Displaying 1 - 4 of 4
  • Print
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 B5012 ANORO ELLIPTA 55/22 INHR (GSK/COL) UMECLIDINI UMECLIDINIUM|VILANTEROL ANORO ELLIPTA 30 DOSES BQ 141.60 141.60 INHALER 1 INHR GSK GLAXOSMITHKLINE COL COLLINS LTD 4892 RESPIRATORY AGENTS MISCELLANEOUS 2022-04-01 2024-03-31 ORAL INHALATION 6 RESPIRATORY TRACT AGENTS
41 B5012 ANORO ELLIPTA 55MCG|22MCG INHR (GSK) UMECLIDINIUM|VILANTEROL (BQ) UMECLIDINIUM|VILANTEROL ANORO ELLIPTA 30 DOSES BQ 108.68 108.6786 INHR 1 BOX GSK GLAXOSMITHKLINE COL COLLINS LTD 4892 RESPIRATORY AGENTS MISCELLANEOUS 2024-04-01 2024-07-16 ORAL INHALATION 6 RESPIRATORY AGENTS MISCELLANEOUS 2024-07-16
41 B5012 ANORO ELLIPTA 55MCG|22MCG INHR (GSK) UMECLIDINIUM|VILANTEROL (BQ) UMECLIDINIUM|VILANTEROL ANORO ELLIPTA 30 DOSES BQ 163.94 163.94 INHR 1 BOX GSK GLAXOSMITHKLINE COL COLLINS LTD 4892 RESPIRATORY AGENTS MISCELLANEOUS 2024-07-17 2026-03-31 ORAL INHALATION 6 RESPIRATORY AGENTS MISCELLANEOUS 2024-07-17
42 B5012 ANORO ELLIPTA 55MCG|22MCG INHR (GSK) UMECLIDINIUM|VILANTEROL UMECLIDINIUM|VILANTEROL ANORO ELLIPTA 30 DOSES BQ 172.12 172.12 INHR 1 BOX GSK GLAXOSMITHKLINE COL AVENTA BARBADOS 4892 RESPIRATORY AGENTS MISCELLANEOUS 2026-04-01 ORAL INHALATION 0 RESPIRATORY AGENTS MISCELLANEOUS