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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 31712 ENBREL 50MG INJ (PFI/STO) ETANERCEPT ETANERCEPT ENBREL 4X50MG C 2,966.78 741.70 INJECTION 0 PFS PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 9200 UNCLASSIFIED THERAPEUTIC AGENTS 2022-04-01 2024-03-31 IV 0 UNCLASSIFIED THERAPEUTIC AGENTS
41 31712 ENBREL 50MG INJ (PFI) ETANERCEPT (C) ETANERCEPT ENBREL 4X50MG C 2995.86 748.9662 PFS 1 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 9200 UNCLASSIFIED THERAPEUTIC AGENTS 2024-04-01 2026-03-31 IV 6 UNCLASSIFIED THERAPEUTIC AGENTS
42 31712 ENBREL 50MG/ML INJ (PFI) ETANERCEP (C) ETANERCEPT ENBREL 4X50MG C 2,995.87 748.97 PFS 0 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 9200 UNCLASSIFIED THERAPEUTIC AGENTS 2026-04-01 IV 0 UNCLASSIFIED THERAPEUTIC AGENTS
41 3171B ERELZI 50MG INJ SOLN (BCH) ETANERCEPT (C) ETANERCEPT ERELZI 4X50MG C 1596.83 399.2063 BOX 1 PFS BCH SANDOZ COL COLLINS LTD 9236 DISEASE MODIFYING ANTIRHEUMATIC AGENTS 2024-04-01 2026-03-31 SC 6 DISEASE MODIFYING ANTIRHEUMATIC AGENTS
42 3171B ERELZI 50MG/ML SOLN FOR INJ (BCH) (C) ETANERCEPT ERELZI 4X50MG C 1,596.83 399.21 PFS 0 PFS BCH SANDOZ COL AVENTA BARBADOS 9236 DISEASE MODIFYING ANTIRHEUMATIC AGENTS 2026-04-01 SC 0 DISEASE MODIFYING ANTIRHEUMATIC AGENTS