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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
42 1134BD ATORVASTATIN 80MG TAB (MOR) ATORVASTATIN ATORVASTATIN 30'S A 3.04 0.10 TAB 30 BLIS MOR MORACEAE CWS CAPSULE WHOLESALE 240608 HMG-CoA REDUCTASE INHIBITORS 2026-04-01 ORAL 6 HMG-CoA REDUCTASE INHIBITORS
41 1134W ATORVASTATIN 80MG TAB (FSB) ATORVASTATIN ATORVASTATIN 10X10 A 13.59 0.1359 TAB 30 BOX FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 240608 HMG-CoA REDUCTASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 HMG-CoA REDUCTASE INHIBITORS
40 1134Y CRESTOR 40MG TAB (AZN/COL) ROSUVASTATIN ROSUVASTATIN CRESTOR 30'S C 46.24 1.54 TABLET 0 TAB AZN ASTRAZENECA AB COL COLLINS LTD 240608 HMG-CoA REDUCTASE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 1134Y CRESTOR 40MG TAB (AZN) ROSUVASTATIN (C) ROSUVASTATIN CRESTOR 30'S C 46.24 1.5413 TAB 30 BOX AZN ASTRAZENECA AB COL COLLINS LTD 240608 HMG-CoA REDUCTASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 HMG-CoA REDUCTASE INHIBITORS
42 1134Y CRESTOR 40MG TAB (AZN) ROSUVASTATIN ROSUVASTATIN CRESTOR 30'S C 46.24 1.54 TAB 30 BLIS AZN ASTRAZENECA AB COL AVENTA BARBADOS 240608 HMG-CoA REDUCTASE INHIBITORS 2026-04-01 ORAL 6 HMG-CoA REDUCTASE INHIBITORS
41 11519 GEMFIBROZIL 300MG TAB (KWA) GEMFIBROZIL GEMFIBROZIL 100'S A 27.1832 0.2718 TAB 60 BOX KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 240606 FIBRIC ACID DERIVATIVES 2024-04-01 2026-03-31 ORAL 6 FIBRIC ACID DERIVATIVES
42 1151B TRILIPIX 135MG DR CAP (ABB) FENOFIBRATE FENOFIBRATE TRILIPIX 3X10 C 89.70 2.99 CAP 0 BLIS ABB ABBOTT SBI MASSY DISTRIBUTION (BDOS) LTD 240606 FIBRIC ACID DERIVATIVES 2026-04-01 ORAL 0 FIBRIC ACID DERIVATIVES
40 11529 GEMFIBROZIL 600MG TAB (CIP/AHI) GEMFIBROZIL GEMFIBROZIL 60'S B 40.86 0.68 TABLET 60 TAB CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 240606 FIBRIC ACID DERIVATIVES 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
41 11529 GEMFIBROZIL 600MG TAB (CIP) GEMFIBROZIL GEMFIBROZIL 60'S B 40.86 0.6809 TAB 60 BOX CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 240606 FIBRIC ACID DERIVATIVES 2024-04-01 2026-03-31 ORAL 6 FIBRIC ACID DERIVATIVES
42 11529 GEMFIBROZIL 600MG TAB (CIP) GEMFIBROZIL GEMFIBROZIL 60'S C 40.91 0.68 TAB 60 BLIS CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 240606 FIBRIC ACID DERIVATIVES 2026-04-01 ORAL 6 FIBRIC ACID DERIVATIVES
40 11613 HYDRALLAZINE 25MG TAB (REM/SBI) HYDRALLAZINE HYDRALLAZINE 10X10 A 6.28 0.06 TABLET 120 TAB REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD B 240820 DIRECT VASODILATOR 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
41 11613 HYDRALLAZINE 25MG TAB (REM) HYDRALLAZINE HYDRALLAZINE 10X10 A 7.07 0.0707 TAB 120 BOX REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD B 240820 DIRECT VASODILATOR 2024-04-01 2026-03-31 ORAL 6 DIRECT VASODILATOR
40 11615 APO-HYDRALLAZINE 25MG TAB (APO/COL) HYDRALLAZINE APO-HYDRALLAZINE 100'S A 7.20 0.07 TABLET 120 TAB APO APOTEX INC. COL COLLINS LTD B 240820 DIRECT VASODILATOR 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
42 11615 APO-HYDRALLAZINE 25MG TAB (APO) HYDRALLAZINE APO-HYDRALLAZINE 100'S A 6.42 0.06 TAB 120 BOTT APO APOTEX INC. COL AVENTA BARBADOS B 240820 DIRECT VASODILATOR 2026-04-01 ORAL 6 DIRECT VASODILATOR
41 1161AA HYDRALLAZINE 25MG TAB (LDP) HYDRALLAZINE HYDRALLAZINE 250'S A 14.87 0.0595 TAB 120 BOTT LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC B 240820 DIRECT VASODILATOR 2024-04-01 2026-03-31 ORAL 6 DIRECT VASODILATOR
41 1161AC APO-HYDRALLAZINE 25MG TAB (APO) HYDRALLAZINE APO-HYDRALLAZINE 100'S A 6.42 0.0642 TAB 120 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD B 240820 DIRECT VASODILATOR 2024-04-01 2026-03-31 ORAL 6 DIRECT VASODILATOR
42 1161AD HYDRALLAZINE 25MG TAB (FSB) HYDRALLAZINE HYDRALLAZINE 10X10 A 6.14 0.06 TAB 120 FSB FLAGSHIP BIOTECH STO BRYDEN STOKES LTD B 240820 DIRECT VASODILATOR 2026-04-01 Add to Contract as Cat A ORAL 6 DIRECT VASODILATOR 2026-03-05
40 11625 APO-HYDRALLAZINE 50MG TAB (APO/COL) HYDRALLAZINE APO-HYDRALLAZINE 100'S A 16.55 0.17 TABLET 60 TAB APO APOTEX INC. COL COLLINS LTD B 240820 DIRECT VASODILATOR 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
42 11625 APO-HYDRALLAZINE 50MG TAB (APO) HYDRALLAZINE APO-HYDRALLAZINE 100'S A 13.32 0.13 TAB 60 BOTT APO APOTEX INC. COL AVENTA BARBADOS B 240820 DIRECT VASODILATOR 2026-04-01 ORAL 6 DIRECT VASODILATOR
41 1162AA APO-HYDRALAZINE 50MG TAB (APO) HYDRALLAZINE APO-HYDRALAZINE 100'S A 13.32 0.1332 TAB 60 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD B 2408 HYPOTENSIVE AGENTS 2024-04-01 2026-03-31 ORAL 6 HYPOTENSIVE AGENTS