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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 A322CL ZOLOFT 100MG TAB (PFI/SBI) SERTRALINE SERTRALINE ZOLOFT 14'S C 29.25 2.09 TABLET 0 TAB PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 A322CL ZOLOFT 100MG TAB (PFI) SERTRALINE (C) SERTRALINE ZOLOFT 14'S C 29.49 2.1067 TAB 42 BOX PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
40 A322CM ZOLOFT 50MG TAB (PFI/SBI) SERTRALINE SERTRALINE ZOLOFT 14'S C 19.49 1.39 TABLET 0 TAB PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 A322CM ZOLOFT 50MG TAB (PFI) SERTRALINE (C) SERTRALINE ZOLOFT 14'S C 19.68 1.4058 TAB 42 BOX PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
42 A322EN PMS-CITALOPRAM 20MG TAB (PMS) CITALOPRAM PMS-CITALOPRAM 100'S A 11.55 0.12 TAB 42 BOTT PMS PHARMASCIENCE COL AVENTA BARBADOS 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2026-04-01 2028-03-31 ORAL 6 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
40 A322FC APO-PAROXETINE 20MG TAB (APO/COL) PAROXETINE APO-PAROXETINE 100'S A 24.93 0.25 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
42 A322FC APO-PAROXETINE 20MG TAB (APO) PAROXETINE APO-PAROXETINE 100'S A 25.42 0.25 TAB 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
40 A322FQ LEXAPRO 10MG TAB (LUN/COL) ESCITALOPRAM ESCITALOPRAM LEXAPRO 28'S C 90.76 3.24 TABLET 0 TAB LUN H. LUNDBECK & CO. A/S COL COLLINS LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
40 A322FZ PRISTIQ 50MG TAB (PFI/STO) DESVENLAFAXINE DESVENLAFAXINE PRISTIQ 28'S C 95.49 3.41 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 A322FZ PRISTIQ 50MG TAB (PFI) DESVENLAFAXINE (C) DESVENLAFAXINE PRISTIQ 28'S C 96.45 3.4445 TAB 0 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2024-04-01 2026-03-31 ORAL 0 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
42 A322FZ PRISTIQ 50MG TAB (PFI) DESVENLAFAXI DESVENLAFAXINE PRISTIQ 28'S C 96.45 3.44 TAB 0 BLIS PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2026-04-01 2028-03-31 ORAL 0 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
40 A322GA EFFEXOR XR 150MG CAP (PFI/STO) VENLAFAXINE VENLAFAXINE EFFEXOR XR 14'S C 67.80 4.84 CAPSULE 0 CAP PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 28160416 SELECTIVE SEROTONIN/NOREPINEPHRINE REUPTAKE INHIBITORS 2022-04-01 2022-08-23 Delete from contract Oral 0 CENTRAL NERVOUS SYSTEM DRUGS 2022-07-12
40 A322GB EFFEXOR XR 75MG CAP (PFI/STO) VENLAFAXINE VENLAFAXINE EFFEXOR XR 14'S C 67.80 4.84 CAPSULE 0 CAP PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 28160416 SELECTIVE SEROTONIN/NOREPINEPHRINE REUPTAKE INHIBITORS 2022-04-01 2022-08-23 Delete from contract Oral 0 CENTRAL NERVOUS SYSTEM DRUGS 2022-07-12
40 A322HL FLUOXETINE 20MG CAP (APL/AHI) FLUOXETINE FLUOXETINE 100'S A 11.20 0.11 CAPSULE 120 CAP APL AUROBINDO PHARMA LTD. AHI ARMSTRONG HEALTHCARE INC 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
42 A322HX APO-ESCITALOPRAM 10MG TAB (APO) ESC ESCITALOPRAM APO-ESCITALOPRAM 100'S C 14.98 0.15 TAB 0 BOTT APO APOTEX INC. COL AVENTA BARBADOS 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2026-04-01 2028-03-31 ORAL 0 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
40 A322JN FLUNIL 20MG TAB (INP/AAL) FLUOXETINE FLUOXETINE FLUNIL 30'S C 5.98 0.20 TABLET 0 TAB INP INTAS PHARMACEUTICALS LTD AAL A. A. LAQUIS LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 A322JN FLUNIL 20MG TAB (INP) FLUOXETINE FLUOXETINE FLUNIL 30'S A 2.39 0.0797 TAB 42 BOX INP INTAS PHARMACEUTICALS LTD AAL A. A. LAQUIS LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
40 A322JQ APO-ESCITALOPRAM 20MG TAB (APO/COL) ESCITALOPRAM APO-ESCITALOPRAM 30'S C 8.97 0.30 TABLET 0 TAB APO APOTEX INC. COL COLLINS LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
40 A322JR APO-ESCITALOPRAM 10MG TAB (APO/COL) ESCITALOPRAM APO-ESCITALOPRAM 30'S C 4.49 0.15 TABLET 0 TAB APO APOTEX INC. COL COLLINS LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
40 A322JU CIPRAMIL 20MG TAB (LUN/COL) CITALOPRAM CITALOPRAM CIPRAMIL 14'S C 48.09 3.44 TABLET 0 TAB LUN H. LUNDBECK & CO. A/S COL COLLINS LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS