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Home > First Nations, Inuit & Aboriginal Health > Reports & Publications > Non-Insured Health Benefits > Updates to the Drug Benefit List - Fall 2007

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Updates to the Drug Benefit List - Fall 2007

Additions to the Drug Benefit List
Open Benefits
New Limited Use Benefits
Changes in Benefit
Not Added to Formulary
Drug Discontinued by the Manufacturer
Name Changes
Manufacturer Changes

DIN (Drug Identification Number)
MFR (Three letter identification code assigned to manufacturer name)

Additions to the Drug Benefits List

Open Benefits

Single-Source Drug Products
DIN MFR Brand Name Effective date
02283131 SAC ALTACE HCT 2.5MG/12.5MG TABLET 16/08/2007
02283158 SAC ALTACE HCT 5MG/12.5MG TABLET 16/08/2007
02283174 SAC ALTACE HCT 5MG/25MG TABLET 16/08/2007
02283166 SAC ALTACE HCT 10MG/12.5MG TABLET 16/08/2007
02283182 SAC ALTACE HCT 10MG/25MG TABLET 16/08/2007
00363812 BOE BUSCOPAN 10MG TABLET 16/08/2007
02289504 NOV DIOVAN 320MG TABLET 16/08/2007
99002981 AVT LOVENOX 100MG/ML INJECTION 10/07/2007
02248610 BMS REYATAZ 150MG CAPSULE 20/08/2007
02248611 BMS REYATAZ 200MG CAPSULE 20/08/2007
02294176 BMS REYATAZ 300MG CAPSULE 20/08/2007
Multi-Source Drug Products
DIN MFR Brand Name Effective date
02290332 APX APO-BENAZEPRIL 5MG TABLET 16/08/2007
02290340 APX APO-BENAZEPRIL 10MG TABLET 16/08/2007
02293943 APX APO-CEFPROZIL 125MG/5ML ORAL LIQUID 16/08/2007
02292998 APX APO-CEFPROZIL 250MG TABLET 12/06/2007
02293951 APX APO-CEFPROZIL 250MG/5ML ORAL LIQUID 30/07/2007
02293005 APX APO-CEFPROZIL 500MG TABLET 06/06/2007
02274744 APX APO-CLARITHROMYCIN 250MG TABLET 16/08/2007
02274752 APX APO-CLARITHROMYCIN 500MG TABLET 16/08/2007
02294745 APX APO-FLUTICASONE 50MCG/ACT 16/06/2007
02288184 APX APO-ONDANSETRON 4MG TABLET 16/08/2007
02288192 APX APO-ONDANSETRON 8MG TABLET 16/08/2007
02250004 CIP FENOMAX 160MG CAPSULE 16/08/2007
02248856 GEN GEN-CLARITHROMYCIN 250MG TABLET 16/08/2007
02248857 GEN GEN-CLARITHROMYCIN 500MG TABLET 16/08/2007
02293218 NOP NOVO-CITALOPRAM 20MG TABLET 16/07/2007
02293226 NOP NOVO-CITALOPRAM 40MG TABLET 16/07/2007
02287730 NOP NOVO-DESMOPRESSIN 0.1MG TABLET 16/08/2007
02287749 NOP NOVO-DESMOPRESSIN 0.2MG TABLET 16/08/2007
02276712 NOP NOVO-OLANZAPINE 2.5MG TABLET 12/07/2007
02276720 NOP NOVO-OLANZAPINE 5MG TABLET 12/07/2007
02276739 NOP NOVO-OLANZAPINE 7.5MG TABLET 12/07/2007
02276747 NOP NOVO-OLANZAPINE 10MG TABLET 12/07/2007
02276755 NOP NOVO-OLANZAPINE 15MG TABLET 12/07/2007
02283891 NOP NOVO-RAMIPRIL 1.25MG CAPSULE 14/06/2007
02247945 NOP NOVO-RAMIPRIL 2.5MG CAPSULE 14/06/2007
02247946 NOP NOVO-RAMIPRIL 5MG CAPSULE 13/06/2007
02247947 NOP NOVO-RAMIPRIL 10MG CAPSULE 14/06/2007
02278618 PMI PHL-ONDANSETRON 4MG TABLET 16/08/2007
02278626 PMI PHL-ONDANSETRON 8MG TABLET 16/08/2007
02249766 PMI PHL-PRAVASTATIN 10MG TABLET 16/08/2007
02249774 PMI PHL-PRAVASTATIN 20MG TABLET 16/08/2007
02249782 PMI PHL-PRAVASTATIN 40MG TABLET 16/08/2007
02284529 PMS PMS-ASA ENTERIC-COATED 325MG TABLET 16/08/2007
02284537 PMS PMS-ASA ENTERIC-COATED 650MG TABLET 16/08/2007
02282348 PMS PMS-FLUCONAZOLE 150MG CAPSULE 16/08/2007
02293528 RBY RAN-CEFPROZIL 250MG TABLET 12/06/2007
02293579 RBY RAN-CEFPROZIL 250MG/5ML ORAL LIQUID 30/07/2007
02293536 RBY RAN-CEFPROZIL 500MG TABLET 12/06/2007
02284421 RBY RAN-PRAVASTATIN 10MG TABLET 16/08/2007
02284448 RBY RAN-PRAVASTATIN 20MG TABLET 16/08/2007
02284456 RBY RAN-PRAVASTATIN 40MG TABLET 16/08/2007
02247818 RAT RATIO-CLARITHROMYCIN 250MG TABLET 16/08/2007
02247819 RAT RATIO-CLARITHROMYCIN 500MG TABLET 16/08/2007
02296071 RAT RATIO-FLUTICASONE 50MCG/ACT 16/08/2007
02291398 SDZ SANDOZ RAMIPRIL 1.25MG TABLET 16/08/2007
02291401 SDZ SANDOZ RAMIPRIL 2.5MG TABLET 16/08/2007
02291428 SDZ SANDOZ RAMIPRIL 5MG TABLET 16/08/2007
02291436 SDZ SANDOZ RAMIPRIL 10MG TABLET 16/08/2007

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New Limited Use Benefits

Single-Source Drug Products
DIN MFR Brand Name Effective date
02269015 HLR TARCEVA 100MG TABLET 01/09/2007
02269023 HLR TARCEVA 150MG TABLET 01/09/2007

Prior approval required.

Treatment of non-small cell lung cancer (NSCLC) after failure of at least one prior chemotherapy regimen, and whose EGFR expression status is positive or unknown.

DIN MFR Brand Name Effective date
02010909 FRS PROSCAR 5MG TABLET 01/11/2007

Prior approval required.

  1. For treatment of Benign Prostatic Hyperplasia (BPH) in patients who do not tolerate or have not responded to an alpha adrenergic blocker.
    or
  2. For use in combination therapy when monotherapy with an alpha-blocker is not sufficient.
DIN MFR Brand Name Effective date
02253283 NOV GLEEVEC 400MG TABLET 01/09/2007

Prior approval required.

  1. For the treatment of patients with chronic myeloid leukemia in blast crisis, accelerated phase, or in chronic phase after failure of interferon-alpha therapy.
  2. For the treatment of patients with gastrointestinal stromal tumour.
  3. For newly diagnosed adult patients with Philadelphia chromosome-positive chronic myeloid leukemia (CML).
DIN MFR Brand Name Effective date
02138018 SAO DEMEROL 50MG TABLET 01/12/2007

Prior approval not required.

Limited to 2 weeks supply for acute pain. Coverage will be limited to 60 tablets per one month period.

DIN MFR Brand Name Effective date
02258129 PFR OXYCONTIN 5MG CONTROLLED-RELEASE 01/09/2007

Prior approval required.

For treatment of moderate to severe chronic pain when other opioids such as morphine have been ineffective in controlling pain or in patients experiencing intolerable side effects.

DIN MFR Brand Name Effective date
02280795 PFI SUTENT 12.5MG CAPSULE 01/09/2007
02280809 PFI SUTENT 25MG CAPSULE 01/09/2007
02280817 PFI SUTENT 50MG CAPSULE 01/09/2007

Prior approval required.

Criteria for initial six month coverage of Sutent:
For patients with histologically proven unresectable or recurrent/metastatic GIST who have failed or are unable to tolerate imatinib therapy. Sunitinib will not be funded concomitantly with imatinib.

Criteria for assessment at every six months:
There is no objective evidence of disease progression.


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Multi-Source Drug Products
DIN MFR Brand Name Effective date
02288079 SDZ SANDOZ ALENDRONATE 5MG TABLET 16/08/2007
02288087 SDZ SANDOZ ALENDRONATE 10MG TABLET 16/08/2007
02288109 SDZ SANDOZ ALENDRONATE 70MG TABLET 16/08/2007

Prior approval required.

For treatment of:

  1. osteoporosis in patients who have documented hip, vertebral or other fractures
  2. osteoporosis in patients with intolerance or lack of response to etidronate or etidronate/calcium
  3. Paget's Disease
DIN MFR Brand Name Effective date
02285657 RPH RATIO-BUPROPION SR 100MG TABLET 12/07/2007
02285665 RPH RATIO-BUPROPION SR 150MG TABLET 12/07/2007

Prior approval required.

For treatment of depression in patients unresponsive to or intolerant of other listed antidepressants. (Note: this product will not be approved for coverage for smoking cessation).

DIN MFR Brand Name Effective date
02288265 PMS PMS-LEFLUNOMIDE 10MG TABLET 16/08/2007
02288273 PMS PMS-LEFLUNOMIDE 20MG TABLET 16/08/2007

Prior approval required.

For treatment of patients with rheumatoid arthritis who:

  1. have failed treatment with methotrexate.
  2. cannot tolerate or have contraindications to methotrexate.
DIN MFR Brand Name Effective date
02296101 PMS PMS-LEVETIRACETAM 250MG TABLET 16/08/2007
02296128 PMS

PMS-LEVETIRACETAM 500MG TABLET

 16/08/2007
02296136 PMS PMS-LEVETIRACETAM 750MG TABLET 16/08/2007

Prior approval required.

For the use in combination with other anti-epileptic medication(s) in the treatment of partial seizures in patients who are refractory to adequate trials of three anti-epileptic medications used either as monotherapy or in combination. This product must be prescribed by a Neurologist.

DIN MFR Brand Name Effective date
02294265 RPH RATIO-TAMSULOSIN 0.4MG ER CAPSULE 16/08/2007
02295121 SDZ SANDOZ TAMSULOSIN 0.4MG ER CAPSULE 16/08/2007

Prior approval required.

For treatment of Benign Prostatic Hyperplasia (BPH) in patients who do not tolerate or have not responded to other alpha-adrenergic blockers.


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Changes in Benefit

DIN MFR Brand Name Status Effective date
02138018 SAC DEMEROL 50MG TABLET Open Benefit 01/12/2007

Due to safety reasons and because meperidine should only be used for the treatment of actue pain, meperidine will change listing status from an open benefit to a limited use benefit with frequency and quantity limits (prior approval not required), with the following criteria:

Limited to 2 weeks supply for acute pain. Coverage will be limited to 60 tablets per one month period.

Exceptions to this limit will be made on a case by case basis. Physicians with clients who have exceeded this maximum in the past have been notified.

DIN MFR Brand Name Status Effective date
02010909 FRS PROSCAR 5MG TABLET Limited Use Benefit 01/11/2007

Effective November 1, 2007, Proscar will change listing status from an open benefit to a limited use benefit. Clients already on Proscar will be grandfathered.

DIN MFR Brand Name Status Effective date
02248610 BMS REYATAZ 150MG CAPSULE Open Benefit 20/08/2007
02248611 BMS REYATAZ 200MG CAPSULE Open Benefit 20/08/2007
02294176 BMS REYATAZ 300MG CAPSULE Open Benefit 20/08/2007

Effective August 20, 2007, Reyataz will change listing status from a limited use benefit to an open benefit.

DIN MFR Brand Name Status Effective date
00522988 APX APO-CHLORDIAZEPOXIDE 10MG Removed from Formulary 01/09/2007
00522996 APX APO-CHLORDIAZEPOXIDE 25MG Removed from Formulary 01/09/2007
00522724 APX APO-CHLORDIAZEPOXIDE 5MG Removed from Formulary 01/09/2007
00860697 APX APO-CLORAZEPATE 15MG CAPSULE Removed from Formulary 01/09/2007
00860689 APX APO-CLORAZEPATE 3.75MG CAPSULE Removed from Formulary 01/09/2007
00860700 APX APO-CLORAZEPATE 7.5MG CAPSULE Removed from Formulary 01/09/2007
00521698 APX APO-FLURAZEPAM 15MG CAPSULE Removed from Formulary 01/09/2007
00521701 APX APO-FLURAZEPAM 30MG CAPSULE Removed from Formulary 01/09/2007
00012696 ICN DALMANE 15 CAPSULE Removed from Formulary 01/09/2007
00012718 ICN DALMANE 30 CAPSULE Removed from Formulary 01/09/2007
00578479 PRO FLURAZEPAM 15MG CAPSULE Removed from Formulary 01/09/2007
00628212 NOP NOVO-CLOPATE 15MG CAPSULE Removed from Formulary 01/09/2007
00628190 NOP NOVO-CLOPATE 3.75MG CAPSULE Removed from Formulary 01/09/2007
00628204 NOP NOVO-CLOPATE 7.5MG CAPSULE Removed from Formulary 01/09/2007
00156590 PRO PDL-CHLORDIAZEPOXIDE 10MG Removed from Formulary 01/09/2007
00434426 PRO PDL-CHLORDIAZEPOXIDE 25MG Removed from Formulary 01/09/2007
00578487 PRO PDL-FLURAZEPAM 30MG CAPSULE Removed from Formulary 01/09/2007
00483826 AXX SOMNOL 15MG TABLET Removed from Formulary 01/09/2007
00483818 AXX SOMNOL 30MG TABLET Removed from Formulary 01/09/2007

Effective September 1, 2007, flurazepam, chlordiazepoxide and clorazepate will no longer be provided as benefits under the Non-Insured Health Benefits (NIHB) program. Patients receiving flurazepam, chlordiazepoxide or clorazepate prior to September 1, 2007 will be grandfathered.


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Not Added to Formulary

The following drug products will not be added to the NIHB Drug Benefit List:
DIN MFR Brand Name
02284642 TEV AZILECT 0.5MG TABLET (RASAGILINE MESYLATE)
02284650 TEV AZILECT 1MG TABLET (RASAGILINE MESYLATE)
02238848 NOV DENAVIR 1% CREAM (PENCICLOVIR)
02287420 NOV EXJADE 125MG TABLET (DEFERASIROX)
02287439 NOV EXJADE 250MG TABLET (DEFERASIROX)
02287447 NOV EXJADE 500MG TABLET (DEFERASIROX)
02264846 JNO TRAMACET 37.5MG/325MG TABLET (TRAMADOL)
02286386 BGN TYSABRI 300MG/15ML INJECTION (NATALIZUMAB)
02278383 PAL VANTAS 50MG INJECTION (HISTRELIN ACETATE)
The following indications will not be added to the NIHB Drug Benefit List:
DIN MFR Brand Name
02280795 PFI SUTENT 12.5MG CAPSULE (SUNITINIB MALATE)
02280809 PFI SUTENT 25MG CAPSULE (SUNITINIB MALATE)
02280817 PFI SUTENT 50MG CAPSULE (SUNITINIB MALATE)

Treatment of metastatic renal cell carcinoma (RCC) of clear cell histology after failure of cytokine-based therapy or in patients who are considered likely to be intolerant of such therapy.

Drugs Discontinued by the Manufacturer

DIN MFR Brand Name
02248262 NOP NOVO-LEVOFLOXACIN 250MG TABLET
02248263 NOP NOVO-LEVOFLOXACIN 500MG TABLET
02042541 JNO ORTHO-CEPT 21 TABLETS
00371033 NOV PARLODEL 2.5MG TABLET
02123320 LIL PERMAX 0.05MG TABLET
02123339 LIL PERMAX 0.25MG TABLET
02123347 LIL PERMAX 1MG TABLET
02043416 WAY PREMARIN 0.9MG TABLET

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Name Changes

DIN MFR Old Brand Name New Brand Name
02243974 PMS ASAPHEN 81MG CHEWABLE ENTROPHEN 81MG CHEWABLE
02242281 PMS ASAPHEN 81MG EC TABLET ENTROPHEN 81MG EC TABLET

Manufacturer Changes

DIN Brand Name Old MFR New MFR
02285606 ALVESCO 100MCG/ACT INHALER ALN NYD
02285614 ALVESCO 200MCG/ACT INHALER ALN NYD
02239616 PANTO IV 40MG/VIAL INJECTION ALN NYD
02241804 PANTOLOC 20MG ENTERIC-COATED ALN NYD
02229453 PANTOLOC 40MG TABLET ALN NYD
02279592 RESULTZ 50% SOLUTION ALN NYD

ALN - ALTANA Pharma Incorporated
NYD - Nycomed Canada Incorporated

Date Modified: 2007-09-07

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Important Notices