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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 B271G VILDAGLIPTIN 50MG TAB (MCP) (B) VILDAGLIPTIN VILDAGLIPTIN 3X10 B 11.15 0.3715 TAB 60 BOX MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC B 682005 DIPEPTIDYL PEPTIDASE INHIBITORS 2024-04-01 2024-05-14 ORAL 6 DIPEPTIDYL PEPTIDASE INHIBITORS 2024-04-02
41 B271R VILDAGLIPTIN 50MG TAB (MCP) VILDAGLIPTIN VILDAGLIPTIN 56'S B 22.29 0.398 TAB 60 BOX MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC B 682005 DIPEPTIDYL PEPTIDASE INHIBITORS 2024-04-03 2026-03-31 ORAL 6 DIPEPTIDYL PEPTIDASE INHIBITORS 2024-04-03
40 B4213 JARDIANCE 10MG TAB (BOE/STO) EMPAGLIFLOZIN EMPAGLIFLOZIN JARDIANCE 30'S A 67.25 2.24 TABLET 60 TAB BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2022-04-01 2024-03-31 Oral 6 HORMONES AND SYNTHETIC SUBSTITUTES
41 B4213 JARDIANCE 10MG TAB (BOE) EMPAGLIFLOZIN EMPAGLIFLOZIN JARDIANCE 30'S A 67.25 2.2417 TAB 60 BOX BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2024-04-01 2026-03-31 ORAL 6 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR
42 B4213 JARDIANCE 10MG TAB (BOE) EMPAGLIFLOZIN EMPAGLIFLOZIN JARDIANCE 30'S A 67.25 2.24 TAB 60 BLIS BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2026-04-01 2028-03-31 ORAL 6 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR
40 B4214 JARDIANCE 25MG TAB (BOE/STO) EMPAGLIFLOZIN EMPAGLIFLOZIN JARDIANCE 30'S A 67.25 2.24 TABLET 30 TAB BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2022-04-01 2024-03-31 Oral 6 HORMONES AND SYNTHETIC SUBSTITUTES
41 B4214 JARDIANCE 25MG TAB (BOE) EMPAGLIFLOZIN EMPAGLIFLOZIN JARDIANCE 30'S A 67.25 2.2417 TAB 30 BOX BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2024-04-01 2026-03-31 ORAL 6 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR
42 B4214 JARDIANCE 25MG TAB (BOE) EMPAGLIFLOZIN EMPAGLIFLOZIN JARDIANCE 30'S A 67.25 2.24 TAB 30 BLIS BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2026-04-01 2028-03-31 ORAL 6 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR
41 B4217 FORXIGA 10MG TAB (AZN) DAPAGLIFLOZI DAPAGLIFLOZIN FORXIGA 30'S A 61.6 2.0532 TAB 30 BOX AZN ASTRAZENECA AB COL COLLINS LTD B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2024-04-01 2024-06-30 ORAL 6 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2024-03-13
41 B4217 FORXIGA 10MG TAB (AZN) DAPAGLIFLOZI DAPAGLIFLOZIN FORXIGA 30'S B 61.6 2.0533 TAB 30 BOX AZN ASTRAZENECA AB COL COLLINS LTD B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2024-08-16 2026-03-31 ORAL 6 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2024-08-16
42 B4217 FORXIGA 10MG TAB (AZN) DAPAGLIFLOZI DAPAGLIFLOZIN FORXIGA 30'S C 61.60 2.05 TAB 30 BLIS AZN ASTRAZENECA AB COL AVENTA BARBADOS B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2026-04-01 2028-03-31 ORAL 6 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR
41 B4218 FORXIGA 5MG TAB (AZN) DAPAGLIFLOZIN DAPAGLIFLOZIN FORXIGA 30'S A 61.6 2.0532 TAB 30 BOX AZN ASTRAZENECA AB COL COLLINS LTD B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2024-04-01 2024-04-24 ORAL 6 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2024-03-13
41 B4218 FORXIGA 5MG TAB (AZN) DAPAGLIFLOZIN DAPAGLIFLOZIN FORXIGA 30'S B 61.6 2.0533 TAB 30 BOX AZN ASTRAZENECA AB COL COLLINS LTD B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2024-08-16 2026-03-31 ORAL 6 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2024-08-16
42 B4218 FORXIGA 5MG TAB (AZN) DAPAGLIFLOZIN DAPAGLIFLOZIN FORXIGA 30'S C 61.60 2.05 TAB 30 BLIS AZN ASTRAZENECA AB COL AVENTA BARBADOS B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2026-04-01 2028-03-31 ORAL 6 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR
41 B421A DAPAGLIFLOZIN 10MG TAB (KWA) DAPAGLIFLOZIN DAPAGLIFLOZIN 28'S A 7.77 0.2777 TAB 30 BOTT KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2024-04-01 2026-03-31 ORAL 6 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR
42 B421AA APO-DAPAGLIFLOZIN 10MG TAB (APO) DAPAGLIFLOZIN APO-DAPAGLIFLOZIN 30'S A 12.40 0.41 TAB 30 BOTT APO APOTEX INC. COL AVENTA BARBADOS B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2026-04-01 2028-03-31 ORAL 6 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR
42 B421AB APO-DAPAGLIFLOZIN 5MG TAB (APO) DAPAGLIFLOZIN APO-DAPAGLIFLOZIN 30'S A 10.33 0.34 TAB 30 BOTT APO APOTEX INC. COL AVENTA BARBADOS B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2026-04-01 2028-03-31 ORAL 6 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR
41 B421H DAPAGLIFLOZIN 5MG TAB (MCP) DAPAGLIFLOZIN DAPAGLIFLOZIN 3X10 A 10.33 0.3443 TAB 30 BOX MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2024-04-01 2024-10-31 ORAL 6 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2024-09-19
41 B421M DAPAGLIFLOZIN 5MG TAB (MCP) DAPAGLIFLOZIN DAPAGLIFLOZIN 100'S A 34.44 0.3444 TAB 30 BLIS MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2024-10-29 2026-03-31 ORAL 6 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2024-09-20
40 B4321 CONCOR AM 5MG | 5MG TAB (MEK/COL) AMLODIPINE | BISOPROLOL AMLODIPINE|BISOPROLOL CONCOR AM 30'S C 36.15 1.21 TABLET 0 TAB MEK MERCK SERONO COL COLLINS LTD 240892 HYPOTENSIVE AGENTS, MISCELLANEOUS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS