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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 0884BV PMS-IPRATROPIUM 0.25MG/ML RESP SOL (PMS) IPRATROPIUM PMS-IPRATROPIUM 20X1ML A 12.37 0.6184 AMPP 1 BOX PMS PHARMASCIENCE COL COLLINS LTD B 48120412 SELECTIVE BETA2 ADRENERGIC AGONIST (RESPIRATORY) 2024-04-01 2026-03-31 ORAL INHALATION 6 SELECTIVE BETA2 ADRENERGIC AGONIST (RESPIRA
41 0884H VENTOLIN 5MG/ML RESP SOL (GSK) SALBUTAMO (C) SALBUTAMOL VENTOLIN 20ML C 12.78 12.7761 BOTT 20 BOTT GSK GLAXOSMITHKLINE COL COLLINS LTD B 48120412 SELECTIVE BETA2 ADRENERGIC AGONIST (RESPIRATORY) 2024-04-01 2026-03-31 INHALATION 6 SELECTIVE BETA2 ADRENERGIC AGONIST (RESPIRA
42 0884H VENTOLIN 5MG/ML RESP SOL (GSK) SALBUTAMO SALBUTAMOL VENTOLIN 20ML C 13.40 13.40 BOTT 20 BOTT GSK GLAXOSMITHKLINE COL AVENTA BARBADOS B 48120412 SELECTIVE BETA2 ADRENERGIC AGONIST (RESPIRATORY) 2026-04-01 Price Change INHALATION 6 SELECTIVE BETA2 ADRENERGIC AGONIST (RESPIRA 2026-02-16
40 08867 SALBUTAMOL 0.5MG/ML INJ (STP/COL) SALBUTAMOL SALBUTAMOL 100X1ML B 157.66 1.58 INJECTION 0 VIAL STP STEROP LABORATORIES COL COLLINS LTD 48120412 SELECTIVE BETA2 ADRENERGIC AGONIST (RESPIRATORY) 2022-04-01 2024-03-31 IV 0 RESPIRATORY TRACT AGENTS
41 08867 SALBUTAMOL 0.5MG/ML INJ (STP) (B) SALBUTAMOL SALBUTAMOL 100X1ML B 163.1 1.631 VIAL 0 BOX STP STEROP LABORATORIES COL COLLINS LTD 48120412 SELECTIVE BETA2 ADRENERGIC AGONIST (RESPIRATORY) 2024-04-01 2026-03-31 IV 0 SELECTIVE BETA2 ADRENERGIC AGONIST (RESPIRA
40 09116 SPIRIVA RESPIMAT 2.5MCG INHR (BOE/STO) TIOTRO TIOTROPIUM SPIRIVA RESPIMAT 60 DOSES BQ 111.29 111.29 INHALER 0 INHR BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD 481208 ANTICHOLINERGIC AGENTS (RESPIRATORY) 2022-04-01 2024-03-31 ORAL INHALATION 6 RESPIRATORY TRACT AGENTS
41 09116 SPIRIVA RESPIMAT 2.5MCG INHR (BOE) TIOTR (BQ) TIOTROPIUM SPIRIVA RESPIMAT 60 DOSES BQ 121.59 121.5906 INHR 1 BOX BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD 481208 ANTICHOLINERGIC AGENTS (RESPIRATORY) 2024-04-01 2026-03-31 ORAL INHALATION 6 ANTICHOLINERGIC AGENTS (RESPIRATORY)
42 09116 SPIRIVA RESPIMAT 2.5MCG INHR (BOE) TIOTR TIOTROPIUM SPIRIVA RESPIMAT 60 DOSES BQ 121.59 121.59 INHR 1 BOX BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD 481208 ANTICHOLINERGIC AGENTS (RESPIRATORY) 2026-04-01 ORAL INHALATION 0 ANTICHOLINERGIC AGENTS (RESPIRATORY)
40 09118 SPIOLTO RESPIMAT 2.5/2.5MCG INHR (BOE/STO) TI OLODATEROL|TIOTROPIUM SPIOLTO RESPIMAT 60 DOSES BQ 111.29 111.29 INHALER 1 INHR BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD 481208 ANTICHOLINERGIC AGENTS (RESPIRATORY) 2022-04-01 2024-03-31 ORAL INHALATION 6 RESPIRATORY TRACT AGENTS
41 09118 SPIOLTO RESPIMAT 2.5MCG|2.5MCG INHR (BOE) OLODATEROL|TIOTROP (BQ) OLODATEROL|TIOTROPIUM SPIOLTO RESPIMAT 60 DOSES BQ 121.59 121.5906 INHR 1 BOX BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD 481208 ANTICHOLINERGIC AGENTS (RESPIRATORY) 2024-04-01 2026-03-31 ORAL INHALATION 6 ANTICHOLINERGIC AGENTS (RESPIRATORY)
42 09118 SPIOLTO RESPIMAT 2.5MCG|2.5MCG INHR (BOE) OLODATEROL|TIOTROP OLODATEROL|TIOTROPIUM SPIOLTO RESPIMAT 60 DOSES BQ 121.59 121.59 INHR 1 BOX BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD 481208 ANTICHOLINERGIC AGENTS (RESPIRATORY) 2026-04-01 ORAL INHALATION 0 ANTICHOLINERGIC AGENTS (RESPIRATORY)
42 09121 PMS-IPRATROPIUM 0.25MG/ML RESP SOL (PMS) IPRATROPIUM PMS-IPRATROPIUM 20X1ML A 11.55 0.58 AMPP 1 AMPP PMS PHARMASCIENCE AVENTA BARBADOS B 481208 ANTICHOLINERGIC AGENTS (RESPIRATORY) 2026-04-01 ORAL INHALATION 6 ANTICHOLINERGIC AGENTS (RESPIRATORY)
42 09122 IPRAVENT 0.25MG/ML RESP SOL (CIP) IPRATROPIUM IPRATROPIUM IPRAVENT 15ML A 3.23 3.23 BOTT 1 BOTT CIP CIPLA LTD ARMSTRONG HEALTHCARE INC B 481208 ANTICHOLINERGIC AGENTS (RESPIRATORY) 2026-04-01 ORAL INHALATION 6 ANTICHOLINERGIC AGENTS (RESPIRATORY)
41 09415 PANCURONIUM BROMIDE 2MG/ML INJ (CIR (B) PANCURONIUM BROMIDE PANCURONIUM BROMIDE 10X2ML B 52.3 5.2301 AMP 0 BOX CIR CIRON PHARMA AHI ARMSTRONG HEALTHCARE INC 122020 NEUROMUSCULAR BLOCKING AGENTS 2024-04-01 2026-03-31 IV 0 NEUROMUSCULAR BLOCKING AGENTS
40 0941F PANCURONIUM BROMIDE 2MG/ML INJ (RTM/PHA) PANCURONIUM BROMIDE PANCURONIUM BROMIDE 5X2ML BQ 40.23 8.05 INJECTION 0 AMP RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 122020 NEUROMUSCULAR BLOCKING AGENTS 2022-04-01 2024-03-31 IV 0 AUTONOMIC DRUGS
41 0941F PANCURONIUM BROMIDE 2MG/ML INJ (RTM (B) PANCURONIUM BROMIDE PANCURONIUM BROMIDE 5X2ML B 114.63 22.9263 AMP 0 BOX RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 122020 NEUROMUSCULAR BLOCKING AGENTS 2024-04-01 2026-03-31 IV 0 NEUROMUSCULAR BLOCKING AGENTS
42 0941F PANCURONIUM BROMIDE 2MG/ML INJ (RTM PANCURONIUM BROMIDE PANCURONIUM BROMIDE 5X2ML BQ 81.55 16.31 AMPG 0 BOX RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 122020 NEUROMUSCULAR BLOCKING AGENTS 2026-04-01 IV 0 NEUROMUSCULAR BLOCKING AGENTS
40 0951L SUXAMETHONIUM 50MG/ML INJ (SLS/AHI) SUXAMETHONIUM SUXAMETHONIUM 10X10ML B 43.11 4.31 INJECTION 0 VIAL SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 122020 NEUROMUSCULAR BLOCKING AGENTS 2022-04-01 2024-03-31 IV 0 AUTONOMIC DRUGS
41 0951N LASULINE PLUS 50MG/ML INJ (LDP) SUXAMETHONIUM SUXAMETHONIUM LASULINE 10X10ML B 133.74 13.3742 VIAL 100 BOX LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 122020 NEUROMUSCULAR BLOCKING AGENTS 2024-04-01 2026-03-31 IV/IM 0 NEUROMUSCULAR BLOCKING AGENTS
40 09712 IFA 40MG | 0.04MG SYR (CAR/COL) FERROUS SULPHAT FERROUS SULPHATE|FOLIC ACID IFA 125ML A 8.05 0.06 SYRUP 375 ML CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 200404 IRON PREPARATIONS 2022-04-01 2024-03-31 Oral 6 BLOOD FORMATION, COAGULATION AND THROMBOSIS