NB Drug Plans Formulary Update

Bulletin # 892
September 30, 2014
NB Drug Plans Formulary Update
Please find attached a list of generic drug product additions to the New Brunswick Drug Plans
Formulary.
Existing generic drug prodcuct categories
• New products will be reimbursed at the current category MAP.
New generic drug prodcut categories
• New products, other than the original brand product, will be reimbursed at the new category
MAP effective September 30, 2014.
• The original brand product will be reimbursed at the new category MAP effective October
28, 2014. Prior to October 28, 2014 the original brand product will be reimbursed at a
higher MAP as indicated on the attached list.
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NB Drug Plans Generic Drug Product Additions
Ajouts de médicaments génériques aux Régimes de médicaments du N.-B.
Drug/Form/Route/Strength
Médicament/Forme/Voie/Dosage
Atorvastatin Calcium
Atorvastatine calcique
Tab
Orl
Co.
Top
Dutasteride
Dutastéride
Cap
Orl
Caps
Ezetimibe
Ézétimibe
Tab
Orl
Co.
Fluocinonide
Crm
Top
Cr.
Fluorometholone
Fluorométholone
Dps
Oph
Gttes
Lactulose
Syr
Orl
Sir
DIN
NIP
MFG
FAB
Plans
Régimes
MAP
PAM
10mg
Mylan-Atorvastatin
2392933
MYL
ADEFGVW
0.3138
20mg
Mylan-Atorvastatin
2392941
MYL
ADEFGVW
0.3922
40mg
Mylan-Atorvastatin
2392968
MYL
ADEFGVW
0.4216
80mg
Mylan-Atorvastatin
2392976
MYL
ADEFGVW
0.4216
pms-Clobetasol
2309521
PMS
ADEFGVW
0.2279
0.05%
pms-Clobetasol
2309548
PMS
ADEFGVW
0.2279
0.5mg
Act Dutasteride
2412691
ATV
Spec. Auth.
0.4205
10mg
Ezetrol
Act Ezetimibe
Apo-Ezetimibe
Jamp-Ezetimibe
Mar-Ezetimibe
Mint-Ezetimibe
Mylan-Ezetimibe
pms-Ezetimibe
Ran-Ezetimibe
Sandoz Ezetimibe
Teva-Ezetimibe
2247521
2414716
2427826
2423235
2422662
2423243
2378035
2416409
2419548
2416778
2354101
FRS
ATV
APX
JPC
MAR
MNT
MYL
PMS
RAN
SDZ
TEV
Spec. Auth.
0.05%
Lyderm
Lidex
716863
2161923
TPH
VAL
ADEFGVW
0.2444
0.1%
Sandoz Fluorometholone
432814
SDZ
ADEFGVW
1.7880
667mg
Lactulose
2412268
SAS
Spec. Auth.
0.0145
Clobetasol propionate
Clobétasol (propionate de)
Crm
Top
0.05%
Cr.
Ont
Ont
Tradename
Marque de commerce
Page 1
1.8477
0.4612
September/septembre 2014
NB Drug Plans Generic Drug Product Additions
Ajouts de médicaments génériques aux Régimes de médicaments du N.-B.
Drug/Form/Route/Strength
Médicament/Forme/Voie/Dosage
Olanzapine
ODT
Orl
Co.D.O.
Rabeprazole Sodium
Rabéprazole sodique
ECT
Orl
Co.Ent.
Travoprost
Liq
Oph
Liq
DIN
NIP
MFG
FAB
Plans
Régimes
MAP
PAM
5mg
Jamp-Olanzapine ODT
2406624
JPC
W & Spec. Auth.
0.8937
10mg
Jamp-Olanzapine ODT
2406632
JPC
W & Spec. Auth.
1.7857
15mg
Jamp-Olanzapine ODT
2406640
JPC
W & Spec. Auth.
2.6778
20mg
Jamp-Olanzapine ODT
2406659
JPC
W & Spec. Auth.
5.9376
20mg
Abbott-Rabeprazole
2422646
ABB
ABDEFGVW
0.2408
0.004%
Travatan Z
Apo-Travoprost Z
Sandoz Travoprost
Teva-Travoprost Z
2318008
2415739
2413167
2412063
ALC
APX
SDZ
TEV
ADEFGVW
11.5040
4.0264
4.0264
4.0264
Jamp-Vancomycin
2407744
JPC
ADEFGVW
5.6300
Jamp-Vancomycin
2407752
JPC
ADEFGVW
11.2500
Aclasta
Taro-Zoledronic Acid
Zoledronic Acid
Zoledronic Acid
2269198
2415100
2422433
2408082
NVR
TAR
RCH
TEV
Spec. Auth.
6.7080
3.3540
3.3540
3.3540
Vancomycin Hydrochloride
Vancomycine (chlorhydrate de)
Cap
Orl
125mg
Caps
250mg
Zoledronic Acid
Acide Zolédronique
Liq
IV
Liq
Tradename
Marque de commerce
5mg/100mL
Page 2
September/septembre 2014

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