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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 12413 APO-RALOXIFENE 60MG TAB (APO) RALOXIFENE APO-RALOXIFENE 100'S C 97.04 0.97 TAB 0 BOTT APO APOTEX INC. COL AVENTA BARBADOS 681612 ESTROGEN AGONIST-ANTAGONIST 2026-04-01 ORAL 0 ESTROGEN AGONIST-ANTAGONIST
40 1241E RALOXIFENE 60MG TAB (DRL/AHI) RALOXIFENE RALOXIFENE 30'S C 39.88 1.33 TABLET 0 TAB DRL DR. REDDY'S LABORATORIES LTD AHI ARMSTRONG HEALTHCARE INC 681612 ESTROGEN AGONIST-ANTAGONIST 2022-04-01 2024-03-31 Oral 0 HORMONES AND SYNTHETIC SUBSTITUTES
41 1241F APO-RALOXIFENE 60MG TAB (APO) RALOXIFENE APO-RALOXIFENE 100'S C 97.04 0.9704 TAB 0 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 681612 ESTROGEN AGONIST-ANTAGONIST 2024-04-01 2026-03-31 ORAL 0 ESTROGEN AGONIST-ANTAGONIST