAL 6 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
40 A3224 APO-CITALOPRAM 20MG TAB (APO/COL) CITALOPRAM APO-CITALOPRAM 30'S A 6.80 0.23 TABLET 30 TAB APO APOTEX INC. COL COLLINS LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
40 A322AA APO-SERTRALINE 50MG CAP (APO/COL) SERTRALINE APO-SERTRALINE 100'S A 11.91 0.12 CAPSULE 30 CAP APO APOTEX INC. COL COLLINS LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
40 A322AF ZOLOFT 50MG TAB (PFI/STO) SERTRALINE SERTRALINE ZOLOFT 14'S C 19.49 1.39 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 A322AF ZOLOFT 50MG TAB (PFI) SERTRALINE (C) SERTRALINE ZOLOFT 14'S C 19.68 1.4058 TAB 42 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
40 A322AQ PAXIL CR 25MG TAB (GSK/COL) PAROXETINE PAROXETINE PAXIL CR 30'S BP 91.39 3.05 TABLET 0 TAB GSK GLAXOSMITHKLINE COL COLLINS LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
41 A322AQ PAXIL 25MG CR TAB (GSK) PAROXETINE PAROXETINE PAXIL 30'S BP 96.88 3.2294 TABCR 42 BOX GSK GLAXOSMITHKLINE COL COLLINS LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
42 A322AQ PAXIL 25MG CR TAB (GSK) PAROXETINE PAROXETINE PAXIL 30'S C 101.75 3.39 TAB 42 BLIS GSK GLAXOSMITHKLINE COL AVENTA BARBADOS 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2026-04-01 2028-03-31 ORAL 6 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
40 A322AY ZOLOFT 100MG TAB (PFI/STO) SERTRALINE SERTRALINE ZOLOFT 14'S C 29.25 2.09 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 A322AY ZOLOFT 100MG TAB (PFI) SERTRALINE (C) SERTRALINE ZOLOFT 14'S C 29.49 2.1067 TAB 42 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
40 A322BB PAXIL CR 12.5MG CAP (GSK/COL) PAROXETINE PAROXETINE PAXIL CR 30'S BP 48.25 1.61 CAPSULE 0 CAP GSK GLAXOSMITHKLINE COL COLLINS LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
41 A322BB PAXIL 12.5MG CR CAP (GSK) PAROXETINE (BP) PAROXETINE PAXIL 30'S BP 51.4 1.7134 CAPCR 0 BOX GSK GLAXOSMITHKLINE COL COLLINS LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2024-04-01 2026-03-31 ORAL 0 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
41 A322BT VENLAFAXINE 150MG SR TAB (CIP) (BP) VENLAFAXINE VENLAFAXINE 100'S BP 125.75 1.2575 TABSR 0 BOX CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 28160416 SELECTIVE SEROTONIN/NOREPINEPHRINE REUPTAKE INHIBITORS 2024-04-01 2026-03-31 ORAL 0 SELECTIVE SEROTONIN/NOREPINEPHRINE REUPTAKE
42 A322BT VENLAFAXINE 150MG SR TAB (CIP) VENLAFAXINE VENLAFAXINE 100'S BP 128.03 1.28 TAB 0 BLIS CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 28160416 SELECTIVE SEROTONIN/NOREPINEPHRINE REUPTAKE INHIBITORS 2026-04-01 2028-03-31 ORAL 0 SELECTIVE SEROTONIN/NOREPINEPHRINE REUPTAKE
41 A322BU VENLAFAXINE 75MG SR TAB (CIP) (BP) VENLAFAXINE VENLAFAXINE 100'S BP 64.42 0.6442 TABSR 0 BOX CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 28160416 SELECTIVE SEROTONIN/NOREPINEPHRINE REUPTAKE INHIBITORS 2024-04-01 2026-03-31 ORAL 0 SELECTIVE SEROTONIN/NOREPINEPHRINE REUPTAKE
42 A322BU VENLAFAXINE 75MG SR TAB (CIP) VENLAFAXINE VENLAFAXINE 100'S BP 71.68 0.72 TAB 0 BLIS CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 28160416 SELECTIVE SEROTONIN/NOREPINEPHRINE REUPTAKE INHIBITORS 2026-04-01 2028-03-31 ORAL 0 SELECTIVE SEROTONIN/NOREPINEPHRINE REUPTAKE
40 A322CJ APO-SERTRALINE 100MG CAP (APO/COL) SERTRALINE APO-SERTRALINE 100'S A 19.03 0.19 CAPSULE 30 CAP APO APOTEX INC. COL COLLINS LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
42 A322CJ APO-SERTRALINE 100MG CAP (APO) SERTRALINE APO-SERTRALINE 100'S A 19.41 0.19 CAP 42 BOTT APO APOTEX INC. COL AVENTA BARBADOS 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2026-04-01 2028-03-31 ORAL 6 SELECTIVE SEROTONIN REUPTAKE INHIBITORS