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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 A661AZ APO-SUMATRIPTAN 100MG TAB (APO) (C) SUMATRIPTAN APO-SUMATRIPTAN 6'S C 7.99 1.332 TAB 0 BOX APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 283228 SELECTIVE SEROTONIN AGONIST 2024-04-01 2026-03-31 ORAL 0 SELECTIVE SEROTONIN AGONIST
41 A661BA PMS-RIZATRIPTAN 10MG TAB (PMS) RIZATRIPTAN PMS-RIZATRIPTAN 6'S A 21.2 3.5338 TAB 14 BOTT PMS PHARMASCIENCE COL COLLINS LTD 283228 SELECTIVE SEROTONIN AGONIST 2024-04-01 2026-03-31 ORAL 6 SELECTIVE SEROTONIN AGONIST
42 A661BA PMS-RIZATRIPTAN 10MG TAB (PMS) RIZATRIPTAN PMS-RIZATRIPTAN 6'S A 18.89 3.15 TAB 14 BOTT PMS PHARMASCIENCE COL AVENTA BARBADOS 283228 SELECTIVE SEROTONIN AGONIST 2026-04-01 2028-03-31 ORAL 6 SELECTIVE SEROTONIN AGONIST
41 A661BD APO-ELETRIPTAN 40MG TAB (APO) (C) ELETRIPTAN HYDROBROMIDE APO-ELETRIPTAN 6'S C 22.18 3.6969 TAB 0 BOX APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 1216 SYMPATHOLYTIC (ADRENERGIC BLOCKING) AGENTS 2024-04-01 2026-03-31 ORAL 0 SYMPATHOLYTIC (ADRENERGIC BLOCKING) AGENTS
42 A661BE RELPAX 40MG TAB (PFI) ELETRIPTAN HYDROBROMIDE ELETRIPTAN HYDROBROMIDE RELPAX 2'S C 24.19 12.10 TAB 0 BLIS PFI PFIZER CORPORATION COL AVENTA BARBADOS 283228 SELECTIVE SEROTONIN AGONIST 2026-04-01 2028-03-31 ORAL 0 SELECTIVE SEROTONIN AGONIST
40 A661D RELPAX 40MG TAB (PFI/STO) ELETRIPTAN HBR ELETRIPTAN HYDROBROMIDE RELPAX 2'S C 23.98 11.99 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 283228 SELECTIVE SEROTONIN AGONIST 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 A661D RELPAX 40MG TAB (PFI) ELETRIPTAN HBR (C) ELETRIPTAN HYDROBROMIDE RELPAX 2'S C 24.19 12.0966 TAB 0 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 283228 SELECTIVE SEROTONIN AGONIST 2024-04-01 2026-03-31 ORAL 0 SELECTIVE SEROTONIN AGONIST
40 A661R RELPAX 40MG TAB (PFI/SBI) ELETRIPTAN HBR ELETRIPTAN HYDROBROMIDE RELPAX 2'S C 23.98 11.99 TABLET 0 TAB PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 283228 SELECTIVE SEROTONIN AGONIST 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 A661R RELPAX 40MG TAB (PFI) ELETRIPTAN HBR (C) ELETRIPTAN HYDROBROMIDE RELPAX 2'S C 24.19 12.0966 TAB 0 BOX PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 283228 SELECTIVE SEROTONIN AGONIST 2024-04-01 2026-03-31 ORAL 0 SELECTIVE SEROTONIN AGONIST
40 A661X APO-SUMATRIPTAN 50MG TAB (APO/COL) SUMATRIPTAN APO-SUMATRIPTAN 6'S C 4.46 0.74 TABLET 0 TAB APO APOTEX INC. COL COLLINS LTD 283228 SELECTIVE SEROTONIN AGONIST 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
42 A661X APO-SUMATRIPTAN 50MG TAB (APO) SUMATRIPTAN APO-SUMATRIPTAN 6'S C 4.54 0.76 TAB 0 BOTT APO APOTEX INC. COL AVENTA BARBADOS 283228 SELECTIVE SEROTONIN AGONIST 2026-04-01 2028-03-31 ORAL 0 SELECTIVE SEROTONIN AGONIST
40 A661Y APO-SUMATRIPTAN 100MG TAB (APO/COL) SUMATRIPTAN APO-SUMATRIPTAN 6'S C 7.83 1.31 TABLET 0 TAB APO APOTEX INC. COL COLLINS LTD 283228 SELECTIVE SEROTONIN AGONIST 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
42 A661Y APO-SUMATRIPTAN 100MG TAB (APO) SUMATRIPTAN APO-SUMATRIPTAN 6'S C 7.99 1.33 TAB 0 BOTT APO APOTEX INC. COL AVENTA BARBADOS 283228 SELECTIVE SEROTONIN AGONIST 2026-04-01 2028-03-31 ORAL 0 SELECTIVE SEROTONIN AGONIST
40 A6711 SINGULAIR 5MG TAB (MSD/STO) MONTELUKAST MONTELUKAST SINGULAIR 30'S C 47.30 1.58 TABLET 0 TAB MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD B 481024 LEUKOTRIENE MODIFIERS 2022-04-01 2024-03-31 Oral 0 RESPIRATORY TRACT AGENTS
41 A6711 SINGULAIR 5MG TAB (MSD/STO) MONTELUKAST (C) MONTELUKAST SINGULAIR 30'S C 47.76 1.592 TAB 30 BOX MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD B 481024 LEUKOTRIENE MODIFIERS 2024-04-01 2026-03-31 ORAL 6 LEUKOTRIENE MODIFIERS
42 A6711 SINGULAIR 5MG TAB (MSD/STO) MONTELUKAST MONTELUKAST SINGULAIR 30'S C 47.76 1.59 TAB 30 BLIS MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD B 481024 LEUKOTRIENE MODIFIERS 2026-04-01 2028-03-31 ORAL 6 LEUKOTRIENE MODIFIERS
40 A6712 SINGULAIR 10MG TAB (MSD/STO) MONTELUKAST MONTELUKAST SINGULAIR 30'S C 47.30 1.58 TABLET 0 TAB MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD B 481024 LEUKOTRIENE MODIFIERS 2022-04-01 2024-03-31 Oral 0 RESPIRATORY TRACT AGENTS
41 A6712 SINGULAIR 10MG TAB (MSD) MONTELUKAST (C) MONTELUKAST SINGULAIR 30'S C 47.76 1.592 TAB 30 BOX MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD B 481024 LEUKOTRIENE MODIFIERS 2024-04-01 2026-03-31 ORAL 6 LEUKOTRIENE MODIFIERS
42 A6712 SINGULAIR 10MG TAB (MSD) MONTELUKAST MONTELUKAST SINGULAIR 30'S C 47.76 1.59 TAB 30 BLIS MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD B 481024 LEUKOTRIENE MODIFIERS 2026-04-01 2028-03-31 ORAL 6 LEUKOTRIENE MODIFIERS
40 A6715 SINGULAIR 4MG TAB (MSD/STO) MONTELUKAST MONTELUKAST SINGULAIR 30'S C 47.30 1.58 TABLET 0 TAB MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD B 481024 LEUKOTRIENE MODIFIERS 2022-04-01 2024-03-31 Oral 0 RESPIRATORY TRACT AGENTS