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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 A831AB ARCOXIA 60MG TAB (MSD/STO) ETORICOXIB ETORICOXIB ARCOXIA 14'S C 24.46 1.75 TABLET 0 TAB MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 28080408 CYCLOOXYGENASE-2 (COX2) INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 A831AB ARCOXIA 60MG TAB (MSD) ETORICOXIB (C) ETORICOXIB ARCOXIA 14'S C 24.68 1.763 TAB 0 BOX MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 28080408 CYCLOOXYGENASE-2 (COX2) INHIBITORS 2024-04-01 2026-03-31 ORAL 0 CYCLOOXYGENASE-2 (COX2) INHIBITORS
42 A831AB ARCOXIA 60MG TAB (MSD) ETORICOXIB ETORICOXIB ARCOXIA 14'S C 24.68 1.76 TAB 0 BLIS MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 28080408 CYCLOOXYGENASE-2 (COX2) INHIBITORS 2026-04-01 ORAL 0 CYCLOOXYGENASE-2 (COX2) INHIBITORS
40 A831AD ARCOXIA 90MG TAB (MSD/STO) ETORICOXIB ETORICOXIB ARCOXIA 14'S C 27.18 1.94 TABLET 0 TAB MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 28080408 CYCLOOXYGENASE-2 (COX2) INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
42 A831AD ARCOXIA 90MG TAB (MSD) ETORICOXIB ETORICOXIB ARCOXIA 14'S C 27.43 1.96 TAB 0 BLIS MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 28080408 CYCLOOXYGENASE-2 (COX2) INHIBITORS 2026-04-01 ORAL 0 CYCLOOXYGENASE-2 (COX2) INHIBITORS
40 A831AF ARCOXIA 120MG TAB (MSD/STO) ETORICOXIB ETORICOXIB ARCOXIA 14'S C 48.52 3.47 TABLET 0 TAB MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 28080408 CYCLOOXYGENASE-2 (COX2) INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 A831AF ARCOXIA 120MG TAB (MSD) ETORICOXIB (C) ETORICOXIB ARCOXIA 14'S C 49.01 3.5008 TAB 0 BOX MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 28080408 CYCLOOXYGENASE-2 (COX2) INHIBITORS 2024-04-01 2026-03-31 ORAL 0 CYCLOOXYGENASE-2 (COX2) INHIBITORS
42 A831AF ARCOXIA 120MG TAB (MSD) ETORICOXIB ETORICOXIB ARCOXIA 14'S C 49.01 3.50 TAB 0 BLIS MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 28080408 CYCLOOXYGENASE-2 (COX2) INHIBITORS 2026-04-01 ORAL 0 CYCLOOXYGENASE-2 (COX2) INHIBITORS
41 A831DG ARCOXIA 90MG TAB (MSD) ETORICOXIB (C) ETORICOXIB ARCOXIA 14'S C 27.43 1.9591 TAB 0 BOX MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 ORAL 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
40 A831EW ETOVAN 60MG TAB (ARP/AHI) ETORICOXIB ETORICOXIB ETOVAN 3X10 C 14.33 0.48 TABLET 0 TAB ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC 28080408 CYCLOOXYGENASE-2 (COX2) INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
40 A831EX ETOVAN 90MG TAB (ARP/AHI) ETORICOXIB ETORICOXIB ETOVAN 2X15 C 11.04 0.37 TABLET 0 TAB ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC 28080408 CYCLOOXYGENASE-2 (COX2) INHIBITORS 2022-04-01 2022-07-13 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
40 A831EX ETOVAN 90MG TAB (ARP/AHI) ETORICOXIB ETORICOXIB ETOVAN 2X15 C 16.55 0.55 TABLET 0 TAB ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC 28080408 CYCLOOXYGENASE-2 (COX2) INHIBITORS 2022-07-14 2024-03-31 Price Change Oral 0 CENTRAL NERVOUS SYSTEM DRUGS 2022-07-13
40 A831EY ETOVAN 120MG TAB (ARP/AHI) ETORICOXIB ETORICOXIB ETOVAN 2X10 C 11.04 0.55 TABLET 0 TAB ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC 28080408 CYCLOOXYGENASE-2 (COX2) INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 A831FU ETORICOXIB 120MG CAP (MCP) (C) ETORICOXIB ETORICOXIB 3X10 C 11.06 0.3688 CAP 0 BOX MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 ORAL 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
41 A831FV ETORICOXIB 60MG CAP (MCP) (C) ETORICOXIB ETORICOXIB 3X10 C 4.27 0.1423 CAP 0 BOX MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 ORAL 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
41 A831FW ETORICOXIB 90MG CAP (MCP) (C) ETORICOXIB ETORICOXIB 3X10 C 5.63 0.1876 CAP 0 BOX MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 ORAL 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS