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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 A5028 DIOVAN 160MG TAB (NVS/COL) VALSARTAN VALSARTAN DIOVAN 28'S A 18.16 0.65 TABLET 30 TAB NVS NOVARTIS CARIBE SA COL COLLINS LTD B 243208 ANGIOTENSIN II RECEPTOR ANTAGONIST 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
41 A5028 DIOVAN 160MG TAB (NVS) VALSARTAN VALSARTAN DIOVAN 28'S A 18.16 0.6485 TAB 30 BOX NVS NOVARTIS CARIBE SA COL COLLINS LTD B 243208 ANGIOTENSIN II RECEPTOR ANTAGONIST 2024-04-01 2026-03-31 ORAL 6 ANGIOTENSIN II RECEPTOR ANTAGONIST
42 A5028 DIOVAN 160MG TAB (NVS) VALSARTAN VALSARTAN DIOVAN 28'S A 15.58 0.56 TAB 30 BLIS NVS NOVARTIS CARIBE SA COL AVENTA BARBADOS B 243208 ANGIOTENSIN II RECEPTOR ANTAGONIST 2026-04-01 2028-03-31 ORAL 6 ANGIOTENSIN II RECEPTOR ANTAGONIST
40 A5029 DIOVAN 320MG TAB (NVS/COL) VALSARTAN VALSARTAN DIOVAN 28'S A 19.49 0.70 TABLET 30 TAB NVS NOVARTIS CARIBE SA COL COLLINS LTD B 243208 ANGIOTENSIN II RECEPTOR ANTAGONIST 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
41 A5029 DIOVAN 320MG TAB (NVS) VALSARTAN VALSARTAN DIOVAN 28'S A 19.49 0.6961 TAB 30 BOX NVS NOVARTIS CARIBE SA COL COLLINS LTD B 243208 ANGIOTENSIN II RECEPTOR ANTAGONIST 2024-04-01 2026-03-31 ORAL 6 ANGIOTENSIN II RECEPTOR ANTAGONIST
42 A5029 DIOVAN 320MG TAB (NVS) VALSARTAN VALSARTAN DIOVAN 28'S A 19.49 0.70 TAB 30 BLIS NVS NOVARTIS CARIBE SA COL AVENTA BARBADOS B 243208 ANGIOTENSIN II RECEPTOR ANTAGONIST 2026-04-01 2028-03-31 ORAL 6 ANGIOTENSIN II RECEPTOR ANTAGONIST
42 A502AC LOSARTAN 100MG TAB (FSB) LOSARTAN LOSARTAN 30'S A 1.96 0.07 TAB 30 FSB FLAGSHIP BIOTECH STO BRYDEN STOKES LTD B 243208 ANGIOTENSIN II RECEPTOR ANTAGONIST 2026-04-01 2028-03-31 ORAL 6 ANGIOTENSIN II RECEPTOR ANTAGONIST 2026-03-05
40 A502B PMS-LOSARTAN 100MG TAB (PMS/COL) LOSARTAN LOSARTAN 100'S A 24.46 0.24 TABLET 30 TAB PMS PHARMASCIENCE COL COLLINS LTD B 243208 ANGIOTENSIN II RECEPTOR ANTAGONIST 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
41 A502BL LOSARTAN 100MG TAB (KWA) LOSARTAN LOSARTAN 28'S A 2.5 0.0893 TAB 30 BOX KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD B 243208 ANGIOTENSIN II RECEPTOR ANTAGONIST 2024-04-01 2026-03-31 ORAL 6 ANGIOTENSIN II RECEPTOR ANTAGONIST
40 A502CY LOSARTAN 100MG TAB (MCP/AHI) LOSARTAN LOSARTAN 3X10 A 5.60 0.19 TABLET 30 TAB MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC B 243208 ANGIOTENSIN II RECEPTOR ANTAGONIST 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
41 A502DM PRESARTAN 100MG TAB (IPC) LOSARTAN LOSARTAN PRESARTAN 100'S A 6.14 0.0614 TAB 30 BOX IPC IPCA Laboratories Ltd. ATB ANSA TRADING BARBADOS LTD B 243208 ANGIOTENSIN II RECEPTOR ANTAGONIST 2024-04-01 2026-03-31 ORAL 6 ANGIOTENSIN II RECEPTOR ANTAGONIST
40 A5213 SURVANTA 25MG/ML INJ (ABB/PHA) BERACTANT BERACTANT SURVANTA 8ML VIAL BQ 1,043.59 1,043.59 INJECTION 0 VIAL ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 4836 PULMONARTY SURFCTANTS 2022-04-01 2024-03-31 IV 0 RESPIRATORY TRACT AGENTS
41 A5213 SURVANTA 25MG/ML INJ (ABB) BERACTANT (BQ) BERACTANT SURVANTA 8ML VIAL BQ 1042.4 1042.3957 VIAL 50 VIAL ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 4836 PULMONARTY SURFCTANTS 2024-04-01 2026-03-31 IV 0 PULMONARTY SURFCTANTS
42 A5213 SURVANTA 25MG/ML INJ (ABB) BERACTANT BERACTANT SURVANTA 8ML VIAL BQ 992.19 992.19 VIAL 50 VIAL ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 4836 PULMONARTY SURFCTANTS 2026-04-01 2028-03-31 IV 0 PULMONARTY SURFCTANTS
40 A5311 XALATAN 0.005% EYE DR (PFI/STO) LATANOPROST LATANOPROST XALATAN 2.5ML A 11.66 11.66 EYE DROP 1 BOTT PFI PFIZER CORPORATION STO BRYDEN STOKES LTD B 524028 EENT PROSTAGLANDIN ANALOGS 2022-04-01 2024-03-31 Price Change OPHTHALMIC 6 EYE, EAR, NOSE AND THROAT PREPARATIONS 2022-05-03
40 A5319 GLAUCOPROST 0.004% EYE DR (LPO/COL) TRAVOPROS TRAVOPROST GLAUCOPROST 3ML A 10.60 10.60 EYE DROP 1 BOTT LPO LABORATORIOS POEN S.A. COL COLLINS LTD B 524028 EENT PROSTAGLANDIN ANALOGS 2022-04-01 2024-03-31 OPHTHALMIC 6 EYE, EAR, NOSE AND THROAT PREPARATIONS
41 A5319 GLAUCOPROST 0.004% EYE DR (LPO) TRAVOPRO (C) TRAVOPROST GLAUCOPROST 3ML C 11.66 11.6616 BOTT 1 BOTT LPO LABORATORIOS POEN S.A. COL COLLINS LTD B 524028 EENT PROSTAGLANDIN ANALOGS 2024-04-01 2026-03-31 OPHTHALMIC 6 EENT PROSTAGLANDIN ANALOGS
42 A5319 GLAUCOPROST 0.004% EYE DR (LPO) TRAVOPRO TRAVOPROST GLAUCOPROST 3ML C 17.67 17.67 BOTT 1 BOTT LPO LABORATORIOS POEN S.A. COL AVENTA BARBADOS B 524028 EENT PROSTAGLANDIN ANALOGS 2026-04-01 2028-03-31 OPHTHALMIC 6 EENT PROSTAGLANDIN ANALOGS
40 A531AH LOUTEN EMULSION 0.005% EYE DR (LPO/COL) LATAN LATANOPROST LOUTEN EMULSION 2.5ML A 9.08 9.08 EYE DROP 1 BOTT LPO LABORATORIOS POEN S.A. COL COLLINS LTD B 524028 EENT PROSTAGLANDIN ANALOGS 2022-04-01 2024-03-31 OPHTHALMIC 6 EYE, EAR, NOSE AND THROAT PREPARATIONS 2022-02-18
41 A531AH LOUTEN EMULSION 0.005% EYE DR (LPO) LATA LATANOPROST LOUTEN EMULSION 2.5ML A 9.08 9.0792 BOTT 1 BOTT LPO LABORATORIOS POEN S.A. COL COLLINS LTD B 524028 EENT PROSTAGLANDIN ANALOGS 2024-04-01 2026-03-31 OPHTHALMIC 6 EENT PROSTAGLANDIN ANALOGS