Drug Benefit List 2010

20:00 BLOOD FORMATION COAGULATION AND THROMBOSIS

20:16.00 HEMATOPOIETIC AGENTS

DARBEPOETIN ALFA

25mcg/mL Injection

2246354 ARANESP AMG

40mcg/mL Injection

2246355 ARANESP AMG

100mcg/mL Injection

2246357 ARANESP AMG

200mcg/mL Injection

2246358 ARANESP AMG

500mcg/mL Injection

2246360 ARANESP AMG

EPOETIN ALFA

20,000IU/mL Injection

2206072 EPREX JNO

20000IU/0.5mL injection

2243239 EPREX JNO

5,000IU/mL Injection

2243400 EPREX JNO

30000IU/0.75mL Injection

2288680 EPREX JNO

1,000IU/0.5mL Prefilled Syringe

2231583 EPREX JNO

2,000IU/0.5mL Prefilled Syringe

2231584 EPREX JNO

3,000IU/0.3mL Prefilled Syringe

2231585 EPREX JNO

4,000IU/0.4mL Prefilled Syringe

2231586 EPREX JNO

6,000IU/0.6mL Prefilled Syringe

2243401 EPREX JNO

8,000IU/0.8mL Prefilled Syringe

2243403 EPREX JNO

10,000IU/mL Prefilled Syringe

2231587 EPREX JNO

40,000IU/mL Prefilled Syringe

2240722 EPREX JNO

40:00 ELECTROLYTIC, CALORIC, AND WATER BALANCE

40:08.00 ALKALINIZING AGENTS

SODIUM BICARBONATE

500mg Tablet

392839 SANDOZ SOD BICARBONATE SDZ

40:12.00 REPLACEMENT PREPARATIONS

CALCIUM (CALCIUM GLUCONOLACTATE, CALCIUM CARBONATE)

300mg & 2940mg Effervescent Tablet

2232482 CALCIUM SANDOZ NVC

1750mg & 2327mg Effervescent Tablet

2232483 GRAMCAL NVC

CALCIUM CARBONATE

500mg Capsule

648353 CALSAN NVC

500mg Chewable Tablet

705373 CALCIUM WAM

648345 CALSAN NVC

250mg Tablet

682047 APO-CAL 250 APX

645958 CALCIUM NOP

CALCIUM CITRATE

300mg Tablet

2231833 CALCIUM CITRATE WNP

PHOSPHORUS

500mg Effervescent Tablet

225819 PHOSPHATE-NOVARTIS NVR

ZINC GLUCONATE

50mg Tablet

503169 ZINC VTH

505463 ZINC JAM

40:18.19 PHOSPHATE - REMOVING AGENTS

SEVELAMER HYDROCHLORIDE

Limited Use Benefit ( Prior approval required ).

1. patients with elevated phosphate levels OR elevated phosphate X calcium product despite dietary restriction of phosphate and use of calcium-based phosphate binders (short term elevations should be managed with aluminium based binders)
2. patients with elevated calcium levels despite discontinuation of calcium binder, and Vitamin D analogue and/or modification of dialysate calcium
3. patients with adynamic bone disease and low PTH levels (<100 pg/ml or <0.9 pmol/L) with normal or elevated calcium levels

800mg Tablet

2244310 RENAGEL GEE

56:00 GASTROINTESTINAL DRUGS

56:04.00 ANTACIDS AND ADSORBENTS

ALUMINUM HYDROXIDE

500mg Capsule

2135620 BASALJEL AXC

60mg/mL Liquid

572527 ALUGEL ATL

64mg/mL Liquid

2125862 AMPHOJEL AXC

600mg Tablet

2124971 AMPHOJEL AXC

CALCIUM CARBONATE

500mg Tablet

1970240 TUMS GSK

750mg Tablet

1967932 TUMS EXTRA STRENGTH GSK

1000mg Tablet

2151138 TUMS ULTRA STRENGTH GSK

88:00 VITAMINS

88:12.00 VITAMIN C

VITAMIN B COMPLEX

Tablet

123803 B COMPLEX PLUS C JAM

VITAMIN B COMPLEX WITH VITAMIN C

Tablet

2245391 DIAMINE EUR

88:28.00 MULTIVITAMIN PREPARATIONS

MULTIVITAMINS

Tablet

2244872 REPLAVITE WNP

80007498 REPLAVITE WNP

558796 STRESS PLEX C JAM

96:00 PHARMACEUTICAL AIDS

96:00.00 PHARMACEUTICAL AIDS

NUTRITIONAL SUPPLEMENT

Liquid

9854258 NOVASOURCE RENAL NES

Liquid

9853723 NEPRO ABB

907995 NOVASOURCE NVR

9853731 SUPLENA ABB

235mL Liquid

99002639 NEPRO ABB

99002647 SUPLENA ABB

Powder

9991056 RESOURCE BENEPROTEIN NVR