List of Medications - BAnQ

List of Medications

Amended Edition, in Force From 30 June 2010

Amendment No. 1 including Correction No. 2,in Force From the Same Date

Produced by: Service des relations avec la clientèle

Legal deposit — Bibliothèque et Archives nationales du Québec, 2010

ISBN 978-2-550-58898-6

Quebec, 28 June 2010

The masculine form designates both men and women, unless the context indicates otherwise.

ISSN 1913-2794

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Schedule 1 List of Medications 30 June 2010

Table of Contents 1. Establishing the Prices Indicated on the List of Medications.................................................................................2 2. Establishing the Price Payable..............................................................................................................................2 3. Extemporaneous Preparations..............................................................................................................................4 4. Exceptional Medications .......................................................................................................................................4 5. Supplies ................................................................................................................................................................5 6. Conditions, Cases and Circumstances on or in Which the Cost of Any Other Medication is Covered by the Basic Plan, Except the Medications or Classes of Medications Specified Below..................................................6 APPENDIX I: Manufacturers That Have Submitted Different Guaranteed Selling Prices for Wholesalers and Pharmacists

APPENDIX II: Drug Wholesalers Accredited by the Minister and Each Wholesaler’s Mark-Up

APPENDIX III: Products for Which the Wholesaler’s Mark-Up Is Limited to a Maximum Amount

APPENDIX IV: List of Exceptional Medications With Recognized Indications for Payment

Sections and Therapeutic Classes 4:00 Antihistamine Drugs 8:00 Anti-infective Agents 10:00 Antineoplastic Agents 12:00 Autonomic Drugs 20:00 Blood Formation and Coagulation 24:00 Cardiovascular Drugs 28:00 Central Nervous System Agents 36:00 Diagnostic Agents 40:00 Electrolytic, Caloric and Water Balance 48:00 Antitussives, Expectorants and Mucolytic Agents 52:00 EENT Preparations 56:00 Gastrointestinal Drugs 60:00 Gold Compounds 64:00 Heavy Metal Antagonists 68:00 Hormones and Synthetic Substitutes 84:00 Skin and Mucous Membrane Agents 86:00 Smooth Muscle Relaxants 88:00 Vitamins 92:00 Unclassified Therapeutic Agents

Exceptional Medications

Supplies

Products for Extemporaneous Preparations

Vehicles, Solvents or Adjuvants

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1. ESTABLISHING THE PRICES INDICATED ON THE LIST OF MEDICATIONS

The prices indicated on the List of Medications are established according to the "guaranteed selling price” concept, in keeping with the manufacturer’s commitment and in accordance with the methods of establishing drug prices provided for in section 60 of the Act respecting prescription drug insurance. However, for certain drugs no price is indicated on the list, in which case the price payable is the pharmacist’s cost price. Such drugs may include:

– drugs produced by non-accredited manufacturers but considered unique and essential (identified by the symbol “UE” in the “unit price” column);

– products for extemporaneous preparations; – solvents, vehicles and adjuvants; – supplies; – drugs listed by generic name only, with no brand

name or manufacturer’s name indicated. For drugs that have been withdrawn from the market by the manufacturer, the symbol “W” appears in the “unit price” column. These drugs remain payable during the period of validity of this edition, so that existing stocks can be sold. 1.1 Guaranteed selling price The manufacturer’s commitment stipulates that the manufacturer must submit a guaranteed selling price, per package size, for any drug it wishes to have included on the List of Medications. The number of package sizes is limited to two, and the price submitted must reflect prices for quantities that are multiples of these package sizes. Where the therapeutic use of more than two package sizes has been established, as in the case of certain drugs such as antibiotics in oral suspensions, ophthalmic solutions, and topical creams and ointments, the manufacturer may submit a guaranteed selling price for each package size. The guaranteed selling price must remain in effect during the period for which the List of Medications is valid. The guaranteed selling price may differ for sales to pharmacists and sales to wholesalers, in which case the difference between the pharmacist’s price and the wholesaler’s price must not exceed 6% for any package size but may be different for each product in question. For a given product, the difference must be the same for all package sizes. A manufacturer’s guaranteed selling price for sales to wholesalers must be the same for all wholesalers.

It should be noted that the guaranteed selling price indicated on the list is the guaranteed selling price for sales to pharmacists. Manufacturers that have submitted different guaranteed selling prices for sales to pharmacists and sales to wholesalers are listed in Appendix I. 2. ESTABLISHING THE PRICE PAYABLE The price paid by the Régie de l’assurance maladie du Québec is the price at which the drug is sold by an accredited manufacturer or wholesaler. This price is established according to the method described below or, in certain cases, is the maximum price indicated on the list. 2.1 Actual purchase price The method used to establish the price payable by the Régie is the actual purchase price method. Under this method, the price paid by the Régie to a pharmacist is the price indicated on the edition of the list that is valid at the time the prescription is filled, taking into account the source of supply and the package size. Where the manufacturer’s name does not appear on the list, the price payable by the Régie is the pharmacist’s cost price. This is the case, for example, with products considered unique and essential, products for which no brand name or manufacturer’s name is indicated, and certain products appearing in the sections entitled Products for Extemporaneous Preparations, Vehicles, Solvents or Adjuvants and Supplies. 2.2 The lowest price For certain drugs (generic names) that have appeared on the List of Medications for 15 years or more and that are produced by two or more manufacturers, the lowest price method is used to establish the price payable. However, for drugs (generic names) that first appeared on this list and on the list drawn up by the Minister under section 116 of the Act respecting health services and social services (R.S.Q., c. S-4.2) after 30 September 2003, the lowest price method applies where the drug is produced by two or more manufacturers and has appeared on either of these lists for 15 years or more. The lowest price method is based on the lowest guaranteed selling price for sales to pharmacists that is submitted by a manufacturer for a given package size. 2.2.1 The lowest price method The lowest price method works as follows:

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– For a given drug (generic name, dosage form,

strength), all products for which the manufacturer has submitted a guaranteed selling price are considered insured and therefore appear on the List of Medications.

– The price payable is the lowest price, which is the price of the manufacturer that submitted the lowest guaranteed selling price.

– Where it exceeds the lowest price, the guaranteed selling price submitted by the manufacturer is payable only where, for particular reasons, the prescriber who issued the prescription wrote on it, in his own handwriting, that no substitutions are allowed.

– Where an insured person refuses a substitution and insists on receiving the more expensive product prescribed, the pharmacist may charge that person the difference between the price of the product prescribed and the lowest price (the price reimbursed by the Régie).

2.2.2 Grouping of dosage forms and strengths For the purpose of applying the lowest price method, certain dosage forms or strengths in active ingredients may be grouped together under the same generic name. Thus, under a given generic name, slow-release products are grouped with regular-release products. The price payable is then established on the basis of the price of the least expensive product, taking into account the corresponding dosages. Dosage forms and strengths are not grouped together where, for therapeutic or other reasons, this is not considered desirable. 2.2.3 Exception to the basic principle The lowest price method does not apply to a drug (generic name) that, for therapeutic or other reasons, is not considered desirable, even if the drug has appeared on the list for 15 years or more and is produced by two or more manufacturers. 2.3 Maximum amount The Minister may establish a maximum amount payable for a drug, in which case the price payable may not exceed the maximum amount indicated on the list. 2.4 Accredited drug wholesaler’s mark-up The drug wholesaler’s mark-up is payable only if the drug was actually purchased through an accredited wholesaler. For certain expensive drugs, the mark-up may be limited to a maximum amount, under the terms and conditions described below.

Under this provision, the wholesaler must, in keeping with its commitment, declare the percentage mark-up that it must add exclusively to the manufacturer’s guaranteed selling price for drugs appearing on the list during the period for which it is valid, except drugs for which different selling prices for sales to wholesalers and sales to pharmacists are submitted. Accredited drug wholesalers and their mark-ups for the period of validity of the List of Medications are listed in Appendix II. 2.4.1 Maximum mark-up Under the regulatory provisions, the mark-up on certain expensive drugs may be limited to a maximum amount. For these drugs, the wholesaler’s mark-up is limited to a maximum of $24. The products to which this measure applies are those whose guaranteed selling price for sales to wholesalers, for the smallest package size or its indivisible multiple, is $400 or more. The price appearing on the list is the guaranteed selling price for sales to pharmacists and does not include the wholesaler’s mark-up. Products for which the wholesaler’s mark-up is limited to $24 are listed in Appendix III. 2.4.2 Two guaranteed selling prices Where a manufacturer has submitted different guaranteed selling prices for sales to wholesalers and sales to pharmacists, the price payable is established as follows: If the difference between the guaranteed selling prices for sales to wholesalers and sales to pharmacists is equal to or greater than 5%, this difference constitutes the wholesaler’s mark-up. The price payable is then the guaranteed selling price for sales to pharmacists, except in the case of expensive products, for which the mark-up is limited to $24. If the difference between the guaranteed selling prices for sales to wholesalers and sales to pharmacists is less than 5%, the price payable is the guaranteed selling price for sales to wholesalers, increased by the wholesaler’s mark-up. 2.5 Conditions of supply The only products for which pharmacists may bill the Régie are those appearing on the list and purchased through a recognized manufacturer or wholesaler. When obtaining drug supplies, pharmacists must apply sound management practices and make rational purchases based on the quantity of a drug dispensed over a period of at least 30 days.

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2.6 Price payable for drugs supplied by institutions Under section 37 of the Pharmacy Act (R.S.Q., c. P-10), institutions are authorized to supply drugs to persons other than persons admitted or registered with them. In addition to the responsibilities entrusted to them under the Regulation respecting the application of the Hospital Insurance Act, these institutions may bill the basic prescription drug insurance plan for drugs appearing on the List of Medications drawn up by the Minister pursuant to section 60 of the Act respecting prescription drug insurance, where these drugs are supplied to persons insured under the basic plan. In such cases, the price payable to institutions is the lesser of the actual purchase price and the price established according to the method described in the list. 3. EXTEMPORANEOUS PREPARATIONS 3.1 Definition An extemporaneous preparation is any drug prepared by a pharmacist from a prescription, as opposed to an officinal preparation, which is pre-prepared. 3.2 Extemporaneous preparations whose cost is

covered by the basic prescription drug insurance plan

The cost of an extemporaneous preparation is covered by the basic plan if the preparation is an extemporaneous mixture of products appearing on the List of Medications, is not equivalent to a drug already manufactured, and consists of:

– A systemic-effect preparation manufactured from oral forms of drugs already appearing on the List of Medications and consisting of a single active substance.

– A mouthwash preparation resulting from the

mixture

• of two or more of the following drugs in non-injectable form: diphenhydramine hydro-chloride, erythromycin, hydroxyzine, ketoconazole, lidocaine, magnesium hydroxide / aluminum hydroxide, nystatin, sucralfate, tetracycline and a corticosteroid, in association, where applicable, with one or more vehicles, solvents or adjuvants or

• of an oral form of tranexamic acid with one or

more vehicles, solvents or adjuvants.

– A preparation for topical use composed of a mixture of a drug listed in Class 84:00 Skin and Mucous Membrane Agents of the List of Medications and of one or more of the following

products for extemporaneous preparations: salicylic acid, sulfur and tar in association, where applicable, with one or more vehicles, solvents or adjuvants.

– A preparation for topical use composed of one or

more of the following products: salicylic acid, erythromycin, sulfur, tar and hydrocortisone in a cream, ethanol, ointment, oil or lotion base, but not a preparation that is only hydrocortisone-based that has a concentration of less than 1%.

– An ophthalmic preparation containing:

• amikacin, amphotericine B, cefazolin, ceftazidime,

fluconazole, mitomycin, penicillin G, vancomycin or

• gentamicin or tobramycin in concentrations of more than 3 mg/mL or

• cyclosporine at a concentration of 1% or 2%.

– A solution or oral suspension of folic acid,

dexamethasone, methadone, phytonadione or vancomycin.

– One of the following preparations:

• a topical preparation of nitrogen mustard

(mechlorethamine hydrochloride);

• a sucralfate-based preparation for rectal use;

• a topical preparation containing glyceryl trinitrate, nifedipine or diltiazem.

Products for extemporaneous preparations, as well as vehicles, solvents or adjuvants whose price is payable by the Régie are listed in two special sections of the List of Medications. 3.3 Price payable The method applicable for establishing the price payable by the Régie for products for extemporaneous preparations is the price indicated on the list. Where no price is indicated, the price payable is the pharmacist’s cost price. 4. EXCEPTIONAL MEDICATIONS 4.1 Objectives The Measure regarding exceptional medications aim to achieve the following objectives: (a) to ensure that the cost of a drug classified as an

exceptional medication is covered by the basic plan only when used for the therapeutic indications recognized by the Conseil du médicament;

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(b) to permit, on an exceptional basis, payment for a drug classified as an exceptional medication where the drug:

– is considered effective for limited indications,

since neither its effectiveness nor the cost of treatment warrants its regular and continuous use for other indications;

– offers no therapeutic advantages to warrant a

higher cost than the cost of using products that have the same pharmacotherapeutic properties and that appear on the list, but where these products are not tolerated, are contraindicated, or have been rendered ineffective by the patient’s clinical condition.

4.2 Classification of exceptional medications Drugs corresponding to the definition of exceptional medications are classified separately, in the section entitled Exceptional Medications. 4.3 Authorization for payment and duration of

authorization The exceptional medications listed in Appendix IV are insured under the basic plan where the following conditions are fulfilled: (1) in the case of persons whose basic plan coverage

is provided by the Régie de l’assurance maladie du Québec, a prior request for authorization, duly completed in accordance with the form prescribed to that effect in the Regulation respecting forms and statements of fees under the Health Insurance Act (R.R.Q., 1981, c. A-29, r. 2) was sent to the Régie;

(2) in the case of persons whose basic plan coverage

is provided by insurers transacting group insurance or by administrators of private-sector employee benefit plans, a prior request for authorization, if required under the applicable group insurance contract or employee benefit plan, was sent to the insurer or to the administrator of the employee benefit plan, according to the terms and conditions provided for in that contract or plan.

Notwithstanding the foregoing, these drugs are covered only for the duration authorized, as the case may be, by the Régie, by the insurer, or by the administrator of the employee benefit plan concerned, if they are prescribed for the therapeutic indications stipulated for each of them. 5. SUPPLIES The List of Medications may include certain supplies considered by the Minister to be essential for the administration of prescription drugs. Supplies whose cost is covered by the basic plan appear on the list in

the sections entitled Supplies and Vehicles, Solvents or Adjuvants. 5.1 Price payable The method used to establish the price payable by the Régie for supplies is the method described in the List of Medications. Where no price is indicated, the price payable for supplies is the pharmacist’s cost price. 6. CONDITIONS, CASES AND CIRCUMSTANCES

ON OR IN WHICH THE COST OF ANY OTHER MEDICATION IS COVERED BY THE BASIC PLAN, EXCEPT THE MEDICATIONS OR CLASSES OF MEDICATIONS SPECIFIED BELOW

6.1 Objective

The purpose of this measure is to provide for the payment, in exceptional circumstances, of a medication that is not on the list or an exceptional medication prescribed for a therapeutic indication not specified on the list for that medication, on or in the conditions, cases and circumstances described below, and to provide for coverage under the basic prescription drug insurance plan of the cost of the medication and the cost of the pharmaceutical services provided by a pharmacist to an eligible person. 6.2 Conditions, cases and circumstances 6.2.1 Conditions

A medication not appearing on the list or an exceptional medication that is prescribed for a therapeutic indication not specified on the list for that medication is covered by the basic prescription drug insurance plan on an exceptional basis when no other pharmacological treatment specified on the list or no other medical treatment whose cost is covered under the Health Insurance Act (chapter A-29) can be considered because the treatment is contraindicated, there is significant intolerance to the treatment, or the treatment has been rendered ineffective due to the clinical condition of the eligible person.

That medication must: (1) be manufactured and marketed in Canada and,

subject to the fourth paragraph of this section, have been assigned a DIN by Health Canada; or

(2) be manufactured and marketed in Canada and have an NPN assigned by Health Canada, on condition that the medication already had been assigned a DIN by the same authority or

(3) be an extemporaneous preparation consisting of ingredients marketed in Canada, on condition that there are no medications marketed in Canada of

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the same form and strength containing the same ingredients; or

(4) be a sterile preparation made by a pharmacist from sterile pharmaceutical products marketed in Canada, at least one of which is not specified on the list for parenteral administration or ophthalmic use, on condition that there are no marketed preparations of the same form and strength containing the same ingredients.

The medication is covered by the basic plan if it satisfies every condition specified for both of the following criteria: (1) severity of the medical condition; and (2) chronicity, treatment of an acute infection, and

palliative care.

An exceptional medication referred to in Appendix IV may be covered by the basic plan even if it has not been assigned a DIN by Health Canada, insofar as its coverage is not subject to any exclusion set out in the list. 6.2.1.1 Severity of the medical condition

The medication is to be used to treat a severe medical condition of an eligible person for whom there is a specific necessity of an exceptional nature to use the medication, recorded in the person's medical file.

"Severe medical condition" means a symptom, illness

or severe complication arising from the illness with consequences that pose a serious health threat, such as significant physical or psychological injury, with a high probability that the person will require the use of a number of services in the health network such as frequent medical services or hospitalization if the medication is not administered, and whose severity is, as the case may be: (1) immediate, in that it already severely restricts the

afflicted person's activities or quality of life or would, according to the current state of scientific knowledge, lead to significant functional injury or the person's death; or

(2) foreseeable in the short term, in that its evolution or

complications could affect the eligible person's morbidity or mortality risk.

If, however, the consequences of the severe medical

condition are significant functional psychological injury, the injury must be immediate and as a consequence already severely restrict the eligible person's activities or quality of life. 6.2.1.2 Chronicity, treatment of an acute severe infection, and palliative care

The medication is to be used, as the case may be: (1) to treat a chronic medical condition or a

complication or manifestation arising from the chronic medical condition provided its degree of severity satisfies subparagraph 1 or 2 of the second paragraph of section 6.2.1.1;

(2) to treat an acute severe infection; (3) notwithstanding the degree of severity criteria in

section 6.2.1.1, to provide for the administration of a medication required for final phase ambulatory palliative care in the case of a terminal illness.

6.3 Exclusions

Despite the conditions being satisfied for coverage by the basic plan under section 6.2.1 as a medication not on the List or as an exceptional medication prescribed for a therapeutic indication not specified on the list for that medication, a request for payment authorization must be denied for the following medications: (1) medications prescribed to treat infertility; (2) medications prescribed for aesthetic or cosmetic

purposes; (3) medications prescribed to treat alopecia or

baldness; (4) medications prescribed to treat erectile dysfunction; (5) medications prescribed to treat obesity; (6) medications prescribed for cachexia and to

stimulate appetite; and (7) oxygen. 6.4 Price payable by the Régie de l’assurance

maladie du Québec

The price of a medication to which section 6 applies, and for which the Régie de l'assurance maladie du Québec assumes payment for persons whose basic plan coverage is provided by the Régie, is the actual purchase price paid for the medication by the pharmacist. 6.5 Payment authorization and duration of

authorization

The prescriber must send: (1) to the Régie de l’assurance maladie du Québec, in

the case of persons whose basic plan coverage is provided by the Régie, a request for prior authorization on the duly completed form provided by the Régie;

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(2) to the insurer or administrator of the employee benefit plan, in the case of persons whose basic plan coverage is provided by insurers transacting group insurance or by administrators of private-sector employee benefit plans, if it is required by the applicable group insurance contract or benefit plan, a prior request for authorization duly completed in accordance with the terms and conditions of the contract or plan, as the case may be.

If the request is accepted, the medication for which payment authorization is sought is covered only for the period authorized by the Régie, by the insurer or by the administrator of the employee benefit plan, as the case may be.

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♦ Symbols used in this list

Z Drug subject to the Narcotic Control Regulations.

X Drug listed in Schedule F to the Regulations made under the Food and Drugs Act.

V Drug subject to the Benzodiazepines and Other Targeted Substances Regulations.

Y Drug listed in Schedule G to the Regulations made under the Food and Drugs Act.

* Drug about which the information has been changed since the previous edition.

+ Drug added since the previous edition was published.

suppl. The service cost for this product is the service cost applicable to nutritional formulas.

UE Drug considered unique and essential from an unrecognized manufacturer.

W Product withdrawn from the market by the manufacturer but covered by the Régie during the period for which this edition is valid.

LPM The lowest price method applies to drugs having this generic name, dosage form and strength.

Identifies the price payable in conformity with the lowest price method.

Identifies the maximum price payable.

APPENDIX IMANUFACTURERS THAT HAVE SUBMITTED DIFFERENT

GUARANTEED SELLING PRICES FOR WHOLESALERS ANDPHARMACISTS

Manufacturer Difference between pharmacist'sGSP and wholesaler's GSP

* Alcon Alcon Canada Inc. 5% * Apotex Apotex Inc. 5%

Atlas Laboratoire Atlas Inc. 5,66%, 5,65%, 5,7%, 5,71%Axxess Axxess Pharma Inc. 5%

* Bayer Bayer Inc. 5% * Biomed Biomed 2002 Inc. 5% * B.M.S. La Société Bristol-Myers Squibb Canada 5%

Cobalt Cobalt Pharmaceuticals 5%Cytex Cytex Pharmaceuticals inc. 5%Del Del Pharmaceuticals Inc. 5,56%

* Erfa Erfa Canada Inc. 5% * Euro-Pharm Euro-Pharm International Canada Inc 5%

Genpharm Genpharm ULC 5% * GSK GlaxoSmithKline Inc. 5%

Home Diag Home Diagnostics Inc. 6% * Jamp Jamp Pharma Corporation 5%

Lalco Laboratoire Lalco Enr. 6%Mantra Ph. Mantra Pharma inc. 5%Mint Mint Pharmaceuticals Inc. 5%

* M.J. Mead Johnson Nutritionals Canada 5% * MM Thera MM Thérapeutiques Inc 5% * Mylan Mylan 5%

NG Pharma Next Generation Pharma Inc. 5% * Novopharm Novopharm Ltée 5%

Nu-Pharm Nu-Pharm Inc. 5% * Odan Laboratoires Odan Ltée 5% * Oméga Laboratoires Omega Ltée 5% * Pendopharm Pendopharm Inc. 5%, 6% * Pharmel Pharmel Inc. 5% * Phmscience Pharmascience Inc. 5%

Prempharm Prempharm Inc. 5%Pro Doc Pro-Doc Ltée 5%Proval Proval Pharma Inc. 5%

* Purdue Purdue Pharma 5%Ranbaxy Ranbaxy Pharmaceuticals Canada Inc. 5%Ratiopharm Ratiopharm Inc. 5%

2010-06 APPENDIX I - 1

Manufacturer Difference between pharmacist'sGSP and wholesaler's GSP

* Riva Laboratoire Riva Inc. 5%Rougier Rougier Pharma 5%Sandoz Sandoz Canada Inc 5%Sanis Sanis Health Inc. 5%

* SanofiAven Sanofi-Aventis Canada Inc. 5% * Schering Schering-Plough Canada Inc. 5% * Serono EMD Serono Canada Inc. 5%

Sterigen Sterigen 5% * Taro Taro Pharmaceuticals Inc. 5% * Teva Teva Neuroscience G.P., S.E.N.C. 5%

Teva Can Teva Canada Ltée 5%Trianon Laboratoires Trianon Inc. 5%

* Tyco Groupe Tyco Médical Canada Inc. 6% * Valeant Valeant Canada Ltée 5% * Valeo Valeo Pharma Inc. 6%, 5%

Zymcan Zymcan Pharmaceuticals Inc. 5%

* The difference applies only to certain of this manufacturer's products.

APPENDIX I - 2 2010-06

APPENDIX IIDRUG WHOLESALERS ACCREDITED BY THE MINISTER AND

EACH WHOLESALER'S MARK-UP

FAMILIPRIX INC.

Head office: FAMILIPRIX INC.6000, rue Armand-ViauQuébec (Québec) G2C 2C5

Mark-up .................................................................... 6%

Supply source code A

LE GROUPE JEAN COUTU (PJC) INC.

Head office: LE GROUPE JEAN COUTU (PJC) INC.530, rue BériaultLongueuil (Québec) J4G 1S8

Mark-up .................................................................... 6%

Supply source code D

MCMAHON DISTRIBUTEUR PHARMACEUTIQUE INC.

Head office: MCMAHON DISTRIBUTEURPHARMACEUTIQUE INC.12225, boul. Industriel, suite 100Montréal (P.A.T.) Québec H1B 5M7

Mark-up .................................................................... 6%

Supply source code F

MCKESSON SERVICES PHARMACEUTIQUES

Head office: MCKESSON SERVICESPHARMACEUTIQUES8290, boul. Pie IXMontréal (Québec) H1Z 4E8

Mark-up .................................................................... 6%

Supply source code G

AMERISOURCEBERGEN

Head office: AMERISOURCEBERGEN210, Binnington CourtKingston (Ontario) K7M 8R6

Mark-up .................................................................... 6%

Supply source code H

KOHL & FRISCH LIMITED

Head office: KOHL & FRISCH LIMITED7622, Keele StreetConcord (Ontario) L4K 2R5

Mark-up .................................................................... 6%

Supply source code I

SHOPPERS DRUG MART LIMITED

Head office: SHOPPERS DRUG MART LIMITED243, Consumers RoadNorth York (Ontario) M2J 4W8

Mark-up .................................................................... 6%

Supply source code J

DISTRIBUTIONS PHARMAPLUS INC.

Head office: DISTRIBUTIONS PHARMAPLUS INC.2797, avenue TurbideBeauport (Québec) G1E 3R1

Mark-up .................................................................... 6%

Supply source code M

INNOMAR STRATEGIES INC.

Head office: INNOMAR STRATEGIES INC.3450, Harvester RoadBurlington (Ontario) L7N 3M7

Mark-up .................................................................... 6%

Supply source code N

GMD DISTRIBUTION INC.

Head office: GMD DISTRIBUTION INC.1215, North Service Rd. W.Oakville (Ontario) L6M 2W2

Mark-up .................................................................... 6%

Supply source code O

PATIENT CARE AUTOMATION SERVICES INC.

Head office: PATIENT CARE AUTOMATION SERVICESINC.2880 Brighton Road, Unit 2Oakville (Ontario) L6H 5S3

Mark-up .................................................................... 6%

Supply source code P

2010-06 APPENDIX II - 1

APPENDIX IIIPRODUCTS FOR WHICH THE WHOLESALER'S MARK-UP IS

LIMITED TO A MAXIMUM AMOUNT

Manufacturer Brand name Packaging

Novartis Aclasta I.V. Perf. Sol. 5 mg/ 100 mL 1S. & N. Acticoat Flex 3 (40 cm x 40 cm - 1 600 cm²) Dressing More

than 500 cm² (active surface)6

Lilly Adcirca Tab. 20 mg 56Astellas Advagraf L.A. Caps. 5 mg 50Shire Agrylin Caps. 0.5 mg 100SanofiAven Anzemet Tab. 100 mg 15Apotex Apo-Levofloxacin Tab. 750 mg 100Apotex Apo-Olanzapine Tab. or Tab. Oral Disint. 15 mg 100Apotex Apo-Olanzapine Tab. or Tab. Oral Disint. 20 mg 100Bo. Ing. Aptivus Caps. 250 mg 120Amgen Aranesp Syringe 40 mcg/0.4 mL 4Amgen Aranesp Syringe 50 mcg/0.5 mL 4Amgen Aranesp Syringe 60 mcg/0.3 mL 4Amgen Aranesp Syringe 80 mcg/0.4 mL 4Amgen Aranesp Syringe 100 mcg/0.5 mL 4Amgen Aranesp Syringe 130 mcg/0.65 mL 4Amgen Aranesp Syringe 150 mcg/0.3 mL 4Amgen Aranesp Syringe 200 mcg/0.4 mL 1Amgen Aranesp Syringe 300 mcg/0.6 mL 1Amgen Aranesp Syringe 500 mcg/1.0 mL 1Novartis Aredia I.V. inf. pd/sol. 90 mg 1Sanis Atorvastatin Tab. 10 mg 500Sanis Atorvastatin Tab. 20 mg 500Sanis Atorvastatin Tab. 40 mg 500B.M.S.-Gil Atripla Tab. 600 mg - 200 mg - 300 mg 30Bayer Avelox I.V. I.V. Perf. Sol. 400 mg/250 mL 12Biogen Avonex I.M. Inj. Pd 30 mcg (6 MUI) 4Biogen Avonex PS I.M. Inj. Sol. 30 mcg (6 MUI) 4B.M.S. Baraclude Oral Sol. 0.05 mg/mL 210 mlB.M.S. Baraclude Tab. 0.5 mg 30Bayer Betaseron Inj. Pd 0.3 mg 15Bayer Betaseron Inj. Pd 0.3 mg 45Bayer Betaseron - Initiation pack Inj. Pd 0.3 mg 1King Bicillin L-A I.M. Inj. Susp. 1 2000 000 UI / 2 mL 10PPC Cefazoline for injection Inj. Pd 10 g 10Apotex Cefazoline for injection Inj. Pd 10 g 10

2010-06 APPENDIX III - 1


PPC Cefazoline for injection Inj. Pd 20 g 10Pfizer Celsentri Tab. 150 mg 60Pfizer Celsentri Tab. 300 mg 60Cobalt Co Olanzapine Tab. or Tab. Oral Disint. 15 mg 100Cobalt Co Olanzapine Tab. or Tab. Oral Disint. 20 mg 100GSK Combivir Tab. 150 mg -300mg 60Teva Copaxone S.C. Inj.Sol (syr) 20 mg/mL 30Merck Crixivan Caps. 200 mg 360RDT Cystadane Oral Pd 1 g/1.7 mL 180 gPurdue Dilaudid-XP Inj. Sol. 50 mg/mL 50 mlSanofiAven Eligard Kit 22.5 mg 1SanofiAven Eligard Kit 30 mg 1SanofiAven Eligard Kit 45 mg 1Amgen Enbrel S.C. Inj. Pd 25 mg 4Amgen Enbrel S.C. Inj.Sol (syr) 50 mg/mL 4Amgen Enbrel SureClick S.C. Inj.Sol (syr) 50 mg/mL 4J.O.I. Eprex Syringe 5 000 UI/0.5 mL 6J.O.I. Eprex Syringe 6 000 UI/0.6 mL 6J.O.I. Eprex Syringe 8 000 UI/0.8 mL 6J.O.I. Eprex Syringe 10 000 UI/1.0 mL 6J.O.I. Eprex Syringe 30 000 UI/0.75 mL 1J.O.I. Eprex Syringe 40 000 UI/mL (1 mL) 1Genzyme Fludara Tab. 10 mg 15Genzyme Fludara Tab. 10 mg 20Genzyme Fludara Tab. 10 mg 100Lilly Forteo S.C. Inj. Sol. 250 mcg/mL (2.4 mL or 3 mL) 1Roche Fuzeon S.C. Inj. Pd 108 mg 60Mylan Gen-Clozapine Tab. 200 mg 100Novartis Gleevec Tab. 100 mg 120Novartis Gleevec Tab. 400 mg 30Gilead Hepsera Tab. 10 mg 30Lilly Humatrope Cartridge 12 mg 1Lilly Humatrope Cartridge 24 mg 1Abbott Humira S.C. Inj.Sol (syr) 40 mg 2Abbott Humira (pen) S.C. Inj.Sol (syr) 40 mg 2Sandoz Hydromorphone HP 50 Inj. Sol. 50 mg/mL 50 mlJ.O.I. Intelence Tab. 100 mg 120Schering Intron A (sans albumine) S.C. Inj.Sol (syr) 60 M UI/ 1.2 mL 1Merck Invanz Inj. Pd 1 g 10Roche Invirase Caps. 200 mg 270

APPENDIX III - 2 2010-06


Roche Invirase Tab. 500 mg 120Merck Isentress Tab. 400 mg 60Jamp Jamp-Docusate Sodium Syr. 50 mg/mL 500 mlAbbott Kaletra Tab. 200 mg -50 mg 120GSK Kivexa Tab. 600 mg - 300 mg 30J.O.I. Levaquin Tab. 750 mg 50Novartis Lioresal Intrathecal Inj. Sol. 2 mg/mL (5 mL) 5Novartis Lucentis Inj. Sol. 2.3 mg / 0.23 mL 1Abbott Lupron Depot Kit 11.25 mg 1Abbott Lupron Depot Kit 22.5 mg 1Abbott Lupron Depot Kit 30 mg 1Pfizer Macugen Syringe 0.3 mg 1GSK Mepron Oral Susp. 150 mg/mL 210 mlNovartis Myfortic Ent. Tab. 360 mg 120Genzyme Myozyme I.V. Perf. Pd 50 mg 1Amgen Neupogen Inj. Sol. 300 mcg/mL (1.0 mL) 10Amgen Neupogen Inj. Sol. 300 mcg/mL (1.6mL) 10Bayer Nimotop Tab. 30 mg 100Biovail Nitoman Tab. 25 mg 112Novopharm Novo-Levofloxacin Tab. 750 mg 100Novopharm Novo-Olanzapine Tab. or Tab. Oral Disint. 15 mg 100Systagenix Nu-Derm Hydrocolloid Border (10 cm x 10 cm - 100 cm²)

Dressing 100 cm² to 200 cm² (active surface)160

Pro Doc Olanzapine Tab. or Tab. Oral Disint. 15 mg 100B.M.S. Orencia I.V. Perf. Pd 250 mg 1Schering Pegetron Kit 200 mg-50 mcg/0.5 mL 1Schering Pegetron Kit 200 mg-80 mcg/0.5 mL 1Schering Pegetron Kit 200 mg-100 mcg/0.5 mL 1Schering Pegetron Kit 200 mg-120 mcg/0.5 mL 1Schering Pegetron Kit 200 mg-150 mcg/0.5 mL 1Schering Pegetron Redipen Kit 200 mg-80 mcg/0.5 mL 1Schering Pegetron Redipen Kit 200 mg-100 mcg/0.5 mL 1Schering Pegetron Redipen Kit 200 mg-120 mcg/0.5 mL 1Schering Pegetron Redipen Kit 200 mg-150 mcg/0.5 mL 1Phmscience pms-Docusate Syr. 50 mg/mL 500 mlPhmscience pms-Levofloxacin Tab. 750 mg 100Phmscience pms-Olanzapine Tab. or Tab. Oral Disint. 15 mg 100Phmscience pms-Vancomycin I.V. Perf. Pd 1 g 10Schering Posanol Oral Susp. 40 mg/mL 1J.O.I. Prezista Tab. 300 mg 120



J.O.I. Prezista Tab. 400 mg 60J.O.I. Prezista Tab. 600 mg 60Merck Primaxin I.V. Perf. Susp. 500 mg -500 mg 25Astellas Prograf Caps. 5 mg 100Roche Pulmozyme Sol. Inh. 1 mg/mL (2.5 mL) 30Ranbaxy Ran-Risperidone Tab. Oral Disint. or Tab. 2 mg 500Wyeth Rapamune Oral Sol. 1 mg/mL 60 mlWyeth Rapamune Tab. 1 mg 100Serono Rebif S.C. Inj. Sol. 22 mcg/0.5 mL (1,5 mL) 4Serono Rebif S.C. Inj. Sol. 44 mcg/0.5 mL (1,5 mL) 4Serono Rebif S.C. Inj.Sol (syr) 44 mcg (12 MUI) 3J.O.I. Regranex Top. Jel. 0.01 % 15 gSchering Remicade I.V. Perf. Pd 100 mg 1U.T.C. Remodulin Inj. Sol. 1 mg/mL 20 mlU.T.C. Remodulin Inj. Sol. 2.5 mg/mL 20 mlU.T.C. Remodulin Inj. Sol. 5 mg/mL 20 mlU.T.C. Remodulin Inj. Sol. 10 mg/mL 20 mlPfizer Revatio Tab. 20 mg 90Celgene Revlimid Caps. 5 mg 28Celgene Revlimid Caps. 10 mg 28Celgene Revlimid Caps. 15 mg 21Celgene Revlimid Caps. 25 mg 21B.M.S. Reyataz Caps. 150 mg 60B.M.S. Reyataz Caps. 200 mg 60B.M.S. Reyataz Caps. 300 mg 30SanofiAven Rilutek Tab. 50 mg 60Roche Rituxan I.V. Perf. Sol. 10 mg/mL 10 mlRoche Rituxan I.V. Perf. Sol. 10 mg/mL 50 mlRiva Riva-Olanzapine Tab. or Tab. Oral Disint. 15 mg 100Riva Riva-Olanzapine Tab. or Tab. Oral Disint. 15 mg 500Novartis Sandostatin LAR I.M. Inj. Susp. 10 mg 1Novartis Sandostatin LAR I.M. Inj. Susp. 20 mg 1Novartis Sandostatin LAR I.M. Inj. Susp. 30 mg 1Sandoz Sandoz Olanzapine Tab. or Tab. Oral Disint. 15 mg 100Amgen Sensipar Tab. 60 mg 30Amgen Sensipar Tab. 90 mg 30Schering Simponi S.C. Inj.Sol (App.) 50 mg/0.5 ml 1Schering Simponi S.C. Inj.Sol (syr) 50 mg/0.5 ml 1Tercica Somatuline Autogel S.C. Inj.Sol (syr) 60 mg/0.3 mL 1Tercica Somatuline Autogel S.C. Inj.Sol (syr) 90 mg/0.3 mL 1



Tercica Somatuline Autogel S.C. Inj.Sol (syr) 120 mg/0.5 mL 1B.M.S. Sprycel Tab. 20 mg 60B.M.S. Sprycel Tab. 50 mg 60B.M.S. Sprycel Tab. 70 mg 60B.M.S. Sprycel Tab. 100 mg 30J.O.I. Stelara S.C. Inj. Sol. 45 mg/0.5 mL 1PPC Sterile Vancomycin Hydrochloride I.V. Perf. Pd 1 g 10PPC Sterile Vancomycin Hydrochloride I.V. Perf. Pd 10 g 1PPC Sterile Vancomycin Hydrochloride I.V. Perf. Pd 500 mg 25SanofiAven Suprefact Depot Implant 6.3 mg 1SanofiAven Suprefact Depot 3 mois Implant 9.45 mg 1B.M.S. Sustiva Caps. 200 mg 90B.M.S. Sustiva Tab. 600 mg 30Pfizer Sutent Caps. 12.5 mg 28Pfizer Sutent Caps. 25 mg 28Pfizer Sutent Caps. 50 mg 28Roche Tarceva Tab. 100 mg 30Roche Tarceva Tab. 150 mg 30GSK Telzir Tab. 700 mg 60Schering Temodal Caps. 100 mg 5Schering Temodal Caps. 140 mg 5Schering Temodal Caps. 140 mg 20Schering Temodal Caps. 180 mg 5Schering Temodal Caps. 180 mg 20Schering Temodal Caps. 250 mg 5Pfizer Thelin Tab. 100 mg 28Novartis Tobi Sol. Inh. 300 mg/5 mL 56Actelion Tracleer Tab. 62.5 mg 56Actelion Tracleer Tab. 125 mg 56Paladin Trelstar LA Kit 11.25 mg 1GSK Trizivir Tab. 300 mg - 150 mg - 300 mg 60Gilead Truvada Tab. 200mg- 300mg 30Wyeth Tygacil I.V. Perf. Pd 50 mg 10Biogen Tysabri I.V. Inj. Sol. 300mg/15ml 1Schering Unitron-Peg S.C. Inj. Pd 50 mcg/0.5 mL 2Schering Unitron-Peg S.C. Inj. Pd 80 mcg/0.5 mL 2Schering Unitron-Peg S.C. Inj. Pd 120 mcg/0.5 mL 2Schering Unitron-Peg S.C. Inj. Pd 150 mcg/0.5 mL 2Roche Valcyte Tab. 450 mg 60Hospira Vancomycine (hydrochloride) I.V. Perf. Pd 1 g 10



B.M.S. Vepesid Caps. 50 mg 20Roche Vesanoid Caps. 10 mg 100AllergiLab Vespides combines Inj. Pd 3.3 mg 1Oméga Vespides combines Inj. Pd 3.3 mg 1Allergy Vespides combines Inj. Pd 3.3 mg 1Oméga Vespides combines Inj. Pd 3.9 mg 1Pfizer Vfend Tab. 200 mg 30Pfizer Viracept Tab. 250 mg 300Pfizer Viracept Tab. 625 mg 120Gilead Viread Tab. 300 mg 30Novartis Visudyne I.V. Inj. Pd 15 mg 1GSK Volibris Tab. 5 mg 30GSK Volibris Tab. 10 mg 30Bayer Xarelto Tab. 10 mg 50Roche Xeloda Tab. 500 mg 120AZC Zoladex LA Implant 10.8 mg 1Novartis Zometa I.V. Perf. Sol. 4 mg/5 mL 5 mlLilly Zyprexa Tab. or Tab. Oral Disint. 7.5 mg 100Lilly Zyprexa Tab. or Tab. Oral Disint. 10 mg 100Lilly Zyprexa Tab. or Tab. Oral Disint. 15 mg 100Lilly Zyprexa Tab. or Tab. Oral Disint. 20 mg 100Pfizer Zyvoxam Tab. 600 mg 203M Canada 3M Tegaderm Foam Dressing (nonadhesive) (20cm x

20cm-400cm²) Dressing 201 cm² to 500 cm² (activesurface)

30


2010-06 APPENDIX IV - 1

APPENDIX IV

LIST OF EXCEPTIONAL MEDICATIONS WITH RECOGNIZED INDICATIONS FOR PAYMENT

ABATACEPT: ♦ for treatment of moderate or severe rheumatoid arthritis;

Upon initiation of treatment or if the person has been receiving the drug for less than five months: • the person must, prior to the beginning of treatment, have eight or more joints with active synovitis and one of

the following five elements must be present: - a positive rheumatoid factor; - radiologically measured erosions; - a score of more than 1 on the Health Assessment Questionnaire (HAQ); - an elevated C-reactive protein level; - an elevated sedimentation rate, and

• the disease must still be active despite treatment with two disease-modifying anti-rheumatic drugs, used either concomitantly or not, for at least three months each. Unless there is serious intolerance or a serious contraindication, one of the two drugs must be methotrexate at a dose of 20 mg or more per week.

The initial request is authorized for a maximum of five months. When requesting continuation of treatment, the physician must provide information making it possible to establish the treatment's beneficial effects, specifically: • a decrease of at least 20% in the number of joints with active synovitis and one of the following four

elements: - a decrease of 20% or more in the C-reactive protein level; - a decrease of 20% or more in the sedimentation rate; - a decrease of 0.20 in the HAQ score; - a return to work.

Requests for continuation of treatment are authorized for a period of 12 months. Authorizations for abatacept are given for three doses of 10 mg/kg every two weeks, then for 10 mg/kg every four weeks;

♦ for treatment of moderate or severe juvenile idiopathic arthritis (juvenile rheumatoid arthritis and juvenile chronic

arthritis) of the polyarticular or systemic type; Upon initiation of treatment or if the person has been receiving the drug for less than five months: • the person must, prior to the beginning of treatment, have five or more joints with active synovitis and one of

the following two elements must be present: - an elevated C-reactive protein level; - an elevated sedimentation rate, and

• the disease must still be active despite treatment with methotrexate at a dose of 15 mg/M2 or more (maximum dose of 20 mg) per week for at least three months, unless there is intolerance or a contraindication.

The initial request is authorized for a maximum of five months.


When requesting continuation of treatment, the physician must provide information making it possible to establish the treatment's beneficial effects, specifically: • a decrease of at least 20% in the number of joints with active synovitis and one of the following six elements:

- a decrease of 20% or more in the C-reactive protein level; - a decrease of 20% or more in the sedimentation rate; - an decrease of 0.13 in the Childhood Health Assessment Questionnaire (CHAQ) score or a return to

school; - an improvement of at least 20% in the physician's overall assessment (visual analogue scale); - an improvement of at least 20% in the person's or parent's overall assessment (visual analogue scale); - a decrease of 20% or more in the number of affected joints with limited movement.

Requests for continuation of treatment are authorized for a maximum of 12 months. Authorizations for abatacept are given for 10 mg/kg every two weeks for three doses, then for 10 mg/kg every four weeks;

ACAMPROSATE: ♦ to maintain abstinence in persons suffering from alcohol dependency who have abstained from alcohol for at

least 5 days and who are taking part in a full alcohol management program centred on alcohol abstinence; The maximum duration of each authorization is three months. When requesting continuation of treatment, the physician must provide evidence of a beneficial clinical effect defined by maintained alcohol abstinence. The total maximum duration of treatment is 12 months;

ADALIMUMAB: ♦ for treatment of moderate or severe rheumatoid arthritis or of moderate or severe psoriasic arthritis of the

rheumatoid type; Upon initiation of treatment or if the person has been receiving the drug for less than five months: • the person must, prior to the beginning of treatment, have eight or more joints with active synovitis and one of

the following five elements must be present: - a positive rheumatoid factor for rheumatoid arthritis only; - radiologically measured erosions; - a score of more than 1 on the Health Assessment Questionnaire (HAQ); - an elevated C-reactive protein level; - an elevated sedimentation rate, and

• the disease must still be active despite treatment with two disease-modifying anti-rheumatic drugs, used either concomitantly or not, for at least three months each. Unless there is serious intolerance or a serious contraindication, one of the two drugs must be: for rheumatoid arthritis: - methotrexate at a dose of 20 mg or more per week; for psoriasic arthritis of the rheumatoid type: - methotrexate at a dose of 20 mg or more per week,

or - sulfasalazine at a dose of 2 000 mg per day.




Requests for continuation of treatment are authorized for a maximum period of 12 months. For rheumatoid arthritis, authorizations for adalimumab are given for a dose of 40 mg every two weeks. However, after 12 weeks of treatment with adalimumab as monotherapy, an authorization may be given for 40 mg per week. For psoriasic arthritis of the rheumatoid type, authorizations for adalimumab are given for a dose of 40 mg every two weeks;

♦ for treatment of moderate or severe psoriasic arthritis of a type other than rheumatoid; Upon initiation of treatment or if the person has been receiving the drug for less than five months: • the person must, prior to the beginning of treatment, have at least three joints with active synovitis and a

score of more than 1 on the Health Assessment Questionnaire (HAQ), and

• the disease must still be active despite treatment with two disease-modifying anti-rheumatic drugs, used either concomitantly or not, for at least three months each. Unless there is serious intolerance or a serious contraindication, one of the two drugs must be: - methotrexate at a dose of 20 mg or more per week,




Requests for continuation of treatment are authorized for a maximum period of 12 months. Authorizations for adalimumab are given for a dose of 40 mg every two weeks;

♦ for treatment of persons suffering from moderate or severe ankylosing spondylitis whose BASDAI score is ≥ 4 on

a scale of 0 to 10 and in whom the sequential use of two non-steroidal anti-inflammatories at the optimal dose for a period of three months each did not adequately control the disease, unless there is a contraindication; • Upon the initial request, the physician must provide the following information:

- the BASDAI score; - the degree of functional injury, according to the BASFI (scale of 0 to 10);

The initial request will be authorized for a maximum of five months. • When requesting continuation of treatment, the physician must provide information making it possible to

establish the treatment's beneficial effects, specifically: - a decrease of 2.2 points or 50% on the BASDAI scale, compared with the pre-treatment score, or - a decrease of 1.5 points or 43% on the BASFI scale, or - a return to work.

Requests for continuation of treatment will be authorized for maximum periods of 12 months. Authorizations for adalimumab are given for a maximum of 40 mg every two weeks;


♦ for treatment of moderate or severe intestinal Crohn's disease that is still active despite treatment with corticosteroids and immunosuppressors, unless there is a contraindication or major intolerance to corticosteroids. An immunosuppressor must have been tried for at least eight weeks; Upon the initial request, the physician must indicate the immunosuppressor used as well as the duration of treatment. The initial request is authorized for a maximum of three months, which includes induction treatment at the rate of 160 mg initially and 80 mg on the second week, followed by maintenance treatment with a dosage of 40 mg every two weeks. Upon subsequent requests, the physician must provide evidence of a beneficial clinical effect. Requests for continuation of treatment will be authorized for a maximum period of 12 months. However, if the medical condition justifies increasing the dosage to 40 mg per week as of the 12th week of treatment, authorization will be given for a maximum period of three months. After which, for subsequent authorizations renewals, lasting a maximum of 12 months, the physician will have to demonstrate the clinical benefits obtained with this dosage;

♦ for treatment of moderate or severe intestinal Crohn's disease that is still active despite treatment with

corticosteroids, unless there is a contraindication or major intolerance to corticosteroids, where immunosuppressors are contraindicated or not tolerated, or where they have been ineffective in the past during a similar episode after treatment combined with corticosteroids; Upon the initial request, the physician must indicate the nature of the contraindication or the intolerance as well as the immunosuppressor used. The initial request is authorized for a maximum of three months, which includes induction treatment at the rate of 160 mg initially and 80 mg on the second week, followed by maintenance treatment with a dosage of 40 mg every two weeks. Upon subsequent requests, the physician must provide evidence of a beneficial clinical effect. Requests for continuation of treatment will be authorized for a maximum period of 12 months. However, if the medical condition justifies increasing the dosage to 40 mg per week as of the 12th week of treatment, authorization will be given for a maximum period of three months. After which, for subsequent authorizations renewals, lasting a maximum of 12 months, the physician will have to demonstrate the clinical benefits obtained with this dosage;

♦ for treatment of persons suffering from a severe form of chronic plaque psoriasis:

• in the presence of a score greater than or equal to 15 on the Psoriasis Area and Severity Index (PASI) or of

large plaques on the face, palms or soles or in the genital area; and

• in the presence of a score greater than or equal to 15 on the Dermatology Quality of Life Index (DQLI) questionnaire; and

• where a phototherapy treatment of 30 sessions or more for three months has not made it possible to optimally control the disease, unless the treatment is contraindicated, not tolerated or not accessible or unless a treatment of 12 sessions or more for one month has not provided significant improvement in the lesions; and

• where a treatment with two systemic agents, used concomitantly or not, for at least three months each, has not made it possible to optimally control the disease. Except in the case of serious intolerance or a serious contraindication, these two agents must be: - methotrexate at a dose of 15 mg or more per week;

or - cyclosporine at a dose of 3 mg/kg or more per day;

or - acitretin at a dose of 25 mg or more per day.

The initial request is authorized for a maximum four months. When requesting continuation of treatment, the physician must provide information making it possible to establish the treatment's beneficial effects, specifically:


• an improvement of at least 75% in the PASI score; or

• an improvement of at least 50% in the PASI score and a decrease of at least five points on the DQLI questionnaire; or

• a significant improvement in lesions on the face, palms or soles or in the genital area and a decrease of at least five points on the DQLI questionnaire.

Requests for continuation of treatment are authorized for a maximum of six months. Authorizations for adalimumab are given for an induction dose of 80 mg, followed by a maintenance treatment beginning the second week at a dose of 40 mg every two weeks;

ADEFOVIR DIPIVOXIL: ♦ for treatment of chronic hepatitis B in persons:

• having a resistance to lamivudine as defined by one of the following: − a 1-log increase in HBV-DNA under treatment with lamivudine, confirmed by a second test one month

later; − a laboratory trial showing resistance to lamivudine; − a 1-log increase in HBV-DNA under treatment with lamivudine, with viremia greater than 20 000 IU/m;

• with cirrhosis that is decompensated or at risk of decompensation, with a Child-Pugh score of > 6; • after a liver transplant or where the graft is infected with the hepatitis B virus; • infected with HIV but not being treated with antiretrovirals for that condition; • not having a resistance to lamivudine and whose viral load is greater than 20 000 IU/mL (HBeAg-positive) or

2 000 IU/mL (HBeAg-negative) prior to the beginning of treatment; ALGLUCOSIDASE ALFA: ♦ for treatment of an infantile-onset (or a rapidly progressive form) of Pompe’s disease, in children whose symptoms

appeared before the age of 12 months;

When requesting continuation of treatment, the physician must provide evidence of a beneficial clinical effect by the absence of extensive deterioration. Extensive deterioration occurs when the following two criteria are met:

• the presence of invasive ventilation;

and • an increase of two points or more in the ventricular mass index Z-score in comparison to the previous value.

The maximum duration of each authorization is six months.

ALISKIREN: ♦ for treatment of arterial hypertension, in association with at least one antihypertensive agent, if there is a

therapeutic failure of, intolerance to, or a contraindication for: • a thiazide diuretic;

and • an angiotensin converting enzyme inhibitor (ACEI);

and • an angiotensin II receptor antagonist (ARA);

However, following therapeutic failure of an ACEI, a trial of an ARA is not required and vice versa.

ALISKIREN / HYDROCHLOROTHIAZIDE: ♦ for treatment of arterial hypertension if there is a therapeutic failure of a thiazide diuretic and if there is a

therapeutic failure of intolerance to, or a contraindication for:

• an angiotensin converting enzyme inhibitor (ACEI); and

• an angiotensin II receptor antagonist (ARA);

However, following therapeutic failure of an ACEI, a trial of an ARA is not required and vice versa.


AMBRISENTAN: ♦ for treatment of pulmonary arterial hypertension of WHO functional class III that is either idiopathic or associated

with connectivitis and that is symptomatic despite the optimal conventional treatment. Persons must be evaluated and followed up on by physicians working at designated centres specializing in the treatment of pulmonary arterial hypertension;

AMLODIPINE BESYLATE / ATORVASTATIN CALCIUM: ♦ for persons who have been receiving a stable-dose treatment with amlodipine and atorvastatin for at least three

months; AMPHETAMINE MIXED SALTS: ♦ for treatment of persons suffering from attention deficit disorder and in whom the use of short-acting

methylphenidate or of dexamphetamine has not properly controlled the symptoms of the disease. Before it can be concluded that these treatments are ineffective, the stimulant must have been titrated optimally, unless there is proper justification;

ANETHOLE TRITHIONE: ♦ for treatment of persons suffering from severe xerostomia; ★ APREPITANT: ♦ As first-line antiemetic therapy for nausea and vomiting during a highly emetic chemotherapy treatment, in

association with dexamethasone and a 5-HT3 receptor antagonist. However, the latter medication must be administered during only the first day of the chemotherapy treatment.

Authorizations are given for a maximum of three doses of aprepitant per chemotherapy treatment;

ATOMOXETINE HYDROCHLORIDE: ♦ for treatment of children and adolescents suffering from attention deficit disorder and in whom it has not been

possible to properly control the symptoms of the disease with methylphenidate and an amphetamine or for whom these drugs are contraindicated. Before it can be concluded that these drugs are ineffective, they must have been titrated at optimal doses and, in addition, a 12-hour controlled-release form of methylphenidate or of amphetamine mixed salts must have been tried, unless there is proper justification for not complying with these requirements;

BECAPLERMIN: ♦ for treatment of grade I or II (Wagner) neuropathic (mal perforant) ulcers of a non-clinically infected diabetic foot,

where the following criteria apply: • acceptable vascularization, including a tibiohumeral index (THI) > 0.70 of the affected lower limb or presence

of a palpable pulse; • absence of underlying infection or of osteitis, as shown by x-rays or bone scanning; • obligatory previous optimal wound care, specifically, wound care during an 8-week period including

debridement, dressing that fosters a moist wound environment for scarring, and a system for relieving pressure on foot;

• patient’s observance of wound care and of a system for relieving pressure on foot; When submitting a renewal request, the physician must be able to demonstrate that the following adjuvant measures were used during the first becaplermin treatment:


• cleansing of ulcer with sterile saline only; • weekly debridement (exeresis of callosity, of necrotic tissue or of foreign body); • use and observance of a system for relieving pressure on foot (walking boot, cast, wheelchair); • daily changes of dressing (becaplermin, non-adhering dressing and dry dressing); • minimum 30 percent improvement in ulcer (proven by file photographs, copies of sketches and supporting

measurements); • absence of cellulitis and of osteomyelitis;

BETAHISTINE DIHYDROCHLORIDE: ♦ to reduce the severity of vertigo of peripheral origin; BISACODYL: ♦ for treatment of constipation related to a medical condition BOSENTAN: ♦ for treatment of pulmonary arterial hypertension of WHO functional class III that is either idiopathic or associated

with connectivitis and that is symptomatic despite the optimal conventional treatment; Persons must be evaluated and followed up on by physicians working at designated centres specializing in the treatment of pulmonary arterial hypertension;

BOTULINUM TOXIN TYPE A: ♦ for treatment of cervical dystonia, blepharospasm, strabismus and other severe spasticity conditions; ♦ for treatment of adults suffering from severe axillary hyperhidrosis causing significant effects on the functional

and psychosocial levels, where an aluminum chloride preparation of at least 20% used for one month or more according to the recommendations to maximize its effect and tolerance has proven ineffective. In the initial request for authorization, the physician must document the above-mentioned effects. Authorization will then be granted for four months for a dose of 100 units of this drug. Upon subsequent requests, the physician must show evidence of a beneficial effect in the form of a decrease in sudation and an observed improvement on the functional and psychosocial levels;

BOTULINUM TOXIN TYPE A WITHOUT COMPLEXING PROTEINS:

♦ for treatment of cervical dystonia, blepharospasm and other severe spasticity conditions;

BUPRENORPHINE / NALOXONE: ♦ for replacement treatment of opioid dependency:

• where methadone has failed, is not tolerated or is contraindicated; or

• where a methadone maintenance program is not available or not accessible;

CABERGOLINE: ♦ for treatment of hyperprolactinemia in persons for whom bromocriptine or quinagolide is ineffective,

contraindicated or not tolerated; Notwithstanding the payment indication set out above, cabergoline remains covered by the basic prescription drug insurance plan for insured persons who used this drug during the 12-month period preceding 1 October 2007 and if its cost was already covered under that plan as part of the recognized indications provided in the appendix hereto. CALCIPOTRIOL / BETAMETHASONE DIPROPIONATE: ♦ for treatment of psoriasis where calciprotriol is ineffective of poorly tolerated;


CALCIUM GLUCONATE/CALCIUM LACTATE: ♦ as a calcium supplement for children suffering from bovine protein or lactose intolerance; ♦ as a calcium supplement for persons suffering from hypoparathyroidism, lactase deficiency or malabsorption and

unable to take tablets; ♦ as a phosphate binder in persons suffering from severe renal failure and unable to take tablets; ♦ as a calcium supplement for persons suffering from osteoporosis and unable to take tablets; CAPECITABINE: ♦ for treatment of advanced or metastatic breast cancer that has not responded to first-line chemotherapy

administered during the advanced or metastatic phase, unless such chemotherapy is contraindicated; ♦ for treatment of colorectal cancer of stage III (stage C according to the Dukes classification) or IV (stage D

according to the Dukes classification or metastatic); CARBOXYMETHYLCELLULOSE SODIUM: ♦ for treatment of keratoconjunctivitis sicca or other severe conditions accompanied by markedly reduced tear

production; CARBOXYMETHYLCELLULOSE SODIUM/PURITE: ♦ for treatment of keratoconjunctivitis sicca or other severe conditions accompanied by markedly reduced tear

production; ★ CASPOFUNGIN ACETATE: ♦ for treatment of invasive aspergillosis in persons for whom first-line treatment has failed or is contraindicated, or

who are intolerant to such a treatment; ♦ for treatment of invasive candidosis in persons for whom treatment with fluconazole has failed or is

contraindicated, or who are intolerant to such a treatment; ♦ for treatment of esophageal candidosis in persons for whom treatment with itraconazole or with fluconazole and

an amphotericin B formulation has failed or is contraindicated or who are intolerant to such a treatment; CINACALCET HYDROCHLORIDE: ♦ for treatment of dialysized persons having severe secondary hyperparathyroiditis with an intact parathormone

level greater than 88 pmol/L measured twice within a three-month period, despite an optimal phosphate binder and vitamin D based treatment, unless there is significant intolerance to these agents or they are contraindicated, and having: • a corrected calcemia ≥ 2.54 mmol/L or; • a phosphoremia ≥ 1.78 mmol/L or; • a phosphocalcic product ≥ 4.5 mmol2/L2 or; • symptomatic osteoarticular manifestations. The optimal vitamin D based treatment is defined as follows: one minimum weekly dose of 3 mcg of calcitriol or alfacalcidol or 30 mcg of doxercalciferol;

★ CIPROFLOXACIN HYDROCHLORIDE, i.v. perf. sol.: ♦ for treatment of infections where oral ciprofloxacin cannot be used;


CLINDAMYCIN PHOSPHATE, vag. cr.: ♦ for treatment of bacterial vaginosis during the first trimester of pregnancy; ♦ where intravaginal metronidazole is ineffective, contraindicated or poorly tolerated; CLINDAMYCIN PHOSPHATE, vag. cr. (single dose): ♦ where intravaginal metronidazole is ineffective, contraindicated or poorly tolerated; ★ CLOPIDOGREL BISULFATE Tab. 75 mg: ♦ for secondary prevention of ischemic vascular manifestations in persons for whom a platelet inhibitor is indicated

but for whom acetylsalicylic acid is ineffective, contraindicated or poorly tolerated; ♦ for prevention of ischemic vascular manifestations, in association with acetylsalicylic acid, in persons for whom

an angioplasty, with or without the installation of a coronary artery stent, has been performed. The duration of the authorization will be 12 months;

♦ for treatment of acute coronary syndrome in persons:

• who are already being treated with acetylsalicylic acid; • who were not previously taking acetylsalicylic acid. The maximum duration of the authorization is 12 months;

★ CODEINE PHOSPHATE, syrup: ♦ for treatment of pain in persons unable to take tablets; DARBEPOETIN ALFA: ♦ for treatment of anemia related to severe chronic renal failure (creatinine clearance less than or equal to 35

mL/min);

♦ for treatment of chronic and symptomatic non-hemolytic anemia not caused by an iron, folic acid or vitamin B12 deficiency; • in persons having a non-myeloid tumour treated with chemotherapy and whose hemoglobin rate is less than

100 g/L. The maximum duration of the initial authorization is three months. When requesting continuation of treatment, the physician must provide evidence of a beneficial effect defined by an increase in the reticulocyte count of at least 40x109/L or an increase in the hemoglobin measurement of at least 10 g/L. A hemoglobin rate under 120 g/L should be targeted. However, for persons suffering from cancer other than those previously specified, darbepeotin alfa remains covered by the basic prescription drug insurance plan until 31 January 2008 insofar as the treatment is already underway on 1 October 2007 and that its cost was already covered under that plan as part of the recognized indications provided in the appendix hereto and that the physician provides evidence of a beneficial effect defined by an increase in the reticulocyte count of at least 40x109/L or an increase in the hemoglobin measurement of at least 10 g/L.

DARUNAVIR Tab. 300 mg and 600 mg: ♦ for treatment, in association with other antiretrovirals, of HIV-infected persons:

• who have tried, since the beginning of their antiretroviral therapy, at least one therapy that included another protease inhibitor and that resulted: − in a documented virological failure, after at least three months of treatment with an association of several

antiretroviral agents; or

− in serious intolerance to at least three protease inhibitors, to the point of calling into question the continuation of the antiretroviral treatment;


♦ for first-line treatment, in association with other antiretrovirals, of HIV-infected persons for whom a laboratory test showed an absence of sensitivity to other protease inhibitors, coupled with a resistance to one or the other class of nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors, or to both, and: • whose current viral load and another dating back at least one month are greater than or equal to

500 copies/mL; and

• whose current CD4 lymphocyte count and another dating back at least one month are less than or equal to 350/μL; and

• for whom the use of darunavir is necessary to establish an effective therapeutic regimen; DASATINIB: ♦ for adults suffering from chronic myeloid leukemia (CML) in the chronic or accelerated phase:

• who have not responded to an imatinib treatment (primary resistance); or

• whose illness has evolved after initially responding to imatinib (secondary resistance); or

• who have serious intolerance to imatinib; For CML in the chronic phase, authorizations will be given for a maximum daily dose of 140 mg for a maximum duration of six months. For CML in the accelerated phase, authorizations will be given for a maximum daily dose of 180 mg for a maximum duration of six months. For continuation of the treatment, the physician must provide evidence of a hematologic response. Where the dose used is less than the above-mentioned maximum dose and there is evidence the disease has progressed, authorization may be obtained for a higher daily dose, which may not exceed the maximum authorized for the phase of the disease;

DELTA-9-TETRAHYDROCANNABINOL: ♦ for treatment of severe vomiting and nausea; DICLOFENAC SODIUM, oph. sol.: ♦ for treatment of ocular inflammation in persons for whom ophthalmic corticosteroids are not indicated; DIPHENHYDRAMINE HYDROCHLORIDE: ♦ for adjuvant treatment of certain psychiatric disorders and of Parkinson’s disease; DIPYRIDAMOLE/ACETYLSALICYLIC ACID: ♦ for secondary prevention of strokes in persons who have already had a stroke or a transient ischemic attack; DOCUSATE CALCIUM: ♦ for treatment of constipation related to a medical condition; DOCUSATE SODIUM: ♦ for treatment of constipation related to a medical condition; ★ DOLASETRON MESYLATE: ♦ during the first day of:

• a moderately or highly emetic chemotherapy treatment, or

• a highly emetic radiotherapy treatment;


♦ during: • a chemotherapy treatment undergone by persons for whom the conventional antiemetic therapy is

ineffective, contraindicated or poorly tolerated and who are not receiving aprepitant, or

• a radiotherapy treatment undergone by persons for whom the conventional antiemetic therapy is ineffective, contraindicated or poorly tolerated;

DONEPEZIL HYDROCHLORIDE: ♦ as monotherapy for persons suffering from Alzheimer's disease at the mild or moderate stage.

Upon the initial request, the following elements must be present: • an MMSE score of 10 to 26, or as high as 27 or 28 if there is proper justification; • medical confirmation of the degree to which the person is affected (intact domain, mildly, moderately or

severely affected) in the following five domains: - intellectual function, including memory; - mood; - behaviour; - autonomy in activities of daily living (ADL) and in instrumental activities of daily living (IADL); - social interaction, including the ability to carry on a conversation.

The duration of the initial authorization for a treatment with donepezil is six months from the beginning of treatment. However, where the cholinesterase inhibitor is used following treatment with memantine, the concomitant use of both medications is authorized for one month. Upon subsequent requests, the physician must provide evidence of a beneficial effect confirmed by each of the following elements: • an MMSE score of 10 or more, unless there is proper justification; • a maximum decrease of 3 points in the MMSE score per six-month period compared with the previous

evaluation, or a greater decrease accompanied by proper justification; • stabilization or improvement of symptoms in one or more of the following domains:

- intellectual function, including memory; - mood; - behaviour; - autonomy in activities of daily living (ADL) and in instrumental activities of daily living (IADL); - social interaction, including the ability to carry on a conversation.

The maximum duration of authorization is 12 months;

DORNASE ALFA: ♦ during initial treatment in persons over 5 years of age suffering from cystic fibrosis and whose forced vital

capacity is more than 40 percent of the predicted value. The maximum duration of the initial authorization is three months;

♦ during maintenance treatment in persons for whom the physician provides evidence of a beneficial clinical effect.

The maximum duration of authorization is one year; DORZOLAMIDE HYDROCHLORIDE / TIMOLOL MALEATE: ♦ where there is significant intolerance to two topical antiglaucoma agents, unless there is proper justification for

not complying with these requirements;


DRESSING, ABSORPTIVE – GELLING FIBRE: ♦ for treatment of persons suffering from severe burns; ♦ for treatment of persons suffering from a pressure sore of stage 2 or greater; ♦ for treatment of persons suffering from a severe wound (affecting the subcutaneous tissue) caused by a chronic

disease or by cancer; ♦ for treatment of persons suffering from a severe cutaneous ulcer (affecting the subcutaneous tissue) related to

arterial or venous insufficiency; ♦ for treatment of persons suffering from a severe chronic wound (affecting the subcutaneous tissue) where the

scarring process is compromised. In this case, a chronic wound is a wound that has lasted for more than 45 days;

DRESSING, ABSORPTIVE – HYDROPHILIC FOAM ALONE OR IN ASSOCIATION: ♦ for treatment of persons suffering from severe burns; ♦ for treatment of persons suffering from a pressure sore of stage 2 or greater; ♦ for treatment of persons suffering from a severe wound (affecting the subcutaneous tissue) caused by a chronic




DRESSING, ABSORPTIVE – SODIUM CHLORIDE: ♦ for treatment of persons suffering from severe burns; ♦ for treatment of persons suffering from a pressure sore of stage 2 or greater; ♦ for treatment of persons suffering from a severe wound (affecting the subcutaneous tissue) caused by a chronic




DRESSING, ANTIMICROBIAL – IODINE: ♦ for treatment of persons suffering from severe burns or severe chronic wounds (affecting the subcutaneous

tissue) with critical colonization by at least one pathogen, documented by a bacterial culture from the debrided wound base. The request is authorized for a maximum of 12 weeks.

Critical colonization is defined by the presence of at least one pathogen, documented by a culture, in a severe wound, showing the following clinical signs: increased exudate, friable granulation tissue, stagnation in the scarring process, accentuated odour, accentuated pain and inflammation less than two cm from the edge. Critical colonization of a chronic wound, if it persists, may lead to infection of the chronic wound with systemic signs or symptoms; DRESSING, ANTIMICROBIAL – SILVER: ♦ for treatment of persons suffering from severe burns or severe chronic wounds (affecting the subcutaneous


Critical colonization is defined by the presence of at least one pathogen, documented by a culture, in a severe wound, showing the following clinical signs: increased exudate, friable granulation tissue, stagnation in the scarring process, accentuated odour, accentuated pain and inflammation less than two cm from the edge. Critical colonization of a chronic wound, if it persists, may lead to infection of the chronic wound with systemic signs or symptoms;


DRESSING, BORDERED ABSORPTIVE– GELLING FIBRE ♦ for treatment of persons suffering from severe burns; ♦ for treatment of persons suffering from a pressure sore of stage 2 or greater; ♦ for treatment of persons suffering from a severe wound (affecting the subcutaneous tissue) caused by a chronic




DRESSING, BORDERED ABSORPTIVE – HYDROPHILIC FOAM ALONE OR IN ASSOCIATION: ♦ for treatment of persons suffering from severe burns; ♦ for treatment of persons suffering from a pressure sore of stage 2 or greater; ♦ for treatment of persons suffering from a severe wound (affecting the subcutaneous tissue) caused by a chronic




DRESSING, BORDERED ABSORPTIVE– POLYESTER AND RAYON FIBRE ♦ for treatment of persons suffering from severe burns; ♦ for treatment of persons suffering from a pressure sore of stage 2 or greater; ♦ for treatment of persons suffering from a severe wound (affecting the subcutaneous tissue) caused by a chronic




DRESSING, BORDERED ANTIMICROBIAL – SILVER: ♦ for treatment of persons suffering from severe burns or severe chronic wounds (affecting the subcutaneous


Critical colonization is defined by the presence of at least one pathogen, documented by a culture, in a severe wound, showing the following clinical signs: increased exudate, friable granulation tissue, stagnation in the scarring process, accentuated odour, accentuated pain and inflammation less than two cm from the edge. Critical colonization of a chronic wound, if it persists, may lead to infection of the chronic wound with systemic signs or symptoms; DRESSING, BORDERED MOISTURE-RETENTIVE– HYDROCOLLOID OR POLYURETHANE: ♦ for treatment of persons suffering from severe burns; ♦ for treatment of persons suffering from a pressure sore of stage 2 or greater; ♦ for treatment of persons suffering from a severe wound (affecting the subcutaneous tissue) caused by a chronic





DRESSING, INTERFACE – POLYAMIDE OR SILICONE: ♦ to facilitate the treatment of persons suffering from very painful severe burns; DRESSING, MOISTURE RETENTIVE – HYDROCOLLOID OR POLYURETHANE: ♦ for treatment of persons suffering from severe burns; ♦ for treatment of persons suffering from a pressure sore of stage 2 or greater; ♦ for treatment of persons suffering from a severe wound (affecting the subcutaneous tissue) caused by a chronic




DRESSING, ODOUR-CONTROL – ACTIVATED CHARCOAL: ♦ for treatment of persons suffering from a foul-smelling pressure sore of stage 2 or greater; ♦ for treatment of persons suffering from a severe foul-smelling wound (affecting the subcutaneous tissue) caused

by a chronic disease or by cancer; ♦ for treatment of persons suffering from a severe foul-smelling cutaneous ulcer (affecting the subcutaneous tissue)

related to arterial or venous insufficiency; ♦ for treatment of persons suffering from a severe foul-smelling chronic wound (affecting the subcutaneous tissue)

where the scarring process is compromised. In this case, a chronic wound is a wound that has lasted for more than 45 days;

DULOXETINE: ♦ for treatment of pain related to a diabetic peripheral neuropathy; ENFUVIRTIDE: ♦ for treatment, in association with other antiretrovirals, of HIV-infected persons for whom a laboratory test showed

sensitivity to only one antiretroviral or to none and for whom enfuvirtide has never led to a virological failure;

The initial authorization, lasting a maximum of 5 months, will be given if the viral load is greater than or equal to 5 000 copies/mL. In the case of a first-line treatment, the CD4 lymphocyte count and another dating back at least one month must be less than or equal to 350/μL.

Upon subsequent requests, the physician must provide evidence of a beneficial effect: • on a recent viral load measurement, showing a reduction of at least 0.5 log compared with the viral load

measurement obtained before the enfuvirtide treatment began, or

• on a recent CD4 count, showing an increase of at least 30% compared with the CD4 count obtained before the enfuvirtide treatment began;

Authorizations will then have a maximum duration of 12 months.

♦ for treatment, in association with other antiretrovirals, of HIV-infected persons who are not concerned by the first paragraph of the previous statement: • whose current viral load and another dating back at least one month are greater than or equal to

500 copies/mL, while having been treated with an association of three or more antiretrovirals for at least three months and during the interval between the two viral load measurements, and

• who previously received at least one other antiretroviral treatment that resulted in a documented virological failure after at least three months of treatment, and


• who have tried, since the beginning of their antiretroviral therapy, at least one non-nucleoside reverse transcriptase inhibitor (except in the presence of a resistance to that class), one nucleoside reverse transcriptase inhibitor and one protease inhibitor;

The maximum duration of the initial authorization is five months. Upon subsequent requests, the physician must provide evidence of a beneficial effect: • on a recent viral load measurement, showing a reduction of at least 0.5 log compared with the viral load

measurement obtained before the enfuvirtide treatment began, or

• on a recent CD4 count, showing an increase of at least 30% compared with the CD4 count obtained before the enfuvirtide treatment began;

Authorizations will then have a maximum duration of 12 months;

ENTECAVIR: ♦ for treatment of chronic hepatitis B, at a dose of 0.5 mg per day, in persons not having a resistance to lamivudine

and whose viral load is greater than 20 000 IU/mL (HBeAg-positive) or 2 000 IU/mL (HBeAg-negative) prior to the beginning of treatment;

♦ for treatment of chronic hepatitis B in persons:

• having a resistance to lamivudine as defined by one of the following: − a 1-log increase in HBV-DNA under treatment with lamivudine, confirmed by a second test one month

later; − a laboratory trial showing resistance to lamivudine; − a 1-log increase in HBV-DNA under treatment with lamivudine, with viremia greater than 20 000 IU/mL; and

• for whom adefovir or tenofovir has failed, is contraindicated or is not tolerated; ★ EPLERENONE: ♦ for persons showing signs of heart failure and left ventricular systolic dysfunction (with ejection fraction ≤ 40 %)

after an acute myocardial infarction, when initiation of eplerenone starts in the days following the infarction as a complement to standard therapy.

EPOETIN ALFA: ♦ for treatment of anemia related to severe chronic renal failure (creatinine clearance less than or equal to

35 mL/min); ♦ for treatment of chronic and symptomatic non-hemolytic anemia not caused by an iron, folic acid or vitamin B12

deficiency: • in persons having a non-myeloid tumour treated with chemotherapy and whose hemoglobin rate less than

100 g/L; • in non cancerous persons whose hemoglobin rate is less than 100 g/L;

The maximum duration of the initial authorization is three months. When requesting continuation of treatment, the physician must provide evidence of a beneficial effect defined by an increase in the reticulocyte count of at least 40x109/L or an increase in the hemoglobin measurement of at least 10 g/L. A hemoglobin rate of less than 120g/L should be targeted.

However, for persons suffering from cancer other than those previously specified, epoetin alfa remains covered by the basic prescription drug insurance plan until 31 January 2008 insofar as the treatment is already underway on 1 October 2007 and that its cost was already covered under that plan as part of the recognized indications provided in the appendix hereto and that the physician provides evidence of a beneficial effect defined by an increase in the reticulocyte count of at least 40x109/L or an increase in the hemoglobin measurement of at least 10 g/L.


EPOPROSTENOL SODIUM: ♦ for treatment of pulmonary arterial hypertension of WHO functional class III or IV that is either idiopathic or

associated with connectivitis and that is symptomatic despite the optimal conventional treatment; Persons must be evaluated and followed up on by physicians working at designated centres specializing in the treatment of pulmonary arterial hypertension;

ERLOTINIB HYDROCHLORIDE: ♦ for treatment of locally advanced or metastatic non-small-cell lung cancer in persons:

• for whom a first-line therapy has failed and who are not eligible for other chemotherapy, or for whom a second-line therapy has failed and;

• who do not have symptomatic cerebral metastases and; • whose ECOG performance status is � 3. The maximum duration of each authorization is three months. Upon subsequent requests, the physician must provide evidence of a beneficial clinical effect (absence of disease progression);

ESTRADIOL-17B: ♦ in persons unable to take estrogens orally because of intolerance or where medical factors favour the

transdermal route; ESTRADIOL-17B / LEVONORGESTREL: ♦ in persons unable to take estrogens or progestogens orally because of intolerance or where medical factors

favour the transdermal route; ESTRADIOL-17B / NORETHINDRONE ACETATE: ♦ in persons unable to take estrogens or progestogens orally because of intolerance or where medical factors

favour the transdermal route; ETANERCEPT: ♦ for treatment of moderate or severe rheumatoid arthritis and moderate or severe psoriasic arthritis of the

rheumatoid type; Upon initiation of treatment or if the person has been receiving the drug for less than five months: • the person must, prior to the beginning of treatment, have eight or more joints with active synovitis and one of

the following five elements must be present: - a positive rheumatoid factor for rheumatoid arthritis only; - radiologically measured erosions; - a score of more than 1 on the Health Assessment Questionnaire (HAQ); - an elevated C-reactive protein level; - an elevated sedimentation rate, and

• the disease must still be active despite treatment with two disease-modifying anti-rheumatic drugs, used either concomitantly or not, for at least three months each. Unless there is serious intolerance or a serious contraindication, one of the two drugs must be: for rheumatoid arthritis: - methotrexate at a dose of 20 mg or more per week; for psoriasic arthritis of the rheumatoid type: - methotrexate at a dose of 20 mg or more per week, or - sulfasalazine at a dose of 2 000 mg per day.



When requesting continuation of treatment, the physician must provide information making it possible to establish the treatment's beneficial effects, specifically: • a decrease of at least 20% in the number of joints with active synovitis and one of the following four


Requests for continuation of treatment are authorized for a maximum period of 12 months. Authorizations for etanercept are given for a dose of 50 mg per week;

♦ for treatment of moderate or severe juvenile idiopathic arthritis (juvenile rheumatoid arthritis and juvenile chronic

arthritis) of the polyarticular or systemic type; Upon initiation of treatment or if the person has been receiving the drug for less than five months: • the person must, prior to the beginning of treatment, have five or more joints with active synovitis and one of


• the disease must still be active despite treatment with methotrexate at a dose of 15 mg/M2 or more (maximum dose of 20 mg) per week for at least three months, unless there is intolerance or a contraindication.

The initial request is authorized for a maximum of five months. When requesting continuation of treatment, the physician must provide information making it possible to establish the treatment's beneficial effects, specifically: • a decrease of 20% or more in the number of joints with active synovitis and one of the following six elements:

- a decrease of 20% or more in the C-reactive protein level; - a decrease of 20% or more in the sedimentation rate; - an decrease of 0.13 in the Childhood Health Assessment Questionnaire (CHAQ) score or a return to


Requests for continuation of treatment are authorized for a maximum of 12 months. Authorizations for etanercept are given for 0.8 mg/kg (maximum dose of 50 mg) per week;

♦ for treatment of moderate or severe psoriasic arthritis of a type other than rheumatoid; Upon initiation of treatment or if the person has been receiving the drug for less than five months: • the person must, prior to the beginning of treatment, have at least three joints with active synovitis and a








Requests for continuation of treatment are authorized for a maximum of 12 months. Authorizations for etanercept are given for a dose of 50 mg per week;

♦ for treatment of persons suffering from moderate or severe ankylosing spondylitis whose BASDAI score is ≥ 4 on a scale of 0 to 10 and in whom the sequential use of two non-steroidal anti-inflammatories at the optimal dose for a period of three months each did not adequately control the disease, unless there is a contraindication; • Upon the initial request, the physician must provide the following information:



establish the treatment's beneficial effects, specifically: - a decrease of 2.2 points or 50% on the BASDAI scale, compared with the pre-treatment score,

or - a decrease of 1.5 points or 43% on the BASFI scale,

or - a return to work.

Requests for continuation of treatment will be authorized for maximum periods of 12 months. Authorizations for etanercept are given for a maximum of 50 mg per week;

♦ for treatment of persons suffering from a severe form of chronic plaque psoriasis:

• in the presence of a score greater than or equal to 15 on the Psoriasis Area and Severity Index (PASI) or of

large plaques on the face, palms or soles or in the genital area; and






The initial request is authorized for a maximum four months. When requesting continuation of treatment, the physician must provide information making it possible to establish the treatment's beneficial effects, specifically:


• an improvement of at least 75% in the PASI score;

or • an improvement of at least 50% in the PASI score and a decrease of at least five points on the DQLI

questionnaire; or

• significant improvement in lesions on the face, palms or soles or in the genital area and a decrease of at least five points on the DQLI questionnaire.

Requests for continuation of treatment are authorized for a maximum of six months. Authorizations for etanercept are given for a maximum of 50 mg, twice per week;

ETRAVIRINE: ♦ for treatment, in association with other antiretrovirals, of HIV-infected persons:

• who have tried, since the beginning of their antiretroviral therapy, at least one therapy that included delavirdine, efavirenz or nevirapine, unless there is a primary resistance to one of those drugs, and that resulted: − in a documented virological failure, after at least three months of treatment with an association of several


− in serious intolerance to one of those agents, to the point of calling into question the continuation of the antiretroviral treatment;

and • who have tried, since the beginning of their antiretroviral therapy, at least one therapy that included a

protease inhibitor and that resulted: − in a documented virological failure, after at least three months of treatment with an association of several


− in serious intolerance to at least three protease inhibitors, to the point of calling into question the continuation of the antiretroviral treatment.

Where a therapy including another non-nucleoside reverse transcriptase inhibitor cannot be used because of a primary resistance to delavirdine, efavirenz or nevirapine, a trial of at least two therapies, each including a protease inhibitor, is necessary and must have resulted in the same conditions as those listed above.

♦ for first-line treatment, in association with other antiretrovirals, of HIV-infected persons for whom a laboratory test

showed a resistance to at least one nucleoside reverse transcriptase inhibitor, one non-nucleoside reverse transcriptase inhibitor and one protease inhibitor, and • whose current viral load and another dating back at least one month are greater than or equal to

500 copies/mL; and


• for whom the use of etravirine is necessary to establish an effective therapeutic regimen; EZETIMIBE: ♦ where ezetimibe is not used in association with an HMG-CoA reductase inhibitor (statin):

• where at least two hypolipemiants are contraindicated, ineffective or not tolerated; ♦ where ezetimibe is used in association with an HMG-CoA reductase inhibitor (statin):

• if the statin treatment, at the optimal dose or at a lower dose in case of intolerance to that dose, did not make it possible to adequately control the cholesterolemia;

★ FILGRASTIM: ♦ for treatment of persons undergoing cycles of moderately or highly myelosuppressive chemotherapy

(≥ 40 percent risk of febrile neutropenia);


♦ for treatment of persons at risk of developing severe neutropenia during chemotherapy; ♦ in subsequent cycles of chemotherapy, for treatment of persons having suffered from severe neutropenia

(neutrophil count below 0.5 x 109/L) during the first cycles of chemotherapy and for whom a reduction in the antineoplastic dose is inappropriate;

♦ in subsequent cycles of curative chemotherapy, for treatment of persons having suffered from neutropenia

(neutrophil count below 1.5 x 109/L) during the first cycles of chemotherapy and for whom a reduction in the dose or a delay in the chemotherapy administration plan is unacceptable;

♦ during chemotherapy undergone by children suffering from solid tumours; ♦ for treatment of persons suffering from severe medullary aplasia (neutrophil count below 0.5 x 109/L) and

awaiting curative treatment by means of a bone marrow transplant or with antithymocyte serum; ♦ for treatment of persons suffering from congenital, hereditary, idiopathic or cyclic chronic neutropenia whose

neutrophil count is below 0.5 x 109/L; ♦ for treatment of HIV-infected persons suffering from severe neutropenia (neutrophil count below 0.5 x 109/L); ♦ to stimulate bone marrow in the recipient in the case of an autograft; ♦ as an adjunctive treatment for acute myeloid leukemia; FLUCONAZOLE, oral susp.: ♦ for treatment of esophageal candidiasis; ♦ for treatment of oropharyngeal candidiasis or other mycoses in persons for whom the conventional therapy is

ineffective or poorly tolerated and who are unable to take fluconazole tablets; FLUDARABINE PHOSPHATE: ♦ for treatment of persons suffering from chronic lymphoid leukemia who have not responded to or do not tolerate

first-line chemotherapy; ♦ for treatment of persons suffering from non-Hodgkin's lymphoma of low-malignancy or from Waldenstrom's

macroglobulinemia where second-line chemotherapy, specifically CAP (cyclophosphamide, doxorubicin and prednisone), CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) and CVP (cyclophosphamide, vincristine and prednisone), has failed, is not tolerated or is contraindicated;

FORMOTEROL FUMARATE DIHYDRATE / BUDESONIDE: ♦ for treatment of asthma and other reversible obstructive diseases of the respiratory tract in persons whose control

of the disease is insufficient despite the use of an inhaled corticosteroid; ♦ for treatment of persons suffering from moderate or severe chronic obstructive pulmonary disease (COPD)

whose symptoms are not under control despite the use of an inhaled short-acting ß2 agonist, an inhaled long-acting ß2 agonist and an inhaled anticholinergic agent.

♦ for treatment of persons suffering from moderate to severe chronic obstructive pulmonary disease (COPD), who

have shown at least one exacerbation of the symptoms of the disease in the last year, despite regular use through inhalation of at least one long-acting bronchodilator;

Exacerbation, is understood as a sustained and repeated aggravation of the symptoms requiring intensified pharmacological treatment, for instance, the addition of oral corticosteroids, or a precipitated medical visit or a hospitalization; In the case of the medical conditions set out in the preceding paragraphs, persons insured by the RAMQ who obtained a reimbursement for an association of formoterol fumarate dihydrate / budesonide or of salmeterol xinafoate / fluticasone propionate within 365 days preceding 1 October 2003 are eligible for a continuation of their treatment.


GALANTAMINE HYDROBROMIDE: ♦ as monotherapy for persons suffering from Alzheimer's disease at the mild or moderate stage.



The duration of the initial authorization for a treatment with galantamine is six months from the beginning of treatment. However, where the cholinesterase inhibitor is used following treatment with memantine, the concomitant use of both medications is authorized for one month. Upon subsequent requests, the physician must provide evidence of a beneficial effect confirmed by each of the following elements: • an MMSE score of 10 or more, unless there is proper justification; • a maximum decrease of 3 points in the MMSE score per six-month period compared with the previous


- intellectual function, including memory; - mood; - behaviour; - autonomy in activities of daily living (ADL) and in instrumental activities of daily living (IADL); - social interaction, including the ability to carry on a conversation. The maximum duration of authorization is 12 months.

GLATIRAMER ACETATE: ♦ for treatment of persons who have had a documented first acute clinical episode of demyelinization;

The physician must provide, at the beginning of treatment, the results of an MRI showing:

• the presence of four or more lesions of the white substance, including a lesion located in the cerebellum, the corpus callosum or the periventricular region, and

• one such lesion having a diameter of 6 mm or more.

The maximum duration of the initial authorization is 12 months. When submitting subsequent requests, the physician must provide evidence of a beneficial effect (absence of new clinical episodes).

♦ for treatment of persons suffering from remitting multiple sclerosis who have had two or more episodes of the

disease within the last two years and whose EDSS scale result is less than 7. The physician must provide, at the beginning of treatment and with each subsequent request, the following information: number of attacks per year and EDSS scale result. The maximum duration of the initial authorization is six months. When submitting subsequent requests, the physician must provide evidence of a beneficial effect (absence of deterioration). For persons who previously received an interferon beta for treatment of the first acute clinical episode with documented demyelinization, the interval between the two episodes may exceed two years;


GLICLAZIDE: ♦ where another sulfonylurea is not tolerated or is ineffective; ♦ for treatment of non-insulindependent diabetic persons suffering from renal failure; GLIMEPIRIDE: ♦ where another sulfonylurea is not tolerated or is ineffective; GLYCERIN, supp.: ♦ for treatment of constipation related to a medical condition; GOLIMUMAB: ♦ for treatment of moderate or severe psoriasic arthritis of the rheumatoid type;


the following four elements must be present: - radiologically measured erosions; - a score of more than 1 on the Health Assessment Questionnaire (HAQ); - an elevated C-reactive protein level; - an elevated sedimentation rate, and






Requests for continuation of treatment are authorized for a maximum period of 12 months.

Authorizations for golimumab are given for a dose of 50 mg per month.

♦ for treatment of moderate or severe psoriasic arthritis of a type other than rheumatoid;

Upon initiation of treatment or if the person has been receiving the drug for less than five months: • the person must, prior to the beginning of treatment, have at least three joints with active synovitis and a


• the disease must still be active despite treatment with two disease-modifying anti-rheumatic drugs, used either concomitantly or not, for at least three months each. Unless there is serious intolerance or a serious contraindication, one of the two drugs must be:


- methotrexate at a dose of 20 mg or more per week, or

- sulfasalazine at a dose of 2 000 mg per day. The initial request is authorized for a maximum of five months. When requesting continuation of treatment, the physician must provide information making it possible to establish the treatment's beneficial effects, specifically: • a decrease of at least 20% in the number of joints with active synovitis and one of the following four


Requests for continuation of treatment are authorized for a maximum of 12 months. Authorizations for golimumab are given for a dose of 50 mg per month;

★ GRANISETRON HYDROCHLORIDE: ♦ during the first day of:


• a highly emetic radiotherapy treatment; ♦ in children during emetic chemotherapy or radiotherapy; ♦ during:

• a chemotherapy treatment undergone by persons for whom the conventional antiemetic therapy is ineffective, contraindicated or poorly tolerated and who are not receiving aprepitant, or


HYDROXYPROPYLMETHYLCELLULOSE: ♦ for treatment of keratoconjunctivitis sicca or other severe conditions accompanied by markedly reduced tear

production; HYDROXYPROPYLMETHYLCELLULOSE / DEXTRAN 70: ♦ for treatment of keratoconjunctivitis sicca or other severe conditions accompanied by markedly reduced tear

production; IMATINIB MESYLATE: ♦ for treatment of chronic myeloid leukemia in the chronic phase; ♦ for treatment of chronic myeloid leukemia in the blastic or accelerated phase; ♦ for treatment of an inoperable, recidivant or metastatic gastrointestinal stromal tumour with presence of the c-kit

receptor (CD117); The initial authorization is for a daily dose of 400 mg for a duration of six months. An authorization for a daily dose of up to 800 mg may be obtained with evidence of disease progression, confirmed by imaging, after at least three months of treatment at a daily dose of 400 mg.


When making subsequent requests, the physician must provide evidence of a complete or partial response or of disease stabilization, confirmed by imaging. Authorizations will be for six-month periods.

♦ in adults suffering from refractary or recidivant acute lymphoblastic leukemia with a positive Philadelphia chromosome and for whom a stem cell transplant is foreseeable. The maximum duration of each authorization is three months. Upon subsequent requests, the physician must provide evidence of a beneficial clinical effect (absence of disease progession);

♦ for treatment of acute lymphoblastic leukemia newly diagnosed in an adult, with a positive Philadelphia

chromosome, after parenteral chemotherapy, specifically, during the maintenance phase. Authorizations are granted for a maximum dose of 600 mg per day. The maximum duration of the initial authorization is six months. Upon subsequent requests, the physician must provide evidence of a beneficial clinical effect, specifically, the absence of disease progression;

IMIQUIMOD: ♦ for treatment of external genital and peri-anal condylomas, as well as condyloma acuminata, upon failure of

physical destructive therapy or of chemical destructive therapy of a minimum duration of four weeks, unless there is a contraindication. The maximum duration of the initial authorization is 16 weeks. When requesting continuation of treatment, the physician must provide evidence of a beneficial effect defined by a reduction in the extent of the lesions. The request may then be authorized for a maximum period of 16 weeks;

INFLIXIMAB: ♦ for treatment of moderate or severe intestinal Crohn's disease that is still active despite treatment with

corticosteroids and immunosuppressors, unless there is a contraindication or a major intolerance to corticosteroids. An immunosuppressor must have been tried for at least eight weeks. The initial authorization is for a maximum of three 5 mg/kg doses. Upon the initial request, the physician must indicate the nature of the contraindication or intolerance, as well as the immunosuppressor used. Upon subsequent requests, the physician must provide evidence of a beneficial clinical effect, in which case the request will be authorized for a period of 12 months.

♦ for treatment of moderate or severe intestinal Crohn's disease that is still active despite treatment with

corticosteroids, unless there is a contraindication or a major intolerance to corticosteroids, where immunosuppressors are contraindicated, are not tolerated or have been ineffective in treating a similar episode after a combined treatment with corticosteroids. The initial authorization is for a maximum of three 5 mg/kg doses. Upon the initial request, the physician must indicate the immunosuppressor used and the duration of the treatment. Upon subsequent requests, the physician must provide evidence of a beneficial clinical effect, in which case the request will be authorized for a period of 12 months.

♦ for treatment of moderate or severe rheumatoid arthritis;


the following five elements must be present: - a positive rheumatoid factor; - radiologically measured erosions;


- a score of more than 1 on the Health Assessment Questionnaire (HAQ); - an elevated C-reactive protein level; - an elevated sedimentation rate, and

• the disease must still be active despite treatment with two disease-modifying anti-rheumatic drugs, used either concomitantly or not, for at least three months each. Unless there is serious intolerance or a serious contraindication, one of the two drugs must be: - methotrexate at a dose of 20 mg or more per week.



Requests for continuation of treatment are authorized for a period of 12 months. Authorizations for infliximab are given for three doses of 3 mg/kg, with the possibility of increasing the dose to 5 mg/kg after three doses or in the 14th week;

♦ for treatment of moderate or severe juvenile idiopathic arthritis (juvenile rheumatoid arthritis and juvenile chronic arthritis) of the polyarticular or systemic type; Upon initiation of treatment or if the person has been receiving the drug for less than five months: • the person must, prior to the beginning of treatment, have five or more joints with active synovitis and one of


• the disease must still be active despite treatment with methotrexate at a dose of 15 mg/M2 or more (maximum 20 mg per dose) per week for at least three months, unless there is intolerance or a contraindication.

The initial request is authorized for a maximum of five months. When requesting continuation of treatment, the physician must provide information making it possible to establish the treatment's beneficial effects: • a decrease of at least 20% in the number of joints with active synovitis and one of the following six elements:

- a decrease of 20% or more in the C-reactive protein level; - a decrease of 20% or more in the sedimentation rate; - an improvement of 0.13 in the Childhood Health Assessment Questionnaire (CHAQ) score or a return to


Requests for continuation of treatment are authorized for a maximum of 12 months. Authorizations for infliximab are given for three doses of 3 mg/kg, with the possibility of increasing the dose to 5 mg/kg after three doses or in the 14th week;

♦ for treatment of persons suffering from moderate or severe ankylosing spondylitis whose BASDAI score is ≥ 4 on

a scale of 0 to 10 and in whom the sequential use of two non-steroidal anti-inflammatories at the optimal dose for a period of three months each did not adequately control the disease, unless there is a contraindication;


• Upon the initial request, the physician must provide the following information:



establish the treatment's beneficial effects, specifically: - a decrease of 2.2 points or 50% on the BASDAI scale, compared with the pre-treatment score, or - a decrease of 1.5 points or 43% on the BASFI scale, or - a return to work.

Requests for continuation of treatment will be authorized for maximum periods of 12 months. Authorizations for infliximab are given for a maximum of 5 mg/kg in weeks 0, 2 and 6 and then every six to eight weeks;

♦ for treatment of moderate or severe psoriasic arthritis of the rheumatoid type;

• where a treatment with an anti-TNF appearing in this appendix for treatment of that disease did not make it possible to optimally control the disease or was not tolerated. The anti-TNF must have been used in respect of the indications for which it is recognized in this appendix for that pathology.

The initial request for is authorized for a maximum of 5 months. When requesting continuation of treatment, the physician must provide information making it possible to establish the treatment's beneficial effects, specifically: • a decrease of at least 20% in the number of joints with active synovitis and one of the following four


Requests for continuation of treatment are authorized for a maximum period of 12 months. For psoriasic arthritis of the rheumatoid type, authorizations for infliximab are given for a maximum of 5 mg/kg in weeks 0, 2 and 6 and then every six to eight weeks.

♦ for treatment of moderate or severe psoriasic arthritis of a type other than rhumatoid;

• where a treatment with an anti-TNF appearing in this appendix for treatment of that disease did not make it possible to optimally control the disease or was not tolerated. The anti-TNF must have been used in respect of the indications for which it is recognized in this appendix for that pathology.

The initial request for is authorized for a maximum of 5 months. When requesting continuation of treatment, the physician must provide information making it possible to establish the treatment's beneficial effects, specifically: • a decrease of at least 20% in the number of joints with active synovitis and one of the following four


Requests for continuation of treatment are authorized for a maximum period of 12 months.


Authorizations for infliximab are given for a maximum of 5 mg/kg in weeks 0, 2 and 6 and then every six to eight weeks.

♦ for treatment of persons suffering from a severe form of chronic plaque psoriasis: • in the presence of a score greater than or equal to 15 on the Psoriasis Area and Severity Index (PASI) or in

the presence of large plaques on the face, palms or soles or in the genital area; and






The initial request is authorized for a maximum of four months. When requesting continuation of treatment, the physician must provide information making it possible to establish the treatment's beneficial effects, specifically: • an improvement of at least 75% in the PASI score;

or • an improvement of at least 50% in the PASI score and a decrease of at least five points on the DLQI

questionnaire; or

• a significant improvement in lesions on the face, palms or soles or in the genital area and a decrease of at least five points on the DLQI questionnaire.

Requests for continuation of treatment are authorized for a maximum of six months. Authorizations for infliximab are given for a maximum of 5 mg/kg in weeks 0, 2 and 6 and then every eight weeks.

INSULIN ASPART / INSULIN ASPART PROTAMINE: ♦ for treatment of diabetes, where a trial of a premixture of 30/70 insuline did not adequately control the glycemic

profile without causing episodes of hypoglycemia; INSULIN DETEMIR: ♦ for treatment of diabetes, where a prior trial of intermediate-acting insulin did not adequately control the glycemic

profile without causing an episode of severe hypoglycemia or frequent episodes of hypoglycemia; INSULIN GLARGINE: ♦ for treatment of diabetes, where a prior trial of intermediate-acting insulin did not adequately control the glycemic

profile without causing an episode of severe hypoglycemia or frequent episodes of hypoglycemia;


INSULIN LISPRO / INSULIN LISPRO PROTAMINE: ♦ for treatment of diabetes, where a trial of a premixture of 30/70 insulin did not adequately control the glycemic

profile without causing episodes of hypoglycemia; INTERFERON ALFA-2B (PEGYLATED): ♦ for treatment of persons suffering from chronic hepatitis C for whom ribavirin is contraindicated:

• in the presence of hereditary hemolytic anemia (thalassemia and others); or • in the presence of severe renal failure (creatinine clearance less than or equal to 35 mL/min). The initial request is authorized for a maximum of 20 weeks. The authorization will be renewed if the decrease in the HCV-RNA is greater than or equal to 1.8 log after 12 weeks of treatment. The authorization will then be given for a maximum of 12 weeks. The request will be renewed if the HCV-RNA is negative after 24 weeks of treatment. The total duration of treatment will be 48 weeks;

♦ for treatment of persons suffering from chronic hepatitis C for whom ribavirin is not tolerated: • in persons who have developed severe anemia while taking ribavirin, despite a decrease in the dosage to

600 mg per day (Hb < 80 g/L or < 100 g/L if co-morbidity of the atherosclerotic heart disease type); or • in persons who have developed a severe intolerance to ribavirin: appearance of an allergy, of an

incapacitating skin rash or of incapacitating dyspnea with effort; The initial request is authorized for a maximum of 20 weeks. The authorization will be renewed if the decrease in the HCV-RNA is greater than or equal to 1.8 log after 12 weeks of treatment. The authorization will then be given for a maximum of 12 weeks. The request will be renewed if the HCV-RNA is negative after 24 weeks of treatment. The total duration of treatment will be 48 weeks.

INTERFERON BETA-1A, i.m. inj. pd. and i.m. inj. sol.: ♦ for treatment of persons who have had a documented first acute clinical episode of demyelinization.

The physician must provide, at the beginning of treatment, the results of an MRI showing: • the presence of four or more lesions of the white substance, including a lesion located in the cerebellum, the

corpus callosum or the periventricular region; and • one such lesion having a diameter of 6 mm or more. Authorizations are given for 30 mcg once per week. The maximum duration of the initial authorization is 12 months. When submitting subsequent requests, the physician must provide evidence of a beneficial effect (absence of new clinical episodes);

♦ for treatment of persons suffering from remitting multiple sclerosis who have had two or more episodes of the disease within the last two years and whose EDSS scale result is less than 7. The physician must provide, at the beginning of treatment and with each subsequent request, the following information: number of attacks per year and EDSS scale result. The maximum duration of the initial authorization is six months. When submitting subsequent requests, the physician must provide evidence of a beneficial effect (absence of deterioration); For persons who previously received an interferon beta for treatment of the first acute clinical episode with documented demyelinization, the interval between the two episodes may exceed two years;

♦ for treatment of persons suffering from secondary progressive multiple sclerosis who have had clinical episodes of the disease and whose EDSS scale result is less than 7.


The physician must provide, at the beginning of treatment and with each subsequent request, the following information: number of attacks per year and EDSS scale result. The maximum duration of the initial authorization is 12 months. When submitting subsequent requests, the physician must provide evidence of a beneficial effect (absence of deterioration). Authorizations are given for 30 mcg once per week;

INTERFERON BETA-1A, s.c. inj. sol. and s.c. inj. sol. (syr.): ♦ for treatment of persons who have had a documented first acute clinical episode of demyelinization.


corpus callosum or the periventricular region, and

• one such lesion having a diameter of 6 mm or more. The maximum duration of the initial authorization is 12 months. When submitting subsequent requests, the physician must provide evidence of a beneficial effect (absence of new clinical episodes). Authorizations are given for 22 mcg once per week;

♦ for treatment of persons suffering from remitting multiple sclerosis who have had two or more episodes of the disease within the last two years and whose EDSS scale result is less than 7. The physician must provide, at the beginning of treatment and with each subsequent request, the following information: number of attacks per year and EDSS scale result. The maximum duration of the initial authorization is six months. When submitting subsequent requests, the physician must provide evidence of a beneficial effect (absence of deterioration). For persons who previously received an interferon beta for treatment of the first acute clinical episode with documented demyelinization, the interval between the two episodes may exceed two years;

♦ for treatment of persons suffering from secondary progressive multiple sclerosis, whether or not they have had clinical episodes, and whose EDSS scale result is less than 7. The physician must provide, at the beginning of treatment and with each subsequent request, the following information: number of attacks per year, where applicable, and EDSS scale result. The maximum duration of the initial authorization is 12 months. When submitting subsequent requests, the physician must provide evidence of a beneficial effect (absence of deterioration). Authorizations are given for 22 mcg three times per week;

INTERFERON BETA-1B: ♦ for treatment of persons who have had a documented first acute clinical episode of demyelinization.


corpus callosum or the periventricular region, and

• one such lesion having a diameter of 6 mm or more. The maximum duration of the initial authorization is 12 months. When submitting subsequent requests, the physician must provide evidence of a beneficial effect (absence of new clinical episodes). Authorizations will be given for a dose of 8 MIU every two days;


♦ for treatment of persons suffering from remitting multiple sclerosis who have had two or more episodes of the

disease within the last two years and whose EDSS scale result is less than 7. The physician must provide, at the beginning of treatment and with each subsequent request, the following information: number of attacks per year and EDSS scale result. The maximum duration of the initial authorization is six months. When submitting subsequent requests, the physician must provide evidence of a beneficial effect (absence of deterioration). For persons who previously received an interferon beta for treatment of the first acute clinical episode with documented demyelinization, the interval between the two episodes may exceed two years;

♦ for treatment of persons suffering from secondary progressive multiple sclerosis, whether or not they have had clinical episodes, and whose EDSS scale result is less than 7. The physician must provide, at the beginning of treatment and with each subsequent request, the following information: number of attacks per year, where applicable, and EDSS scale result. The maximum duration of the initial authorization is 12 months. When submitting subsequent requests, the physician must provide evidence of a beneficial effect (absence of deterioration);

KETOROLAC TROMETHAMINE: ♦ for treatment of ocular inflammation in persons for whom ophthalmic corticosteroids are not indicated; LACTULOSE: ♦ for prevention and treatment of hepatic encephalopathy; ♦ for treatment of constipation related to a medical condition; LANTHANUM HYDRATE: ♦ as a phosphate binder in persons suffering from severe renal failure, where a calcium salt is contraindicated, is

not tolerated, or does not make it possible to optimally control the hyperphosphoremia;

It must be noted that lanthanum hydrate will not be authorized concomitantly with sevelamer. LATANOPROST / TIMOLOL MALEATE: ♦ for control of intra-ocular pressure where the use of an antiglaucoma agent as monotherapy is insufficient; LEFLUNOMIDE: ♦ for treatment of rheumatoid arthritis in persons for whom methotrexate is ineffective, contraindicated or not

tolerated; LENALIDOMIDE: ♦ for treatment of anemia caused by a myelodysplastic syndrome (MDS) of low-risk or intermediate-1-risk,

according to the IPSS (International Prognostic Scoring System for MDS), accompanied by a deletion 5q cytogenetic abnormality. Anemia in this case is characterized by a hemoglobin rate of less than 90 g/L or by transfusion dependence. Upon each request, the physician must provide a recent hemoglobin rate result for the person concerned and a history of the person’s blood transfusions over the past six months. Upon requests for continuation of treatment:


• in the case of a person with transfusion dependence before the beginning of the treatment, the physician must provide evidence of a beneficial effect defined by: - a reduction of at least 50% in blood transfusions, in comparison to the beginning of the treatment;

• in the case of a person who did not have a blood transfusion during the six months preceding the beginning

of the treatment, the physician must provide evidence of a beneficial effect defined by: - an increase of at least 15 g/L in the hemoglobin rate, in comparison to the rate observed before the

beginning of the treatment; and

- the maintenance of transfusion independence. The duration of each authorization is six months. The maximum dose authorized is 10 mg per day.

♦ in association with dexamethasone, for treatment of refractary or recidivant multiple myeloma in persons: • who have received at least two therapies for treatment of multiple myeloma;

and • whose ECOG performance status is � 2.

The maximum duration of the initial authorization is four 28-day cycles.

Upon subsequent requests, the physician must provide evidence of a beneficial clinical effect (absence of disease progression) documented by each of the following three elements:

The disease is progressing as soon as one of the elements is met. Disease progression is defined for each of them in the following manner:

• an increase of ≥ 25% (in comparison to the result observed at the beginning of the treatment) of:

- serum monoclonal protein (the absolute increase must be ≥ 5 g/L); - urinary monclonal protein (the absolute increase must be ≥ 200 mg per 24 hours); - the difference between free light chains (the absolute increase must be ≥ 100 mg/L); - medullary plasmocytes (the absolute increase must be ≥ 10 %); Among the four above dosages, the physician must provide the test result he or she deems the most appropriate for the person being treated.

• an increase in bone lesions or plasmacytomas;

• the appearance of hypercalcemia defined by corrected calcemia > 2,8 mmol/L without any other apparent

cause.

The maximum duration of subsequent authorizations is six 28-day cycles.

It must be noted that lenalidomide will not be authorized in association with bortezomib.

★ LEVOFLOXACIN, i.v. perf. sol.: ♦ for treatment of infections where oral levofloxacin cannot be used; ★ LINEZOLID, i.v. perf. sol.: ♦ for treatment of proven or presumed methicillin-resistant staphylococci infections, where vancomycin is

ineffective, contraindicated or not tolerated and where linezolid cannot be used orally; ♦ for treatment of vancomycin-resistant proven enterococci infections, where linezolide cannot be used orally; ★ LINEZOLID, tab.: ♦ for treatment of proven or presumed methicillin-resistant staphylococci infections, where vancomycin is

ineffective, contraindicated or not tolerated; ♦ for treatment of vancomycin-resistant proven enterococci infections;


MAGNESIUM HYDROXIDE: ♦ for treatment of constipation related to a medical condition; MAGNESIUM HYDROXYDE/ALUMINUM HYDROXYDE: ♦ as a phosphate binder in persons suffering from severe renal failure; MARAVIROC ♦ for treatment, in association with other antiretrovirals, of HIV-infected persons for whom the tropism test carried

out during the past three months showed the presence of a CCR5 tropic virus exclusively and: • who have tried, since the beginning of their antiretroviral therapy, at least one therapy that included

delavirdine, efavirenz or nevirapine, unless there is a primary resistance to one of those drugs, and that resulted: - in a documented virological failure, after at least three months of treatment with an association of several


- in serious intolerance to one of those agents, to the point of calling into question the continuation of the antiretroviral treatment;


protease inhibitor and that resulted: - in a documented virological failure, after at least three months of treatment with an association of several


- in serious intolerance to at least three protease inhibitors, to the point of calling into question the continuation of the antiretroviral treatment.

Where a therapy including a non-nucleoside reverse transcriptase inhibitor cannot be used because of a primary resistance to delavirdine, efavirenz or nevirapine, a trial of at least two therapies, each including a protease inhibitor, is necessary and must have resulted in the same conditions as those listed above. The maximum duration of the initial authorization is six months. Upon the first request for continuation of treatment, the physician must provide evidence of a beneficial effect, specifically, a recent viral load measurement of which the result is less than 400 copies/mL. That second authorization will have a maximum duration of six months. Upon subsequent requests for continuation of treatment, the physician must provide evidence of a beneficial effect, specifically, a recent viral load measurement of which the result is less than 50 copies/mL. The authorizations will then have a maximum duration of 12 months.

♦ for first-line treatment, in association with other antiretrovirals, of HIV-infected persons for whom the tropism test carried out during the past three months showed the presence of a CCR5 tropic virus exclusively and for whom a laboratory test showed a resistance to at least one nucleoside reverse transcriptase inhibitor, one non-nucleoside reverse transcriptase inhibitor and one protease inhibitor, and: • whose current viral load and another dating back at least one month are greater than or equal to 500

copies/mL; and


• for whom the use of maraviroc is necessary for constituting an effective therapeutic regimen. The maximum duration of the initial authorization is six months. Upon the first request for continuation of treatment, the physician must provide evidence of a beneficial effect, specifically, a recent viral load measurement of which the result is less than 400 copies/mL. That second authorization will have a maximum duration of six months.


Upon subsequent requests for continuation of treatment, the physician must provide evidence of a beneficial effect, specifically, a recent viral load measurement of which the result is less than 50 copies/mL. The authorizations will then have a maximum duration of 12 months.

MEGESTROL ACETATE: ♦ for hormone therapy in the treatment of breast, endometrium and prostate cancer; ♦ for hormone replacement therapy where oral progestogens are ineffective or contraindicated or not tolerated; MEMANTINE HYDROCHLORIDE: ♦ as monotherapy for person suffering from Alzheimer's disease at the moderate or severe stage who are living at

home, specifically, who do not live in a residential and long-term care centre that is either a public institution or a private institution under agreement; Upon the initial request, the following elements must be present: • an MMSE score of 3 to 14; • medical confirmation of the degree to which the person is affected (intact domain, mildly, moderately or


The duration of the initial authorization for a treatment with memantine is six months from the beginning of treatment. However, where memantine is used following treatment with a cholinesterase inhibitor, the concomitant use of both medications is authorized for one month. Upon subsequent requests, the physician must provide evidence of a beneficial effect confirmed by stabilization or improvement of symptoms in at least three of the following domains: - intellectual function, including memory; - mood; - behaviour; - autonomy in activities of daily living (ADL) and in instrumental activities of daily living (IADL); - social interaction, including the ability to carry on a conversation. The maximum duration of the authorization is six months;

METHYLPHENIDATE HYDROCHLORIDE, l.a. caps.: ♦ for treatment of children and adolescents suffering from attention deficit disorder and in whom the use of short-

acting methylphenidate or of dexamphetamine has not properly controlled the symptoms of the disease. Before it can be concluded that these treatments are ineffective, the stimulant must have been titrated optimally, unless there is proper justification;

METHYLPHENIDATE HYDROCHLORIDE, l.a. tab. (12 h): ♦ for treatment of persons suffering from attention deficit disorder and in whom the use of short-acting

methylphenidate or of dexamphetamine has not properly controlled the symptoms of the disease. Before it can be concluded that these treatments are ineffective, the stimulant must have been titrated optimally, unless there is proper justification;

METRONIDAZOLE, vag. gel: ♦ for treatment of bacterial vaginosis during the second and third trimesters of pregnancy; ♦ for treatment of bacterial vaginosis where metronidazole administered orally is not tolerated;


★ MICAFUNGIN SODIUM: ♦ for prevention of fungal infections in persons who will undergo a hematopoietic stem cell transplant; ♦ for treatment of invasive candidosis in persons for whom treatment with fluconazole has failed or is

contraindicated, or who are intolerant to such a treatment; MICRONIZED PROGESTERONE, caps.: ♦ for persons unable to take medroxyprogesterone acetate because of major intolerance; MINERAL OIL: ♦ for treatment of constipation related to a medical condition; MODAFINIL: ♦ for symptomatic treatment of diurnal hypersomnolence accompanying narcolepsy or idiopathic or post-traumatic

hypersomnia, where dexamphetamine sulfate or methylphenidate is ineffective, contraindicated or not tolerated; ♦ for adjunctive treatment of diurnal hypersomnolence secondary to sleep apnea or hypopnea syndrome that

persists despite the use of a nasal continuous positive airway pressure device; ★ MOXIFLOXACIN HYDROCHLORIDE, i.v. perf. sol.: ♦ for treatment of infections, where oral moxifloxacin cannot be used; MULTIVITAMINS: ♦ for persons suffering from cystic fibrosis; NATALIZUMAB: ♦ for monotherapy treatment of persons suffering from remitting multiple sclerosis whose EDSS scale score is � 5

before the treatment and in whom there has been a rapid evolution of the disease, defined as: • the occurrence of two or more incapacitating clinical episodes with partial recovery during the past year;

or • the occurrence of two or more incapacitating clinical episodes with full recovery during the past year and:

- the presence of at least one gadolinium-enhanced lesion on magnetic resonance imaging (MRI); or

- an increase of two or more T2 hyperintense lesions in comparison with a previous MRI. The maximum duration of the authorizations is one year. For continuation of the treatment, the physician must provide evidence of a beneficial effect in comparison with the evaluation carried out before the treatment began, specifically: • a reduction in the annual frequency of incapacitating episodes during the past year;

and • a stabilization of the EDSS scale score or an increase of less than 2 points without the score exceeding 5. An incapacitating episode means an episode during which a neurological examination confirms optical neuritis, posterior fossa syndrome (cerebral trunk and cervelet) or symptoms revealing that the spinal cord is affected (myelitis).

NUTRITIONAL FORMULAS – CASEIN-BASED (INFANTS AND CHILDREN): ♦ for infants and children who are allergic to complete milk proteins.

In such cases, the maximum duration of the initial authorization is up to the age of 12 months. The results of an allergen skin test or of re-exposure to milk must be provided in order for utilization to continue;


♦ for infants and children suffering from galactomsemia and requiring a lactose-free diet; ♦ for infants and children suffering from persistent diarrhea or other severe gastrointestinal problems. The results of

re-exposure to milk must be provided in order for utilization to continue; NUTRITIONAL FORMULAS – FAT EMULSION (INFANTS AND CHILDREN): ♦ to increase the caloric content of the diet or of other nutritional formulas in the presence of cardiac or metabolic

disorders in children under age 4, and for whom the polymerized glucose nutritional formulas are not sufficient or not tolerated;

NUTRITIONAL FORMULAS – FOLLOW-UP PREPARATIONS FOR PREMATURE INFANTS: ♦ for infants whose birth weight is less than or equal to 1 800 g or who are born after 34 weeks of pregnancy or

less. In this case, the maximum duration of the authorization will be until one year corrected age, in other words, until one year after the expected date of birth;

NUTRITIONAL FORMULAS – FRACTIONATED COCONUT OIL: ♦ for persons unable to effectively digest or absorb long-chain fatty foods; NUTRITIONAL FORMULAS – MONOMERIC: ♦ for enteral feeding; ♦ for oral feeding of persons requiring monomeric nutritional formulas or semi-elemental nutritional formulas as

their source of nutrition in the presence of severe maldigestion or malabsorption disorders and for whom polymeric formulas are not recommended or not tolerated;

♦ for children suffering from malnutrition, malabsorption or growth failure related to a medical condition; ♦ for persons suffering from cystic fibrosis; NUTRITIONAL FORMULAS – MONOMERIC WITH IRON (INFANTS OR CHILDREN): ♦ for infants or children who are allergic to complete milk proteins, soy proteins or multiple dietary proteins and in

whom the utilization of a casein hydrolysate formula has not succeeded in eliminating the symptoms. In such cases, the maximum duration of the initial authorization is one year. The results of an allergen skin test or of re-exposure to a casein hydrolysate formula or milk must be provided in order for utilization to continue;

♦ for infants or children who are suffering from persistent diarrhea or other severe gastrointestinal problems and in

whom the utilization of a casein hydrolysate formula has not succeeded in eliminating the symptoms. In such cases, the maximum duration of the initial authorization is one year. The results of re-exposure to a casein hydrolysate formula or milk must be provided in order for utilization to continue;

♦ for infants or children whose condition requires hospitalization and who have severe gastrointestinal problems of which the confirmed cause is a bovine protein allergy. In such cases, the maximum duration of the initial authorization is one year. The results of an allergen skin test or of re-exposure to a casein hydrolysate formula or milk must be provided in order for the authorization to continue;

NUTRITIONAL FORMULAS – POLYMERIC LOW-RESIDUE: ♦ for enteral feeding; ♦ for total oral feeding of persons requiring nutritional formulas as their source of nutrition in presence of

esophageal dysfunction or dysphagia, maldigestion or malabsorption;


♦ for children suffering from malnutrition, malabsorption or growth failure related to a medical condition; ♦ for persons suffering from cystic fibrosis; NUTRITIONAL FORMULAS – POLYMERIC WITH RESIDUE: ♦ for enteral feeding; ♦ for total oral feeding of persons requiring nutritional formulas as their source of nutrition in presence of

esophageal dysfunction or dysphagia, maldigestion or malabsorption; ♦ for children suffering from malnutrition, malabsorption or growth failure related to a medical condition; ♦ for persons suffering from cystic fibrosis; NUTRITIONAL FORMULAS – POLYMERIZED GLUCOSE: ♦ to increase the caloric content of the diet or of other nutritional formulas; NUTRITIONAL FORMULAS – PROTEINS: ♦ to increase the protein content of other nutritional formulas; NUTRITIONAL FORMULAS – SEMI-EMEMENTAL: ♦ for enteral feeding; ♦ for oral feeding in persons requiring monometric nutritional formulas or semi-elemental nutritional formulas as

their source of nutrition in the presence of severe maldigestion or malabsorption disorders and for whom polymeric formulas are not recommended or not tolerated;

♦ for children suffering from malnutrition, malabsorption or growth failure related to a medical condition; ♦ for persons suffering from cystic fibrosis; NUTRITIONAL FORMULAS – SKIM MILK/COCONUT OIL: ♦ for persons unable to effectively digest or absorb long-chain fatty foods; ★ ONDANSETRON: ♦ during the first day of:


• a highly emetic radiotherapy treatment; ♦ in children during emetic chemotherapy or radiotherapy; ♦ during:

• a chemotherapy treatment undergone by persons for whom the conventional antiemetic therapy is ineffective, contraindicated or poorly tolerated and who are not receiving aprepitant, or


OXCARBAZEPINE: ♦ for treatment of epilepsy;


♦ for persons for whom carbamazepine is not tolerated or is contraindicated, or for whom treatment with

carbamazepine has failed; OXYBUTYNINE, skin patch: ♦ for treatment of vesical hyperactivity in persons for whom immediate-release oxybutynine is poorly tolerated; OXYBUTYNINE CHLORIDE, l.a. tab.: ♦ for treatment of vesical hyperactivity in persons for whom immediate-release oxybutynine is poorly tolerated; PARAFFIN/MINERAL OIL: ♦ for treatment of keratoconjunctivitis sicca or other severe conditions accompanied by markedly reduced tear

production; PEGAPTANIB SODIUM: ♦ for treatment of age-related macular degeneration

• in the presence of minimally classic choroidal neovascularization where less than 50% of the lesions are of the classic type, or of the occult type without lesions of the classic type;

• in the presence of predominantly classic choroidal neovascularization where 50% or more of the lesions are of the classic type, following failure of a therapy consisting of four treatments with verteporfin, unless that drug is not tolerated or is contraindicated.

The initial request is authorized for a maximum of six months and the request for continuation of treatment will be authorized for another six months, for a total authorization period of 12 months. However, in the latter case, a beneficial clinical effect, consisting in a stabilization or improvement of the medical condition shown by a retinal angiography or by optical coherence tomography, must be proven. Pegaptanib will not be authorized concomitantly with verteporfin for treatment of the same eye;

PEGINTERFERON ALFA-2A: ♦ for treatment of persons suffering from chronic hepatitis C for whom ribavirin is contraindicated:

• in the presence of hereditary hemolytic anemia (thalassemia and others); or • in the presence of severe renal failure (creatinine clearance less than or equal to 35 mL/min). The initial request is authorized for a maximum of 20 weeks. The authorization will be renewed if the decrease in the HCV-RNA is greater than or equal to 1.8 log after 12 weeks of treatment. The authorization will then be given for a maximum of 12 weeks. The request will be renewed if the HCV-RNA is negative after 24 weeks of treatment. The total duration of treatment will be 48 weeks;

♦ for treatment of persons suffering from chronic hepatitis C for whom ribavirin is not tolerated:

• in persons who have developed severe anemia while taking ribavirin, despite a decrease in the dosage to

600 mg per day (Hb < 80 g/L or < 100 g/L if co-morbidity of the atherosclerotic heart disease type); or • in persons who have developed a severe intolerance to ribavirin: appearance of an allergy, of an

incapacitating skin rash or of incapacitating dyspnea with effort; The initial request is authorized for a maximum of 20 weeks. The authorization will be renewed if the decrease in the HCV-RNA is greater than or equal to 1.8 log after 12 weeks of treatment. The authorization will then be given for a maximum of 12 weeks. The request will be renewed if the HCV-RNA is negative after 24 weeks of treatment. The total duration of treatment will be 48 weeks;

♦ for treatment of HBeAg-negative chronic hepatitis B. The request is authorized for a maximum of 48 weeks;


PENTOXIFYLLINE: ♦ for treatment of persons suffering from serious and chronic peripheral vascular ailments, specifically:

• in the case of venous insufficiency with cutaneous ulcer (or antecedents); • in the case of arterial insufficiency with cutaneous ulcer (or antecedents), gangrene, antecedents of

amputation or pain at rest; PILOCARPINE HYDROCHLORIDE, tab.: ♦ for treatment of severe xerostomia; PIMECROLIMUS: ♦ for treatment of atopical dermatitis in children, where a topical corticosteroid treatment has failed; PIOGLITAZONE HYDROCHLORIDE: ♦ for treatment of type-2 diabetic persons:

• in association with metformin where a sulfonylurea is contraindicated, not tolerated or ineffective; • in association with a sulfonylurea where metformin is contraindicated, not tolerated or ineffective; • where metformin and a sulfonylurea cannot be used because of a contraindication or an intolerance to those

drugs; • in association with metformin and a sulfonylurea where going to insulin therapy is indicated but the person is

not in a position to receive it; • who are suffering from renal failure.

However, pioglitazone remains covered by the basic prescription drug insurance plan for those insured persons having used this drug in the three months before 1 October 2009 and if its cost was already covered under that plan as part of the indications provided in the appendix hereto. For information purposes, the association of pioglitazone and insulin and the association of rosiglitazone and insulin increase the risk of congestive heart failure. POLYETHYLENE GLYCOL: ♦ for treatment of constipation related to a medical condition;

POLYETHYLENE GLYCOL / SODIUM (sulfate) / SODIUM (bicarbonate) / SODIUM (chloride) / POTASSIUM (chloride): ♦ for treatment of constipation related to a medical condition; POLYVINYL ALCOHOL: ♦ for treatment of keratoconjunctivitis sicca or other severe conditions accompanied by markedly reduced tear

production; POLYVINYL ALCOHOL/POVIDONE: ♦ for treatment of keratoconjunctivitis sicca or other severe conditions accompanied by markedly reduced tear

production; ★ POSACONAZOLE: ♦ for prevention of invasive fungal infections in persons having developed neutropenia following chemotherapy to

treat acute myeloid leucemia or myelodysplastic syndrome; ♦ for treatment of invasive aspergillosis in persons for whom first-line treatment has failed or is contraindicated, or

who are intolerant to such a treatment;


PSYLLIUM MUCILLOID: ♦ for treatment of constipation related to a medical condition; ♦ for treatment of chronic diarrhea; QUANTITATIVE PROTHROMBIN-TIME BLOOD TEST: ♦ to measure the international normalized ratio (INR) in persons who require life-long anticoagulation, whose

unstable coagulation condition necessitates close monitoring (INR one or more times per week), and whose access to a sample-taking site is particularly difficult.

RALTEGRAVIR: ♦ for treatment, in association with other antiretrovirals, of HIV-infected persons:








Where a therapy including a non-nucleoside reverse transcriptase inhibitor cannot be used because of a primary resistance to delavirdine, efavirenz or nevirapine, a trial of at least two therapies, each including a protease inhibitor, is necessary and must have resulted in the same conditions as those listed above.

♦ for first-line treatment, in association with other antiretrovirals, of HIV-infected persons for whom a laboratory test

showed a resistance to at least one nucleoside reverse transcriptase inhibitor, one non-nucleoside reverse transcriptase inhibitor and one protease inhibitor, and: • whose current viral load and another dating back at least one month are greater than or equal to

500 copies/mL; and


• for whom raltegravir is necessary to establish an effective therapeutic regimen; RANIBIZUMAB: ♦ for treatment of age-related macular degeneration in the presence of choroidal neovascularization. The eye to be

treated must meet the following four criteria: • optimal visual acuity after correction between 6/12 and 6/96; • linear dimension of the lesion less than or equal to 12 disc areas; • absence of significant permanent structural damage to the centre of the macula. The structural damage is

defined by fibrosis, atrophy or a chronic disciform scar such that, according to the treating physician, it precludes a functional benefit;

• progression of the disease in the last three months, confirmed by retinal angiography, optical coherence tomography or recent changes in visual acuity.


The initial request is authorized for a maximum of four months. Upon subsequent requests, the physician must provide information making it possible to establish a clinical beneficial effect, consisting in a stabilization or improvement of the medical condition shown by a retinal angiography or by optical coherence tomography. Authorizations will then be given for a maximum of 12 months. Authorizations are given for one dose per month and per eye. Ranibizumab will not be authorized concomitantly with verteporfin for treatment of the same eye.

However, ranibizumab remains covered by the basic prescription drug insurance plan for those insured persons having used this drug in the 12 months before 1 February 2010 and if its cost was already covered under that plan as part of the indications provided in the appendix hereto.

RASAGILINE MESYLATE: ♦ for persons suffering from Parkinson's disease with motor fluctuations, despite levodopa therapy. REPAGLINIDE: ♦ where a sulfonylurea is contraindicated, not tolerated or ineffective; ♦ for treatment of non-insulindependent diabetic persons suffering from renal failure; RIBAVIRIN / INTERFERON ALFA-2B (PEGYLATED): ♦ for treatment of persons suffering from chronic hepatitis C of genotype 2 or 3.

The maximum duration of the authorization will be 24 weeks. However, persons who, during a previous treatment with an association of ribavirin / interferon alfa-2b (pegylated): - did not obtain a negativation of their viremia after 24 weeks of treatment,

or - did not obtain a sustained virological response 24 weeks after the end of the treatment, except in the case of

rapid responders (negativation) at four weeks who relapsed after a shortened 12-week to 16-week treatment; are not eligible for a second treatment;

♦ for treatment of persons suffering from chronic hepatitis C of a genotype other than 2 or 3,

and for treatment of chronic hepatitis C of any genotype in persons infected with HIV. The total duration of the authorization is a maximum of 48 weeks. For persons suffering from chronic hepatitis C of genotype 2 or 3 and who are coinfected with HIV, the initial request is authorized for a maximum of 32 weeks. Thereafter, an authorization will be granted for a maximum of 16 weeks for treatment termination purposes, only if the qualitative HCV-RNA result 24 weeks from the beginning of the treatment is negative. For other persons, authorizations will be granted under different conditions based on the type of test conducted for the purpose of evaluating response to the treatment after the first 12 weeks of treatment. The initial request is authorized for a maximum of 20 weeks. A quantitative or qualitative HCV-RNA screening test 12 weeks from the beginning of the treatment is necessary to determine response to the treatment. • In the case of a qualitative test, another authorization, for a maximum of 28 weeks, will be granted for

treatment termination purposes, only if the test result is negative. • In the case of a quantitative test, another authorization, for an additional maximum of 12 weeks, will be

granted only if the test result shows a decrease in viremia greater than or equal to 1.8 log compared with pre-treatment viremia. Thereafter, an authorization will be granted for a maximum of 16 weeks for treatment termination purposes, only if the qualitative HCV-RNA result is negative after 24 weeks of treatment.


However, persons who, during a previous treatment with an association of ribavirin / interferon alfa-2b (pegylated): - did not obtain a 1.8-log decrease in viremia after 12 weeks compared to the pre-treatment value; - did not obtain a negativation of their viremia after a minimum of 24 weeks of treatment; - did not obtain a sustained virological response 24 weeks after the end of the treatment, except in the case of

rapid responders (negativation) at four weeks who relapsed after a shortened 24-week treatment; are not eligible for a second treatment;

♦ for treatment of chronic hepatitis C in persons having received a transplant.

The maximum duration of the authorization will be 48 weeks. However, persons who, during a previous treatment with an association of ribavirin / interferon alfa-2b (pegylated), did not obtain a negativation of their viremia after 48 weeks of treatment or a sustained virological response 24 weeks after the end of the treatment are not eligible for a second treatment;

RIBAVIRIN / PEGINTERFERON ALFA-2A: ♦ for treatment of persons suffering from chronic hepatitis C of genotype 2 or 3.

The maximum duration of the authorization will be 24 weeks. However, persons who, during a previous treatment with an association of ribavirin / peginterferon alfa-2a: - did not obtain a negativation of their viremia after 24 weeks of treatment,

or - did not obtain a sustained virological response 24 weeks after the end of the treatment, except in the case of

rapid responders (negativation) at four weeks who relapsed after a shortened 12-week to 16-week treatment; are not eligible for a second treatment;

♦ for treatment of persons suffering from chronic hepatitis C of a genotype other than 2 or 3,

and for treatment of chronic hepatitis C of any genotype in persons infected with HIV. The total duration of the authorization is a maximum of 48 weeks. For persons suffering from chronic hepatitis C of genotype 2 or 3 and who are coinfected with HIV, the initial request is authorized for a maximum of 32 weeks. Thereafter, an authorization will be granted for a maximum of 16 weeks for treatment termination purposes, only if the qualitative HCV-RNA result 24 weeks from the beginning of the treatment is negative. For other persons, authorizations will be granted under different conditions based on the type of test conducted for the purpose of evaluating response to the treatment after the first 12 weeks of treatment. The initial request is authorized for a maximum of 20 weeks. A quantitative or qualitative HCV-RNA screening test 12 weeks from the beginning of the treatment is necessary to determine response to the treatment. • In the case of a qualitative test, another authorization, for a maximum of 28 weeks, will be granted for

treatment termination purposes, only if the test result is negative. • In the case of a quantitative test, another authorization, for an additional maximum of 12 weeks, will be

granted only if the test result shows a decrease in viremia greater than or equal to 1.8 log compared with pre-treatment viremia. Thereafter, an authorization will be granted for a maximum of 16 weeks for treatment termination purposes, only if the qualitative HCV-RNA result 24 weeks from the beginning of the treatment is negative.

However, persons who, during a previous treatment with an association of ribavirin / peginterferon alfa-2a: - did not obtain a 1.8-log decrease in viremia in the 12th week compared to the pre-treatment value; - did not obtain a negativation of their viremia after a minimum of 24 weeks of treatment; - did not obtain a sustained virological response 24 weeks after the end of the treatment, except in the case of

rapid responders (negativation) at four weeks who relapsed after a shortened 24-week treatment; are not eligible for a second treatment;

♦ for treatment of chronic hepatitis C in persons having received a transplant.


The maximum duration of the authorization will be 48 weeks. However, persons who, during a previous treatment with an association of ribavirin / peginterferon alfa-2a, did not obtain a negativation of their viremia after 48 weeks of treatment or a sustained virological response 24 weeks after the end of the treatment are not eligible for a second treatment;

RILUZOLE: ♦ for treatment of amiotrophic lateral sclerosis in patients who have had symptoms of the disease for less than 5

years, whose vital capacity is more than 60% of the predicted value and who have not undergone a tracheotomy. Upon the initial request (new case), the physician must indicate the date on which symptoms of the disease began and the patient's vital capacity measurement, and must confirm that the patient has not undergone a tracheotomy. The maximum duration of the initial authorization is six months. Upon subsequent requests, and for patients already being treated, the physician must confirm that the patient has not undergone a tracheotomy. The maximum duration of authorization is six months. No renewal will be authorized in the presence of a tracheotomy.

RISPERIDONE, i.m. inj. pd.: ♦ in persons who have an observance problem with an oral antipsychotic agent or for whom a prolonged-acting

injectable conventional antipsychotic agent is ineffective or poorly tolerated; RITUXIMAB: ♦ for treatment of moderate or severe rheumatoid arthritis, in association with methotrexate;

Upon the initial request: • the person must, prior to the beginning of treatment, have eight or more joints with active synovitis and one of

the following five elements must be present: - a positive rheumatoid factor; - radiologically measured erosions; - a score of more than 1 on the Health Assessment Questionnaire (HAQ); - an elevated C-reactive protein level; - an elevated sedimentation rate, and

• the disease must still be active despite treatment of four months or more with infliximab, or of three months or more with etanercept or adalimumab, unless there is a significant intolerance or contraindication.

The initial request is authorized for a treatment comprising two perfusions of rituximab of 1 000 mg each. When requesting continuation of treatment, the physician must provide information making it possible to establish a treatment response observed during the first six months after the last injection, followed by a loss of its effectiveness. A treatment response is defined by: • a decrease of at least 20% in the number of joints with active synovitis and one of the following four


Each subsequent treatment is authorized after an interval of at least six months since the last perfusion of rituximab. Each authorization is given for a treatment comprising 2 perfusions of rituximab of 1 000 mg each.

★ RIVAROXABAN: ♦ for prevention of venous thromboembolism following a knee arthroplasty;


The maximum duration of the authorization is 14 days. ♦ for prevention of venous thromboembolism following a hip arthroplasty;

The maximum duration of the authorization is 35 days. RIVASTIGMINE: ♦ as monotherapy for persons suffering from Alzheimer's disease at the mild or moderate stage.



The duration of the initial authorization for a treatment with rivastigmine is six months from the beginning of treatment. However, where the cholinesterase inhibitor is used following treatment with memantine, the concomitant use of both medications is authorized for one month. Upon subsequent requests, the physician must provide evidence of a beneficial effect confirmed by each of the following elements: • an MMSE score of 10 or more, unless there is proper justification; • a maximum decrease of 3 points in the MMSE score per six-month period compared with the previous


- intellectual function, including memory; - mood; - behaviour; - autonomy in activities of daily living (ADL) and in instrumental activities of daily living (IADL); - social interaction, including the ability to carry on a conversation.

The maximum duration of authorization is 12 months.

ROSIGLITAZONE MALEATE: ♦ for treatment of type-2 diabetic persons:

• in association with metformin where a sulfonylurea is contraindicated, not tolerated or ineffective; • in association with a sulfonylurea where metformin is contraindicated, not tolerated or ineffective; • where metformin and a sulfonylurea cannot be used because of a contraindication or an intolerance to those

drugs; • in association with metformin and a sulfonylurea where going to insulin therapy is indicated but the person is

not in a position to receive it; • who are suffering from renal failure;

However, rosiglitazone remains covered by the basic prescription drug insurance plan for those insured persons having used this drug in the three months before 1 October 2009 and if its cost was already covered under that plan as part of the indications provided in the appendix hereto. For information purposes, the association of pioglitazone and insulin and the association of rosiglitazone and insulin increase the risk of congestive heart failure.


ROSIGLITAZONE MALEATE / METFORMIN HYDROCHLORIDE: ♦ for treatment of type-2 diabetic persons under treatment with metformin and a thiazolidinedione and whose daily

doses have been stable for at least three months. These persons must also fulfill the requirements of the recognized payment indication for thiazolidinediones.

However, the rosiglitazone / metformin association remains covered by the basic prescription drug insurance plan for those insured persons having used this drug in the three months before 1 October 2009 and if its cost was already covered under that plan as part of the indications provided in the appendix hereto.

SALBUTAMOL SULFATE, pd for inh.: ♦ for treatment of persons having difficulty using an inhalation device other than the Diskus™ device or who are

already receiving another drug through this device; SALMETEROL XINAFOATE / FLUTICASONE PROPIONATE: ♦ for treatment of asthma and other reversible obstructive diseases of the respiratory tract in persons whose

control of the disease is insufficient despite the use of an inhaled corticosteroid; ♦ for treatment of persons suffering from moderate or severe chronic obstructive pulmonary disease (COPD)

whose symptoms are not under control despite the use of an inhaled short-acting ß2 agonist, an inhaled long-acting ß2 agonist and an inhaled anticholinergic agent.

♦ for treatment of persons suffering from moderate to severe chronic obstructive pulmonary disease (COPD), who

have shown at least one exacerbation of the symptoms of the disease in the last year, despite regular use through inhalation of at least one long-acting bronchodilator; Exacerbation, is understood as a sustained and repeated aggravation of the symptoms requiring intensified pharmacological treatment, for instance, the addition of oral corticosteroids, or a precipitated medical visit or a hospitalization; In the case of the medical conditions set out in the preceding paragraphs, persons insured by the Régie de l'assurance maladie du Québec who obtained a reimbursement for an association of formoterol fumarate dihydrate / budesonide or of salmeterol xinafoate / fluticasone propionate within 365 days preceding 1 October 2003 are eligible for a continuation of their treatment.

SAXAGLIPTIN: ♦ for treatment of type-2 diabetic persons:

• in association with metformin where a sulfonylurea is contraindicated, not tolerated or ineffective; or

• in association with a sulfonylurea where metformin is contraindicated, not tolerated or ineffective; SENNOSIDES A & B: ♦ for treatment of constipation related to a medical condition; SEVELAMER HYDROCHLORIDE: ♦ as a phosphate binder in persons suffering from severe renal failure, where a calcium salt is contraindicated, is

not tolerated, or does not make it possible to optimally control the hyperphosphoremia. It must be noted that sevelamer will not be authorized concomitantly with lanthanum hydrate.


SILDENAFIL CITRATE: ♦ for treatment of pulmonary arterial hypertension (WHO functional class III) that is either idiopathic or related to

connectivitis and that is symptomatic despite the optimal conventional treatment. The person must be evaluated and followed up on by physicians working at designated centres specializing in the treatment of pulmonary arterial hypertension. Authorizations will be given for 20 mg three times per day.

SITAGLIPTIN: ♦ for treatment of type-2 diabetic persons, in association with metformin, where a sulfonylurea is contraindicated,

not tolerated or ineffective; SITAGLIPTIN / METFORMIN: ♦ for treatment of type-2 diabetic persons:

• where a sulfonylurea is contraindicated, not tolerated or ineffective; and

• where the daily doses of metformin have been stable for at least three months; SITAXSENTAN SODIUM: ♦ for treatment of pulmonary arterial hypertension of WHO functional class III that is either idiopathic or associated

with connectivitis and that is symptomatic despite the optimal conventional treatment. Persons must be evaluated and followed up on by physicians working at designated centres specializing in the treatment of pulmonary arterial hypertension.

SODIUM CITRATE / SODIUM LAURYLSULFOACETATE / SORBITOL: ♦ for treatment of constipation related to a medical condition; SODIUM PHOSPHATE MONOBASIC/SODIUM PHOSPHATE DIBASIC: ♦ for treatment of constipation related to a medical condition; SOLIFENACIN SUCCINATE: ♦ for treatment of vesical hyperactivity in persons for whom oxybutynine is poorly tolerated, contraindicated or

ineffective; SOMATOTROPHIN: ♦ for treatment of children and adolescents suffering from delayed growth due to insufficient secretion of

endogenous growth hormone, where they meet the following criteria: • unterminated growth, a growth rate for their bone age below the 25th percentile (calculated over at least a

12-month period), and a somatotrophin serum or plasma level below 8 μg/L in two pharmacological stimulation tests or between 8 and 10 μg/L if the tests are repeated twice at a 6-month interval. The 12-month observation period does not apply to children suffering from hypoglycemia secondary to growth hormone deficiency;

• excluded are children and adolescents suffering from achondroplasia or delayed growth of a genetic or familial type;

• excluded are children and adolescents whose bone age has reached 15 years for girls and 16 years for boys; • excluded are children and adolescents whose growth rate during treatment falls below 2 cm per year when

evaluated on two consecutive visits (at a 3-month interval);


♦ for treatment of children and adolescents suffering from delayed growth related to chronic renal failure until they

undergo a kidney transplant, where they meet the following criteria: • unterminated growth, a glomerular filtration rate ≤ 1.25 mL/s./1.73m² (75 mL/min./ 1.73m²), and a Z score

(HSDS) ≤ a standard deviation of -2 (HSDS = height compared to the average of normal values for their age and sex) or a Δ Z score (HSDS) < a standard deviation of 0 where their height is below the 10th percentile (based on observation periods of at least six months for children over the age of one and at least three months for children under the age of one);

• excluded are children and adolescents in whom, during treatment, no response (no increase in Δ of Z score (HSDS) in the first 12 months of treatment) is observed;

• excluded are children and adolescents in whom, during treatment, an ossification of the conjugative cartilages is observed or who have reached their final predicted height;

• excluded are children and adolescents whose growth rate, evaluated on two consecutive visits (at a 3-month interval), falls below 2 cm per year;

♦ for treatment of growth hormone deficiency in persons whose bone growth has terminated and who meet the

following criteria: • somatotrophin serum or plasma level between 0 and 3 μg/mL in a pharmacological test;

In persons who have a multiple hypophyseal hormone deficiency, and to confirm a deficiency acquired during childhood or adolescence, only one pharmacological stimulation test is necessary. In the case of an isolated growth hormone deficiency, two tests are required. The insulin hypoglycemia test is recommended. If this test is contraindicated, the arginine test alone, or combined with the GHRH, may be substituted for it. Where the arginine test is combined with the GHRH, the value must be ≤ 9 μg/L;

• in the case of adult onset, the deficiency must be secondary to hypophyseal or hypothalamic disease, surgery, radiotherapy or trauma;

♦ for treatment of Turner’s syndrome:

• the syndrome must have been demonstrated by a karyotype compatible with this diagnosis (complete

absence or structural anomaly of one of the X chromosomes). This karyotype may be homogeneous or may be a mosaic;

• excluded are girls whose bone age has reached 14 years; • excluded are girls whose growth rate, during treatment, falls below 2 cm per year when evaluated on two

consecutive visits (at a 3-month interval); SOMATROPIN: ♦ for treatment of children and adolescents suffering from delayed growth due to insufficient secretion of

endogenous growth hormone, where they meet the following criteria: • unterminated growth, a growth rate for their bone age below the 25th percentile (calculated over at least a

12-month period), and a somatotrophin serum or plasma level below 8 μg/L in two pharmacological stimulation tests or between 8 and 10 μg/L if the tests are repeated twice at a 6-month interval. The 12-month observation period does not apply to children suffering from hypoglycemia secondary to growth hormone deficiency;

• excluded are children and adolescents suffering from achondroplasia or delayed growth of a genetic or familial type;

• excluded are children and adolescents whose bone age has reached 15 years for girls and 16 years for boys; • excluded are children and adolescents whose growth rate during treatment falls below 2 cm per year when

evaluated on two consecutive visits (at a 3-month interval);


SUNITINIB MALATE: ♦ for treatment of an inoperable, recidivant or metastatic gastrointestinal stromal tumour, in persons whose ECOG

performance status is � 2 and: • who have not responded to an imatinib treatment (primary resistance); • whose cancer has evolved after initially responding to imatinib (secondary resistance); • who have an intolerance to imatinib. The initial authorization is for a maximum duration of six months. Upon subsequent requests, the physician must provide evidence of a complete or partial response or of disease stabilization, confirmed by imaging. In addition, the ECOG performance status must remain � 2. Subsequent authorizations will also be for maximum durations of six months. Authorizations are given for a daily dose of 50 mg for four weeks every six weeks.

♦ for first-line treatment of a metastatic renal adenocarcinoma characterized by the presence of clear cells, in

persons whose ECOG performance status is 0 or 1; The initial authorization is for a maximum duration of three cycles (18 weeks). Upon subsequent requests, the physician must provide evidence of a complete or partial response or of disease stabilization, confirmed by imaging during the six weeks before the end of the current authorization. In addition, the ECOG performance status must remain at 0 or 1. Subsequent authorizations will also be for maximum durations of three cycles (18 weeks). Authorizations are given for one daily dose of 50 mg for four weeks every six weeks.

TACROLIMUS, top. oint.: ♦ for treatment of atopic dermatitis in children, following failure of a treatment with a topical corticosteroid; ♦ for treatment of atopical dermatitis in adults, following failure of at least two treatments with a different topical

corticosteroid of intermediate strength or greater, or following failure of at least two treatments on the face with a different low-strength topical corticosteroid;

TADALAFIL: ♦ for treatment of pulmonary arterial hypertension (WHO functional class III) that is either idiopathic or related to

connectivitis and that is symptomatic despite the optimal conventional treatment. The persons must be evaluated and followed up on by physicians working at designated centres specializing in the treatment of pulmonary arterial hypertension. Authorizations will be given for 40 mg once per day.

TEMOZOLOMIDE: ♦ for treatment of persons suffering from anaplastic astrocytoma or glioblastoma multiforme and in whom a

recurrence or progression of the disease is observed after administration of a first-line treatment; ♦ for first-line treatment, in association with radiotherapy, of persons suffering from glioblastoma multiforme; TERIPARATIDE: ♦ for treatment of severe osteoporosis in menopausal women:

• whose osteoporotic fractures are documented by a T-score of less than or equal to – 3.0; and

• who have shown an inadequate response to continued taking of a bisphosphonate (or raloxifene, if a bisphosphonate is contraindicated), that is, who have shown the following characteristics: - a new fragility fracture following continued taking of the antiresorptive therapy for at least 12 months;

or


- significant decrease in mineral bone density, less than the T-score observed during pretreatment, despite continued taking of the antiresorptive therapy for at least 24 months.

The total duration of the authorization is 18 months. ★ TIGECYCLINE: ♦ for treatment of proven or presumed methicillin-resistant staphylococcus aureus (MRSA) polymicrobial

complicated skin infections: • necessitating antibiotherapy targeting simultaneously the MRSA and Gram-negative bacteria,

and • where vancomycin in combination with another antibiotic is ineffective, contraindicated or not tolerated;

♦ for treatment of complicated intra-abdominal infections where first-line treatment has failed, is contraindicated or

is not tolerated; TIPRANAVIR: ♦ for treatment, in association with other antiretrovirals, of HIV-infected persons:




and • who have tried, since the beginning of their antiretroviral therapy, at least one therapy that included another




Where a therapy including a non-nucleoside reverse transcriptase inhibitor cannot be used because of a primary resistance to delavirdine, efavirenz or nevirapine, a trial of at least two therapies, each including a protease inhibitor, is necessary and must have resulted in the same conditions as those listed above.

♦ for first line treatment, in association with other antiretrovirals, of HIV infected persons for whom a laboratory test showed an absence of sensitivity to other protease inhibitors, coupled with a resistance to one or the other class of nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors, or to both, and: • whose current viral load and another dating back at least one month are greater than or equal to

500 copies/mL; and


• for whom darunavir or tipranavir is necessary to establish an effective therapeutic regimen;

TIZANIDINE HYDROCHLORIDE: ♦ for treatment of spasticity where baclofen is ineffective, contraindicated or not tolerated; TOBRAMYCIN SULFATE, inh. sol.: ♦ for treatment of chronic Pseudomonas aeruginosa infections in persons suffering from cystic fibrosis, where

deterioration of the person's clinical condition is observed despite the conventional treatment or where the person is allergic to preservatives;


TOCOPHERYL ACETATE (DL-ALPHA): ♦ for prevention and treatment of neurological manifestations associated with malabsorption of vitamin E; TOLTERODINE L-TARTRATE: ♦ for treatment of vesical hyperactivity in persons for whom oxybutynin is poorly tolerated, contraindicated or

ineffective; TRANDOLAPRIL / VERAPAMIL (HYDROCHLORIDE): ♦ for persons already being treated with an angiotensin converting enzyme inhibitor and verapamil taken

separately; TRAVOPROST / TIMOLOL MALEATE: ♦ for control of intra-ocular pressure where the use of an antiglaucoma agent as monotherapy is insufficient; TREPROSTINIL SODIUM: ♦ for treatment of pulmonary arterial hypertension of WHO functional class III or IV that is either idiopathic or

associated with connectivitis and that is symptomatic despite the optimal conventional treatment; Persons must be evaluated and followed up on by physicians working at designated centres specializing in the treatment of pulmonary arterial hypertension;

TRETINOIN, top. cr., top. gel, top. sol.: ♦ for treatment of acne or other skin diseases necessitating a keratolytic treatment; TROSPIUM CHLORIDE: ♦ for treatment of vesical hyperactivity in persons for whom oxybutynine is poorly tolerated, contraindicated or

ineffective; USTEKINUMAB: ♦ for treatment of persons suffering from a severe form of chronic plaque psoriasis:

• in the presence of a score greater than or equal to 15 on the Psoriasis Area and Severity Index (PASI) or of large plaques on the face, palms or soles or in the genital area; and






The initial request is authorized for a maximum five months.


When requesting continuation of treatment, the physician must provide information making it possible to establish the treatment's beneficial effects, specifically: • an improvement of at least 75% in the PASI score;

or • an improvement of at least 50% in the PASI score and a decrease of at least five points on the

DQLI questionnaire; or

• a significant improvement in lesions on the face, palms or soles or in the genital area and a decrease of at least five points on the DQLI questionnaire.

Requests for continuation of treatment are authorized for a maximum of six months. Authorizations for ustekinumab are given for a dose of 45 mg in weeks 0 and 4, then every 12 weeks. A dose of 90 mg may be authorized for persons whose body weight is greater than 100 kg.

★ VALGANCICLOVIR HYDROCHLORIDE: ♦ for treatment of cytomegalovirus (CMV) retinitis in immunocompromised persons; ♦ for CMV-infection prophylaxis in D+R- persons having had a solid organ transplant and in D+R+ and D-R+

persons having had a lung transplant. The maximum duration of the authorization is 100 days; ♦ for CMV-infection prophylaxis in D+R-, D+R+ and D-R+ persons having had a solid organ transplant when

receiving antilymphocyte antibodies. The maximum duration of each authorization is 100 days; ♦ for pre-emptive treatment (in the presence of documented CMV viral replication) of CMV infection in D+R-, D+R+

and D-R+ persons who have had a solid organ transplant. The maximum duration of the authorization is 100 days per episode;

VERTEPORFIN: ♦ for treatment of age-related macular degeneration with neovascularization in persons where 50% or more of the

macular area is affected; ♦ for treatment of pathological myopia with neovascularization; ♦ for treatment of presumed ocular histoplasmosis syndrome with neovascularisation; ★ VORICONAZOLE, i.v. perf. pd.: ♦ for treatment of invasive aspergillosis; ♦ for treatment of candidemia in non-neutropenic persons for whom fluconazole and an amphotericin B formulation

have failed, are not tolerated or are contraindicated; ★ VORICONAZOLE, tab.: ♦ for treatment of invasive aspergillosis. The initial authorization is for a maximum duration of three months. Upon

submission of a subsequent request, the authorization may be renewed if relevant justification is provided; ♦ for treatment of candidemia in non-neutropenic persons for whom fluconazole and an amphotericin B formulation

have failed, are not tolerated or are contraindicated; ZOLEDRONIC ACID, i.v. perf. pd. 4 mg, i.v. perf. sol. 4 mg/5 mL: ♦ for treatment of hypercalcemia of tumoral origin, where pamidronate is ineffective or not tolerated; ♦ for prevention of bone events in persons suffering from breast cancer with bone metastases, where pamidronate

is not tolerated;


♦ for prevention of bone events in persons suffering from multiple myeloma with bone lesions, where pamidronate is not tolerated.

Notwithstanding the payment indications set out above, zoledronic acid is covered by the basic prescription drug insurance plan for insured persons who used this drug during the 12-month period preceding 28 April 2004. Persons referred to in the preceding paragraph who are insured by the Régie de l’assurance maladie du Québec are not required to submit the form entitled "Demande d’autorisation – médicament d’exception". The Régie de l’assurance maladie du Québec will cover the cost of this drug without other formalities, if it had already done so during the above-mentioned period. ZOLEDRONIC ACID, i.v. perf. sol. 5 mg/100 mL: ♦ for treatment of Paget's disease; ♦ for treatment of postmenopausal osteoporosis in women who cannot receive an oral bisphosphonate because of

serious intolerance or a contraindication.

4:00ANTIHISTAMINE DRUGS

4:04 first generation antihistamines4:04.04 ethanolamine derivatives4:04.16 piperazine derivatives

4:00ANTIHISTAMINE DRUGSKETOTIFENE FUMARATE XXSyr. 1 mg/5 mL

02176084 Novo-Ketotifen Novopharm 250 ml 33.25 0.1330

Tab. 1 mg PPB

02230730 Novo-Ketotifen Novopharm 100 38.00 0.380000577308 Zaditen Paladin 56 21.28 0.3800

4:04.04ETHANOLAMINE DERIVATIVESDIPHENHYDRAMINE HYDROCHLORIDE Inj. Sol. 50 mg/mL PPB

00596612 Diphenhydramine(chlorhydrate de)

Sandoz 1 ml 3.41

00878200 pms-Diphenhydramine Phmscience 10 ml 11.50 1.1500

4:04.16PIPERAZINE DERIVATIVESFLUNARIZINE HYDROCHLORIDE XCaps. 5 mg

02246082 Apo-Flunarizine Apotex 60100

31.8553.08

0.53080.5308

CODE BRAND NAME MANUFACTURER SIZE COST OF PKG.SIZE UNIT PRICE

2010-06 Page 3

8:00ANTI-INFECTIVE AGENTS

8:08 anthelmintics8:12 antibiotique8:12.02 aminoglycosides8:12.06 cephalosporins8:12.07 miscellaneous b-lactam antibiotics8:12.08 chloramphenicol8:12.12 macrolides8:12.16 penicillins8:12.18 quinolones8:12.20 sulfonamides8:12.24 tetracyclines8:12.28 miscellaneous antibiotics8:14 antifungals8:14.04 allylamines8:14.08 azoles8:14.28 polyenes8:16 antimycobacterials agents8:16.04 antituberculosis agents8:16.92 miscellaneous antimycobacterials8:18 antivirals8:18.04 adamantanes8:18.08 antiretroviral agents8:18.20 interferons8:18.32 nucleosides and nucleotides8:30 antiprotozoals8:30.04 amebicides8:30.08 antimalarials8:30.92 miscellaneous antiprotozoals8:36 urinary anti-infectives

8:08ANTHELMINTICSMEBENDAZOLE XXTab. 100 mg

00556734 Vermox J.O.I. 6 18.54 3.0900

PRAZIQUANTEL XTab. 600 mg

02230897 Biltricide Bayer 6 33.37 5.5617

8:12.02AMINOGLYCOSIDESAMIKACINE SULFATE XInj. Sol. 250 mg/mL

02242971 Amikacine (Sulfate d') Sandoz 2 ml 31.07

GENTAMICIN SULFATE XInj. Sol. 40 mg/mL

02242652 Gentamicine Sandoz 2 ml 4.91

STREPTOMYCIN SULFATE XInj. Pd 1 g

02243660 Streptomycin Sterimax 1 43.60

TOBRAMYCIN SULFATE XInj. Sol. 40 mg/mL

99005069 Tobramycine (sanspreservatif)

Sandoz 2 ml 4.45

02241210 Tobramycine (sulfate de) Sandoz 2 ml30 ml

4.4566.61 2.2203

8:12.06CEPHALOSPORINSCEFACLOR XCaps. 250 mg PPB

02230263 Apo-Cefaclor Apotex 100 96.97 0.969700465186 Ceclor MM Thera 100 102.07 0.9874

Caps. 500 mg PPB

02230264 Apo-Cefaclor Apotex 100 193.00 1.930000465194 Ceclor MM Thera 100 200.40 1.9652


2010-06 Page 7

Oral Susp. 125 mg/5 mL PPB

02237500 Apo-Cefaclor Apotex 100 ml150 ml

10.3715.55

W W

00465208 Ceclor MM Thera 100 ml150 ml

10.8916.34

0.10560.1056


02237501 Apo-Cefaclor Apotex 100 ml150 ml

18.9528.43

W W


19.9329.90

0.19300.1930

Oral Susp. 375 mg/5 mL


20.1028.72

0.20470.2047

CEFADROXIL MONOHYDRATE XCaps. 500 mg PPB

02240774 Apo-Cefadroxil Apotex 100 84.21 0.842102235134 Novo-Cefadroxil Novopharm 100 84.21 0.842102311062 Pro-Cefadroxil-500 Pro Doc 100 84.21 0.8421

CEFAZOLIN (SODIUM) XInj. Pd 1 g PPB

02108127 Cefazoline Novopharm 10 60.00 6.000002297205 Cefazoline for injection Apotex 10 60.00 6.000002237138 Cefazoline for injection PPC 25 150.00 6.000002308959 Cefazoline for injection Sandoz 10 60.00 6.0000

Inj. Pd 10 g PPB

02297213 Cefazoline for injection Apotex 10 560.00 56.000002237140 Cefazoline for injection PPC 10 560.00 56.000002308967 Cefazoline for injection Sandoz 1 56.00

Inj. Pd 20 g

02237141 Cefazoline for injection PPC 10 1120.00 112.0000

Inj. Pd 500 mg PPB

02108119 Cefazoline Novopharm 10 40.00 4.000002237137 Cefazoline for injection PPC 25 100.00 4.000002308932 Cefazoline for injection Sandoz 10 40.00 4.0000


Page 8 2010-06

CEFEPIME HYDROCHLORIDE XXInj. Pd 1 g

02163632 Maxipime B.M.S. 1 15.30

Inj. Pd 2 g

02319039 Cefepime for injection Apotex 10 224.26 18.366002163640 Maxipime B.M.S. 1 30.61

CEFIXIME XOral Susp. 100 mg/5 mL

00868965 Suprax SanofiAven 50 ml 17.61 0.3522

Tab. 400 mg

00868981 Suprax SanofiAven 710

22.0931.56

3.15573.1560

CEFOTAXIME (SODIUM) XInj. Pd 1 g

02225093 Claforan SanofiAven 1 9.20

Inj. Pd 2 g


Inj. Pd 500 mg


CEFPROZIL XOral Susp. 125 mg/5 mL

02293943 Apo-Cefprozil Apotex 75 ml100 ml

5.937.91

0.07910.0791

02163675 Cefzil B.M.S. 75 ml100 ml

11.8415.79

0.15790.1579

02329204 Ran-Cefprozil Ranbaxy 75 ml100 ml

5.937.91

0.07910.0791

02303426 Sandoz Cefprozil Sandoz 75 ml100 ml

5.937.91

0.07910.0791


2010-06 Page 9


02293951 Apo-Cefprozil Apotex 75 ml100 ml

11.8515.81

0.15800.1581

02163683 Cefzil B.M.S. 75 ml100 ml

23.7031.60

0.31600.3160

02293579 Ran-Cefprozil Ranbaxy 75 ml100 ml

11.8515.81

0.15800.1581

02303434 Sandoz Cefprozil Sandoz 75 ml100 ml

11.8515.81

0.15800.1581

Tab. 250 mg

02292998 Apo-Cefprozil Apotex 100 80.92 0.809202163659 Cefzil B.M.S. 100 161.73 1.617302317303 Mint-Cefprozil Mint 100 80.92 0.809202293528 Ran-Cefprozil Ranbaxy 100 80.92 0.809202302179 Sandoz Cefprozil Sandoz 100 80.92 0.8092

Tab. 500 mg

02293005 Apo-Cefprozil Apotex 100 158.67 1.586702324180 Cefprozil Pro Doc 100 158.67 1.586702163667 Cefzil B.M.S. 100 317.10 3.171002317311 Mint-Cefprozil Mint 100 158.67 1.586702293536 Ran-Cefprozil Ranbaxy 100 158.67 1.586702302187 Sandoz Cefprozil Sandoz 100 158.67 1.5867

CEFTAZIDIME PENTAHYDRATE XXInj. Pd 1 g PPB

00886971 Ceftazidime pour injection PPC 1 18.8502212218 Fortaz GSK 1 21.35

Inj. Pd 2 g PPB


Inj. Pd 6 g PPB


CEFTIZOXIME SODIUM XInj. Pd 1 g

01919490 Cefizox GSK 1 10.00 10.0000

Inj. Pd 2 g

01919504 Cefizox GSK 1 20.00 20.0000


Page 10 2010-06

CEFTRIAXONE SODIUM XXInj. Pd 1 g PPB

02292874 Ceftriaxone for injection Apotex 10 170.00 17.000002292270 Ceftriaxone for injection Sandoz 10 170.00 17.000002250292 Ceftriaxone sodium for

injectionHospira 10 170.00 17.0000

02287633 Ceftriaxone sodium forinjection

Novopharm 1 17.00

00657417 Rocephin Roche 10 340.00 34.0000

Inj. Pd 2 g PPB

02292882 Ceftriaxone for injection Apotex 10 335.00 33.500002292289 Ceftriaxone for injection Sandoz 10 335.00 33.500002250306 Ceftriaxone sodium for


Inj. Pd 10 g PPB

02292904 Ceftriaxone for injection Apotex 1 183.6002292815 Ceftriaxone sodium for

injectionHospira 1 183.60

02287668 Ceftriaxone sodium forinjection

Novopharm 1 183.60

Inj. Pd 250 mg PPB

02292866 Ceftriaxone for injection Apotex 10 53.75 5.375002250276 Ceftriaxone sodium for


00657387 Rocephin Roche 10 107.50 10.7500

CEFUROXIME (SODIUM) XInj. Pd 1.5 g

02241639 Cefuroxime for injection PPC 1 28.04

Inj. Pd 7.5 g


Inj. Pd 750 mg


CEFUROXIME AXETIL XOral Susp. 125 mg/5 mL

02212307 Ceftin GSK 70 ml100 ml

11.5716.52

0.16530.1652


2010-06 Page 11

Tab. 250 mg PPB

02244393 Apo-Cefuroxime Apotex 100 72.37 0.723702212277 Ceftin GSK 60 91.79 1.529802242656 ratio-Cefuroxime Ratiopharm 60 43.42 0.7237

Tab. 500 mg PPB

02244394 Apo-Cefuroxime Apotex 100 143.37 1.433702212285 Ceftin GSK 60 181.85 3.030802311453 Pro-Cefuroxime-500 Pro Doc 100 143.37 1.433702242657 ratio-Cefuroxime Ratiopharm 60 86.02 1.4337

CEPHALEXIN MONOHYDRATE XXCaps. or Tab. 250 mg PPB

00768723 Apo-Cephalex Apotex 1001000

22.50225.00

0.22500.2250

00342084 Novo-Lexin Novopharm 100 22.50 0.225000583413 Novo-Lexin (Co.) Novopharm 100

100022.50

225.000.22500.2250

Caps. or Tab. 500 mg PPB

00768715 Apo-Cephalex Apotex 100500

45.00225.00

0.45000.4500

00828866 Cephalexin-500 Pro Doc 100500

45.00225.00

0.45000.4500

00342114 Novo-Lexin Novopharm 100500

45.00225.00

0.45000.4500

00583421 Novo-Lexin (Co.) Novopharm 100500

45.00225.00

0.45000.4500


00342106 Novo-Lexin 125 Novopharm 100 ml150 ml

4.576.86

0.04570.0457


00342092 Novo-Lexin 250 Novopharm 100 ml150 ml

9.4814.22

0.09480.0948

8:12.07MISCELLANEOUS B-LACTAM ANTIBIOTICSCEFOXITIN SODIUM XInj. Pd 1 g PPB

02128187 Cefoxitine Novopharm 1 10.6002291711 Cefoxitine for injection Apotex 10 106.00 10.6000


Page 12 2010-06

Inj. Pd 2 g PPB

02128195 Cefoxitine Novopharm 1 21.2502291738 Cefoxitine for injection Apotex 10 212.50 21.2500

DORIPENEM XXI.V. Perf. Pd 500 mg

02332906 Doribax J.O.I. 1 32.46

ERTAPENEM SODIUM XInj. Pd 1 g

02247437 Invanz Merck 10 499.50 49.9500

IMIPENEM/ CILASTATIN XI.V. Perf. Susp. 250 mg -250 mg

00717274 Primaxin Merck 25 326.00

I.V. Perf. Susp. 500 mg -500 mg

00717282 Primaxin Merck 25 609.50 24.3800

MEROPENEM XInj. Pd 1 g

02218496 Merrem AZC 1 48.70 48.7000

Inj. Pd 500 mg

02218488 Merrem AZC 1 24.35 24.3500

8:12.08CHLORAMPHENICOLCHLORAMPHENICOL SODIUM SUCCINATE XInj. Pd 1 g

00312363 Chloromycetin Erfa 1 4.84

8:12.12MACROLIDESAZITHROMYCIN XI.V. Perf. Pd 500 mg

02239952 Zithromax I.V. Pfizer 10 203.85 20.3850


2010-06 Page 13


02315157 Novo-Azithromycin Pediatric Novopharm 15 ml 8.32 0.554702274388 pms-Azithromycin Phmscience 15 ml 8.32 0.554702332388 Sandoz Azithromycin Sandoz 15 ml 8.32 0.554702223716 Zithromax Pfizer 15 ml 15.97 1.0647


02315165 Novo-Azithromycin Pediatric Novopharm 15 ml22.5 ml

11.7917.68

0.78600.7858

02274396 pms-Azithromycin Phmscience 15 ml22.5 ml

11.7917.68

0.78600.7858

02332396 Sandoz Azithromycin Sandoz 15 ml37.5 ml

11.7929.47

0.78600.7858

02223724 Zithromax Pfizer 15 ml22.5 ml

22.6333.94

1.50871.5084

Tab. 250 mg PPB

02247423 Apo-Azithromycin Apotex 6100

14.80246.67

2.46672.4667

02330881 Azithromycin Sanis 630

14.8074.00

2.46672.4667

02255340 Co Azithromycin Cobalt 6100

14.80246.67

2.46672.4667

02278359 Mylan-Azithromycin Mylan 630

14.8074.00

2.46672.4667

02267845 Novo-Azithromycin Novopharm 630

14.8074.00

2.46672.4667

02278588 phl-Azithromycin Pharmel 6100

14.80246.67

2.46672.4667

02261634 pms-Azithromycin Phmscience 6100

14.80246.67

2.46672.4667

02310600 Pro-Azithromycine Pro Doc 6 14.80 2.466702275287 ratio-Azithromycin Ratiopharm 6

10014.80

246.672.46672.4667

02275309 Riva-Azithromycin Riva 6100

14.80246.67

2.46672.4667

02265826 Sandoz Azithromycin Sandoz 6100

14.80246.67

2.46672.4667

02212021 Zithromax Pfizer 30 144.57 4.8190

Tab. 600 mg PPB

02330911 Azithromycin Sanis 6 36.00 6.000002256088 Co Azithromycin Cobalt 6 36.00 6.000002261642 pms-Azithromycin Phmscience 30 180.00 6.000002275317 Riva-Azithromycin Riva 6 36.00 6.000002231143 Zithromax Pfizer 30 346.97 11.5657


Page 14 2010-06

CLARITHROMYCINE XXCo. or Co. L.A. 250 mg / 500 mg L.A. PPB

02274744 Apo-Clarithromycin Apotex 100 78.61 0.786101984853 Biaxin Bid Abbott 100 157.09 1.570902244756 Biaxin XL Abbott 60 150.86 2.514302324482 Clarithromycin Pro Doc 100 78.61 0.786102248856 Mylan-Clarithromycin Mylan 100

50078.61

393.050.78610.7861

02247573 pms-Clarithromycin Phmscience 100250

78.61196.53

0.78610.7861

02247818 ratio-Clarithromycin Ratiopharm 100500

78.61393.05

0.78610.7861

02266539 Sandoz Clarithromycin Sandoz 100250

78.61196.53

0.78610.7861


02146908 Biaxin Abbott 55 ml105 ml150 ml

15.1728.9441.35

0.27580.27560.2757


02244641 Biaxin Abbott 105 ml 57.89 0.5513

Tab. 500 mg PPB

02274752 Apo-Clarithromycin Apotex 100 162.97 1.629702126710 Biaxin Bid Abbott 100 314.17 3.141702324490 Clarithromycin Pro Doc 100 162.97 1.629702248857 Mylan-Clarithromycin Mylan 100 162.97 1.629702247574 pms-Clarithromycin Phmscience 100

250162.97407.43

1.62971.6297

02247819 ratio-Clarithromycin Ratiopharm 100500

162.97814.86

1.62971.6297

02266547 Sandoz Clarithromycin Sandoz 100250

162.97407.43

1.62971.6297

ERYTHROMYCIN XEnt. Caps. 250 mg PPB

00726672 Apo-Erythro E-C Apotex 100 39.00 0.287700607142 Eryc Pfizer 100

50047.94

110.240.47940.2205

Ent. Caps. 333 mg PPB

01925938 Apo-Erythro E-C Apotex 100 43.32 0.4332

Ent. Tab. 250 mg

00682020 Apo-Erythro-Base Apotex 1001000

18.28182.80

0.18280.1828


2010-06 Page 15

Ent. Tab. 500 mg

00893862 Erybid Abbott 250 208.43 0.8337

ERYTHROMYCIN ESTOLATE XXOral Susp. 250 mg/5 mL

00262595 Novo-Rythro Estolate Novopharm 100 ml500 ml

7.1335.65

0.07130.0713

ERYTHROMYCIN ETHYLSUCCINATE XOral Susp. 200 mg/5 mL

00605859 Novo-Rythro Ethylsuccinate Novopharm 100 ml150 ml

6.6910.03

0.06690.0669


00652318 Novo-Rythro Ethylsuccinate Novopharm 100 ml150 ml

10.1315.20

0.10130.1013

Tab. 600 mg

00637416 Apo-Erythro-Es Apotex 100 33.63 0.3363

ERYTHROMYCIN STEARATE XTab. 250 mg

00545678 Apo-Erythro-S Apotex 100 21.18 0.2118

Tab. 500 mg

00688568 Apo-Erythro-S Apotex 100 54.25 0.5425

SPIRAMYCIN XCaps. 250 mg

01927825 Rovamycine Odan 50 60.50 1.1724

Caps. 500 mg

01927817 Rovamycine Odan 50 116.40 2.3280

TELITHROMYCIN XTab. 400 mg

02247520 Ketek SanofiAven 60 192.38 3.2063


Page 16 2010-06

8:12.16PENICILLINSAMOXICILLIN XXCaps. 250 mg PPB

00628115 Apo-Amoxi Apotex 1001000

17.50175.00

0.17500.1750

02238171 Mylan-Amoxicillin Mylan 1000 175.00 0.175000406724 Novamoxin Novopharm 100

100017.50

175.000.17500.1750

02262851 phl-Amoxicillin Pharmel 5001000

87.50175.00

0.17500.1750

02230243 pms-Amoxicillin Phmscience 5001000

87.50175.00

0.17500.1750

Caps. 500 mg PPB

00628123 Apo-Amoxi Apotex 100500

34.17170.85

0.34170.3417

02238172 Mylan-Amoxicillin Mylan 100500

34.17170.85

0.34170.3417

00406716 Novamoxin Novopharm 100500

34.17170.85

0.34170.3417

02262878 phl-Amoxicillin Pharmel 250500

85.42170.85

0.34170.3417

02230244 pms-Amoxicillin Phmscience 250500

85.42170.85

0.34170.3417

00644315 Pro-Amox-500 Pro Doc 500 170.85 0.3417

Chew. Tab. 125 mg

02036347 Novamoxin Novopharm 100 41.67 0.4167

Chew. Tab. 250 mg

02036355 Novamoxin Novopharm 100 61.38 0.6138


00628131 Apo-Amoxi Apotex 100 ml150 ml

3.535.30

0.03530.0353

99002582 Apo-Amoxi sans sucrose Apotex 100 ml150 ml

3.535.30

0.03530.0353

01934171 Novamoxin Novopharm 75 ml100 ml150 ml

2.703.535.30

0.03600.03530.0353

00452149 Novamoxin 125 Novopharm 75 ml100 ml150 ml

2.703.535.30

0.03600.03530.0353

02262886 phl-Amoxicillin Pharmel 100 ml150 ml

3.535.30

0.03530.0353

02230245 pms-Amoxicillin Phmscience 100 ml150 ml

3.535.30

0.03530.0353


2010-06 Page 17


00628158 Apo-Amoxi Apotex 100 ml150 ml

5.408.10

0.05400.0540

99002590 Apo-Amoxi sans sucrose Apotex 100 ml150 ml

5.408.10

0.05400.0540

00452130 Novamoxin 250 Novopharm 75 ml100 ml150 ml

4.055.408.10

0.05400.05400.0540

01934163 Novamoxin Hypoglucidique Novopharm 75 ml100 ml150 ml

4.055.408.10

0.05400.05400.0540

02262894 phl-Amoxicillin Pharmel 100 ml150 ml

5.408.10

0.05400.0540

02230246 pms-Amoxicillin Phmscience 100 ml150 ml

5.408.10

0.05400.0540

00644331 Pro-Amox-250 Pro Doc 100 ml150 ml

5.408.10

0.05400.0540

AMOXICILLIN/ POTASSIUM CLAVULANATE XXOral Susp. 125 mg -31.25 mg/5 mL PPB

02243986 Apo-Amoxi Clav Apotex 100 ml150 ml

5.177.76

0.05170.0517

01916882 Clavulin-125 F GSK 100 ml 10.88 0.108802244646 ratio-Aclavulanate 125F Ratiopharm 100 ml 5.17 0.0517

Oral Susp. 200 mg -28.5 mg/5 mL

02238831 Clavulin-200 GSK 70 ml 9.39 0.1341

Oral Susp. 250 mg -62.5 mg/5 mL PPB

02243987 Apo-Amoxi Clav Apotex 100 ml150 ml

8.6913.04

0.08690.0869

01916874 Clavulin-250 F GSK 100 ml 18.72 0.187202244647 ratio-Aclavulanate 250F Ratiopharm 100 ml 8.69 0.0869

Oral Susp. 400 mg - 57 mg/5mL PPB

02288559 Apo-Amoxi Clav Apotex 70 ml 13.78 0.153902238830 Clavulin-400 GSK 70 ml 17.95 0.2564

Tab. 250 mg -125 mg

02243350 Apo-Amoxi Clav Apotex 100 43.65 0.4365

Tab. 500 mg -125 mg PPB

02326515 Amoxi-Clav Pro Doc 100 66.73 0.667302243351 Apo-Amoxi Clav Apotex 100 66.73 0.667301916858 Clavulin-500 F GSK 100 137.82 1.378202243771 ratio-Aclavulanate Ratiopharm 100 66.73 0.6673


Page 18 2010-06


02326523 Amoxi-Clav Pro Doc 100 100.08 1.000802245623 Apo-Amoxi Clav Apotex 100 100.08 1.000802238829 Clavulin-875 GSK 60 124.03 2.067202248138 Novo-Clavamoxin 875 Novopharm 20 20.02 1.000802247021 ratio-Aclavulanate Ratiopharm 60 60.05 1.0008

AMPICILLIN XXCaps. 250 mg

00020877 Novo-Ampicillin Novopharm 100 30.71 0.3071

Caps. 500 mg

00020885 Novo-Ampicillin Novopharm 100 59.55 0.5955

AMPICILLIN (SODIUM) XInj. Pd 1 g

01933345 Ampicilline Sodique Novopharm 1 3.60

Inj. Pd 2 g PPB

02226995 Ampicillin for Injection PPC 1 7.2001933353 Ampicilline Sodique Novopharm 1 7.20

Inj. Pd 250 mg


Inj. Pd 500 mg


CLOXACILLIN (SODIUM) XCaps. 250 mg PPB

00618292 Apo-Cloxi Apotex 100 18.50 0.185000337765 Novo-Cloxin Novopharm 100 18.50 0.185000717584 Nu-Cloxi Nu-Pharm 100 18.50 0.1850

Caps. 500 mg PPB

00618284 Apo-Cloxi Apotex 100500

34.98183.75

0.34980.3675

02069679 Cloxacilline-500 Pro Doc 100 34.98 0.349800337773 Novo-Cloxin Novopharm 100 34.98 0.349800717592 Nu-Cloxi Nu-Pharm 100 36.75 0.3675


2010-06 Page 19

Inj. Pd 2 g

01912410 Cloxacilline Sodique Novopharm 1 7.32

Inj. Pd 500 mg

01912429 Cloxacilline Sodique Novopharm 1 4.56


00644633 Apo-Cloxi Apotex 100 ml200 ml

4.509.00

0.04500.0450

00337757 Novo-Cloxin Novopharm 100 ml200 ml

4.509.00

0.04500.0450

00717630 Nu-Cloxi Nu-Pharm 100 ml 4.50 0.0450

PENICILLIN G (BENZATHINE) XXI.M. Inj. Susp. 1 2000 000 UI / 2 mL

02291924 Bicillin L-A King 10 406.96 40.6960

PENICILLIN G (SODIUM) XInj. Pd 1 000 000 U PPB

02060086 Crystapen Bioniche 1 2.4001930672 Penicilline G Novopharm 1 2.4002220261 Penicilline G sodium for

injectionPPC 1 2.40

Inj. Pd 5 000 000 U PPB


injectionPPC 1 5.10

Inj. Pd 10 000 000 U PPB


injectionPPC 1 8.90

PHENOXYMETHYLPENICILLIN (BASE OR POTASSIUM SALT) XTab. 250 mg to 300 mg PPB

00642215 Apo-Pen-VK Apotex 1001000

7.1071.00

0.07100.0710

00021202 Novo-Pen VK Novopharm 1001000

7.1071.00

0.07100.0710

00717568 Nu-Pen-VK Nu-Pharm 1001000

7.1071.00

0.07100.0710

00468029 Penicilline V Pro Doc 1000 71.00 0.0710


Page 20 2010-06

PHENOXYMETHYLPENICILLIN (POTASSIUM) XXOral Susp. 125 mg/5 mL

00642223 Apo-Pen-VK Apotex 100 ml 5.35 0.0535

Oral Susp. 250 mg to 300 mg/5 mL PPB

00642231 Apo-Pen-VK Apotex 100 ml 4.72 0.047200391603 Novo-Pen VK 500 Novopharm 100 ml 4.72 0.0472

PIPERACILLIN (SODIUM) XInj. Pd 2 g PPB

02246640 Piperacilline Hospira 1 8.5002248939 Piperacilline for injection PPC 1 8.50

Inj. Pd 3 g PPB


Inj. Pd 4 g PPB


PIPERACILLIN SODIUM/ TABACTAM SODIUM XI.V. Perf. Pd 2 g -0.25 g PPB

02308444 Piperacilline et Tazobactamfor injection

Apotex 1 9.00 6.0600

02299623 Piperacilline sodique/Tazobactam sodique

Sandoz 1 9.00 6.0600

02170817 Tazocin Wyeth 1 11.21

I.V. Perf. Pd 3 g -0.375 g PPB


Apotex 1 13.50 9.0800


Sandoz 1 13.50 9.0800


I.V. Perf. Pd 4 g -0.5 g PPB


Apotex 1 18.00 12.1100


Sandoz 1 18.00 12.1100



2010-06 Page 21

TICARCILLINE DISODIUM/ CLAVULANATE POTASSIUM XXI.V. Inj. Pd 3 g -0,1 g

01916939 Timentin GSK 1 10.16

8:12.18QUINOLONESCIPROFLOXACIN HYDROCHLORIDE XL.A. Tab. 500 mg

02247916 Cipro XL Bayer 50 144.81 2.8962

L.A. Tab. 1000 mg

02251787 Cipro XL Bayer 50 144.81 2.8962


02237514 Cipro Bayer 100 ml 53.23 0.5323

Tab. 250 mg PPB

02229521 Apo-Ciproflox Apotex 100 111.05 1.110502155958 Cipro Bayer 100 229.35 2.293502247339 Co Ciprofloxacin Cobalt 100 111.05 1.110502317427 Mint-Ciprofloxacine Mint 100 111.05 1.110502245647 Mylan-Ciprofloxacin Mylan 100 111.05 1.110502161737 Novo-Ciprofloxacin Novopharm 100 111.05 1.110502251310 phl-Ciprofloxacin Pharmel 100

500111.05555.25

1.11051.1105

02248437 pms-Ciprofloxacin Phmscience 100500

111.05555.25

1.11051.1105

02317796 Pro-Ciprofloxacin Pro Doc 100 111.05 1.110502303728 Ran-Ciproflox Ranbaxy 100 111.05 1.110502267934 Ran-Ciprofloxacin Ranbaxy 100 111.05 1.110502246825 ratio-Ciprofloxacin Ratiopharm 100 111.05 1.110502251221 Riva-Ciprofloxacin Riva 100 111.05 1.110502248756 Sandoz Ciprofloxacin Sandoz 100 111.05 1.110502266962 Taro-Ciprofloxacin Taro 100 111.05 1.1105


Page 22 2010-06

Tab. 500 mg PPB

02229522 Apo-Ciproflox Apotex 100500

125.29626.45

1.25291.2529

02155966 Cipro Bayer 100 258.76 2.587602247340 Co Ciprofloxacin Cobalt 100 125.29 1.252902317435 Mint-Ciprofloxacine Mint 100 125.29 1.252902245648 Mylan-Ciprofloxacin Mylan 100

500125.29626.45

1.25291.2529

02161745 Novo-Ciprofloxacin Novopharm 100500

125.29626.45

1.25291.2529

02251329 phl-Ciprofloxacin Pharmel 100500

125.29626.45

1.25291.2529


125.29626.45

1.25291.2529

02317818 Pro-Ciprofloxacin Pro Doc 100500

125.29626.45

1.25291.2529

02303736 Ran-Ciproflox Ranbaxy 100 125.29 1.252902267942 Ran-Ciprofloxacin Ranbaxy 100 125.29 1.252902246826 ratio-Ciprofloxacin Ratiopharm 100 125.29 1.252902251248 Riva-Ciprofloxacin Riva 100

500125.29626.45

1.25291.2529

02248757 Sandoz Ciprofloxacin Sandoz 100 125.29 1.252902266970 Taro-Ciprofloxacin Taro 100 125.29 1.2529

Tab. 750 mg PPB

02229523 Apo-Ciproflox Apotex 100 236.31 2.363102155974 Cipro Bayer 50

100241.13482.21

4.82264.8221

02247341 Co Ciprofloxacin Cobalt 50 118.16 2.363102317443 Mint-Ciprofloxacine Mint 100 236.31 2.363102245649 Mylan-Ciprofloxacin Mylan 100 236.31 2.363102161753 Novo-Ciprofloxacin Novopharm 50

100118.16236.31

2.36312.3631

02251337 phl-Ciprofloxacin Pharmel 50100

118.16236.31

2.36312.3631


118.16236.31

2.36312.3631

02303744 Ran-Ciproflox Ranbaxy 100 236.31 2.363102267950 Ran-Ciprofloxacin Ranbaxy 50 118.16 2.363102246827 ratio-Ciprofloxacin Ratiopharm 50 118.16 2.363102251256 Riva-Ciprofloxacin Riva 100 236.31 2.363102248758 Sandoz Ciprofloxacin Sandoz 50 118.16 2.3631

LEVOFLOXACIN XXTab. 250 mg

02284707 Apo-Levofloxacin Apotex 100 222.00 2.220002315424 Co Levofloxacin Cobalt 50 111.00 2.220002236841 Levaquin J.O.I. 50 230.35 4.607002313979 Mylan-Levofloxacin Mylan 100 222.00 2.220002248262 Novo-Levofloxacin Novopharm 100 222.00 2.220002284677 pms-Levofloxacin Phmscience 100 222.00 2.220002298635 Sandoz Levofloxacin Sandoz 50 111.00 2.2200


2010-06 Page 23

Tab. 500 mg

02284715 Apo-Levofloxacin Apotex 100 250.50 2.505002315432 Co Levofloxacin Cobalt 100 250.50 2.505002236842 Levaquin J.O.I. 50 256.81 5.136202313987 Mylan-Levofloxacin Mylan 100 250.50 2.505002248263 Novo-Levofloxacin Novopharm 100 250.50 2.505002284685 pms-Levofloxacin Phmscience 100 250.50 2.505002298643 Sandoz Levofloxacin Sandoz 100 250.50 2.5050

Tab. 750 mg

02325942 Apo-Levofloxacin Apotex 100 484.79 4.847902315440 Co Levofloxacin Cobalt 50 242.40 4.847902246804 Levaquin J.O.I. 50 472.50 9.450002285649 Novo-Levofloxacin Novopharm 100 484.79 4.847902305585 pms-Levofloxacin Phmscience 100 484.79 4.847902298651 Sandoz Levofloxacin Sandoz 50 283.50 5.1030

MOXIFLOXACIN HYDROCHLORIDE XTab. 400 mg

02242965 Avelox Bayer 30 158.87 5.2957

NORFLOXACIN XTab. 400 mg PPB

02229524 Apo-Norflox Apotex 100 108.97 1.089702269627 Co Norfloxacin Cobalt 100 108.97 1.089702237682 Novo-Norfloxacin Novopharm 100 108.97 1.089702246596 pms-Norfloxacin Phmscience 100 108.97 1.089702301504 Riva-Norfloxacin Riva 100 108.97 1.0897

OFLOXACINE XTab. 200 mg PPB

02231529 Apo-Oflox Apotex 100 130.41 1.304102243474 Novo-Ofloxacin Novopharm 100 130.41 1.3041

Tab. 300 mg PPB

02231531 Apo-Oflox Apotex 100 121.61 1.216102243475 Novo-Ofloxacin Novopharm 100 121.61 1.2161

Tab. 400 mg PPB

02231532 Apo-Oflox Apotex 100 121.61 1.216102243476 Novo-Ofloxacin Novopharm 100 121.61 W


Page 24 2010-06

8:12.20SULFONAMIDESSULFASALAZINE XXEnt. Tab. 500 mg PPB

00598488 pms-Sulfasalazine-E.C. Phmscience 100500

20.00100.00

0.15600.1561

02064472 Salazopyrin EN-Tabs Pfizer 100300

25.9978.03

0.25990.2601

Tab. 500 mg PPB

00598461 pms-Sulfasalazine Phmscience 100500

12.8064.00

0.09990.0999

02064480 Salazopyrin Pfizer 100300

16.6549.94

0.16650.1665

TRIMETHOPRIM/ SULFAMETHOXAZOLE XI.V. Perf. Sol. 16 mg -80 mg/mL

00550086 Septra GSK 5 ml 6.08

Oral Susp. 40 mg -200 mg/5 mL

00726540 Novo-Trimel Novopharm 100 ml400 ml

1.987.92

0.01980.0198

Tab. 20 mg -100 mg

00445266 Apo-Sulfatrim-PED Apotex 100 9.11 0.0911


00445274 Apo-Sulfatrim Apotex 1001000

4.8248.20

0.04820.0482

00510637 Novo-Trimel Novopharm 1001000

4.8248.20

0.04820.0482


00445282 Apo-Sulfatrim-DS Apotex 100500

12.2161.05

0.12210.1221

00510645 Novo-Trimel D.S. Novopharm 100500

12.2161.05

0.12210.1221

00512524 Protrin DF Pro Doc 100 12.21 0.1221


2010-06 Page 25

8:12.24TETRACYCLINESDOXYCYCLINE HYCLATE XXCaps. or Tab. 100 mg PPB

00740713 Apo-Doxy Apotex 100250

58.60146.50

0.58600.5860

00874256 Apo-Doxy-Tabs Apotex 100250

58.60146.50

0.58600.5860

00817120 Doxycin Riva 100300

58.60175.80

0.58600.5860

00860751 Doxycin (co.) Riva 100300

58.60175.80

0.58600.5860

00887064 Doxytab Pro Doc 100 58.60 0.586000725250 Novo-Doxilin Novopharm 100

20058.60

117.200.58600.5860

02158574 Novo-Doxylin (Co.) Novopharm 100 58.60 0.586002289431 phl-Doxycycline (Caps.) Pharmel 100 58.60 0.586002289458 phl-Doxycycline (Co.) Pharmel 100 58.60 0.586002289539 pms-Doxycycline (Caps.) Phmscience 100 58.60 0.586002289466 pms-Doxycycline (Co.) Phmscience 100 58.60 0.586000024368 Vibramycine Pfizer 50 81.34 1.6268

MINOCYCLINE HYDROCHLORIDE XCaps. 50 mg PPB

02084090 Apo-Minocycline Apotex 100250

32.1380.33

0.32130.3213

02248208 Enca Prempharm 100 53.50 0.330502173514 Minocin Stiefel 100 61.19 0.611902287226 * Minocycline Sanis 100 32.13 0.321302153394 Minocycline-50 Pro Doc 100

25032.1380.33

0.32130.3213

02230735 Mylan-Minocycline Mylan 100250

32.1380.33

0.32130.3213

02108143 Novo-Minocycline Novopharm 100 32.13 0.321302294133 phl-Minocycline Pharmel 100 32.13 0.321302239238 pms-Minocycline Phmscience 100

25032.1380.33

0.32130.3213

02294419 pms-Minocycline Phmscience 100 32.13 0.321301914138 ratio-Minocycline Ratiopharm 100 32.13 0.321302242080 Riva-Minocycline Riva 100

25032.1380.33

0.32130.3213

02237313 Sandoz Minocycline Sandoz 100 32.13 0.3213


Page 26 2010-06

Caps. 100 mg PPB

02084104 Apo-Minocycline Apotex 100250

61.99154.98

0.61990.6199

02248209 Enca Prempharm 100 103.32 0.637602173506 Minocin Stiefel 100 118.06 1.180602287234 * Minocycline Sanis 100 61.99 0.619902154366 Minocycline-100 Pro Doc 100

25061.99

154.980.61990.6199

02230736 Mylan-Minocycline Mylan 100250

61.99154.98

0.61990.6199

02108151 Novo-Minocycline Novopharm 100 61.99 0.619902294141 phl-Minocycline Pharmel 100 61.99 0.619902239239 pms-Minocycline Phmscience 100

25061.99

154.980.61990.6199

02294427 pms-Minocycline Phmscience 100 61.99 0.619901914146 ratio-Minocycline Ratiopharm 100 61.99 0.619902242081 Riva-Minocycline Riva 100

25061.99

154.980.61990.6199

02237314 Sandoz Minocycline Sandoz 100 61.99 0.6199

TETRACYCLINE HYDROCHLORIDE XCaps. 250 mg PPB

00580929 Apo-Tetra Apotex 1001000

6.5754.88

0.06570.0549

00156744 Tetracycline-250 Pro Doc 1001000

6.3553.00

0.06350.0530

8:12.28MISCELLANEOUS ANTIBIOTICSBACITRACIN Inj./Top. Pd 50 000 U

00030708 Bacitracine Pfizer 50 ml 8.99

CLINDAMYCIN HYDROCHLORIDE XCaps. 150 mg PPB

02245232 Apo-Clindamycine Apotex 100 38.81 0.388102248525 Clindamycine-150 Pro Doc 100 38.81 0.388100030570 Dalacin C Pfizer 100 84.89 0.848902258331 Mylan-Clindamycin Mylan 100 38.81 0.388102241709 Novo-Clindamycin Novopharm 100 38.81 0.388102294826 pms-Clindamycin Phmscience 100 38.81 0.388102130033 ratio-Clindamycin Ratiopharm 100 38.81 W 02242409 Riva-Clindamycin Riva 100 38.81 0.3881


2010-06 Page 27

Caps. 300 mg PPB

02245233 Apo-Clindamycine Apotex 100 77.62 0.776202248526 Clindamycine-300 Pro Doc 100 77.62 0.776202182866 Dalacin C Pfizer 100 170.54 1.705402258358 Mylan-Clindamycin Mylan 100 77.62 0.776202241710 Novo-Clindamycin Novopharm 100 77.62 0.776202294834 pms-Clindamycin Phmscience 100 77.62 0.776202192659 ratio-Clindamycin Ratiopharm 100 77.62 W 02242410 Riva-Clindamycin Riva 100 77.62 0.7762

CLINDAMYCIN PALMITATE HYDROCHLORIDE XXOral Susp. 75 mg/5 mL

00225851 Dalacin C Pfizer 100 ml 11.47 0.1147

CLINDAMYCIN PHOSPHATE XInj. Sol. 150 mg/mL PPB

02230540 Clindamycine Sandoz 2 ml4 ml6 ml

4.579.15

13.73

1.83502.04001.8517

02230535 Clindamycine (formatpharmacie)

Sandoz 60 ml 195.51 1.8333

00260436 Dalacin C Pfizer 2 ml4 ml6 ml

6.7913.5918.51

COLISTIMETHATE (SODIUM) XInj. Pd 150 mg PPB

02244849 Colistimethate Sterimax 1 30.4200476420 Coly-Mycin M Parenteral Erfa 1 34.48

ERYTROMYCIN ETHYLSUCCINATE/ SULFISOXAZOLE ACETYL XOral Susp. 200 mg -600 mg/5 mL

00583405 Pediazole Abbott 105 ml150 ml

11.3516.21

0.10810.1081

LINCOMYCIN HYDROCHLORIDE XInj. Sol. 300 mg/mL

00030732 Lincocin Pfizer 2 ml 5.25

VANCOMYCIN HYDROCHLORIDE XCaps. 125 mg

00800430 Vancocin Iroko 20 148.03 7.4015


Page 28 2010-06

Caps. 250 mg

00788716 Vancocin Iroko 20 296.05 14.8025

I.V. Perf. Pd 1 g PPB

02241821 pms-Vancomycin Phmscience 10 589.90 58.990002139383 Sterile Vancomycin

HydrochloridePPC 10 589.90 58.9900

02230192 Vancomycine(hydrochloride)

Hospira 10 589.90 58.9900

I.V. Perf. Pd 5 g

02139243 Sterile VancomycinHydrochloride

PPC 1 294.95

I.V. Perf. Pd 10 g

02241807 Sterile VancomycinHydrochloride

PPC 1 589.90

I.V. Perf. Pd 500 mg PPB

02241820 pms-Vancomycin Phmscience 10 310.50 31.050002139375 Sterile Vancomycin

HydrochloridePPC 25 776.25 31.0500

02230191 Vancomycine(hydrochloride)

Hospira 10 310.50 31.0500

8:14.04ALLYLAMINESTERBINAFIN HYDROCHLORIDE XXTab. 250 mg PPB

02239893 Apo-Terbinafine Apotex 30100

55.63185.45

1.85431.8545

02254727 Co Terbinafine Cobalt 30100

55.63185.45

1.85431.8545

02031116 Lamisil Novartis 28 99.62 3.557902242503 Mylan-Terbinafine Mylan 28

10051.92

185.451.85431.8545

02240346 Novo-Terbinafine Novopharm 28100

51.92185.45

1.85431.8545

02297973 phl-Terbinafine Pharmel 100 185.45 1.854502294273 pms-Terbinafine Phmscience 30

10055.63

185.451.85431.8545

02262924 Riva-Terbinafine Riva 30100

55.63185.45

1.85431.8545

02262177 Sandoz Terbinafine Sandoz 28100

51.92185.45

1.85431.8545

02242735 Terbinafine-250 Pro Doc 30100

55.63185.45

1.85431.8545


2010-06 Page 29

8:14.08AZOLESFLUCONAZOLE XXCaps. 150 mg PPB

02241895 Apo-Fluconazole-150 Apotex 1 7.2902323419 Co Fluconazole-150 Cobalt 3 21.87 7.290002141442 Diflucan-150 Pfizer 1 14.2302245697 Mylan-Fluconazole Mylan 1 7.2902294044 phl-Fluconazole Pharmel 1 7.2902282348 pms-Fluconazole Phmscience 1 7.2902310694 Pro-Fluconazole Pro Doc 1 7.2902255510 Riva-Fluconazole Riva 1 7.2902301954 Zym-Fluconazole Zymcan 1 7.29

I.V. Perf. Sol. 2 mg/mL PPB

00891835 Diflucan Pfizer 100 ml 51.7902247922 Fluconazole Injectable Novopharm 100 ml 26.8702248443 Fluconazole Injection Sandoz 100 ml 26.8702247749 Fluconazole Omega Oméga 100 ml 26.87

Tab. 50 mg PPB

02237370 Apo-Fluconazole Apotex 50 123.04 2.460802281260 Co Fluconazole Cobalt 50 123.04 2.460802245292 Mylan-Fluconazole Mylan 50 123.04 2.460802236978 Novo-Fluconazole Novopharm 100 246.08 2.460802245643 pms-Fluconazole Phmscience 50 123.04 2.460802301938 Zym-Fluconazole Zymcan 50 123.04 2.4608

Tab. 100 mg PPB

02237371 Apo-Fluconazole Apotex 50 218.27 4.365402281279 Co Fluconazole Cobalt 50 218.27 4.365402245293 Mylan-Fluconazole Mylan 50 218.27 4.365402236979 Novo-Fluconazole Novopharm 50 218.27 4.365402245644 pms-Fluconazole Phmscience 50 218.27 4.365402310686 Pro-Fluconazole Pro Doc 50 218.27 4.365402271516 Riva-Fluconazole Riva 50 218.27 4.365402301946 Zym-Fluconazole Zymcan 50 218.27 4.3654

ITRACONAZOLE XCaps. 100 mg

02047454 Sporanox J.O.I. 2830

103.46110.85

3.69503.6950

Oral Sol. 10 mg/mL

02231347 Sporanox J.O.I. 150 ml 115.28 0.7685


Page 30 2010-06

KETOCONAZOLE XXTab. 200 mg PPB

02237235 Apo-Ketoconazole Apotex 100 93.93 0.939302231061 Novo-Ketoconazole Novopharm 100 93.93 0.939302122197 Nu-Ketocon Nu-Pharm 100 93.93 0.9393

8:14.28POLYENESNYSTATIN XOral Susp. 100 000 U/mL PPB

00792667 pms-Nystatin Phmscience 24 ml48 ml

100 ml

1.252.505.20

0.05210.05210.0520

02194201 ratio-Nystatin Ratiopharm 24 ml48 ml

100 ml

1.252.505.20

0.05210.05210.0520

Tab. 500 000 U

02194198 ratio-Nystatin Ratiopharm 100 16.80 0.1680

8:16.04ANTITUBERCULOSIS AGENTSETHAMBUTOL HYDROCHLORIDE XTab. 100 mg

00247960 Etibi Valeant 100 9.73 0.0973

Tab. 400 mg

00247979 Etibi Valeant 100 27.11 0.2711

ISONIAZID XSyr. 50 mg/5 mL

00577812 pms-Isoniazid Phmscience 500 ml 95.00 0.1900

Tab. 100 mg

00577790 pms-Isoniazid Phmscience 100 28.31 0.2831

Tab. 300 mg

00577804 pms-Isoniazid Phmscience 100 62.60 0.6260

PYRAZINAMIDE XTab. 500 mg

00618810 pms-Pyrazinamide Phmscience 100 100.00 1.0000


2010-06 Page 31

RIFABUTIN XXCaps. 150 mg

02063786 Mycobutin Pfizer 100 390.00 3.9000

RIFAMPIN X

Caps. 150 mg PPB

02091887 Rifadin SanofiAven 100 64.14 0.641400393444 Rofact 150 Valeant 100 60.38 0.6038

Caps. 300 mg PPB

02092808 Rifadin SanofiAven 100 100.94 1.009400343617 Rofact 300 Valeant 100 95.03 0.9503

RIFAMPINE/ ISONIAZIDE/ PYRAZINAMIDE XTab. 120 mg- 50 mg- 300 mg

02148625 Rifater SanofiAven 60 20.55 0.3425

8:16.92MISCELLANEOUS ANTIMYCOBACTERIALSDAPSONE XTab. 100 mg

02041510 Dapsone Jacobus 100 UE

8:18.04ADAMANTANESAMANTADINE HYDROCHLORIDE XCaps. 100 mg PPB

02139200 Mylan-Amantadine Mylan 100 51.79 0.517901990403 pms-Amantadine Phmscience 100 51.79 0.5179

Syr. 50 mg/5 mL

02022826 pms-Amantadine Phmscience 500 ml 40.50 0.0810

8:18.08ANTIRETROVIRAL AGENTSABACAVIR (SULFATE) / LAMIVUDINE / ZIDOVUDINE XTab. 300 mg - 150 mg - 300 mg

02244757 Trizivir GSK 60 998.88 16.6480


Page 32 2010-06

ABACAVIR SULFATE XXOral Sol. 20 mg/mL

02240358 Ziagen GSK 240 ml 103.26 0.4303

Tab. 300 mg

02240357 Ziagen GSK 60 396.38 6.6063

ABACAVIR/LAMIVUDINE XTab. 600 mg - 300 mg

02269341 Kivexa GSK 30 661.99 22.0663

ATAZANAVIR SULFATE XCaps. 150 mg

02248610 Reyataz B.M.S. 60 620.36 10.3393

Caps. 200 mg

02248611 Reyataz B.M.S. 60 624.06 10.4010

Caps. 300 mg

02294176 Reyataz B.M.S. 30 620.36 20.6787

DARUNAVIR XTab. 400 mg 10

02324016 Prezista J.O.I. 60 570.96 9.5160

DELAVIRDINE MESYLATE XTab. 100 mg

02238348 Rescriptor Pfizer 360 258.40 0.7178

DIDANOSIN XEnt. Caps. 125 mg

02244596 Videx EC B.M.S. 30 98.31 3.2770

Ent. Caps. 200 mg

02244597 Videx EC B.M.S. 30 157.29 5.2430

10 Reimbursement of 400 mg-strength darunavir tablets is limited to two tablets per day.


2010-06 Page 33

Ent. Caps. 250 mg

02244598 Videx EC B.M.S. 30 196.61 6.5537

Ent. Caps. 400 mg

02244599 Videx EC B.M.S. 30 315.20 10.5067

EFAVIRENZ XXCaps. 50 mg

02239886 Sustiva B.M.S. 30 33.90 1.1300

Caps. 200 mg

02239888 Sustiva B.M.S. 90 406.79 4.5199

Tab. 600 mg

02246045 Sustiva B.M.S. 30 406.79 13.5597

EFAVIRENZ/ EMTRICITABINE/ TENOFOVIR DISOPROXIL FUMARATE XTab. 600 mg - 200 mg - 300 mg

02300699 Atripla B.M.S.-Gil 30 1158.29 38.6097

EMTRICITABINE/ TENOFOVIR DISOPROXIL FUMARATE XTab. 200mg- 300mg

02274906 Truvada Gilead 30 751.50 25.0500

FOSAMPRENAVIR CALCIUM XOral Susp. 50 mg/mL

02261553 Telzir GSK 225 ml 129.27 0.5745

Tab. 700 mg

02261545 Telzir GSK 60 471.52 7.8587

INDINAVIR (SULFATE) XCaps. 200 mg

02229161 Crixivan Merck 360 484.80 1.3467

Caps. 400 mg

02229196 Crixivan Merck 180 484.80 2.6933


Page 34 2010-06

LAMIVUDINE XXOral Sol. 10 mg/mL

02192691 3TC GSK 240 ml 72.93 0.3039

Tab. 100 mg

02239193 Heptovir GSK 60 273.50 4.5583

Tab. 150 mg

02192683 3TC GSK 60 279.05 4.6508

Tab. 300 mg

02247825 3TC GSK 30 279.05 9.3017

LAMIVUDINE/ ZIDOVUDIN XTab. 150 mg -300mg

02239213 Combivir GSK 60 602.50 10.0417

LOPINAVIR/ RITONAVIR XOral Sol. 80 mg - 20 mg/mL

02243644 Kaletra Abbott 160 ml 335.91 2.0994

Tab. 100 mg -25 mg

02312301 Kaletra Abbott 60 153.83 2.5638

Tab. 200 mg -50 mg

02285533 Kaletra Abbott 120 629.81 5.2484

NELFINAVIR MESYLATE XTab. 250 mg

02238617 Viracept Pfizer 300 546.00 1.8200

Tab. 625 mg

02248761 Viracept Pfizer 120 546.00 4.5500

NEVIRAPINE XTab. 200 mg

02238748 Viramune Bo. Ing. 60 294.90 4.9150


2010-06 Page 35

RITONAVIR XXCaps. 100 mg

02241480 Norvir Sec Abbott 120 170.21 1.4184

Oral Sol. 80 mg/mL

02229145 Norvir Abbott 240 ml 272.27 1.1345

SAQUINAVIR MESYLATE XCaps. 200 mg

02216965 Invirase Roche 270 491.40 1.8200

Tab. 500 mg

02279320 Invirase Roche 120 504.00 4.2000

STAVUDINE XCaps. 15 mg

02216086 Zerit B.M.S. 60 239.72 3.9953

Caps. 20 mg

02216094 Zerit B.M.S. 60 249.25 4.1542

Caps. 30 mg

02216108 Zerit B.M.S. 60 260.02 4.3337

Caps. 40 mg

02216116 Zerit B.M.S. 60 269.54 4.4923

TENOFOVIR DISOPROXIL FUMARATE XTab. 300 mg

02247128 Viread Gilead 30 495.76 16.5253

ZIDOVUDIN XCaps. 100 mg PPB

01946323 Apo-Zidovudine Apotex 100 127.50 1.053301902660 Retrovir GSK 100 175.55 1.7555

Inj. Sol. 10 mg/mL

01902644 Retrovir GSK 20 ml 16.70


Page 36 2010-06

Syr. 10 mg/mL

01902652 Retrovir GSK 240 ml 44.94 0.1873

8:18.20INTERFERONSINTERFERON ALFA-2B XXS.C. Inj. Pd 10 millions UI

02223406 Intron A Schering 1 ml 120.81

S.C. Inj. Pd 18 millions UI


INTERFERON ALFA-2B (HUMAN ALBUMIN FREE) XInj. Sol. 6 M UI/mL

02238674 Intron A (sans albumine) Schering 3 ml 210.06

Inj. Sol. 10 millions UI/mL

02238675 Intron A (sans albumine) Schering 1 ml2.5 ml

116.70291.75

S.C. Inj.Sol (syr) 18 millions UI/1.2 mL

02240693 Intron A (sans albumine) Schering 1 210.06

S.C. Inj.Sol (syr) 30 M UI / 1.2 mL


S.C. Inj.Sol (syr) 60 M UI/ 1.2 mL


8:18.32NUCLEOSIDES AND NUCLEOTIDESACYCLOVIR XOral Susp. 200 mg/5 mL

00886157 Zovirax GSK 475 ml 115.14 0.2424


2010-06 Page 37

Tab. 200 mg PPB

02286556 * Acyclovir Sanis 100 64.52 0.645202207621 Apo-Acyclovir Apotex 100

50064.52

322.600.64520.6452

02242784 Mylan-Acyclovir Mylan 100250

64.52161.30

0.64520.6452

02285959 Novo-Acyclovir Novopharm 100 64.52 0.645202078627 ratio-Acyclovir Ratiopharm 100

50064.52

322.600.64520.6452

00634506 Zovirax GSK 100 120.92 1.2092

Tab. 400 mg PPB

02286564 * Acyclovir Sanis 100 127.00 1.270002207648 Apo-Acyclovir Apotex 100 127.00 1.270002242463 Mylan-Acyclovir Mylan 100 127.00 1.270002285967 Novo-Acyclovir Novopharm 100 127.00 1.270002197413 Nu-Acyclovir Nu-Pharm 100 127.00 1.270002078635 ratio-Acyclovir Ratiopharm 100 127.00 1.270001911627 Zovirax GSK 56 136.44 2.4364

Tab. 800 mg PPB

02286572 * Acyclovir Sanis 100 226.64 2.266402207656 Apo-Acyclovir Apotex 100 226.64 2.266402242464 Mylan-Acyclovir Mylan 100 226.64 2.266402285975 Novo-Acyclovir Novopharm 100 226.64 2.266402197421 Nu-Acyclovir Nu-Pharm 100 226.64 2.266402078651 ratio-Acyclovir Ratiopharm 100

250226.64566.60

2.26642.2664

01911635 Zovirax GSK 50 239.56 4.7912

ACYCLOVIR SODIUM XXI.V. Perf. Sol. 25 mg/mL

02236916 Acyclovir Hospira 20 ml 55.00

I.V. Perf. Sol. 50 mg/mL

02236926 Acyclovir Sodique PPC 10 ml20 ml

85.78171.57

FAMCICLOVIR XTab. 125 mg

02292025 Apo-Famciclovir Apotex 30 41.82 1.394002305682 Co Famciclovir Cobalt 10 13.94 1.394002324865 Famciclovir Pro Doc 10 13.94 1.394002229110 Famvir Novartis 10 26.12 2.612002278081 pms-Famciclovir Phmscience 10 13.94 1.394002278634 Sandoz Famciclovir Sandoz 10 13.94 1.3940


Page 38 2010-06

Tab. 250 mg

02292041 Apo-Famciclovir Apotex 30 56.20 1.873302305690 Co Famciclovir Cobalt 30 56.20 1.873302324873 Famciclovir Pro Doc 30 56.20 1.873302229129 Famvir Novartis 30 107.82 3.594002278103 pms-Famciclovir Phmscience 30

10056.20

187.331.87331.8733

02278642 Sandoz Famciclovir Sandoz 30100

56.20187.33

1.87331.8733

Tab. 500 mg

02292068 Apo-Famciclovir Apotex 30 96.07 3.202302305704 Co Famciclovir Cobalt 21

10067.25

320.263.20233.2026

02324881 Famciclovir Pro Doc 21 67.25 3.202302177102 Famvir Novartis 21 134.07 6.384302278111 pms-Famciclovir Phmscience 21

10067.25

320.263.20233.2026

02278650 Sandoz Famciclovir Sandoz 21100

67.25320.26

3.20233.2026

GANCICLOVIR SODIUM XXI.V. Perf. Pd 500 mg

02162695 Cytovene Roche 5 206.07 41.2140

VALACYCLOVIR (HYDROCHLORIDE) XTab. 500 mg

02295822 Apo-Valacyclovir Apotex 8100

13.47168.38

1.68381.6838

02298457 pms-Valacyclovir Phmscience 100 168.38 1.683802315173 Pro-Valacyclovir Pro Doc 100 168.38 1.683802316447 Riva-Valacyclovir Riva 100 168.38 1.683802219492 Valtrex GSK 30 93.56 3.1187

8:30.04AMEBICIDESIODOQUINOL XTab. 210 mg

01997769 Diodoquin Glenwood 100 58.48 0.5848

Tab. 650 mg

01997750 Diodoquin Glenwood 100 72.56 0.7256

PAROMOMYCINE SULFATE XCaps. 250 mg

02078759 Humatin Erfa 100 218.48 2.1848


2010-06 Page 39

8:30.08ANTIMALARIALSATOVAQUONE/ PROGUANIL (HYDROCHLORIDE) XXTab. 62.5 mg - 25 mg

02264935 Malarone pediatrique GSK 12 17.40 1.4500

Tab. 250 mg - 100 mg

02238151 Malarone GSK 12 50.74 4.2283

CHLOROQUINE PHOSPHATE XTab. 250 mg

00021261 Novo-Chloroquine Novopharm 100 32.08 0.3208

HYDROXYCHLOROQUIN SULFATE XTab. 200 mg PPB

02246691 Apo-Hydroxyquine Apotex 100500

26.20131.00

0.26200.2620

02252600 Mylan-Hydroxychloroquine Mylan 100 26.20 0.262002017709 Plaquenil SanofiAven 100 54.11 0.541102311011 Pro-Hydroxyquine-200 Pro Doc 100

50026.20

131.000.26200.2620

MEFLOQUINE HYDROCHLORIDE XTab. 250 mg PPB

02244366 Apo-Mefloquine Apotex 8 29.56 2.845002018055 Lariam Roche 8 37.92 4.7400

PRIMAQUINE PHOSPHATE XTab. 26.3 mg

02017776 Primaquine SanofiAven 100 35.04 0.3504

PYRIMETHAMINE XTab. 25 mg

00004774 Daraprim GSK 50 62.74 1.2548


Page 40 2010-06

QUININE SULFATECaps. 200 mg PPB

02254514 Apo-Quinine Apotex 100 23.90 0.239000021008 Novo-Quinine Novopharm 100

50023.90

119.500.23900.2390

02311216 Pro-Quinine-200 Pro Doc 100 23.90 0.239000695440 Quinine-Odan (Caps.) Odan 100

50023.90

119.500.23900.2390


02254522 Apo-Quinine (Caps.) Apotex 100 37.50 0.375000021016 Novo-Quinine (Caps.) Novopharm 100

50037.50

187.500.37500.3750

02311224 Pro-Quinine-300 (Caps.) Pro Doc 100 37.50 0.375000695459 Quinine-Odan (Caps.) Odan 100

50037.50

187.500.37500.3750

00695432 Quinine-Odan (Co.) Odan 100 37.50 0.3750

8:30.92MISCELLANEOUS ANTIPROTOZOALSATOVAQUONE XXOral Susp. 150 mg/mL

02217422 Mepron GSK 210 ml 493.78 2.3513

ISERIONATE PENTAMIDINE XInj. Pd 300 mg

02183080 Pentamidine Hospira 5 140.00 28.0000

METRONIDAZOLE XI.V. Perf. Sol. 5 mg/mL

00649074 Metronidazole Hospira 100 ml 14.21

Tab. 250 mg PPB

00545066 Apo-Metronidazole Apotex 500 29.75 0.059500420409 Metronidazole-250 Pro Doc 500 28.75 0.0575

8:36URINARY ANTI-INFECTIVESNITROFURANTIN MONOHYDRATE (MACROCRYSTALS) XCaps. 100 mg

02063662 MacroBid Warner 100 65.57 0.6557


2010-06 Page 41

NITROFURANTOIN XXTab. 50 mg

00319511 Apo-Nitrofurantoine Apotex 100 16.70 0.1670

Tab. 100 mg

00312738 Apo-Nitrofurantoine Apotex 100 22.27 0.2227

NITROFURANTOIN (MACROCRYSTALS) XCaps. 50 mg

02231015 Novo-Furantoin Novopharm 100 31.87 0.3187

Caps. 100 mg

02231016 Novo-Furantoin Novopharm 100 61.10 0.6110

TRIMETHOPRIM XTab. 100 mg

02243116 Apo-Trimethoprim Apotex 100 25.66 0.2566

Tab. 200 mg

02243117 Apo-Trimethoprim Apotex 100 52.73 0.5273


Page 42 2010-06

10:00ANTINEOPLASTIC AGENTS

10:00ANTINEOPLASTIC AGENTSANASTROZOLE XXTab. 1 mg

02224135 Arimidex AZC 30 148.50 4.9500

BICALUTAMIDE XTab. 50 mg

02296063 Apo-Bicalutamide Apotex 30 96.60 3.220002184478 Casodex AZC 30 193.20 6.440002274337 Co Bicalutamide Cobalt 30

10096.60

322.003.22003.2200

02302403 Mylan-Bicalutamide Mylan 30100

96.60322.00

3.22003.2200

02270226 Novo-Bicalutamide Novopharm 30100

96.60322.00

3.22003.2200

02281163 phl-Bicalutamide Pharmel 30100

96.60322.00

3.22003.2200

02275589 pms-Bicalutamide Phmscience 30100

96.60322.00

3.22003.2200

02311038 Pro-Bicalutamide-50 Pro Doc 100 322.00 3.220002277700 ratio-Bicalutamide Ratiopharm 30 96.60 3.220002276089 Sandoz Bicalutamide Sandoz 30 96.60 3.220002325233 Zym-Bicalutamide Zymcan 100 322.00 3.2200

BUSERELIN ACETATE XImplant 6.3 mg

02228955 Suprefact Depot SanofiAven 1 705.50

Implant 9.45 mg

02240749 Suprefact Depot 3 mois SanofiAven 1 1042.43

Nas. spray 10 mL

02225158 Suprefact SanofiAven 10 ml 66.70

S.C. Inj. Sol. 1 mg/mL

02225166 Suprefact SanofiAven 5.5 ml 49.79

BUSULFAN XTab. 2 mg

00004618 Myleran GSK 25 33.96 1.3584


2010-06 Page 45

CHLORAMBUCIL XXTab. 2 mg

00004626 Leukeran GSK 25 32.02 1.2808

CYCLOPHOSPHAMIDE XTab. 25 mg

02241795 Procytox Baxter 200 70.40 0.3520

Tab. 50 mg

02241796 Procytox Baxter 100 47.40 0.4740

ESTRAMUSTINE DISODIUM PHOSPHATE XCaps. 140 mg

02063794 Emcyt Pfizer 100 300.70 3.0070

ETOPOSIDE XCaps. 50 mg

00616192 Vepesid B.M.S. 20 639.41 31.9705

EXEMESTANE XTab. 25 mg

02242705 Aromasin Pfizer 30 148.50 4.9500

FLUTAMIDE XTab. 250 mg PPB

02238560 Apo-Flutamide Apotex 100 135.30 1.353000637726 Euflex Schering 100 135.30 1.353002230089 Novo-Flutamide Novopharm 100 135.30 1.353002230104 pms-Flutamide Phmscience 100 135.30 1.3530

GOSERELINE ACETATE XImplant 3.6 mg

02049325 Zoladex AZC 1 381.75

Implant 10.8 mg

02225905 Zoladex LA AZC 1 1087.98


Page 46 2010-06

HYDROXYUREA XXCaps. 500 mg PPB

02247937 Apo-Hydroxyurea Apotex 100 102.03 1.020300465283 Hydrea B.M.S. 100 102.03 1.020302242920 Mylan-Hydroxyurea Mylan 100 102.03 1.0203

INTERFERON ALFA-2B XS.C. Inj. Pd 10 millions UI


S.C. Inj. Pd 18 millions UI


INTERFERON ALFA-2B (HUMAN ALBUMIN FREE) XInj. Sol. 6 M UI/mL

02238674 Intron A (sans albumine) Schering 3 ml 210.06

Inj. Sol. 10 millions UI/mL

02238675 Intron A (sans albumine) Schering 1 ml2.5 ml

116.70291.75

S.C. Inj.Sol (syr) 18 millions UI/1.2 mL


S.C. Inj.Sol (syr) 30 M UI / 1.2 mL


S.C. Inj.Sol (syr) 60 M UI/ 1.2 mL


LETROZOLE XTab. 2.5 mg

02231384 Femara Novartis 30 157.71 5.2570

LEUPORIDE ACETATE XKit 3.75 mg

00884502 Lupron Depot Abbott 1 323.41


2010-06 Page 47

Kit 5 mg/mL

00727695 Lupron Abbott 14 189.41

Kit 7.5 mg

02248239 Eligard SanofiAven 1 343.5800836273 Lupron Depot Abbott 1 387.97

Kit 11.25 mg

02239834 Lupron Depot Abbott 1 970.22

Kit 22.5 mg


Kit 30 mg


Kit 45 mg

02268892 Eligard SanofiAven 1 1450.00

MECHLORETHAMINE HYDROCHLORIDE XXI.V. Inj. Pd 10 mg

00016063 Mustargen Lundb Inc 20 ml 7.35

MELPHALAN XTab. 2 mg

00004715 Alkeran GSK 50 71.91 1.4382

MERCAPTOPURINE XTab. 50 mg

00004723 Purinethol Novopharm 25 91.70 3.6680

METHOTREXATE XInj. Sol. 25 mg/mL

02182777 Methotrexate Sodium Hospira 2 ml 11.2502182955 Methotrexate Sodium sans

preservatifHospira 2 ml 11.25


Page 48 2010-06

Tab. 2.5 mg PPB

02182963 Apo-Methotrexate Hospira 100 63.25 0.632502244798 ratio-Methotrexate Ratiopharm 100 63.25 0.6325

Tab. 10 mg

02182750 Methotrexate Hospira 100 209.00 2.0900

NILUMAMID XXTab. 50 mg

02221861 Anandron SanofiAven 90 158.00 1.7556

PROCARBAZINE HYDROCHLORIDE XCaps. 50 mg

00012750 Matulane Sigma-Tau 100 UE

TAMOXIFEN CITRATE XTab. 10 mg PPB

00812404 Apo-Tamox Apotex 100 17.50 0.175002088428 Mylan-Tamoxifen Mylan 60

25010.5043.75

0.17500.1750

00851965 Novo-Tamoxifen Novopharm 100 17.50 0.175001926624 Tamofen 10 SanofiAven 60 10.50 0.1750

Tab. 20 mg PPB

00812390 Apo-Tamox Apotex 100250

35.0087.50

0.35000.3500

02089858 Mylan-Tamoxifen Mylan 30250

10.5087.50

0.35000.3500

02048485 Nolvadex-D AZC 30 10.80 0.360000851973 Novo-Tamoxifen Novopharm 30

10010.5035.00

0.35000.3500

01926632 Tamofen 20 SanofiAven 3060

10.5021.00

0.35000.3500

THIOGUANINE XTab. 40 mg

00282081 Lanvis GSK 25 98.98 3.9592

TRETINOIN X

Caps. 10 mg

02145839 Vesanoid Roche 100 1274.51 12.7451


2010-06 Page 49

TRIPTORELIN (AS PAMOATE) XXKit 3.75 mg

02240000 Trelstar Paladin 1 291.00

Kit 11.25 mg

02243856 Trelstar LA Paladin 1 891.00


Page 50 2010-06

12:00AUTONOMIC DRUGS

12:04 parasympathomimetic agents12:08 anticholinergic agents12:08.08 antimuscarinics / antispasmodics12:12 sympathomimetic agents12:12.04 alpha-adrenergic agonists12:12.08 beta adrenergic agonists12:12.12 alpha and beta adrenergic agonists12:16 sympatholytic agents12:16.04 alpha-adrenergic blocking agents12:20 skeletal muscle relaxants12:20.04 centrally acting skeletal muscle relaxants12:20.08 direct-acting skeletal muscle relaxants12:20.12 GABA-derivative skeletal muscle

relaxants12:20.92 skeletal muscle relaxants, miscellaneous12:92 Miscellaneous autonomic drugs

12:04PARASYMPATHOMIMETIC AGENTSBETHANECHOL CHLORIDE XXTab. 10 mg

01947958 Duvoid Paladin 100 24.99 0.2499

Tab. 25 mg

01947931 Duvoid Paladin 100 40.47 0.4047

Tab. 50 mg

01947923 Duvoid Paladin 100 53.15 0.5315

NEOSTIGMINE BROMIDE XTab. 15 mg

00869945 Prostigmin Valeant 100 43.70 0.4370

PYRIDOSTIGMINE BROMIDE XL.A. Tab. 180 mg

00869953 Mestinon Supraspan Valeant 30 28.19 0.9397

Tab. 60 mg

00869961 Mestinon Valeant 100 42.95 0.4295

12:08.08ANTIMUSCARINICS / ANTISPASMODICSATROPINE SULFATE XInj. Sol. 0.3 mg/mL

00497223 Atropine Hospira 1 ml 0.45

Inj. Sol. 0.4 mg/mL

00392782 Atropine Sandoz 1 ml 1.39

Inj. Sol. 0.6 mg/mL

00392693 Atropine Sandoz 1 ml 1.39

GLYCOPYRROLATEInj. Sol. 0.2 mg/mL

02039508 Glycopyrrolate injection Sandoz 1 ml2 ml

3.146.27


2010-06 Page 53

HYOSCINE BUTYLBROMIDEInj. Sol. 20 mg/mL

02229868 Butylbromure d'hyoscine Sandoz 1 ml 3.94

IPRATROPIUM (BROMIDE) / SALBUTAMOL (SULFATE) XXSol. Inh. 0.2 mg -1 mg/mL (2.5 mL) PPB

02231675 Combivent UDV Bo. Ing. 20 30.15 1.507502272695 Mylan-Combo Sterinebs Mylan 20 14.68 0.734002243789 ratio-Ipra Sal UDV Ratiopharm 20 14.68 0.7340

IPRATROPIUM BROMIDE XOral aerosol 0.02 mg/dose

02247686 Atrovent HFA Bo. Ing. 200 dose(s) 18.34

Sol. Inh. 0.125 mg/mL (2 mL) PPB

02231135 pms-Ipratropium Polynebs Phmscience 20 13.18 0.659002097176 ratio-Ipratropium UDV Ratiopharm 20 13.18 0.6590

Sol. Inh. 0.25 mg/mL PPB

02126222 Apo-Ipravent Apotex 20 ml 8.7902239131 Mylan-Ipratropium Mylan 20 ml 8.7902210479 Novo-Ipramide Novopharm 20 ml 8.7902231136 pms-Ipratropium Phmscience 20 ml 8.7902097141 ratio-Ipratropium Ratiopharm 20 ml 8.79 W


02216221 Mylan-Ipratropium sterinebs Mylan 20 13.18 0.659002231244 pms-Ipratropium Polynebs Phmscience 20 13.18 0.659099001446 ratio-Ipratropium UDV Ratiopharm 20 13.18 0.6590


99002795 Mylan-Ipratropium sterinebs Mylan 10 13.18 1.318002231245 pms-Ipratropium Polynebs Phmscience 10 13.18 1.318002097168 ratio-Ipratropium UDV Ratiopharm 10 13.18 1.3180

SCOPOLAMINE HYDROBROMIDE

Inj. Sol. 0.4 mg/mL

00541869 Hyoscine Hospira 1 ml 1.06

Inj. Sol. 0.6 mg/mL

00541877 Hyoscine Hospira 1 ml 1.06


Page 54 2010-06

TIOTROPIUM MONOHYDRATED BROMIDE XXInh. Pd (App.) 18 mcg

02246793 Spiriva Bo. Ing. 30 63.00

12:12.04ALPHA-ADRENERGIC AGONISTSMIDODRINE HYDROCHLORIDE XTab. 2.5 mg PPB

01934392 Amatine Shire 100 29.99 0.299902278677 Apo-Midodrine Apotex 100 29.99 0.2999

Tab. 5 mg PPB

01934406 Amatine Shire 100 49.98 0.499802278685 Apo-Midodrine Apotex 100 49.98 0.4998

12:12.08BETA ADRENERGIC AGONISTSFORMOTEROL (FUMARATE) XInh. Pd 12 mcg/caps.

02230898 Foradil & Aerolizer Novartis 60 44.71 0.7452

FORMOTEROL FUMARATE DIHYDRATE XInh. Pd 6 mcg /dose

02237225 Oxeze Turbuhaler AZC 60 dose(s) 32.70

Inh. Pd 12 mcg/dose

02237224 Oxeze Turbuhaler AZC 60 dose(s) 43.55

ORCIPRENALINE SULFATE X

Syr. 10 mg/5 mL

02236783 Apo-Orciprenaline Apotex 250 ml 7.55 0.0302

SALBUTAMOL XOral aerosol 100 mcg/dose PPB

02232570 * Airomir Graceway 200 dose(s) 6.0002245669 * Apo-Salvent sans CFC Apotex 200 dose(s) 6.0002326450 * Novo-Salbutamol HFA Novopharm 200 dose(s) 6.0002244914 * ratio-Salbutamol HFA Ratiopharm 200 dose(s) 6.0002241497 Ventolin HFA GSK 200 dose(s) 6.50


2010-06 Page 55

SALBUTAMOL SULFATE XXOral Sol. 0.4 mg/mL

02091186 pms-Salbutamol Phmscience 250 ml 11.90 0.0476

Sol. Inh. 0.5 mg/mL (2.5mL) PPB

02208245 pms-Salbutamol Polynebs Phmscience 20 5.37 0.268502239365 ratio-Salbutamol Ratiopharm 20 5.37 0.268502213400 Ventolin Nebules P.F. GSK 20 9.95 0.4975

Sol. Inh. 1 mg/mL (2.5 mL) PPB

01926934 Mylan-Salbutamol Sterinebs Mylan 20 9.66 0.483002208229 pms-Salbutamol Polynebs Phmscience 20 9.66 0.483001986864 ratio-Salbutamol Ratiopharm 20 9.66 0.483002213419 Ventolin Nebules P.F. GSK 20 20.00 1.0000

Sol. Inh. 2 mg/mL (2.5 mL) PPB

02173360 Mylan-Salbutamol Sterinebs Mylan 20 18.35 0.917502208237 pms-Salbutamol Polynebs Phmscience 20 18.35 0.917502239366 ratio-Salbutamol Ratiopharm 20 18.35 0.917502228297 Salmol Riva 20 18.35 0.917502213427 Ventolin Nebules P.F. GSK 20 38.01 1.9005

Sol. Inh. 5 mg/mL PPB

02232987 Mylan-Salbutamol Mylan 10 ml 4.6902069571 pms-Salbutamol Phmscience 10 ml 4.6900860808 ratio-Salbutamol Ratiopharm 10 ml 4.6902154412 Sandoz Salbutamol Sandoz 10 ml 4.6902213486 Ventolin GSK 10 ml 9.71

Tab. 2 mg

02146843 Apo-Salvent Apotex 100 12.74 0.1274

Tab. 4 mg

02146851 Apo-Salvent Apotex 100 21.34 0.2134

SALMETEROL XINAFOATE XInh. Pd 50 mcg/coque

02231129 Serevent Diskus GSK 60 dose(s) 52.64

Inh. Pd 50 mcg/coque (4)

02214261 Serevent GSK 15 52.64 3.5093


Page 56 2010-06

Inh. Pd (App.) 50 mcg/coque (4)

99000091 Serevent & Diskhaler GSK 15 55.91

TERBUTALIN SULFATE XXInh. Pd 0.5 mg/dose

00786616 Bricanyl Turbuhaler AZC 200 dose(s) 14.70

12:12.12ALPHA AND BETA ADRENERGIC AGONISTSEPINEPHRINE Inj. Sol. (App.) 0,15 mg/dose PPB

00578657 EpiPen Jr. King 1 81.0002268205 Twinject Paladin 1

281.00

152.00

Inj. Sol. (App.) 0,3 mg/dose PPB

00509558 EpiPen King 1 81.0002247310 Twinject Paladin 1

281.00

152.00

EPINEPHRINE HYDROCHLORIDE Inj. Sol. 1 mg/mL

00721891 Epinephrine injectable Abbott 1 2.61

12:16.04ALPHA-ADRENERGIC BLOCKING AGENTSALFUZOSINE HYDROCHLORIDE XL.A. Tab. 10 mg

02315866 Apo-Alfuzosin Apotex 100 49.66 0.496602304678 Sandoz Alfuzosin Sandoz 100 49.66 0.496602245565 Xatral SanofiAven 100 98.58 0.9858

DIHYDROERGOTAMINE MESYLATE XInj. Sol. 1 mg/mL PPB

00027243 Dihydroergotamine Sterimax 1 ml 4.2202241163 Mesylate de

dihydroergotamineSandoz 1 ml 3.72 3.2300

Nas. spray 4 mg/mL

02228947 Migranal Sterimax 3 27.15 9.0500


2010-06 Page 57

TAMSULOSIN HYDROCHLORIDE XXLA Caps or LA Tab 0.4 mg

02270102 Flomax CR Bo. Ing. 30 18.00 0.600002298570 Mylan-Tamsulosin Mylan 100 45.00 0.450002281392 Novo-Tamsulosin Novopharm 100 45.00 0.450002294885 Ran-Tamsulosin Ranbaxy 100 45.00 0.450002294265 ratio-Tamsulosin Ratiopharm 100 45.00 0.450002295121 Sandoz Tamsulosin Sandoz 100 45.00 0.4500

12:20.04CENTRALLY ACTING SKELETAL MUSCLE RELAXANTSCYCLOBENZAPRINE HYDROCHLORIDE XTab. 10 mg PPB

02177145 Apo-Cyclobenzaprine Apotex 100500

37.65188.25

0.37650.3765

02287064 * Cyclobenzaprine Sanis 100 37.65 0.376502220644 Cyclobenzaprine-10 Pro Doc 100

50037.65

188.250.37650.3765

02231353 Mylan-Cyclobenzaprine Mylan 100500

37.65188.25

0.37650.3765

02080052 Novo-Cycloprine Novopharm 100500

37.65188.25

0.37650.3765

02171848 Nu-Cyclobenzaprine Nu-Pharm 100500

37.65188.25

0.37650.3765

02249359 phl-Cyclobenzaprine Pharmel 100500

37.65188.25

0.37650.3765

02212048 pms-Cyclobenzaprine Phmscience 100500

37.65188.25

0.37650.3765

02236506 ratio-Cyclobenzaprine Ratiopharm 100500

37.65188.25

0.37650.3765

02242079 Riva-Cycloprine Riva 100500

37.65188.25

0.37650.3765

02325195 Zym-Cyclobenzaprine Zymcan 100 37.65 0.3765

12:20.08DIRECT-ACTING SKELETAL MUSCLE RELAXANTSDANTROLENE (SODIUM) XCaps. 25 mg

01997602 Dantrium JHP 100 36.74 0.3674

Caps. 100 mg

01997653 Dantrium JHP 100 74.73 0.7473

12:20.12GABA-DERIVATIVE SKELETAL MUSCLE RELAXANTSBACLOFEN XInj. Sol. 0.05 mg/mL (1 mL)

02131048 Lioresal Intrathecal Novartis 5 48.32 9.6640


Page 58 2010-06

Inj. Sol. 0.5 mg/mL (20 mL)

02131056 Lioresal Intrathecal Novartis 1 144.80

Inj. Sol. 2 mg/mL (5 mL)

02131064 Lioresal Intrathecal Novartis 5 724.08 144.8160

Tab. 10 mg PPB

02139332 Apo-Baclofen Apotex 100500

23.11115.55

0.23110.2311

02287021 * Baclofen Sanis 100 23.11 0.231102152584 Baclofen-10 Pro Doc 100

50023.11

115.550.23110.2311

00455881 Lioresal Novartis 100 49.08 0.490802088398 Mylan-Baclofen Mylan 100

50023.11

115.550.23110.2311

02136090 Nu-Baclofen Nu-Pharm 100500

23.11115.55

0.23110.2311

02236963 phl-Baclofen Pharmel 100500

23.11115.55

0.23110.2311

02063735 pms-Baclofen Phmscience 100500

23.11115.55

0.23110.2311

02236507 ratio-Baclofen Ratiopharm 100500

23.11115.55

0.23110.2311

02242150 Riva-Baclofen Riva 100500

23.11115.55

0.23110.2311

Tab. 20 mg PPB

02139391 Apo-Baclofen Apotex 100 44.98 0.449802287048 * Baclofen Sanis 100 44.98 0.449802152592 Baclofen-20 Pro Doc 100 44.98 0.449800636576 Lioresal D.S. Novartis 100 95.54 0.955402088401 Mylan-Baclofen Mylan 100 44.98 0.449802136104 Nu-Baclofen Nu-Pharm 100 44.98 0.449802236964 phl-Baclofen Pharmel 100 44.98 0.449802063743 pms-Baclofen Phmscience 100 44.98 0.449802236508 ratio-Baclofen Ratiopharm 100 44.98 0.449802242151 Riva-Baclofen Riva 100

50044.98

224.900.44980.4498

12:20.92SKELETAL MUSCLE RELAXANTS, MISCELLANEOUSORPHENADRINE CITRATE L.A. Tab. 100 mg PPB

01966154 Norflex Graceway 100 63.70 0.637002243559 Sandoz Orphenadrine Sandoz 100 45.52 0.3822

Tab. 100 mg

02047535 Orfenace Sterimax 100 34.00 0.3400


2010-06 Page 59

12:92MISCELLANEOUS AUTONOMIC DRUGSNICOTINE 1Chewing gum 2 mg

02091933 Nicorette McNeil Co 30105

8.8027.08

0.29330.2579

80000396 Thrive N.C.H.C. 36108

9.1521.77

0.25420.2016

Chewing gum 4 mg

02091941 Nicorette McNeil Co 30105

10.1231.13

0.33730.2965

80000402 Thrive N.C.H.C. 36108

10.4028.47

0.28890.2636

Past. Or. 1 mg

80007461 Thrive N.C.H.C. 36108

9.1521.77

0.25420.2016

Past. Or. 2 mg

80007464 Thrive N.C.H.C. 36108

10.4028.47

0.28890.2636

Patch 7 mg/24 h

01943057 Habitrol N.C.H.C. 7 18.75 2.678602093111 Nicoderm McNeil Co 7 24.24 3.4629

Patch 14 mg/24 h

01943065 Habitrol N.C.H.C. 7 18.75 2.678602093138 Nicoderm McNeil Co 7 24.24 3.4629

Patch 21 mg/24 h

01943073 Habitrol N.C.H.C. 7 18.75 2.678602093146 Nicoderm McNeil Co 7

1424.2446.10

3.46293.2929

VARENICLINE TARTRATE 7 XXTab. 0.5 mg

02291177 Champix Pfizer 56 94.36 1.6850

1 The duration of reimbursements for stop-smoking treatments with various nicotine preparations is limited to 12consecutive weeks per 12-month period. In addition, the total quantity of chewing gum or lozenges for whichthe cost is reimbursable during the 12 weeks is limited to 840 units, all forms combined.

7 The duration of reimbursements for stop-smoking treatments with various varenicline content preparations islimited to 12 consecutive weeks per 12-month period.


Page 60 2010-06

Tab. 0.5 mg (11 tab.) and 1 mg (14 tab.)

02298309 Champix (Starter pack) Pfizer 25 42.13

Tab. 1 mg

02291185 Champix Pfizer 28 47.18 1.6850


2010-06 Page 61

20:00BLOOD FORMATION AND COAGULATION

20:04 antianémique20:04.04 iron preparations20:12 antithrombotic agents20:12.04 anticoagulants20:12.14 Platelet-reducing Agents20:12.18 platelet-aggregation inhibitors20:28 antihemorrhagic agents20:28.16 hemostatics

20:04.04IRON PREPARATIONSFERROUS SULFATEEnt. Tab. or Tab. 300 mg to 325 mg (Fe-60 mg to 65 mg) PPB

01912518 Apo-Ferrous Sulfate Apotex 1000 15.71 0.015702246733 Euro-Ferrous Sulfate Euro-Pharm 1000 15.71 0.015702248699 Ferodan Odan 1000 15.71 0.015700031100 Jamp-Ferrous Sulfate Jamp 1000 15.71 0.015700586323 pms-Ferrous Sulfate Phmscience 100

10002.07

15.710.02070.0157

02125471 Sulfate Ferreux-300 Pro Doc 1000 15.71 0.0157

Ped. Oral Sol. 75 mg/mL(Fe-15mg/mL) PPB

00762954 Fer-in-Sol M.J. 50 ml 9.2702237385 Ferodan Odan 50 ml 9.2780008309 Jamp-Ferrous Sulfate Jamp 50 ml 9.2702232202 Pediafer Euro-Pharm 50 ml 9.2702222574 pms-Ferrous Sulfate Phmscience 50 ml 9.27

Syr. or Oral Sol. 150 mg/5 mL(Fe-30 mg/5 mL) PPB

00017884 Fer-in-Sol M.J. 250 ml 12.61 0.050400758469 Ferodan Odan 250 ml

500 ml6.80

13.600.02720.0272

80008295 Jamp-Ferrous Sulfate Jamp 250 ml 6.80 0.027202242863 Pediafer Sirop Euro-Pharm 250 ml 6.80 0.027200792675 pms-Ferrous Sulfate Phmscience 250 ml

500 ml6.80

13.600.02720.0272

IRON (FERRIC GLUCONATE/ SUCROSE COMPLEX) XXI.V. Inj. Sol. 12.5 mg (Ir)/mL (5 mL)

02243333 Ferrlecit J.O.I. 10 235.08 23.5080

IRON DEXTRANInj. Sol. 50 mg/mL PPB

02205963 Dexiron Mylan 2 ml 27.5002221780 Infufer Sandoz 2 ml 27.50

IRON SUCROSEI.V. Inj. Sol. 20 mg (Fe)/mL (5 mL)

02243716 Venofer Mylan 10 375.00 37.5000

20:12.04ANTICOAGULANTSDALTEPARINE SODIC XInj. Sol. 25 000 U/mL

02231171 Fragmin Pfizer 3.8 ml 148.20


2010-06 Page 65

S.C. Inj. Sol. 10 000 UI/mL

02132664 Fragmin Pfizer 1 ml 15.60

S.C. Inj.Sol (syr) 2 500 UI/0.2 mL

02132621 Fragmin Pfizer 1 4.94



S.C. Inj.Sol (syr) 7 500 UI/0.3 ml










ENOXAPARIN XXS.C. Inj. Sol. 100 mg/mL

02236564 Lovenox SanofiAven 3 ml 61.22

S.C. Inj.Sol (syr) 30 mg/ 0.3 mL

02012472 Lovenox SanofiAven 1 6.16

S.C. Inj.Sol (syr) 40 mg/0.4 mL





Page 66 2010-06






99004941 Lovenox HP SanofiAven 1 24.48


02242692 Lovenox HP SanofiAven 1 30.60

FONDAPARINUX XXS.C. Inj.Sol (syr) 2.5 mg/0.5 mL

02245531 Arixtra GSK 1 14.51

S.C. Inj.Sol (syr) 7.5 mg/0.6 mL

02258056 Arixtra GSK 1 25.00

HEPARIN (SODIUM)Inj. Sol. 10 U/mL

00725323 Solution de rinçage hépariné Hospira 10 ml 2.04

Inj. Sol. 100 U/mL PPB

00727520 Heparine Leo Leo 2 ml 1.5300725315 Solution de rinçage hépariné Hospira 10 ml 2.15

Inj. Sol. 1 000 U/mL

00740519 Hepalean Schering 1 ml10 ml30 ml

0.943.508.38

W W W

Inj. Sol. 10 000 UI/mL

00740497 Hepalean Schering 1 ml5 ml

2.215.89

W W

Inj. Sol. 25 000 U/mL

00453781 Heparine Leo 2 ml 14.91


2010-06 Page 67

NADROPARINE CALCIUM XXS.C. Inj.Sol (syr) 2 850 U/0.3 mL

99002698 Fraxiparine GSK 1 9.06

S.C. Inj.Sol (syr) 3 800 U/0.4 mL









99003309 Fraxiparine Forte GSK 1 18.12





NICOUMALONE XTab. 1 mg

00010383 Sintrom Paladin 100 26.29 0.2629

Tab. 4 mg

00010391 Sintrom Paladin 100 82.63 0.8263

SODIUM DANAPAROID XInj. Sol. 750 U/0.6 mL

02129043 Orgaran Schering 10 185.87 18.5870


Page 68 2010-06

TINZAPARIN SODIUM XXS.C. Inj. Sol. 10 000 UI/mL

02167840 Innohep Leo 2 ml 32.00

S.C. Inj. Sol. 20 000 UI/mL

02229515 Innohep Leo 2 ml 65.00


99100530 Innohep Leo 2 8.07 4.0350


02229755 Innohep Leo 2 11.29 5.6450


99002655 Innohep Leo 2 14.52 7.2600

S.C. Inj.Sol (syr) 10 000 UI/ 0.5 mL

02231478 Innohep Leo 2 32.96 16.4800

S.C. Inj.Sol (syr) 14 000 UI/ 0.7 mL

99002612 Innohep Leo 2 46.14 23.0700


99002620 Innohep Leo 2 59.32 29.6600

WARFARIN (SODIUM) XTab. 1 mg PPB

02242924 Apo-Warfarin Apotex 100500

14.1470.70

0.14140.1414

01918311 Coumadin B.M.S. 1001000

14.14141.40

0.14140.1414

02244462 Mylan-Warfarin Mylan 1001000

14.14141.40

0.14140.1414

02265273 Novo-Warfarin Novopharm 100250

14.1435.35

0.14140.1414

02242680 Taro-Warfarin Taro 100250

14.1435.35

0.14140.1414


2010-06 Page 69

Tab. 2 mg PPB


14.9674.80

0.14960.1496

01918338 Coumadin B.M.S. 100250

14.9637.40

0.14960.1496


14.96149.60

0.14960.1496


14.9637.40

0.14960.1496


14.9637.40

0.14960.1496

Tab. 2.5 mg PPB


11.9759.85

0.11970.1197

01918346 Coumadin B.M.S. 100250

11.9729.93

0.11970.1197


11.97119.70

0.11970.1197


11.9729.93

0.11970.1197


11.9729.93

0.11970.1197

Tab. 3 mg PPB

02245618 Apo-Warfarin Apotex 100 18.55 0.185502240205 Coumadin B.M.S. 100

25018.5546.35

0.18550.1854

02287498 Mylan-Warfarin Mylan 100 18.55 0.185502265311 Novo-Warfarin Novopharm 100 18.55 0.185502242683 Taro-Warfarin Taro 100 18.55 0.1855

Tab. 4 mg PPB


18.5592.70

0.18550.1854

02007959 Coumadin B.M.S. 100250

18.5546.35

0.18550.1854

02244465 Mylan-Warfarin Mylan 100 18.55 0.185502265338 Novo-Warfarin Novopharm 100

25018.5546.35

0.18550.1854


18.5546.35

0.18550.1854


Page 70 2010-06

Tab. 5 mg PPB


12.0060.00

0.12000.1200

01918354 Coumadin B.M.S. 100250

12.0030.00

0.12000.1200


12.00120.00

0.12000.1200


12.0030.00

0.12000.1200


12.0030.00

0.12000.1200

Tab. 6 mg PPB

02240206 Coumadin B.M.S. 100 22.25 0.222502287501 Mylan-Warfarin Mylan 100 22.25 0.222502242686 Taro-Warfarin Taro 100 22.25 0.2225

Tab. 7.5 mg PPB

02287528 Mylan-Warfarin Mylan 100 30.14 0.301402242697 Taro-Warfarin Taro 100 30.14 0.3014

Tab. 10 mg PPB

02242929 Apo-Warfarin Apotex 100 21.53 0.215301918362 Coumadin B.M.S. 100 21.53 0.215302244467 Mylan-Warfarin Mylan 100 21.53 0.215302242687 Taro-Warfarin Taro 100 21.53 0.2153

20:12.14PLATELET-REDUCING AGENTSANAGRELIDE HYDROCHLORIDE XXCaps. 0.5 mg

02236859 Agrylin Shire 100 508.16 5.081602253054 Mylan-Anagrelide Mylan 100 263.61 2.636102274949 pms-Anagrelide Phmscience 100 263.61 2.636102260107 Sandoz Anagrelide Sandoz 100 263.61 2.6361

20:12.18PLATELET-AGGREGATION INHIBITORSTICLOPIDIN HYDROCHLORIDE XTab. 250 mg PPB

02237701 Apo-Ticlopidine Apotex 100 54.64 0.546402239744 Mylan-Ticlopidine Mylan 28

10015.3054.64

0.54640.5464

02236848 Novo-Ticlopidine Novopharm 28100

15.3054.64

0.54640.5464

02243587 Sandoz Ticlopidine Sandoz 100 54.64 0.546402343045 Ticlopidine Sanis 100 54.64 0.5464


2010-06 Page 71

20:28.16HEMOSTATICSTRANEXAMIC ACID XXTab. 500 mg

02064405 Cyklokapron Pfizer 100 101.19 1.0119


Page 72 2010-06

24:00CARDIAC DRUGS

24:04 cardiac drugs24:04.04 Antiarrhythmic Agents24:04.08 cardiotonic agents24:06 antilipemic agents24:06.04 bile acid sequestrants24:06.06 fibric acid derivatives24:06.08 HMG-CoA reductase inhibitors24:06.92 miscellaneous antilipemic agents24:08 hypotensive agents24:08.16 central alpha-agonists24:08.20 direct vasodilators24:12 vasodilating agents24:12.08 nitrates and nitrites24:12.92 miscellaneous vasodilating agents24:20 alpha-adrenergics blocking agents24:24 bêta-adrenergics blocking agents24:28 calcium-channel blocking agents24:28.08 dihydropyridines24:28.92 miscellaneous calcium-channel blocking

agents24:32 renin-angiotensin system inhibitors24:32.04 angiotensin-converting enzyme inhibitors

(ACEI)24:32.08 angiotensin II receptor antagonists24:32.20 aldosterone receptor antagonists

24:04.04ANTIARRHYTHMIC AGENTSAMIODARONE HYDROCHLORIDE XXTab. 100 mg

02292173 pms-Amiodarone Phmscience 100 65.17 0.6517

Tab. 200 mg PPB

02246194 Apo-Amiodarone Apotex 100 102.94 1.029402036282 Cordarone Wyeth 100 205.89 2.058902240604 Mylan-Amiodarone Mylan 100 102.94 1.029402239835 Novo-Amiodarone Novopharm 100 102.94 1.029402245781 phl-Amiodarone Pharmel 100 102.94 1.029402242472 pms-Amiodarone Phmscience 100 102.94 1.029402309661 Pro-Amiodarone-200 Pro Doc 100 102.94 1.029402240071 ratio-Amiodarone Ratiopharm 100 102.94 1.029402247217 Riva-Amiodarone Riva 100 102.94 1.029402243836 Sandoz Amiodarone Sandoz 100 102.94 1.029402300893 Zym-Amiodarone Zymcan 100 102.94 1.0294

DISOPYRAMIDE XCaps. 100 mg

02224801 Rythmodan SanofiAven 84 18.69 0.2225

Caps. 150 mg

02224828 Rythmodan SanofiAven 84 26.41 0.3144

DISOPYRAMIDE PHOSPHATE XL.A. Tab. 250 mg

02224836 Rythmodan-LA SanofiAven 100 74.21 W

FLECAINIDE ACETATE XTab. 50 mg PPB

02275538 Apo-Flecainide Apotex 100 39.56 0.310101966197 Tambocor Graceway 100 51.68 0.5168

Tab. 100 mg PPB

02275546 Apo-Flecainide Apotex 100 79.12 0.620301966200 Tambocor Graceway 100 103.37 1.0337

MEXILETINE HYDROCHLORIDE XCaps. 100 mg

02230359 Novo-Mexiletine Novopharm 100 81.62 0.8162


2010-06 Page 75

Caps. 200 mg

02230360 Novo-Mexiletine Novopharm 100 109.30 1.0930

PROCAINAMIDE HYDROCHLORIDE XXL.A. Tab. 250 mg

00638692 Procan SR Erfa 100 15.60 0.1560

L.A. Tab. 500 mg

00638676 Procan SR Erfa 100 31.21 0.3121

L.A. Tab. 750 mg

00638684 Procan SR Erfa 100 46.81 0.4681

PROPAFENONE HYDROCHLORIDE XTab. 150 mg PPB

02243324 Apo-Propafenone Apotex 100 33.95 0.339502245372 Mylan-Propafenone Mylan 100 33.95 0.339502294559 pms-Propafenone Phmscience 100 33.95 0.339502343053 Propafenone Sanis 100 33.95 0.339502243783 Propafenone-150 Pro Doc 100 33.95 0.339500603708 Rythmol Abbott 100 90.51 0.9051

Tab. 300 mg PPB

02243325 Apo-Propafenone Apotex 100 59.85 0.598502245373 Mylan-Propafenone Mylan 100 59.85 0.598502294575 pms-Propafenone Phmscience 100 59.85 0.598502343061 Propafenone Sanis 100 59.85 0.598502243784 Propafenone-300 Pro Doc 100 59.85 0.598500603716 Rythmol Abbott 100 159.53 1.5953

24:04.08CARDIOTONIC AGENTSDIGOXIN XPed. Elix. 0.05 mg/mL

02242320 Lanoxin Phmscience 115 ml 38.83 0.3377

Tab. 0.0625 mg

02335700 Toloxin MM Thera 250 51.61 0.2064

Tab. 0.125 mg

02335719 Toloxin MM Thera 250 51.61 0.2064


Page 76 2010-06

Tab. 0.25 mg

02335727 Toloxin MM Thera 250 51.61 0.2064

MILRINONE LACTATE XXI.V. Inj. Sol. 1 mg/mL

02244622 Milrinone Lactate Injection PPC 10 ml20 ml

46.8093.60

24:06.04BILE ACID SEQUESTRANTSCHOLESTYRAMIN RESIN XOral Pd 4 g/sac.

02210320 pms-Cholestyramine Phmscience 30 39.50 1.316700890960 pms-Cholestyramine Leger Phmscience 30 39.50 1.3167

COLESTIPOL HYDROCHLORIDE XOral Pd 5 g/sac.

00642975 Colestid Pfizer 30 25.53 0.851002132699 Colestid Orange Pfizer 30 25.53 0.8510

Tab. 1 g

02132680 Colestid Pfizer 120 29.12 0.2427

24:06.06FIBRIC ACID DERIVATIVESBEZAFIBRATE XL.A. Tab. 400 mg

02083523 Bezalip S.R. Tribute 30 48.00 1.6000

Tab. 200 mg

02240331 pms-Bezafibrate Phmscience 90 79.50 0.8833


2010-06 Page 77

FENOFIBRATE (NANOCRYSTALIZED OR MICROCOATED OR MICRONIZED) XXCaps. or Tab. 145 mg or 160 mg or 200 mg PPB

02239864 Apo-Feno-Micro (200 mg) Apotex 30100

16.5055.00

0.55000.5500

02246860 Apo-Feno-Super (160 mg) Apotex 30100

16.5055.00

0.55000.5500

02286092 * Fenofibrate Micro (200 mg) Sanis 100 55.00 0.550002240360 Feno-Micro-200 Pro Doc 30

10016.5055.00

0.55000.5500

02269082 Lipidil EZ (145 mg) Solvay 30 31.50 1.050002146959 Lipidil Micro (200 mg) Fournier 30 32.67 1.089002241602 Lipidil Supra (160 mg) Fournier 30 36.30 1.210002240210 Mylan-Fenofibrate Micro

(200 mg)Mylan 30

10016.5055.00

0.55000.5500

02243552 Novo-Fenofibrate Micronise(200 mg)

Novopharm 30100

16.5055.00

0.55000.5500

02289091 Novo-Fenofibrate-S (160mg)

Novopharm 30100

16.5055.00

0.55000.5500

02273551 pms-Fenofibrate Micro (200mg)

Phmscience 30100

16.5055.00

0.55000.5500

02310236 Pro-Feno-Super-160 Pro Doc 100 55.00 0.550002250039 ratio-Fenofibrate MC (200

mg)Ratiopharm 30

10016.5055.00

0.55000.5500

02247306 Riva-Fenofibrate Micro (200mg)

Riva 30100

16.5055.00

0.55000.5500

02288052 Sandoz Fenofibrate S (160mg)

Sandoz 90 49.50 0.5500

FENOFIBRATE (NANOCRYSTALLIZED) XTab. 48 mg

02269074 Lipidil EZ Solvay 30 12.30 0.4100

GEMFIBROZIL XCaps. 300 mg PPB

01979574 Apo-Gemfibrozil Apotex 100500

23.52117.60

0.23520.2352

00599026 Lopid Pfizer 100250

51.29122.30

0.51290.4892

02185407 Mylan-Gemfibrozil Mylan 100 23.52 0.235202241704 Novo-Gemfibrozil Novopharm 100 23.52 0.235202058456 Nu-Gemfibrozil 300 mg Nu-Pharm 100 23.52 0.235202239951 pms-Gemfibrozil Phmscience 100

50023.52

117.600.23520.2352


Page 78 2010-06

Tab. 600 mg PPB

01979582 Apo-Gemfibrozil Apotex 100500

53.55267.60

0.53550.5352

02136058 Gemfibrozil-600 Pro Doc 100 53.55 0.535500659606 Lopid Pfizer 100

250103.13257.84

1.03131.0314

02230476 Mylan-Gemfibrozil Mylan 100 53.55 0.535502142074 Novo-Gemfibrozil Novopharm 100 53.55 0.535502058464 Nu-Gemfibrozil 600 mg Nu-Pharm 100 53.55 0.535502230183 pms-Gemfibrozil Phmscience 100

50053.55

267.600.53550.5352

02242126 Riva-Gemfibrozil Riva 100250

53.55133.80

0.53550.5352

MICROCOATED FENOFIBRATE XXTab. 100 mg PPB

02246859 Apo-Feno-Super Apotex 30100

17.0156.70

0.56700.5670

02241601 Lipidil Supra Fournier 30 31.50 1.050002289083 Novo-Fenofibrate-S Novopharm 30 17.01 0.567002310228 Pro-Feno-Super-100 Pro Doc 100 56.70 0.567002288044 Sandoz Fenofibrate S Sandoz 90 51.03 0.5670

MICRONIZED FENOFIBRATE XCaps. 67 mg PPB

02243180 Apo-Feno-Micro Apotex 100 43.25 0.432502243551 Novo-Fenofibrate Micronise Novopharm 100 43.25 0.4325

24:06.08HMG-COA REDUCTASE INHIBITORSATORVASTATINE CALCIUM XTab. 10 mg

02295261 + Apo-Atorvastatin Apotex 90500

37.44208.00

0.41600.4160

02348705 + Atorvastatin Sanis 500 208.00 0.416002346486 + Atorvastatin calcium tablets Apotex 100

50041.60

208.000.41600.4160

02310899 + Co Atorvastatin Cobalt 90500

37.44208.00

0.41600.4160

02230711 Lipitor Pfizer 90 149.76 1.664002302675 + Novo-Atorvastatin Teva 30

50012.48

208.000.41600.4160

02313448 + pms-Atorvastatin Phmscience 90500

37.44208.00

0.41600.4160

02313707 + Ran-Atorvastatin Ranbaxy 90500

37.44208.00

0.41600.4160

02350297 + ratio-Atorvastatin Ratiopharm 30500

12.48208.00

0.41600.4160

02324946 + Sandoz Atorvastatin Sandoz 30500

12.48208.00

0.41600.4160


2010-06 Page 79

Tab. 20 mg


46.80260.00

0.52000.5200


50052.00

260.000.52000.5200


46.80260.00

0.52000.5200


50015.60

260.000.52000.5200


46.80260.00

0.52000.5200


46.80260.00

0.52000.5200


15.60260.00

0.52000.5200


15.60260.00

0.52000.5200

Tab. 40 mg


50.31279.50

0.55900.5590


50055.90

279.500.55900.5590


50.31279.50

0.55900.5590


50016.77

279.500.55900.5590


50.31279.50

0.55900.5590


50.31279.50

0.55900.5590


16.77279.50

0.55900.5590


16.77279.50

0.55900.5590


Page 80 2010-06

Tab. 80 mg


50.31279.50

0.55900.5590

02348748 + Atorvastatin Sanis 90500

50.31279.50

0.55900.5590

02346516 + Atorvastatin calcium tablets Apotex 30100

16.7755.90

0.55900.5590

02310929 + Co Atorvastatin Cobalt 90 50.31 0.559002243097 Lipitor Pfizer 30 67.08 2.236002302713 + Novo-Atorvastatin Teva 30

50016.77

279.500.55900.5590


50.31279.50

0.55900.5590


50.31279.50

0.55900.5590


16.7755.90

0.55900.5590


16.7755.90

0.55900.5590

FLUVASTATINE SODIUM XXCaps. 20 mg

02061562 Lescol Novartis 100 81.25 0.8125

Caps. 40 mg

02061570 Lescol Novartis 100 113.75 1.1375

L.A. Tab. 80 mg

02250527 Lescol XL Novartis 28 38.48 1.3743


2010-06 Page 81

LOVASTATINE XXTab. 20 mg PPB

02220172 Apo-Lovastatin Apotex 100500

86.57432.83

0.86570.8657

02248572 Co Lovastatin Cobalt 30500

25.97432.83

0.86570.8657

00795860 Mevacor Merck 28 51.23 1.829602243127 Mylan-Lovastatin Mylan 30

50025.97

432.830.86570.8657

02246542 Novo-Lovastatin Novopharm 100500

86.57432.83

0.86570.8657

02246989 phl-Lovastatin Pharmel 100500

86.57432.83

0.86570.8657

02246013 pms-Lovastatine Phmscience 100500

86.57432.83

0.86570.8657

02312670 Pro-Lovastatin Pro Doc 30100

25.9786.57

0.86570.8657

02267969 Ran-Lovastatin Ranbaxy 100500

86.57432.83

0.86570.8657

02245822 ratio-Lovastatin Ratiopharm 100500

86.57432.83

0.86570.8657

02272288 Riva-Lovastatin Riva 100 86.57 0.865702247056 Sandoz Lovastatin Sandoz 100 86.57 0.8657

Tab. 40 mg PPB

02220180 Apo-Lovastatin Apotex 100 159.67 1.596702248573 Co Lovastatin Cobalt 30

10047.90

159.671.59671.5967

00795852 Mevacor Merck 28 94.50 3.375002243129 Mylan-Lovastatin Mylan 30

10047.90

159.671.59671.5967

02246543 Novo-Lovastatin Novopharm 100 159.67 1.596702246990 phl-Lovastatin Pharmel 30

10047.90

159.671.59671.5967

02246014 pms-Lovastatine Phmscience 100 159.67 1.596702312689 Pro-Lovastatin Pro Doc 30

10047.90

159.671.59671.5967

02267977 Ran-Lovastatin Ranbaxy 100 159.67 1.596702245823 ratio-Lovastatin Ratiopharm 100 159.67 1.596702272296 Riva-Lovastatin Riva 100 159.67 1.596702247057 Sandoz Lovastatin Sandoz 100 159.67 1.5967


Page 82 2010-06

PRAVASTATINE SODIUM XXTab. 10 mg PPB

02243506 Apo-Pravastatin Apotex 30100

22.7075.67

0.75670.7567

02248182 Co Pravastatin Cobalt 30100

22.7075.67

0.75670.7567

02330954 Jamp-Pravastatin Jamp 100 75.67 0.756702317451 Mint-Pravastatin Mint 30

10022.7075.67

0.75670.7567

02257092 Mylan-Pravastatin Mylan 30100

22.7075.67

0.75670.7567

02247008 Novo-Pravastatin Novopharm 30100

22.7075.67

0.75670.7567

02249766 phl-Pravastatin Pharmel 30100

22.7075.67

0.75670.7567

02247655 pms-Pravastatin Phmscience 30100

22.7075.67

0.75670.7567

00893749 Pravachol B.M.S. 90 68.10 0.756702243824 Pravastatin-10 Pro Doc 30

10022.7075.67

0.75670.7567

02284421 Ran-Pravastatin Ranbaxy 30100

22.7075.67

0.75670.7567

02246930 ratio-Pravastatin Ratiopharm 30100

22.7075.67

0.75670.7567

02270234 Riva-Pravastatin Riva 30100

22.7075.67

0.75670.7567

02247856 Sandoz Pravastatin Sandoz 30100

22.7075.67

0.75670.7567

02301792 Zym-Pravastatin Zymcan 100 75.67 0.7567


2010-06 Page 83

Tab. 20 mg PPB


26.77446.25

0.89230.8925


26.7789.25

0.89230.8925


10026.7789.25

0.89230.8925


26.77446.25

0.89230.8925


26.7789.25

0.89230.8925


26.77446.25

0.89230.8925


26.77446.25

0.89230.8925


10026.7789.25

0.89230.8925


26.7789.25

0.89230.8925


26.77446.25

0.89230.8925


26.7789.25

0.89230.8925


26.7789.25

0.89230.8925


Tab. 40 mg PPB


32.25107.50

1.07501.0750


32.25107.50

1.07501.0750


10032.25

107.501.07501.0750


32.25107.50

1.07501.0750


32.25107.50

1.07501.0750


32.25107.50

1.07501.0750


32.25107.50

1.07501.0750


10032.25

107.501.07501.0750


32.25107.50

1.07501.0750


32.25107.50

1.07501.0750


32.25107.50

1.07501.0750


32.25107.50

1.07501.0750



Page 84 2010-06

ROSUVASTATIN CALCIUM XXTab. 5 mg

02265540 Crestor AZC 30 38.70 1.2900

Tab. 10 mg

02247162 Crestor AZC 30 40.80 1.3600

Tab. 20 mg

02247163 Crestor AZC 30 51.00 1.7000

Tab. 40 mg

02247164 Crestor AZC 30 59.70 1.9900

SIMVASTATIN XTab. 5 mg PPB

02247011 Apo-Simvastatin Apotex 100 45.00 0.450002248103 Co Simvastatin Cobalt 100 45.00 0.450002331020 Jamp-Simvastatin Jamp 100 45.00 0.450002246582 Mylan-Simvastatin Mylan 100 45.00 0.450002250144 Novo-Simvastatin Novopharm 30

10013.5045.00

0.45000.4500

02281546 phl-Simvastatin Pharmel 30100

13.5045.00

0.45000.4500

02269252 pms-Simvastatin Phmscience 30100

13.5045.00

0.45000.4500

02329131 Ran-Simvastatin Ranbaxy 100 45.00 0.450002247297 Riva-Simvastatin Riva 30

10013.5045.00

0.45000.4500

02284723 * Simvastatin Sanis 100 45.00 0.450000884324 Zocor Merck 28 26.63 0.951102300907 Zym-Simvastatin Zymcan 100 45.00 0.4500


2010-06 Page 85

Tab. 10 mg PPB

02247012 Apo-Simvastatin Apotex 30500

26.70445.00

0.89000.8900

02248104 Co Simvastatin Cobalt 30500

26.70445.00

0.89000.8900

02331039 Jamp-Simvastatin Jamp 100 89.00 0.890002246583 Mylan-Simvastatin Mylan 30

10026.7089.00

0.89000.8900

02250152 Novo-Simvastatin Novopharm 30500

26.70445.00

0.89000.8900


26.7089.00

0.89000.8900


26.7089.00

0.89000.8900

02329158 Ran-Simvastatin Ranbaxy 100500

89.00445.00

0.89000.8900

02247068 ratio-Simvastatin Ratiopharm 100 89.00 0.890002247298 Riva-Simvastatin Riva 30

50026.70

445.000.89000.8900

02247828 Sandoz Simvastatin Sandoz 30100

26.7089.00

0.89000.8900

02284731 * Simvastatin Sanis 100 89.00 0.890002247221 Simvastatin-10 Pro Doc 30

50026.70

445.000.89000.8900

02265885 Taro-Simvastatin Taro 100 89.00 0.890000884332 Zocor Merck 28 52.68 1.881402300915 Zym-Simvastatin Zymcan 100 89.00 0.8900

Tab. 20 mg PPB


33.00550.00

1.10001.1000


33.00550.00

1.10001.1000


10033.00

110.001.10001.1000


33.00110.00

1.10001.1000


33.00110.00

1.10001.1000


33.00110.00

1.10001.1000


110.00550.00

1.10001.1000

02247069 ratio-Simvastatin Ratiopharm 100 110.00 1.100002247299 Riva-Simvastatin Riva 30

50033.00

550.001.10001.1000


33.00110.00

1.10001.1000

02284758 * Simvastatin Sanis 100500

110.00550.00

1.10001.1000

02247222 Simvastatin-20 Pro Doc 30500

33.00550.00

1.10001.1000



Page 86 2010-06

Tab. 40 mg PPB


33.00110.00

1.10001.1000


33.00550.00

1.10001.1000


10033.00

110.001.10001.1000


33.00110.00

1.10001.1000


33.00110.00

1.10001.1000


33.00110.00

1.10001.1000


110.00550.00

1.10001.1000

02247070 ratio-Simvastatin Ratiopharm 30100

33.00110.00

1.10001.1000

02247300 Riva-Simvastatin Riva 30100

33.00110.00

1.10001.1000


33.00110.00

1.10001.1000

02284766 * Simvastatin Sanis 100 110.00 1.100002247223 Simvastatin-40 Pro Doc 30

10033.00

110.001.10001.1000


Tab. 80 mg PPB


33.00110.00

1.10001.1000


33.00110.00

1.10001.1000

02331063 Jamp-Simvastatin Jamp 100 110.00 1.100002246585 Mylan-Simvastatin Mylan 100 110.00 1.100002250187 Novo-Simvastatin Novopharm 30

10033.00

110.001.10001.1000


33.00110.00

1.10001.1000


33.00110.00

1.10001.1000

02329182 Ran-Simvastatin Ranbaxy 100 110.00 1.100002247071 ratio-Simvastatin Ratiopharm 30 33.00 1.100002247301 Riva-Simvastatin Riva 30

10033.00

110.001.10001.1000


33.00110.00

1.10001.1000

02247224 Simvastatin Pro Doc 30100

33.00110.00

1.10001.1000

02284774 * Simvastatin Sanis 100 110.00 1.100002240332 Zocor Merck 28 65.11 2.325402300974 Zym-Simvastatin Zymcan 100 110.00 1.1000


2010-06 Page 87

24:06.92MISCELLANEOUS ANTILIPEMIC AGENTSNIACIN XX

L.A. Tab. 500 mg

02309254 Niaspan FCT Sepracor 90 101.82 1.1313

L.A. Tab. 750 mg


L.A. Tab. 1000 mg


NIACIN

Tab. 100 mg

00268585 Niacine-ICN Valeant 500 12.00 0.0240

Tab. 500 mg PPB

00557412 Jamp-Niacin Jamp 100 4.50 0.045001939130 Niacine Odan 100 4.50 0.045000294950 Niacine-ICN Valeant 500 22.78 0.0456

NIACIN/ LOVASTATIN XL. A tab 1000 mg - 20 mg

02270447 Advicor Oryx 90 125.10 1.3900

L.A. Tab. 500 mg - 20 mg

02270439 Advicor Oryx 90 111.60 1.2400

L.A. Tab. 1000 mg - 40 mg

02293501 Advicor Oryx 90 170.10 1.8900


Page 88 2010-06

24:08.16CENTRAL ALPHA-AGONISTSCLONIDINE HYDROCHLORIDE XXTab. 0.1 mg PPB

00868949 Apo-Clonidine Apotex 100500

13.5867.90

0.13580.1358

00259527 Catapres Bo. Ing. 100 18.53 0.185301910396 Clonidine 0.1 Pro Doc 100

50013.5867.90

0.13580.1358

02046121 Novo-Clonidine Novopharm 100 13.58 0.135801913786 Nu-Clonidine Nu-Pharm 100

50013.5867.90

0.13580.1358

Tab. 0.2 mg PPB

00868957 Apo-Clonidine Apotex 100 24.24 0.242400291889 Catapres Bo. Ing. 100 33.06 0.330601908162 Clonidine 0.2 Pro Doc 100 24.24 0.242402046148 Novo-Clonidine Novopharm 100 24.24 0.242401913220 Nu-Clonidine Nu-Pharm 100 24.24 0.2424

METHYLDOPA XTab. 125 mg

00360252 Apo-Methyldopa Apotex 100 9.89 0.0989

Tab. 250 mg

00360260 Apo-Methyldopa Apotex 1001000

14.33143.30

0.14330.1433

Tab. 500 mg

00426830 Apo-Methyldopa Apotex 100 25.38 0.2538

24:08.20DIRECT VASODILATORSDIAZOXIDE XCaps. 100 mg

00503347 Proglycem Schering 100 157.23 1.5723

HYDRALAZINE HYDROCHLORIDE XTab. 10 mg PPB

00441619 Apo-Hydralazine Apotex 100 10.26 0.093901913638 Hydralazine-10 Pro Doc 100

50010.2651.30

W 0.0955 W 0.0955

00759465 Novo-Hylazin Novopharm 100 9.22 0.0922


2010-06 Page 89

Tab. 25 mg PPB

00441627 Apo-Hydralazine Apotex 100 16.44 0.164402082071 Hydralazine-25 Pro Doc 100

50016.4482.20

W W

02004828 Nu-Hydral Nu-Pharm 100 23.14 0.1656

Tab. 50 mg PPB

00441635 Apo-Hydralazine Apotex 100 25.27 0.252700759481 Novo-Hylazin Novopharm 100

50025.27

126.350.25270.2527

02004836 Nu-Hydral Nu-Pharm 100 25.27 0.2527

MINOXIDIL XTab. 2.5 mg

00514497 Loniten Pfizer 100 32.88 0.3288

Tab. 10 mg

00514500 Loniten Pfizer 100 72.50 0.7250

24:12.08NITRATES AND NITRITESGLYCERYL TRINITRATE

Patch 0.2 mg/h PPB

02162806 Minitran Graceway 30 17.00 0.566701911910 Nitro-Dur Key 30 17.00 0.566700584223 Transderm-Nitro Novartis 30 18.05 0.601702230732 Trinipatch Paladin 30 17.00 0.5667

Patch 0.4 mg/h PPB


Patch 0.6 mg/h PPB


Patch 0.8 mg/h

02011271 Nitro-Dur Key 30 33.30 1.1100


Page 90 2010-06

S.-Ling. Spray 0.4 mg PPB

02243588 Mylan-Nitro SL Spray Mylan 200 dose(s) 8.46 0.034702231441 Nitrolingual Pompe SanofiAven 200 dose(s) 12.8502238998 Rho-Nitro SanofiAven 200 dose(s) 8.46 0.0347

Top. Oint. 2 %

01926454 Nitrol Paladin 30 g60 g

7.9316.53

GLYCERYL TRINITRATE (STABILIZED) S-Ling. Tab. 0.3 mg

00037613 Nitrostat Pfizer 100 2.77

S-Ling. Tab. 0.6 mg

00037621 Nitrostat Pfizer 100 2.89

ISOSORBIDE DINITRATES-Ling. Tab. 5 mg

00670944 Apo-Isdn Apotex 100 6.21 0.0621

Tab. 10 mg

00441686 Apo-Isdn Apotex 1001000

3.6536.50

0.03650.0365

Tab. 30 mg

00441694 Apo-Isdn Apotex 100 8.57 0.0857

ISOSORBIDE-5-MONONITRATE XL.A. Tab. 60 mg PPB

02272830 Apo-ISMN Apotex 100 35.23 0.352302126559 Imdur AZC 30

10019.7766.00

0.65900.6600

02301288 pms-ISMN Phmscience 30100

10.5735.23

0.35230.3523

02311321 Pro-ISMN-60 Pro Doc 100 35.23 0.3523

24:12.92MISCELLANEOUS VASODILATING AGENTSDIPYRIDAMOLE XTab. 25 mg

00895644 Apo-Dipyridamole-FC Apotex 100 26.33 0.1466


2010-06 Page 91

Tab. 50 mg PPB

00895652 Apo-Dipyridamole-FC Apotex 100 29.32 0.209500067393 Persantine Bo. Ing. 100 38.79 0.3879

Tab. 75 mg PPB

00895660 Apo-Dipyridamole-FC Apotex 100 43.98 0.282100452092 Persantine Bo. Ing. 100 52.24 0.5224

24:20ALPHA-ADRENERGICS BLOCKING AGENTSDOXAZOSIN MESYLATE XTab. 1 mg PPB

02240588 Apo-Doxazosin Apotex 100 27.50 0.275001958100 Cardura-1 Pfizer 100 56.65 0.566502240978 Doxazosin-1 Pro Doc 100 27.50 0.275002240498 Mylan-Doxazosin Mylan 100 27.50 0.275002242728 Novo-Doxazosin Novopharm 100 27.50 0.275002244527 pms-Doxazosin Phmscience 100 27.50 0.2750

Tab. 2 mg PPB


Tab. 4 mg PPB


PRAZOSIN HYDROCHLORIDE XTab. 1 mg PPB

00882801 Apo-Prazo Apotex 100 13.71 0.137101934198 Novo-Prazin Novopharm 100 13.71 0.137101913794 Nu-Prazo Nu-Pharm 100 13.71 0.1371

Tab. 2 mg PPB



Page 92 2010-06

Tab. 5 mg PPB


TERAZOSIN HYDROCHLORIDE XXKit 1 mg, 2 mg, 5 mg

02187876 Hytrin Abbott 1 22.20

Tab. 1 mg PPB

02234502 Apo-Terazosin Apotex 100500

27.70138.50

0.27700.2770

00818658 Hytrin Abbott 100 58.84 0.588402230805 Novo-Terazosin Novopharm 100 27.70 0.277002233047 Nu-Terazosin Nu-Pharm 100 27.70 0.277002246544 phl-Terazosin Pharmel 100 27.70 0.277002243518 pms-Terazosin Phmscience 100 27.70 0.277002218941 ratio-Terazosin Ratiopharm 100 27.70 0.277002237476 Terazosin-1 Pro Doc 100

50027.70

138.500.27700.2770

Tab. 2 mg PPB


35.21176.05

0.35210.3521

00818682 Hytrin Abbott 100 74.80 0.748002230806 Novo-Terazosin Novopharm 100 35.21 0.352102233048 Nu-Terazosin Nu-Pharm 100 35.21 0.352102246545 phl-Terazosin Pharmel 100 35.21 0.352102243519 pms-Terazosin Phmscience 100 35.21 0.352102218968 ratio-Terazosin Ratiopharm 100 35.21 0.352102237477 Terazosin-2 Pro Doc 100 35.21 0.3521

Tab. 5 mg PPB


47.82239.10

0.47820.4782

00818666 Hytrin Abbott 100 101.58 1.015802230807 Novo-Terazosin Novopharm 100 47.82 0.478202233049 Nu-Terazosin Nu-Pharm 100 47.82 0.478202246546 phl-Terazosin Pharmel 100 47.82 0.478202243520 pms-Terazosin Phmscience 100 47.82 0.478202218976 ratio-Terazosin Ratiopharm 100 47.82 0.478202237478 Terazosin-5 Pro Doc 100 47.82 0.4782


2010-06 Page 93

Tab. 10 mg PPB

02234505 Apo-Terazosin Apotex 100 70.00 0.700000818674 Hytrin Abbott 100 148.70 1.487002230808 Novo-Terazosin Novopharm 100 70.00 0.700002233050 Nu-Terazosin Nu-Pharm 100 70.00 0.700002246547 phl-Terazosin Pharmel 100 70.00 0.700002243521 pms-Terazosin Phmscience 100 70.00 0.700002218984 ratio-Terazosin Ratiopharm 100 70.00 0.700002237479 Terazosin-10 Pro Doc 100 70.00 0.7000

24:24BÊTA-ADRENERGICS BLOCKING AGENTSACEBUTOL HYDROCHLORIDE XXTab. 100 mg PPB

02286246 * Acebutolol Sanis 100 12.94 0.129402164396 Acebutolol-100 Pro Doc 100

50012.9464.70

0.12940.1294

02147602 Apo-Acebutolol Apotex 100500

12.9464.70

0.12940.1294

02237721 Mylan-Acebutolol Mylan 100500

12.9464.70

0.12940.1294

02237885 Mylan-Acebutolol S Mylan 100500

12.9464.70

0.12940.1294

02204517 Novo-Acebutolol Novopharm 100 12.94 0.129401910140 Rhotral SanofiAven 100

50012.9464.70

0.12940.1294

02257599 Sandoz Acebutolol Sandoz 100500

12.9464.70

0.12940.1294

01926543 Sectral SanofiAven 100 28.87 0.2887

Tab. 200 mg PPB


50019.3696.80

0.19360.1936


19.3696.80

0.19360.1936

02237722 Mylan-Acebutolol Mylan 100500

19.3696.80

0.19360.1936

02237886 Mylan-Acebutolol S Mylan 100500

19.3696.80

0.19360.1936

02204525 Novo-Acebutolol Novopharm 100 19.36 0.193601910159 Rhotral SanofiAven 100

50019.3696.80

0.19360.1936


19.3696.80

0.19360.1936



Page 94 2010-06

Tab. 400 mg PPB


50038.47

192.350.38470.3847


38.47192.35

0.38470.3847

02237723 Mylan-Acebutolol Mylan 100 38.47 0.384702237887 Mylan-Acebutolol S Mylan 100 38.47 0.384702204533 Novo-Acebutolol Novopharm 100 38.47 0.384701910167 Rhotral SanofiAven 100

50038.47

192.350.38470.3847


38.47192.35

0.38470.3847


ATENOLOL XXTab. 25 mg PPB

02326701 Atenolol Pro Doc 100500

17.5787.85

0.17570.1757

02303647 Mylan-Atenolol Mylan 30100

5.2717.57

0.17570.1757

02266660 Novo-Atenol Novopharm 100 17.57 0.175702247182 phl-Atenolol Pharmel 100 17.57 0.175702246581 pms-Atenolol Phmscience 100 17.57 0.175702277379 Riva-Atenolol Riva 100

50017.5787.85

0.17570.1757

Tab. 50 mg PPB

00773689 Apo-Atenol Apotex 100500

27.90139.45

0.27900.2789

00828807 Atenolol-50 Pro Doc 100500

27.90139.45

0.27900.2789

02255545 Co Atenolol Cobalt 30500

8.37139.45

0.27900.2789


8.37139.45

0.27900.2789

01912062 Novo-Atenol Novopharm 30500

8.37139.45

0.27900.2789

00886114 Nu-Atenol Nu-Pharm 100500

27.90139.45

0.27900.2789

02238316 phl-Atenolol Pharmel 30500

8.37139.45

0.27900.2789

02237600 pms-Atenolol Phmscience 30500

8.37139.45

0.27900.2789

02267985 Ran-Atenolol Ranbaxy 30500

8.37139.45

0.27900.2789

02171791 ratio-Atenolol Ratiopharm 30500

8.37139.45

0.27900.2789

02242094 Riva-Atenolol Riva 30500

8.37139.45

0.27900.2789

02231731 Sandoz Atenolol Sandoz 30500

8.37139.45

0.27900.2789

02039532 Tenormin AZC 30 17.24 0.5747


2010-06 Page 95

Tab. 100 mg PPB

00773697 Apo-Atenol Apotex 100500

45.86229.30

0.45860.4586

00828793 Atenolol-100 Pro Doc 100500

45.86229.30

0.45860.4586

02255553 Co Atenolol Cobalt 30500

13.76229.30

0.45860.4586


13.76229.30

0.45860.4586

01912054 Novo-Atenol Novopharm 30500

13.76229.30

0.45860.4586

00886122 Nu-Atenol Nu-Pharm 100 45.86 0.458602238318 phl-Atenolol Pharmel 30

50013.76

229.300.45860.4586

02237601 pms-Atenolol Phmscience 30500

13.76229.30

0.45860.4586

02267993 Ran-Atenolol Ranbaxy 30500

13.76229.30

0.45860.4586

02171805 ratio-Atenolol Ratiopharm 30500

13.76229.30

0.45860.4586

02242093 Riva-Atenolol Riva 30500

13.76229.30

0.45860.4586

02231733 Sandoz Atenolol Sandoz 30500

13.76229.30

0.45860.4586

02039540 Tenormin AZC 30 28.34 0.9447

BISOPROLOL FUMARATE XXTab. 5 mg

02256134 Apo-Bisoprolol Apotex 100 17.50 0.175002267470 Novo-Bisoprolol Novopharm 100 17.50 0.175002308339 phl-Bisoprolol Pharmel 100 17.50 0.175002302632 pms-Bisoprolol Phmscience 100 17.50 0.175002306999 Pro-Bisoprolol-5 Pro Doc 100 17.50 0.175002247439 Sandoz Bisoprolol Sandoz 100 17.50 0.175002321556 Zym-Bisoprolol Zymcan 100 17.50 0.1750

Tab. 10 mg

02256177 Apo-Bisoprolol Apotex 100 29.00 0.290002241149 Monocor Biovail 100 58.00 0.580002267489 Novo-Bisoprolol Novopharm 100 29.00 0.290002308347 phl-Bisoprolol Pharmel 100 29.00 0.290002302640 pms-Bisoprolol Phmscience 100 29.00 0.290002307006 Pro-Bisoprolol-10 Pro Doc 100 29.00 0.290002247440 Sandoz Bisoprolol Sandoz 100 29.00 0.290002321572 Zym-Bisoprolol Zymcan 100 29.00 0.2900


Page 96 2010-06

CARVEDILOL XXTab. 3.125 mg

02247933 Apo-Carvedilol Apotex 100 63.50 0.635002324504 Carvedilol Pro Doc 100 63.50 0.635002248752 phl-Carvedilol Pharmel 100 63.50 0.635002245914 pms-Carvedilol Phmscience 100 63.50 0.635002268027 Ran-Carvedilol Ranbaxy 100 63.50 0.635002252309 ratio-Carvedilol Ratiopharm 100 63.50 0.635002338068 Zym-Carvedilol Zymcan 100 63.50 0.6350

Tab. 6.25 mg


Tab. 12.5 mg


Tab. 25 mg


LABETALOL (HYDROCHLORIDE) XTab. 100 mg

02106272 Trandate Paladin 100 25.01 0.2501

Tab. 200 mg

02106280 Trandate Paladin 100 44.20 0.4420


2010-06 Page 97

METOPROLOL TARTRATE XXCo. or Co. L.A. 50 mg /100 mg L.A. PPB

00618632 Apo-Metoprolol 50 mg Apotex 1001000

7.0896.80

0.07080.0968

00749354 Apo-Metoprolol L 50 mg Apotex 1001000

7.0896.80

0.07080.0968

02285169 Apo-Metoprolol SR Apotex 100 14.15 0.137800397423 Lopresor 50 mg Novartis 100

50021.84

102.750.21840.2055

00658855 Lopresor SR 100 mg Novartis 100250

25.5163.75

0.25510.2550

00648019 Metoprolol-50 Pro Doc 1001000

7.0896.80

0.07080.0968

02174545 Mylan-Metoprolol (Type L) Mylan 1001000

7.0896.80

0.07080.0968

00842648 Novo-Metoprol B 50 mg Novopharm 100500

7.0848.40

0.07080.0968

00648035 Novo-Metoprol L 50 mg Novopharm 100500

7.0848.40

0.07080.0968

00865605 Nu-Metop 50 mg Nu-Pharm 1001000

9.6896.80

0.09680.0968

02253518 phl-Metoprolol-L Pharmel 1001000

7.0896.80

0.07080.0968

02230803 pms-Metoprolol-L Phmscience 100500

7.0848.40

0.07080.0968

02315319 Riva-Metoprolol-L Riva 1001000

7.0896.80

0.07080.0968

02247875 Sandoz Metoprolol L 50 Sandoz 100500

7.0848.40

0.07080.0968

02303396 Sandoz Metoprolol SR 100 Sandoz 100 14.15 0.137802315114 Zym-Metoprolol-L Zymcan 100 7.08 0.0708


Page 98 2010-06

Co. or Co. L.A. 100 mg / 200 mg L.A. PPB

00618640 Apo-Metoprolol 100 mg Apotex 1001000

12.84174.70

0.12840.1747

00751170 Apo-Metoprolol L 100 mg Apotex 1001000

12.84174.70

0.12840.1747

02285177 Apo-Metoprolol SR Apotex 100 25.68 0.250000397431 Lopresor 100 mg Novartis 100 44.82 0.448200534560 Lopresor SR 200 mg Novartis 100

25046.28

115.690.46280.4628


12.84174.70

0.12840.1747

02174553 Mylan-Metoprolol (Type L) Mylan 1001000

12.84174.70

0.12840.1747

00842656 Novo-Metoprol B 100 mg Novopharm 100500

12.8487.35

0.12840.1747

00648043 Novo-Metoprol L 100 mg Novopharm 100500

12.8487.35

0.12840.1747

00865613 Nu-Metop 100 mg Nu-Pharm 100 17.47 0.174702253526 phl-Metoprolol-L Pharmel 100

100012.84

174.700.12840.1747

02230804 pms-Metoprolol-L Phmscience 100500

12.8487.35

0.12840.1747

02315327 Riva-Metoprolol-L Riva 1001000

12.84174.70

0.12840.1747

02247876 Sandoz Metoprolol L 100 Sandoz 100500

12.8487.35

0.12840.1747

02303418 Sandoz Metoprolol SR 200 Sandoz 100 25.68 0.250002315122 Zym-Metoprolol-L Zymcan 100 12.84 0.1284

Tab. 25 mg PPB

02246010 Apo-Metoprolol Apotex 1001000

6.4364.30

0.06430.0643


6.4364.30

0.06430.0643

02302055 Mylan-Metoprolol (Type L) Mylan 100 6.43 0.064302261898 Novo-Metoprol Novopharm 100 6.43 0.064302253496 phl-Metoprolol-L Pharmel 100 6.43 0.064302248855 pms-Metoprolol 25 mg Phmscience 100 6.43 0.064302315300 Riva-Metoprolol-L Riva 100

5006.43

32.150.06430.0643

02315106 Zym-Metoprolol-L Zymcan 100 6.43 0.0643

NADOLOL XTab. 40 mg PPB

00782505 Apo-Nadol Apotex 100500

24.65123.25

0.24650.2465

00828815 Nadolol-40 Pro Doc 100 24.65 0.246502126753 Novo-Nadolol Novopharm 100 24.65 0.2465

Tab. 80 mg PPB

00782467 Apo-Nadol Apotex 100 35.15 0.351500818704 Nadolol-80 Pro Doc 100 35.15 0.351502126761 Novo-Nadolol Novopharm 100 35.15 0.3515


2010-06 Page 99

Tab. 160 mg

00782475 Apo-Nadol Apotex 100 65.95 0.6595

PINDOLOL XXTab. 5 mg PPB

00755877 Apo-Pindol Apotex 100 20.23 0.202302057808 Gen-Pindolol Genpharm 100 20.23 0.202300869007 Novo-Pindol Novopharm 100

50020.23

101.130.20230.2023

00828416 Pindolol-5 Pro Doc 100 20.23 0.202302231536 pms-Pindolol Phmscience 100 20.23 0.202302261782 Sandoz Pindolol Sandoz 100 20.23 0.202300417270 Visken Novartis 100 43.97 0.4397

Tab. 10 mg PPB

00755885 Apo-Pindol Apotex 100500

34.90174.50

0.34900.3490

02057816 Gen-Pindolol Genpharm 100 34.90 0.349000869015 Novo-Pindol Novopharm 100

50034.90

174.500.34900.3490

00828424 Pindolol-10 Pro Doc 100 34.90 0.349002231537 pms-Pindolol Phmscience 100 34.90 0.349002261790 Sandoz Pindolol Sandoz 100 34.90 0.349000443174 Visken Novartis 100 75.09 0.7509

Tab. 15 mg PPB

00755893 Apo-Pindol Apotex 100 51.28 0.512802057824 Gen-Pindolol Genpharm 100 51.28 0.512800869023 Novo-Pindol Novopharm 100 51.28 0.512800886130 Nu-Pindol Nu-Pharm 100 51.28 0.512802231539 pms-Pindolol Phmscience 100 51.28 0.512802261804 Sandoz Pindolol Sandoz 100 51.28 0.512800417289 Visken Novartis 100 108.92 1.0892

PINDOLOL / HYDROCHLOROTHIAZIDE XTab. 10 mg -25 mg

00568627 Viskazide 10/25 Novartis 105 77.22 0.7354

PROPRANOLOL HYDROCHLORIDE XL.A. Caps or Tab. 20 mg /60 mg L.A. PPB

00663719 Apo-Propranolol 20 mg Apotex 1001000

3.4634.60

0.03460.0346

02042231 Inderal L.A. 60 mg Wyeth 100 44.37 0.443700740675 Novo-Pranol 20 mg Novopharm 100

5003.46

17.300.03460.0346

02044692 Nu-Propranolol 20 mg Nu-Pharm 1001000

3.4634.60

0.03460.0346


Page 100 2010-06

L.A. Caps or Tab. 40 mg / 80 mg / 120 mg L.A. PPB

00402753 Apo-Propranolol 40 mg Apotex 1001000

3.4834.80

0.03480.0348

02042266 Inderal L.A. 120 mg Wyeth 100 77.04 0.770402042258 Inderal L.A. 80 mg Wyeth 100 49.93 0.499300496499 Novo-Pranol 40 mg Novopharm 100

10003.48

34.800.03480.0348

02044706 Nu-Propranolol 40 mg Nu-Pharm 1000 34.80 0.034800582263 pms-Propranolol 40mg Phmscience 100

10003.48

34.800.03480.0348

L.A. Caps or Tab. 80 mg / 160 mg L.A. PPB

00402761 Apo-Propranolol 80 mg Apotex 100 5.85 0.058502042274 Inderal L.A. 160 mg Wyeth 100 91.11 0.911100496502 Novo-Pranol 80 mg Novopharm 100

5005.85

29.250.05850.0585

00582271 pms-Propranolol 80mg Phmscience 100 5.85 0.0585

Tab. 10 mg PPB

00402788 Apo-Propranolol Apotex 1001000

1.9219.20

0.01920.0192

00496480 Novo-Pranol Novopharm 1001000

1.9219.20

0.01920.0192

00582255 pms-Propranolol Phmscience 1001000

1.9219.20

0.01920.0192

Tab. 120 mg

00504335 Apo-Propranolol Apotex 100 30.91 0.1097

SOTALOL HYDROCHLORIDE XTab. 80 mg PPB

02210428 Apo-Sotalol Apotex 100500

59.32296.60

0.59320.5932

02270625 Co Sotalol Cobalt 100 59.32 0.593202229778 Mylan-Sotalol Mylan 100 59.32 0.593202231181 Novo-Sotalol Novopharm 100

50059.32

296.600.59320.5932

02200996 Nu-Sotalol Nu-Pharm 100 59.32 0.593202238768 phl-Sotalol Pharmel 100 59.32 0.593202238326 pms-Sotatol Phmscience 100

50059.32

296.600.59320.5932

02316528 Pro-Sotalol Pro Doc 100500

59.32296.60

0.59320.5932

02084228 ratio-Sotalol Ratiopharm 100 59.32 0.593202242156 Riva-Sotalol Riva 100 59.32 0.593202257831 Sandoz Sotalol Sandoz 100 59.32 0.593202325209 Zym-Sotalol Zymcan 100 59.32 0.5932


2010-06 Page 101

Tab. 160 mg PPB

02167794 Apo-Sotalol Apotex 100500

64.92324.60

0.64920.6492

02270633 Co Sotalol Cobalt 100 64.92 0.649202229779 Mylan-Sotalol Mylan 100 64.92 0.649202231182 Novo-Sotalol Novopharm 100

50064.92

324.600.64920.6492

02163772 Nu-Sotalol Nu-Pharm 100 64.92 0.649202238769 phl-Sotalol Pharmel 100 64.92 0.649202238327 pms-Sotatol Phmscience 100

50064.92

324.600.64920.6492

02316536 Pro-Sotalol Pro Doc 100 64.92 0.649202084236 ratio-Sotalol Ratiopharm 100 64.92 0.649202242157 Riva-Sotalol Riva 100 64.92 0.649202257858 Sandoz Sotalol Sandoz 100 64.92 0.649202325217 Zym-Sotalol Zymcan 100 64.92 0.6492

TIMOLOL MALEATE XXTab. 5 mg PPB

00755842 Apo-Timol Apotex 100 16.49 0.164901947796 Novo-Timol Novopharm 100 16.49 0.164902044609 Nu-Timolol Nu-Pharm 100 16.49 0.164900812455 Timolol-5 Pro Doc 100 16.49 0.1649

Tab. 10 mg PPB

00755850 Apo-Timol Apotex 100 25.72 0.257201947818 Novo-Timol Novopharm 100 25.72 0.257202044617 Nu-Timol Nu-Pharm 100 25.72 0.257200812447 Timolol-10 Pro Doc 100 25.72 0.2572

Tab. 20 mg PPB

00755869 Apo-Timol Apotex 100 50.05 0.500501947826 Novo-Timol Novopharm 100 50.05 0.5005

24:28.08DIHYDROPYRIDINESAMLODIPIN BESYLATE D' XTab. 2.5 mg PPB

02326795 Amlodipine Pro Doc 100 32.82 0.328202297477 Co Amlodipine Cobalt 100 32.82 0.328202326760 phl-Amlodipine Pharmel 100 32.82 0.328202295148 pms-Amlodipine Phmscience 100 32.82 0.328202331489 Riva-Amlodipine Riva 100 32.82 0.328202330474 Sandoz Amlodipine Sandoz 100 32.82 0.3282


Page 102 2010-06

Tab. 5 mg PPB

02331284 Amlodipine Mylan 100500

65.65328.24

0.65650.6565

02326809 Amlodipine Pro Doc 100500

65.65328.24

0.65650.6565

02273373 Apo-Amlodipine Apotex 100500

65.65328.24

0.65650.6565

02297485 Co Amlodipine Cobalt 100500

65.65328.24

0.65650.6565

02331071 Jamp-Amlodipine Jamp 100 65.65 0.656502272113 Mylan-Amlodipine Mylan 100

50065.65

328.240.65650.6565

00878928 Norvasc Pfizer 100250

125.04312.58

1.25041.2503

02250497 Novo-Amlodipine Novopharm 100500

65.65328.24

0.65650.6565

02326779 phl-Amlodipine Pharmel 100500

65.65328.24

0.65650.6565

02284065 pms-Amlodipine Phmscience 100500

65.65328.24

0.65650.6565

02321858 Ran-Amlodipine Ranbaxy 100500

65.65328.24

0.65650.6565

02259605 ratio-Amlodipine Ratiopharm 100500

65.65328.24

0.65650.6565

02331497 Riva-Amlodipine Riva 100500

65.65328.24

0.65650.6565

02284383 Sandoz Amlodipine Sandoz 100500

65.65328.24

0.65650.6565

Tab. 10 mg PPB

02331292 Amlodipine Mylan 100500

97.44487.22

0.97440.9744

02326817 Amlodipine Pro Doc 100500

97.44487.22

0.97440.9744

02273381 Apo-Amlodipine Apotex 100500

97.44487.22

0.97440.9744

02297493 Co Amlodipine Cobalt 100500

97.44487.22

0.97440.9744

02331098 Jamp-Amlodipine Jamp 100 97.44 0.974402272121 Mylan-Amlodipine Mylan 100

50097.44

487.220.97440.9744

00878936 Norvasc Pfizer 100250

185.60464.00

1.85601.8560

02250500 Novo-Amlodipine Novopharm 100250

97.44243.61

0.97440.9744

02326787 phl-Amlodipine Pharmel 100500

97.44487.22

0.97440.9744

02284073 pms-Amlodipine Phmscience 100500

97.44487.22

0.97440.9744

02321866 Ran-Amlodipine Ranbaxy 100500

97.44487.22

0.97440.9744

02259613 ratio-Amlodipine Ratiopharm 100500

97.44487.22

0.97440.9744

02331500 Riva-Amlodipine Riva 100500

97.44487.22

0.97440.9744

02284391 Sandoz Amlodipine Sandoz 100500

97.44487.22

0.97440.9744


2010-06 Page 103

FELODIPIN XXL.A. Tab. 2.5 mg PPB

02057778 Plendil AZC 30 15.08 0.502702221985 Renedil SanofiAven 30 15.37 0.5123

L.A. Tab. 5 mg PPB

00851779 Plendil AZC 30 20.15 0.671702221993 Renedil SanofiAven 30 20.85 0.695002280264 Sandoz Felodipine Sandoz 30

10013.8646.20

0.41700.4170

L.A. Tab. 10 mg PPB

00851787 Plendil AZC 30 30.24 1.008002222000 Renedil SanofiAven 30 31.26 1.042002280272 Sandoz Felodipine Sandoz 30

10020.7769.25

0.62530.6252

NIFEDIPINE XCaps. 5 mg

00725110 Apo-Nifed Apotex 100 36.79 0.3679

L.A. Tab. (24 h) 20 mg

02237618 Adalat XL Bayer 2898

25.3288.59

0.90430.9040

L.A. Tab. (24 h) 30 mg


30.36106.25

1.08431.0842

L.A. Tab. (24 h) 60 mg PPB


26.2591.87

0.93740.9374

02321149 Mylan-Nifedipine ExtentedRelease

Mylan 100 93.74 0.9374

NIFEDIPINE/ACETYLSALICYLIC (ACIDE) XL.A. Tab. (24 h) 20 mg - 81 mg (28 L.A. Tab.(24h) - 28 Ent. Tab.)

02313766 Adalat XL PLUS Bayer 56 24.62 0.4396

L.A. Tab. (24 h) 30 mg - 81 mg (28 L.A. Tab.(24h) - 28 Ent. Tab.)



Page 104 2010-06

L.A. Tab. (24 h) 60 mg - 81 mg (28 L.A. Tab.(24h) - 28 Ent. Tab.)


NIMODIPINE XXTab. 30 mg

02325926 Nimotop Bayer 100 988.00 9.8800

24:28.92MISCELLANEOUS CALCIUM-CHANNEL BLOCKING AGENTSDILTIAZEM HYDROCHLORIDE XL.A. Caps. 120 mg PPB

02291037 Apo-Diltiaz TZ Apotex 100 40.43 0.404302325306 Diltiazem TZ Pro Doc 100 40.43 0.404302271605 Novo-Diltiazem HCl ER Novopharm 100 40.43 0.404302245918 Sandoz Diltiazem T Sandoz 100

50040.43

202.150.40430.4043

02231150 Tiazac Biovail 100 83.49 0.8349

L.A. Caps. 180 mg PPB


50053.66

268.310.53660.5366

02231151 Tiazac Biovail 100 112.48 1.1248



50071.18

355.880.71180.7118

02231152 Tiazac Biovail 100 149.20 1.4920



50088.97

444.850.88970.8897

02231154 Tiazac Biovail 100 183.75 1.8375


2010-06 Page 105



500107.32536.60

1.07321.0732

02231155 Tiazac Biovail 100 224.97 2.2497

L.A. Caps. (24 h) 120 mg PPB

02230997 Apo-Diltiaz CD Apotex 100500

63.65318.25

0.63650.6365

02097249 Cardizem CD Biovail 100 128.16 1.281602231472 Diltiazem-CD Pro Doc 100

50063.65

318.250.63650.6365

02242538 Novo-Diltiazem CD Novopharm 100500

63.65318.25

0.63650.6365

02231052 Nu-Diltiaz-CD Nu-Pharm 100 63.65 0.636502229781 ratio-Diltiazem CD Ratiopharm 100

50063.65

318.250.63650.6365

02243338 Sandoz Diltiazem CD Sandoz 100500

63.65318.25

0.63650.6365



84.49422.45

0.84490.8449


50084.49

422.450.84490.8449


84.49422.45

0.84490.8449


50084.49

422.450.84490.8449


84.49422.45

0.84490.8449



112.07560.35

1.12071.1207


500112.07560.35

1.12071.1207


112.07560.35

1.12071.1207


500112.07560.35

1.12071.1207


112.07560.35

1.12071.1207


Page 106 2010-06



140.09700.45

1.40091.4009

02097273 Cardizem CD Biovail 100 282.07 2.820702231057 Diltiazem-CD Pro Doc 100 140.09 1.400902242541 Novo-Diltiazem CD Novopharm 100

500140.09700.45

1.40091.4009

02229784 ratio-Diltiazem CD Ratiopharm 100500

140.10700.50

1.40101.4010

02243341 Sandoz Diltiazem CD Sandoz 100 140.09 1.4009

L.A. Tab. 120 mg

02256738 Tiazac XC Biovail 90 70.76 0.7862

L.A. Tab. 180 mg


L.A. Tab. 240 mg


L.A. Tab. 300 mg


L.A. Tab. 360 mg


Tab. 30 mg PPB

00771376 Apo-Diltiaz Apotex 100500

18.6693.30

0.18660.1866

02097370 Cardizem Biovail 100 38.20 0.382000828785 Diltiazem-30 Pro Doc 100

50018.6693.30

0.18660.1866

00862924 Novo-Diltazem Novopharm 100 18.66 0.1866

Tab. 60 mg PPB

00771384 Apo-Diltiaz Apotex 100 32.73 0.327300828777 Diltiazem-60 Pro Doc 100

50032.73

163.650.32730.3273

00862932 Novo-Diltazem Novopharm 100 32.73 0.3273


2010-06 Page 107

VERAPAMIL HYDROCHLORIDE XXL.A. Tab. 120 mg PPB

02246893 Apo-Verap SR Apotex 100 50.78 0.507801907123 Isoptin SR Abbott 100 97.90 0.979002210347 Mylan-Verapamil SR Mylan 100 50.78 0.507802324156 Pro-Verapamil SR Pro Doc 100 50.78 0.5078

L.A. Tab. 180 mg PPB

02246894 Apo-Verap SR Apotex 100 52.04 0.520401934317 Isoptin SR Abbott 100 110.56 1.105602210355 Mylan-Verapamil SR Mylan 100 52.04 0.520402324164 Pro-Verapamil SR Pro Doc 100 52.04 0.5204


02246895 Apo-Verap SR Apotex 100500

69.40347.00

0.69400.6940

00742554 Isoptin SR Abbott 100 147.41 1.474102210363 Mylan-Verapamil SR Mylan 100

50069.40

347.000.69400.6940

02211920 Novo-Veramil SR Novopharm 100500

69.40347.00

0.69400.6940

02238276 phl-Verapamil SR Pharmel 100 69.40 0.694002237791 pms-Verapamil SR Phmscience 100

50069.40

347.000.69400.6940

02312697 Pro-Verapamil SR Pro Doc 100500

69.40347.00

0.69400.6940

02248082 Riva-Verapamil SR Riva 100 69.40 0.694002303558 Zym-Verapamil SR Zymcan 100 69.40 0.6940

Tab. 80 mg PPB

00782483 Apo-Verap Apotex 100500

27.35136.74

0.27350.2735

00554316 Isoptin Abbott 250 68.37 0.273502237921 Mylan-Verapamil Mylan 100 27.35 0.273500871028 Verapamil-80 Pro Doc 100 27.35 0.2735

Tab. 120 mg PPB

00782491 Apo-Verap Apotex 100 42.50 0.425000554324 Isoptin Abbott 250 106.25 0.425002237922 Mylan-Verapamil Mylan 100 42.50 0.4250

24:32.04ANGIOTENSIN-CONVERTING ENZYME INHIBITORS (ACEI)BENAZEPRIL XTab. 5 mg PPB

02290332 Apo-Benazepril Apotex 100 44.98 0.366500885835 Lotensin Novartis 28 17.10 0.6107


Page 108 2010-06

Tab. 10 mg PPB


Tab. 20 mg PPB


CAPTOPRIL XTab. 6.25 mg

01999559 Apo-Capto Apotex 100 12.37 0.1237

Tab. 12.5 mg PPB

00893595 Apo-Capto Apotex 100500

21.20106.00

0.21200.2120

02238555 Captopril Pharmel 500 106.00 0.212002163551 Mylan-Captopril Mylan 100

50021.20

106.000.21200.2120

01942964 Novo-Captoril Novopharm 100 21.20 0.212001913824 Nu-Capto Nu-Pharm 100

50021.20

106.000.21200.2120

02230203 pms-Captopril Phmscience 100500

21.20106.00

0.21200.2120

Tab. 25 mg PPB

00893609 Apo-Capto Apotex 100 30.00 0.300000546283 Capoten B.M.S. 100 30.00 0.300002238556 Captopril Pharmel 1000 300.00 0.300001910337 Captopril-25 Pro Doc 100

50030.00

150.000.30000.3000

02163578 Mylan-Captopril Mylan 1001000

30.00300.00

0.30000.3000

01942972 Novo-Captoril Novopharm 1001000

30.00300.00

0.30000.3000

01913832 Nu-Capto Nu-Pharm 1001000

30.00300.00

0.30000.3000


30.00300.00

0.30000.3000


2010-06 Page 109

Tab. 50 mg PPB

00893617 Apo-Capto Apotex 100500

55.90279.50

0.55900.5590

00546291 Capoten B.M.S. 100 55.90 0.559002238557 Captopril Pharmel 500 279.50 0.559002163586 Mylan-Captopril Mylan 100

50055.90

279.500.55900.5590

01942980 Novo-Captoril Novopharm 100500

55.90279.50

0.55900.5590

01913840 Nu-Capto Nu-Pharm 100500

55.90279.50

0.55900.5590


55.90279.50

0.55900.5590

Tab. 100 mg PPB

00893625 Apo-Capto Apotex 100 103.95 1.039502238558 Captopril Pharmel 100 103.95 1.039502163594 Mylan-Captopril Mylan 100 103.95 1.039501942999 Novo-Captoril Novopharm 100 103.95 1.039501913859 Nu-Capto Nu-Pharm 100 103.95 1.039502230206 pms-Captopril Phmscience 100 103.95 1.0395

CILAZAPRIL XXTab. 1 mg PPB

02291134 Apo-Cilazapril Apotex 100 29.50 0.295001911465 Inhibace Roche 100 62.29 0.622902283778 Mylan-Cilazapril Mylan 100 29.50 0.295002266350 Novo-Cilazapril Novopharm 100 29.50 0.295002309378 phl-Cilazapril Pharmel 100 29.50 0.295002280442 pms-Cilazapril Phmscience 100 29.50 0.2950

Tab. 2.5 mg PPB

02291142 Apo-Cilazapril Apotex 100 34.00 0.340002285215 Co Cilazapril Cobalt 100 34.00 0.340001911473 Inhibace Roche 100 71.79 0.717902283786 Mylan-Cilazapril Mylan 100 34.00 0.340002266369 Novo-Cilazapril Novopharm 100

50034.00

170.000.34000.3400

02309386 phl-Cilazapril Pharmel 100 34.00 0.340002280450 pms-Cilazapril Phmscience 100 34.00 0.3400


Page 110 2010-06

Tab. 5 mg PPB

02291150 Apo-Cilazapril Apotex 100 39.50 0.395002285223 Co Cilazapril Cobalt 100 39.50 0.395001911481 Inhibace Roche 100 83.41 0.834102283794 Mylan-Cilazapril Mylan 100 39.50 0.395002266377 Novo-Cilazapril Novopharm 100

50039.50

197.500.39500.3950

02309394 phl-Cilazapril Pharmel 100500

39.50197.50

0.39500.3950

02280469 pms-Cilazapril Phmscience 100500

39.50197.50

0.39500.3950

CILAZAPRIL/ HYDROCHLOROTHIAZIDE XXTab. 5 mg -12.5 mg PPB

02284987 Apo-Cilazapril - HCTZ Apotex 100 41.70 0.417002181479 Inhibace Plus Roche 28 23.35 0.833902313731 Novo-Cilazapril/HCTZ Novopharm 100 41.70 0.4170

ENALAPRIL MALEATE XTab. 2.5 mg PPB

02020025 Apo-Enalapril Apotex 100 36.17 0.361702291878 Co Enalapril Cobalt 100

50036.17

180.830.36170.3617

02300036 Mylan-Enalapril Mylan 30500

10.85180.83

0.36170.3617

02300680 Novo-Enalapril Novopharm 30100

10.8536.17

0.36170.3617

02300079 pms-Enalapril Phmscience 30500

10.85180.83

0.36170.3617

02311402 Pro-Enalapril-2.5 Pro Doc 100 36.17 0.361702299984 ratio-Enalapril Ratiopharm 100

50036.17

180.830.36170.3617

02300796 Riva-Enalapril Riva 100500

36.17180.83

0.36170.3617

02299933 Sandoz Enalapril Sandoz 30500

10.85180.83

0.36170.3617

02300117 Taro-Enalapril Taro 100500

36.17180.83

0.36170.3617

00851795 Vasotec Merck 28100

10.1336.17

0.36180.3617


2010-06 Page 111

Tab. 5 mg PPB

02019884 Apo-Enalapril Apotex 100500

42.79213.93

0.42790.4279

02291886 Co Enalapril Cobalt 30500

12.84213.93

0.42790.4279


12.84213.93

0.42790.4279


12.84213.93

0.42790.4279


12.84213.93

0.42790.4279

02311410 Pro-Enalapril-5 Pro Doc 100500

42.79213.93

0.42790.4279

02299992 ratio-Enalapril Ratiopharm 100500

42.79213.93

0.42790.4279


12.84213.93

0.42790.4279


12.84213.93

0.42790.4279


42.79213.93

0.42790.4279


11.98213.95

0.42790.4279

Tab. 10 mg PPB


51.40257.08

0.51400.5142


15.42257.08

0.51400.5142


15.42257.08

0.51400.5142


15.42257.08

0.51400.5142


15.42257.08

0.51400.5142


51.40257.08

0.51400.5142


51.40257.08

0.51400.5142


15.42257.08

0.51400.5142


15.42257.08

0.51400.5142


51.40257.08

0.51400.5142


14.40257.10

0.51430.5142


Page 112 2010-06

Tab. 20 mg PPB


62.03310.18

0.62030.6204


62.03310.18

0.62030.6204


18.61310.18

0.62030.6204


18.61310.18

0.62030.6204


18.61310.18

0.62030.6204


62.03310.18

0.62030.6204


62.03310.18

0.62030.6204


18.61310.18

0.62030.6204


18.61310.18

0.62030.6204


62.03310.18

0.62030.6204

00670928 Vasotec Merck 28 17.37 0.6204

ENALAPRIL MALEATE/ HYDROCHLOROTHIAZIDE XXTab. 5 mg -12.5 mg

02300222 Novo-Enalapril/HCTZ Novopharm 30 14.78 0.4927


02300230 Novo-Enalapril/HCTZ Novopharm 30100

17.7659.20

0.59200.5920

00657298 Vaseretic Merck 28 28.41 1.0146


2010-06 Page 113

LISINOPRIL XXTab. 5 mg PPB

02217481 Apo-Lisinopril Apotex 100500

26.93134.65

0.26930.2693

02271443 Co Lisinopril Cobalt 100500

26.93134.65

0.26930.2693

02317397 Mint-Lisinopril Mint 100500

26.93134.65

0.26930.2693

02274833 Mylan-Lisinopril Mylan 100500

26.93134.65

0.26930.2693

02285061 Novo-Lisinopril (Type P) Novopharm 30100

8.0826.93

0.26930.2693

02285118 Novo-Lisinopril (Type Z) Novopharm 30100

8.0826.93

0.26930.2693

02294583 phl-Lisinopril Pharmel 100500

26.93134.65

0.26930.2693

02292203 pms-Lisinopril Phmscience 30500

8.08134.65

0.26930.2693

00839388 Prinivil Merck 28100

15.6355.82

0.55820.5582

02310961 Pro-Lisinopril-5 Pro Doc 100500

26.93134.65

0.26930.2693

02294230 Ran-Lisinopril Ranbaxy 100500

26.93134.65

0.26930.2693

02256797 ratio-Lisinopril P Ratiopharm 100500

26.93134.65

0.26930.2693

02299879 ratio-Lisinopril Z Ratiopharm 100500

26.93134.65

0.26930.2693

02300958 Riva-Lisinopril Riva 100500

26.93134.65

0.26930.2693

02289199 Sandoz Lisinopril Sandoz 30500

8.08134.65

0.26930.2693

02049333 Zestril AZC 100 53.88 0.538802321580 Zym-Lisinopril Zymcan 100 26.93 0.2693


Page 114 2010-06

Tab. 10 mg PPB


32.37161.85

0.32370.3237


32.37161.85

0.32370.3237


32.37161.85

0.32370.3237


32.37161.85

0.32370.3237


9.7132.37

0.32370.3237


9.7132.37

0.32370.3237


32.37161.85

0.32370.3237


9.71161.85

0.32370.3237

00839396 Prinivil Merck 28 18.77 0.670402310988 Pro-Lisinopril-10 Pro Doc 100

50032.37

161.850.32370.3237


32.37161.85

0.32370.3237


32.37161.85

0.32370.3237


32.37161.85

0.32370.3237


32.37161.85

0.32370.3237


9.71161.85

0.32370.3237



2010-06 Page 115

Tab. 20 mg PPB


38.90194.50

0.38900.3890


38.90194.50

0.38900.3890


38.90194.50

0.38900.3890


38.90194.50

0.38900.3890


11.67194.50

0.38900.3890


11.67194.50

0.38900.3890


38.90194.50

0.38900.3890


11.67194.50

0.38900.3890

00839418 Prinivil Merck 28100

22.5680.59

0.80570.8059

02310996 Pro-Lisinopril-20 Pro Doc 100500

38.90194.50

0.38900.3890


38.90194.50

0.38900.3890


38.90194.50

0.38900.3890


38.90194.50

0.38900.3890


38.90194.50

0.38900.3890


11.67194.50

0.38900.3890


LISINOPRIL HYDROCHLOROTHIAZIDE XXTab. 10 mg -12.5 mg PPB

02261979 Apo-Lisinopril/HCTZ Apotex 100 33.34 0.333402297736 Mylan-Lisinopril HCTZ Mylan 30

10010.0033.34

0.33330.3334

02302136 Novo-Lisinopril/HCTZ (TypeP)

Novopharm 30100

10.0033.34

0.33330.3334

02301768 Novo-Lisinopril/HCTZ (TypeZ)

Novopharm 30100

10.0033.34

0.33330.3334

02108194 Prinzide Merck 100 68.43 0.684302302365 Sandoz Lisinopril HCT Sandoz 30

10010.0033.34

0.33330.3334

02103729 Zestoretic AZC 100 83.35 0.8335


Page 116 2010-06

Tab. 20 mg -12.5 mg PPB


10012.0240.06

0.40070.4006


Novopharm 100 40.06 0.4006


Novopharm 30100

12.0240.06

0.40070.4006

00884413 Prinzide Merck 100 82.23 0.822302302373 Sandoz Lisinopril HCT Sandoz 30

10012.0240.06

0.40070.4006

02045737 Zestoretic AZC 100 100.16 1.0016



10012.8642.86

0.42870.4286


Novopharm 100 42.86 0.4286


Novopharm 30100

12.8642.86

0.42870.4286

02302381 Sandoz Lisinopril HCT Sandoz 30100

12.8642.86

0.42870.4286

02045729 Zestoretic AZC 100 100.16 1.0016

PERINDOPRIL ERBUMIN XXTab. 2 mg

02123274 Coversyl Servier 30 18.05 0.6017

Tab. 4 mg


Tab. 8 mg


PERINDOPRIL ERBUMIN/INDAPAMIDE XTab. 4 mg -1.25 mg

02246569 Coversyl Plus Servier 30 28.20 0.9400

Tab. 8 mg - 2.5 mg

02321653 Coversyl Plus HD Servier 30 32.76 1.0920

QUINAPRIL HYDROCHLORIDE XTab. 5 mg

01947664 Accupril Pfizer 90 76.89 0.8543


2010-06 Page 117

Tab. 10 mg

01947672 Accupril Pfizer 90 76.89 0.8543

Tab. 20 mg

01947680 Accupril Pfizer 90 76.89 0.8543

Tab. 40 mg

01947699 Accupril Pfizer 90 76.89 0.8543

QUINAPRIL HYDROCHLORIDE / HYDROCHLOROTHIAZIDE XXTab. 10 mg -12.5 mg

02237367 Accuretic Pfizer 28 23.92 0.8543

Tab. 20 mg -12.5 mg


Tab. 20 mg -25 mg


RAMIPRIL XCaps. 1.25 mg PPB

02221829 Altace SanofiAven 30100

20.5468.46

0.68470.6846

02251515 Apo-Ramipril Apotex 30100

9.7532.50

0.32500.3250

02295482 Co Ramipril Cobalt 100 32.50 0.325002331101 Jamp-Ramipril Jamp 100 32.50 0.325002301148 Mylan-Ramipril Mylan 30

1009.75

32.500.32500.3250

02295369 pms-Ramipril Phmscience 30100

9.7532.50

0.32500.3250

02299372 Ramipril Riva 30100

9.7532.50

0.32500.3250

02310503 Ran-Ramipril Ranbaxy 100500

32.50162.50

0.32500.3250

02287692 ratio-Ramipril Ratiopharm 30100

9.7532.50

0.32500.3250


Page 118 2010-06

Caps. 2.5 mg PPB


23.7079.00

0.79000.7900


11.25187.50

0.37500.3750

02295490 Co Ramipril Cobalt 30500

11.25187.50

0.37500.3750

02331128 Jamp-Ramipril Jamp 100 37.50 0.375002301156 Mylan-Ramipril Mylan 30

50011.25

187.500.37500.3750

02247945 Novo-Ramipril Novopharm 30500

11.25187.50

0.37500.3750


11.25187.50

0.37500.3750


11.25187.50

0.37500.3750


37.50187.50

0.37500.3750


11.25187.50

0.37500.3750

Caps. 5 mg PPB


23.7079.00

0.79000.7900


11.25187.50

0.37500.3750


11.25187.50

0.37500.3750


50011.25

187.500.37500.3750


11.25187.50

0.37500.3750


11.25187.50

0.37500.3750


11.25187.50

0.37500.3750


37.50187.50

0.37500.3750


11.25187.50

0.37500.3750


2010-06 Page 119

Caps. 10 mg PPB


30.02100.06

1.00071.0006


14.25237.50

0.47500.4750


14.25237.50

0.47500.4750


50014.25

237.500.47500.4750


14.25237.50

0.47500.4750


14.25237.50

0.47500.4750


14.25237.50

0.47500.4750


47.50237.50

0.47500.4750


14.25237.50

0.47500.4750

Caps. 15 mg PPB


32.53108.43

1.08431.0843


17.5758.55

0.58570.5855


17.5758.55

0.58570.5855

RAMIPRIL/ HYDROCHLOROTHIAZIDE XXTab. 2.5 mg - 12.5 mg

02283131 Altace HCT SanofiAven 28 10.50 0.3750

Tab. 5 mg -12.5 mg


Tab. 5 mg - 25 mg


Tab. 10 mg -12.5 mg


Tab. 10 mg -25 mg



Page 120 2010-06

SODIUM FOSINOPRIL XXTab. 10 mg PPB

02266008 Apo-Fosinopril Apotex 100 39.50 0.395002303000 Fosinopril-10 Pro Doc 100 39.50 0.395002331004 Jamp-Fosinopril Jamp 100 39.50 0.395001907107 Monopril B.M.S. 30 11.85 0.395002262401 Mylan-Fosinopril Mylan 100 39.50 0.395002247802 Novo-Fosinopril Novopharm 30

10011.8539.50

0.39500.3950

02294524 Ran-Fosinopril Ranbaxy 100 39.50 0.395002265923 Riva-Fosinopril Riva 100 39.50 0.3950

Tab. 20 mg PPB

02266016 Apo-Fosinopril Apotex 100 47.50 0.475002303019 Fosinopril-20 Pro Doc 100 47.50 0.475002331012 Jamp-Fosinopril Jamp 100 47.50 0.475001907115 Monopril B.M.S. 30 14.25 0.475002262428 Mylan-Fosinopril Mylan 100 47.50 0.475002247803 Novo-Fosinopril Novopharm 30

10014.2547.50

0.47500.4750

02294532 Ran-Fosinopril Ranbaxy 100 47.50 0.475002265931 Riva-Fosinopril Riva 100 47.50 0.4750

TRANDOLAPRIL XCaps. 0.5 mg

02231457 Mavik Abbott 100 40.30 0.4030

Caps. 1 mg

02231459 Mavik Abbott 100 67.00 0.6700

Caps. 2 mg

02231460 Mavik Abbott 100 77.00 0.7700

Caps. 4 mg

02239267 Mavik Abbott 100 95.00 0.9500

24:32.08ANGIOTENSIN II RECEPTOR ANTAGONISTSCANDESARTAN CILEXETIL XTab. 8 mg

02239091 Atacand AZC 30 34.20 1.1400

Tab. 16 mg

02239092 Atacand AZC 30 34.20 1.1400


2010-06 Page 121

Tab. 32 mg

02311658 Atacand AZC 30 34.20 1.1400

CANDESARTAN CILEXETIL/ HYDROCHLOROTHIAZIDE XXTab. 16 mg -12.5 mg

02244021 Atacand Plus AZC 30 34.20 1.1400

Tab. 32 mg - 12.5 mg

02332922 Atacand Plus AZC 30 34.20 1.1400

Tab. 32 mg - 25 mg

02332957 Atacand Plus AZC 30 34.20 1.1400

EPROSARTAN (MESYLATE D')/ HYDROCHLOROTHIAZIDE XTab. 600 mg - 12.5 mg

02253631 Teveten Plus Solvay 28 29.43 1.0511

EPROSARTAN MESYLATE XTab. 400 mg

02240432 Teveten Solvay 28 19.61 0.7004

Tab. 600 mg

02243942 Teveten Solvay 28 29.43 1.0511

IRBESARTAN XTab. 75 mg

02237923 Avapro SanofiAven 90 102.74 1.1416

Tab. 150 mg


Tab. 300 mg


IRBESARTAN/ HYDROCHLOROTHIAZIDE XTab. 150 mg- 12.5 mg

02241818 Avalide SanofiAven 90 102.74 1.1416


Page 122 2010-06

Tab. 300 mg- 12.5 mg


Tab. 300 mg - 25 mg


LOSARTAN POTASSIUM XXTab. 25 mg

02182815 Cozaar Merck 100 116.29 1.1629

Tab. 50 mg

02182874 Cozaar Merck 30100

34.88116.29

1.16271.1629

Tab. 100 mg

02182882 Cozaar Merck 30100

34.88116.29

1.16271.1629

LOSARTAN POTASSIUM/ HYDROCHLOROTHIAZIDE XTab. 50 mg -12.5 mg

02230047 Hyzaar Merck 30100

34.88116.29

1.16271.1629

Tab. 100 mg - 12.5 mg

02297841 Hyzaar Merck 30100

34.47114.90

1.14901.1490

Tab. 100 mg -25 mg

02241007 Hyzaar DS Merck 30100

34.88116.29

1.16271.1629

OLMESARTAN MEDOXOMIL XTab. 20 mg

02318660 Olmetec Schering 28 27.72 0.9900

Tab. 40 mg

02318679 Olmetec Schering 28 27.72 0.9900


2010-06 Page 123

OLMESARTAN MEDOXOMIL/HYDROCHLOROTHIAZIDE XXTab. 20 mg -12.5 mg

02319616 Olmetec Plus Schering 28 27.72 0.9900

Tab. 40 mg - 12.5 mg


Tab. 40 mg - 25 mg


TELMISARTAN XTab. 40 mg

02240769 Micardis Bo. Ing. 28 31.63 1.1296

Tab. 80 mg

02240770 Micardis Bo. Ing. 28 31.63 1.1296

TELMISARTAN/ HYDROCHLOROTHIAZIDE XTab. 80 mg - 12.5 mg

02244344 Micardis Plus Bo. Ing. 28 31.63 1.1296

Tab. 80 mg - 25 mg

02318709 Micardis Plus Bo. Ing. 28 31.63 1.1296

VALSARTAN XTab. 40 mg

02270528 Diovan Novartis 28 30.46 1.0879

Tab. 80 mg

02244781 Diovan Novartis 28 31.08 1.1100

Tab. 160 mg

02244782 Diovan Novartis 28 31.08 1.1100

Tab. 320 mg

02289504 Diovan Novartis 28 31.08 1.1100


Page 124 2010-06

VALSARTAN/HYDROCHLOROTHIAZIDE XXTab. 80 mg - 12.5 mg

02241900 Diovan-HCT Novartis 28 31.08 1.1100

Tab. 160 mg -12.5 mg


Tab. 160 mg - 25 mg


Tab. 320 mg - 12.5 mg


Tab. 320 mg - 25 mg


24:32.20ALDOSTERONE RECEPTOR ANTAGONISTSSPIRONOLACTONE XTab. 25 mg PPB

00028606 Aldactone Pfizer 100 7.19 0.071900613215 Novo-Spiroton Novopharm 500 34.60 0.0418

Tab. 100 mg PPB

00285455 Aldactone Pfizer 100 22.06 0.220600613223 Novo-Spiroton Novopharm 100 21.20 0.1282


2010-06 Page 125

28:00CENTRAL NERVOUS SYSTEM AGENTS

28:08 analgesics and antipyretics28:08.04 nonsteroidal anti- inflammatory agents28:08.08 opiate agonists28:08.12 opiate partial agonists28:08.92 miscellaneous analgesics and

antipyretics28:10 opiate antagonists28:12 anticonvulsants28:12.04 barbiturates28:12.08 benzodiazepines28:12.12 hydantoins28:12.20 succinimides28:12.92 miscellaneous anticonvulsants28:16 psychotropics28:16.04 antidepressants28:16.08 antipsychotic agents28:20 cns stimulants28:20.04 amphetamines28:20.92 cns stimulants, miscellaneous28:24 anxiolytics, sedatives and hypnotics28:24.08 benzodiazepines28:24.92 miscellaneous anxiolytics, sedatives,

hypnotics28:28 antimanic agents28:32 antimigraine agents28:32.28 selective serotonin agonists28:32.92 antimigraine agents, miscellaneous28:36 Antiparkinsonian Agents28:36.04 Adamantanes28:36.08 Anticholinergic Agents28:36.12 Catechol-O-Methyltransferase Inhibitors28:36.16 Dopamine Precursors28:36.20 Dopamine Receptor Agonists28:36.32 Monoamine Oxydase B Inhibitors28:36.92 Antiparkinsonian Agents, Miscellaneous28:92 miscellaneous Central Nervous System

Agents

28:08.04NONSTEROIDAL ANTI- INFLAMMATORY AGENTSACETYLSALICYLIC ACID

Ent. Tab. 325 mg PPB

02010526 Jamp-AAS EC Jamp 500 14.00 0.028002284529 pms-ASA EC Phmscience 1000 28.00 0.0280

Ent. Tab. 650 mg

00794244 Enteric coated ASA Jamp 500 27.50 0.0550

Supp. 640 mg to 650 mg

00582867 pms-ASA Phmscience 10 11.00 1.1000

Tab or EntTab or ChewTab 80 mg or 81 mg PPB

02009013 Asaphen Phmscience 100500

5.6028.00

0.05600.0560

02238545 Asaphen E.C. Phmscience 5001000

28.0056.00

0.05600.0560

02280167 Asatab Odan 500 28.00 0.056002150352 Aspirin (Chew Tab) Bayer 300 16.80 0.056002237726 Aspirin (Co. Ent.) Bayer 400 22.40 0.056002250675 Euro-ASA Euro-Pharm 500 28.00 0.056002269139 Jamp-A.A.S. (Chew. Tab.) Jamp 500 28.00 0.056002283905 Jamp-A.A.S. (Ent. Tab.) Jamp 1000 56.00 0.056002296004 Lowprin (chew. tab.) Euro-Pharm 30

6001.68

33.600.05600.0560

02295563 Lowprin (tab.) Euro-Pharm 30600

1.6833.60

0.05600.0560

02247318 phl-Asa Pharmel 100500

5.6028.00

0.05600.0560

02247355 phl-Asa E.C. Pharmel 120500

6.7228.00

0.05600.0560

02311496 Pro-AAS EC-80 Pro Doc 5001000

28.0056.00

0.05600.0560

02311518 Pro-AAS-80 (chewable) Pro Doc 100500

5.6028.00

0.05600.0560

02202352 Rivasa (Co. Croq.) Riva 100500

5.6028.00

0.05600.0560

02202360 Rivasa FC (Co.) Riva 1001000

5.6056.00

0.05600.0560

02321750 Zym-ASA 80 Zymcan 100 5.60 0.056002321769 Zym-ASA EC 80 Zymcan 500 28.00 0.0560

CELECOXIB XXCaps. 100 mg

02239941 Celebrex Pfizer 100500

65.00325.00

0.65000.6500


2010-06 Page 129

Caps. 200 mg

02239942 Celebrex Pfizer 100500

130.00650.00

1.30001.3000

DICLOFENAC POTASSIUM OR SODIUM XXTab - Ent.Tab or LA Tab 50 mg /100 mg L.A. PPB

00839183 Apo-Diclo 50 mg Apotex 100500

31.25156.25

0.31250.3125

02243433 Apo-Diclo Rapide 50 mg Apotex 100 31.25 0.312502091194 Apo-Diclo S.R. 100 mg Apotex 100

25062.50

156.25 W W

00870978 Diclofenac-50 Pro Doc 100 31.25 0.312502224127 Diclofenac-SR 100 mg Pro Doc 100 62.50 0.625000808547 Novo-Difenac 50 mg Novopharm 100

50031.25

156.250.31250.3125

02048698 Novo-Difenac SR 100 mg Novopharm 100 62.50 0.625002239355 Novo-Difenac-K 50 mg Novopharm 100

50031.25

156.250.31250.3125

02302624 pms-Diclofenac 50 mg Phmscience 100500

31.25156.25

0.31250.3125

02239753 pms-Diclofenac-K 50 mg Phmscience 100500

31.25156.25

0.31250.3125

02231505 pms-Diclofenac-SR 100 mg Phmscience 100250

62.50156.25

0.62500.6250

02311461 Pro-Diclo Fast-50 Pro Doc 100 31.25 0.312502261960 Sandoz Diclofenac 50 mg Sandoz 100 31.25 0.312502261774 Sandoz Diclofenac Rapide

50 mgSandoz 100 31.25 0.3125

02261944 Sandoz Diclofenac SR 100mg

Sandoz 100 62.50 0.6250

00514012 Voltaren 50 mg Novartis 100 70.03 0.700300881635 Voltaren Rapide 50 mg Novartis 100 65.85 0.658500590827 Voltaren S.R. 100 mg Novartis 100 139.62 1.3962

DICLOFENAC SODIC/MISOPROSTOL XTab. 50 mg -200 mcg

01917056 Arthrotec Pfizer 250 144.04 0.5762

Tab. 75 mg - 200 mcg

02229837 Arthrotec 75 Pfizer 250 196.04 0.7842


Page 130 2010-06

DICLOFENAC SODIUM XXEnt.Tab.or L.A.Tab 25 mg / 75 mg L.A. PPB

00839175 Apo-Diclo 25 mg Apotex 100500

15.6378.15

0.15630.1563

02162814 Apo-Diclo S.R. 75 mg Apotex 100500

46.89234.45

W W

02224119 Diclofenac-SR 75 mg Pro Doc 100500

46.89234.45

0.46890.4689

00808539 Novo-Difenac 25 mg Novopharm 100 15.63 0.156302158582 Novo-Difenac SR 75 mg Novopharm 100 46.89 0.468902302616 pms-Diclofenac 25 mg Phmscience 100

50015.6378.15

0.15630.1563

02231504 pms-Diclofenac- SR 75 mg Phmscience 100500

46.89234.45

0.46890.4689

02261952 Sandoz Diclofenac Sandoz 100 15.63 0.156302261901 Sandoz Diclofenac SR 75 mg Sandoz 100 46.89 0.468900782459 Voltaren S.R. 75 mg Novartis 100 97.95 0.9795

Supp. 50 mg PPB

02231506 pms-Diclofenac Phmscience 30 14.85 0.495002261928 Sandoz Diclofenac Sandoz 30 14.85 0.495000632724 Voltaren Novartis 30 31.54 1.0513

Supp. 100 mg PPB

02231508 pms-Diclofenac Phmscience 30 20.00 0.666702261936 Sandoz Diclofenac Sandoz 30 20.00 0.666700632732 Voltaren Novartis 30 42.46 1.4153

DIFLUNISAL XTab. 250 mg PPB

02039486 Apo-Diflunisal Apotex 100 28.23 0.282302048493 Novo-Diflunisal Novopharm 60 16.94 0.282302058405 Nu-Diflunisal Nu-Pharm 100 28.23 0.2823

Tab. 500 mg PPB

02039494 Apo-Diflunisal Apotex 100 53.63 0.536302058413 Nu-Diflunisal Nu-Pharm 100

50053.63

268.150.53630.5363

ETODOLAC XCaps. 200 mg

02232317 Apo-Etodolac Apotex 100 76.00 0.6213

Caps. 300 mg

02232318 Apo-Etodolac Apotex 100 76.00 0.6213


2010-06 Page 131

FLURBIPROFEN XXL.A. Caps or Tab. 100 mg / 200 mg L.A. PPB

00600792 Ansaid Pfizer 100 63.24 0.632401912038 Apo-Flurbiprofen Apotex 100 30.39 0.303902223074 Froben Abbott 100 40.90 0.409002100517 Novo-Flurprofen Novopharm 100 30.39 0.303902020688 Nu-Flurbiprofen Nu-Pharm 100 30.39 0.3039

Tab. 50 mg PPB

00647942 Ansaid Pfizer 100 48.30 0.483001912046 Apo-Flurbiprofen Apotex 100 22.21 0.222102100509 Novo-Flurprofen Novopharm 100 22.21 0.222102020661 Nu-Flurbiprofen Nu-Pharm 100 22.21 0.2221

IBUPROFENTab. 200 mg

02272849 Jamp-Ibuprofene Jamp 100 5.20 0.0520

Tab. 300 mg

00441651 Apo-Ibuprofen Apotex 100 6.90 0.0690

Tab. 400 mg PPB

00506052 Apo-Ibuprofen Apotex 1001000

3.7237.20

0.03720.0372

00636533 Ibuprofen-400 Pro Doc 1001000

3.7237.20

0.03720.0372

02317338 Ibuprofene Jamp 1000 37.20 0.037200629340 Novo-Profen Novopharm 1000 37.20 0.037200836133 pms-Ibuprofen Phmscience 100

5003.72

18.600.03720.0372

IBUPROFEN XTab. 600 mg PPB

00585114 Apo-Ibuprofen Apotex 100500

4.6523.25

0.04650.0465

00658804 Ibuprofen-600 Pro Doc 100500

4.6523.25

0.04650.0465

00629359 Novo-Profen Novopharm 100500

4.6523.25

0.04650.0465

02020726 Nu-Ibuprofen Nu-Pharm 100 13.13 0.046900839264 pms-Ibuprofen Phmscience 100

5004.65

23.250.04650.0465


Page 132 2010-06

INDOMETHACIN XXCaps. 25 mg PPB

00611158 Apo-Indomethacin 25 mg Apotex 1001000

8.7187.10

0.08710.0871

00337420 Novo-Methacin 25 mg Novopharm 1001000

8.7187.10

0.08710.0871

00865850 Nu-Indo 25 mg Nu-Pharm 1001000

8.7187.10

0.08710.0871

00646261 Pro-Indo-25 Pro Doc 100 8.71 0.0871

Caps. 50 mg PPB

00611166 Apo-Indomethacin Apotex 100500

15.1175.55

0.15110.1511

00337439 Novo-Methacin Novopharm 100500

15.1175.55

0.15110.1511

00865869 Nu-Indo Nu-Pharm 100500

15.1175.55

0.15110.1511

00646288 Pro-Indo-50 Pro Doc 100 15.11 0.1511

Supp. 50 mg

02231799 Sandoz Indomethacine Sandoz 30 24.60 0.8200

Supp. 100 mg PPB

01934139 ratio-Indomethacin Ratiopharm 30 26.73 0.891002231800 Sandoz Indomethacine Sandoz 30 26.73 0.8910

KETOPROFEN XCaps. 50 mg

00790427 Apo-Keto 50 mg Apotex 100 33.73 0.1721

Ent. Tab. 100 mg

00842664 Apo-Keto-E 100 mg Apotex 100500

68.23341.15

0.31870.3187

L.A. Tab. 200 mg

02172577 Apo-Ketoprofen SR 200mg Apotex 100 138.90 0.6374

Supp. 50 mg

02148773 pms-Ketoprofen Phmscience 30 23.60 0.7867

Supp. 100 mg

02015951 pms-Ketoprofen Phmscience 30 29.79 0.9930


2010-06 Page 133

MELOXICAM XXTab. 7.5 mg

02248973 Apo-Meloxicam Apotex 100500

39.00195.00

0.39000.3900

02250012 Co Meloxicam Cobalt 30100

11.7039.00

0.39000.3900

02324326 Meloxicam Pro Doc 100 39.00 0.390002242785 Mobicox Bo. Ing. 100 80.11 0.801102255987 Mylan-Meloxicam Mylan 100 39.00 0.390002258315 Novo-Meloxicam Novopharm 30

10011.7039.00

0.39000.3900

02248607 phl-Meloxicam Pharmel 30500

11.70195.00

0.39000.3900

02248267 pms-Meloxicam Phmscience 30500

11.70195.00

0.39000.3900

02247889 ratio-Meloxicam Ratiopharm 100500

39.00195.00

0.39000.3900

Tab. 15 mg

02248974 Apo-Meloxicam Apotex 100 45.00 0.450002250020 Co Meloxicam Cobalt 30

10013.5045.00

0.45000.4500

02324334 Meloxicam Pro Doc 100 45.00 0.450002242786 Mobicox Bo. Ing. 100 92.43 0.924302255995 Mylan-Meloxicam Mylan 100 45.00 0.450002258323 Novo-Meloxicam Novopharm 30

10013.5045.00

0.45000.4500

02248608 phl-Meloxicam Pharmel 30500

13.50225.00

0.45000.4500

02248268 pms-Meloxicam Phmscience 30500

13.50225.00

0.45000.4500

02248031 ratio-Meloxicam Ratiopharm 100500

45.00225.00

0.45000.4500

NABUMETONE XTab. 500 mg PPB

02238639 Apo-Nabumetone Apotex 100 36.91 0.369102244563 Mylan-Nabumetone Mylan 100 36.91 0.369102343282 Nabumetone Sanis 100 36.91 0.369102240867 Novo-Nabumetone Novopharm 100 36.91 0.369102083531 Relafen GSK 100 69.19 0.6919

Tab. 750 mg PPB

02240868 Novo-Nabumetone Novopharm 100 56.11 0.561102083558 Relafen GSK 100 93.97 0.9397


Page 134 2010-06

NAPROXEN XXEnt. Tab. or Tab. 250 mg PPB

00522651 Apo-Naproxen 250 mg Apotex 1001000

10.68106.80

0.10680.1068

02246699 Apo-Naproxen EC Apotex 100 10.68 0.106802162792 Naprosyn E 250 mg Roche 100 40.15 0.401500590762 Naproxen-250 Pro Doc 100 10.68 0.106800565350 Novo-Naprox 250 mg Novopharm 100

50010.6853.40

0.10680.1068

02243312 Novo-Naprox EC Novopharm 100 10.68 0.106802240786 Riva-Naproxen Riva 100

25010.6826.70

0.10680.1068

Ent. Tab. or Tab. 500 mg PPB

00592277 Apo-Naproxen Apotex 100500

21.10105.50

0.21100.2110

02246701 Apo-Naproxen EC Apotex 100 21.10 0.211002241024 Mylan-Naproxen EC Mylan 100 49.31 0.493102162423 Naprosyn E Roche 100

50095.05

475.280.95050.9506

00618721 Naproxen-500 Pro Doc 100500

21.10105.50

0.21100.2110

00589861 Novo-Naprox Novopharm 100500

21.10105.50

0.21100.2110

02243314 Novo-Naprox EC Novopharm 100 21.10 0.211002294710 pms-Naproxen EC Phmscience 100 21.10 0.211002310953 Pro-Naproxen EC-500 Pro Doc 100 21.10 0.211002240788 Riva-Naproxen Riva 100

50021.10

105.500.21100.2110

Oral Susp. 25 mg/mL

02162431 Naprosyn Roche 474 ml 28.83 0.0608

Supp. 500 mg

02017237 pms-Naproxen Phmscience 30 14.33 0.4777


2010-06 Page 135

Tab - Ent.Tab or LA Tab 375 mg / 750 mg L.A. PPB

00600806 Apo-Naproxen 375 mg Apotex 100500

14.5872.90

0.14580.1458

02246700 Apo-Naproxen EC 375 mg Apotex 100 14.58 0.145802177072 Apo-Naproxen SR 750 mg Apotex 100 100.48 0.570302243432 Mylan-Naproxen EC 375 Mylan 100 27.08 0.270802162415 Naprosyn E 375 mg Roche 100

50053.05

261.000.53050.5220

00655686 Naproxen-375 Pro Doc 100500

14.5872.90

0.14580.1458

00627097 Novo-Naprox 375 mg Novopharm 100500

14.5872.90

0.14580.1458

02243313 Novo-Naprox EC 375 mg Novopharm 100 14.58 0.145802294702 pms-Naproxen EC Phmscience 100 14.58 0.145802310945 Pro-Naproxen EC-375 Pro Doc 100 14.58 0.145802240787 Riva-Naproxen 375 mg Riva 100

50014.5872.90

0.14580.1458

Tab. 125 mg

00522678 Apo-Naproxen Apotex 100 7.81 0.0781

PIROXICAM XCaps. 10 mg PPB

00642886 Apo-Piroxicam Apotex 100 41.47 0.414702171813 Gen-Piroxicam Genpharm 100 41.47 0.414700695718 Novo-Pirocam Novopharm 100 41.47 0.414700865761 Nu-Pirox Nu-Pharm 100 41.47 0.4147

Caps. 20 mg PPB

00642894 Apo-Piroxicam Apotex 100 71.58 0.715802171821 Gen-Piroxicam Genpharm 100 71.58 0.715800695696 Novo-Pirocam Novopharm 100 71.58 0.715800865788 Nu-Pirox Nu-Pharm 100 71.58 0.7158

Supp. 20 mg

02154463 pms-Piroxicam Phmscience 30 49.38 1.6460

SULINDAC XTab. 150 mg PPB

00778354 Apo-Sulin Apotex 100 38.24 0.382400745588 Novo-Sundac Novopharm 100 38.24 0.382402042576 Nu-Sulindac Nu-Pharm 100 38.24 0.3824

Tab. 200 mg PPB

00778362 Apo-Sulin Apotex 100 48.40 0.399200745596 Novo-Sundac Novopharm 100 39.20 0.3920


Page 136 2010-06

TENOXICAM XXTab. 20 mg

02230661 Apo-Tenoxicam Apotex 100 115.52 0.9443

TIAPROFENIC ACID XTab. 200 mg PPB

02136112 Apo-Tiaprofenique Apotex 100 34.37 0.343702179679 Novo-Tiaprofenic Novopharm 100 34.37 0.3437

Tab. 300 mg PPB

02136120 Apo-Tiaprofenique Apotex 100500

32.57162.85

0.32570.3257

02179687 Novo-Tiaprofenic Novopharm 100500

32.57162.85

0.32570.3257

02230828 pms-Tiaprofenic Phmscience 100500

32.57162.85

0.32570.3257

28:08.08OPIATE AGONISTSBASE AND CODEINE SULFATE ZL.A. Tab. 50 mg

02230302 Codeine Contin Purdue 50 14.93 0.2986

L.A. Tab. 100 mg


L.A. Tab. 150 mg


L.A. Tab. 200 mg


CODEINE PHOSPHATE ZInj. Sol. 30 mg/mL

00544884 Codeine Sandoz 1 ml 1.09

Tab. 30 mg PPB

02009757 Codeine Trianon 100500

7.7338.66

0.07730.0773

02243979 pms-Codeine Phmscience 100 7.73 0.077300593451 ratio-Codeine Ratiopharm 100

5007.73

38.660.07730.0773


2010-06 Page 137

FENTANYL ZZPatch 12 mcg/h PPB

02280345 Duragesic J.O.I. 5 21.75 4.350002341379 pms-Fentanyl MTX Phmscience 5 11.74 2.348002330105 Ran-Fentanyl Matrix Patch Ranbaxy 5 11.74 2.348002311925 ratio-Fentanyl Ratiopharm 5 11.74 2.348002327112 Sandoz Fentanyl Patch Sandoz 5 11.74 2.3480

Patch 25 mcg/h PPB

01937383 Duragesic J.O.I. 5 44.90 8.980002314630 Novo-Fentanyl 25 Novopharm 5 21.25 4.250002341387 pms-Fentanyl MTX Phmscience 5 21.25 4.250002330113 Ran-Fentanyl Matrix Patch Ranbaxy 5 21.25 4.250002249391 Ran-Fentanyl Transdermal

SystemRanbaxy 5 21.25 4.2500

02282941 ratio-Fentanyl Ratiopharm 5 21.25 4.250002327120 Sandoz Fentanyl Patch Sandoz 5 21.25 4.2500

Patch 37 mcg/h

02327139 Sandoz Fentanyl Patch Sandoz 5 32.99 6.5980

Patch 50 mcg/h PPB




Patch 75 mcg/h PPB




Patch 100 mcg/h PPB





Page 138 2010-06

HYDROMORPHONE HYDROCHLORIDE ZZInj. Pd 250 mg

02085895 Dilaudid Purdue 1 67.58

Inj. Sol. 2 mg/mL PPB

00627100 Dilaudid Purdue 1 ml 0.9502145901 Hydromorphone Sandoz 1 ml 0.95


00622133 Dilaudid-HP Purdue 1 ml5 ml

50 ml

2.3411.69

116.9002145928 Hydromorphone HP 10 Sandoz 1 ml

5 ml50 ml

2.3411.69

116.90


02146118 Dilaudid-HP-Plus Purdue 50 ml 183.4002145936 Hydromorphone HP 20 Sandoz 50 ml 183.40


02145863 Dilaudid-XP Purdue 50 ml 486.6702146126 Hydromorphone HP 50 Sandoz 50 ml 486.6799003163 Hydromorphone HP 50 Sandoz 1 ml 9.73

L.A. Caps. (12 h) 3 mg

02125323 Hydromorph Contin Purdue 50 31.86 0.6372

L.A. Caps. (12 h) 6 mg


L.A. Caps. (12 h) 12 mg


L.A. Caps. (12 h) 18 mg


L.A. Caps. (12 h) 24 mg


L.A. Caps. (12 h) 30 mg



2010-06 Page 139

Supp. 3 mg

01916394 pms-Hydromorphone Phmscience 10 22.66 2.2660

Syr. 1 mg/mL PPB

00786535 Dilaudid Purdue 450 ml 29.34 0.065201916386 pms-Hydromorphone Phmscience 500 ml 32.60 0.0652

Tab. 1 mg PPB

00705438 Dilaudid Purdue 100 9.59 0.095900885444 pms-Hydromorphone Phmscience 100 9.59 0.0959

Tab. 2 mg PPB


Tab. 4 mg PPB


Tab. 8 mg PPB


MEPERIDINE HYDROCHLORIDE ZZInj. Sol. 50 mg/mL PPB

02242003 Demerol Hospira 1 ml 0.8700725765 Meperidine Sandoz 1 ml 0.87





Tab. 50 mg

02138018 Demerol SanofiAven 100 12.59 0.1259


Page 140 2010-06

METHADONE HYDROCHLORIDE ZZOral Sol. 1 mg/mL

02247694 Metadol Paladin 250 ml 24.28 0.0971

Oral Sol. 10 mg/mL

02241377 Metadol Paladin 100 ml 35.09 0.3509

Tab. 1 mg

02247698 Metadol Paladin 100 16.12 0.1612

Tab. 5 mg

02247699 Metadol Paladin 100 53.71 0.5371

Tab. 10 mg

02247700 Metadol Paladin 100 85.94 0.8594

Tab. 25 mg

02247701 Metadol Paladin 100 161.13 1.6113

MORPHINE HYDROCHLORIDE OR SULFATE ZInj. Epi. Sol. 0.5 mg/mL

02021056 Morphine LP Epidurale Sandoz 10 ml 9.88

Inj. Epi. Sol. 1 mg/mL

02021048 Morphine LP Epidurale Sandoz 5 ml 9.88

Inj. Sol. 1 mg/mL

01980696 Morphine (sulfate de) Sandoz 10 ml 2.40

Inj. Sol. 2 mg/mL

01964437 Morphine (sulfate de) Sandoz 50 ml 11.2102242484 Morphine (sulfate de) Sandoz 1 ml 0.88

Inj. Sol. 5 mg/mL

01964429 Morphine (sulfate de) Sandoz 30 ml 10.81


00392588 Morphine (sulfate de) Sandoz 1 ml 0.9000850322 Sulfate de Morphine Hospira 1 ml 0.90


2010-06 Page 141


00392561 Morphine (sulfate de) Sandoz 1 ml30 ml

0.9027.00

00850330 Sulfate de Morphine Hospira 1 ml 0.90

Inj. Sol. 25 mg/mL

00676411 Morphine H.P. 25 Sandoz 1 ml4 ml

2.5110.04

Inj. Sol. 50 mg/mL

00617288 Morphine H.P. 50 Sandoz 1 ml5 ml

10 ml50 ml

3.2216.0832.15

160.71

L.A. Caps. 10 mg

02019930 M-Eslon Ethypharm 2050

5.8014.50

0.29000.2900

L.A. Caps. 15 mg


6.7016.75

0.33500.3350

L.A. Caps. 30 mg


10.0025.00

0.50000.5000

L.A. Caps. 60 mg


17.7544.40

0.88750.8880

L.A. Caps. 100 mg


38.2095.50

1.91001.9100

L.A. Caps. 200 mg


76.40190.99

3.82003.8198

L.A. Caps. (24 h) 10 mg

02242163 Kadian Abbott 100 35.44 0.3544


Page 142 2010-06

L.A. Caps. (24 h) 20 mg

02184435 Kadian Abbott 100 59.73 0.5973

L.A. Caps. (24 h) 50 mg

02184443 Kadian Abbott 100 128.75 1.2875

L.A. Caps. (24 h) 100 mg

02184451 Kadian Abbott 50 112.27 2.2454

L.A. Tab. 15 mg PPB

02015439 MS Contin Purdue 50 31.62 0.632402302764 Novo-Morphine SR Novopharm 50 14.89 0.297802245284 pms-Morphine Sulfate SR Phmscience 50 14.89 0.297802244790 ratio-Morphine SR Ratiopharm 100 29.77 0.2977

L.A. Tab. 30 mg PPB

00776181 M.O.S.-S.R. Valeant 50 22.48 0.449502014297 MS Contin Purdue 50 47.73 0.954602302772 Novo-Morphine SR Novopharm 50

10022.4844.95

0.44950.4495

02245285 pms-Morphine Sulfate SR Phmscience 50 22.48 0.449502244791 ratio-Morphine SR Ratiopharm 100 44.95 0.4495

L.A. Tab. 60 mg PPB

00776203 M.O.S.-S.R. Valeant 50 39.62 0.792402014300 MS Contin Purdue 50 84.16 1.683202302780 Novo-Morphine SR Novopharm 50

10039.6279.24

0.79240.7924

02245286 pms-Morphine Sulfate SR Phmscience 50 39.62 0.792402244792 ratio-Morphine SR Ratiopharm 100 79.24 0.7924


02014319 MS Contin Purdue 50 128.31 2.566202302799 Novo-Morphine SR Novopharm 50 64.55 1.291002245287 pms-Morphine Sulfate SR Phmscience 50 64.55 1.2910


02014327 MS Contin Purdue 50 238.53 4.770602302802 Novo-Morphine SR Novopharm 50 120.00 2.400002245288 pms-Morphine Sulfate SR Phmscience 50 120.00 2.4000

Oral Sol. 20 mg/mL PPB

00690791 ratio-Morphine Ratiopharm 50 ml 24.90 0.498000621935 Statex Paladin 25 ml

100 ml12.4538.57

0.49800.3857


2010-06 Page 143

Supp. 10 mg

00632201 Statex Paladin 10 15.75 1.5750

Supp. 20 mg

00596965 Statex Paladin 10 18.63 1.8630

Supp. 30 mg

00639389 Statex Paladin 10 20.69 2.0690

Syr. 1 mg/mL PPB

00614491 Doloral 1 Atlas 250 ml500 ml

5.0010.00

0.02000.0200

00607762 ratio-Morphine Ratiopharm 200 ml450 ml

4.009.00

0.02000.0200

00591467 Statex Paladin 250 ml500 ml

5.0010.00

0.02000.0200

Syr. 5 mg/mL PPB

00614505 Doloral 5 Atlas 250 ml500 ml

9.6319.26

0.03850.0385

00607770 ratio-Morphine Ratiopharm 200 ml450 ml

7.7017.33

0.03850.0385

00591475 Statex Paladin 250 ml500 ml

9.6319.26

0.03850.0385

Syr. 10 mg/mL

00690783 ratio-Morphine Ratiopharm 200 ml 36.76 0.1838

Syr. 50 mg/mL

00705799 Statex Paladin 50 ml 47.32 0.9464

Tab. 5 mg PPB

02009773 M.O.S. - Sulfate-5 Valeant 100 11.00 0.110002014203 MS-IR Purdue 50 5.83 0.116600594652 Statex Paladin 100 11.00 0.1100

Tab. 10 mg PPB

02009765 M.O.S. - Sulfate-10 Valeant 100 17.00 0.170002014211 MS-IR Purdue 50 9.08 0.181600594644 Statex Paladin 100 17.00 0.1700

Tab. 20 mg

02014238 MS-IR Purdue 50 16.03 0.3206


Page 144 2010-06

Tab. 25 mg PPB

02009749 M.O.S. - Sulfate-25 Valeant 100 22.50 0.225000594636 Statex Paladin 100 22.50 0.2250

Tab. 30 mg

02014254 MS-IR Purdue 50 20.57 0.4114

Tab. 50 mg PPB

02009706 M.O.S. - Sulfate-50 Valeant 100 34.50 0.345000675962 Statex Paladin 100 34.50 0.3450

OXYCODONE HYDROCHLORIDE ZZL.A. Tab. 5 mg

02258129 OxyContin Purdue 50 30.69 0.6138

L.A. Tab. 10 mg


L.A. Tab. 15 mg


L.A. Tab. 20 mg


L.A. Tab. 30 mg


L.A. Tab. 40 mg


L.A. Tab. 60 mg


L.A. Tab. 80 mg


Supp. 10 mg

00392480 Supeudol Sandoz 12 24.08 2.0067


2010-06 Page 145

Supp. 20 mg

00392472 Supeudol Sandoz 12 30.47 2.5392

Tab. 5 mg PPB

02325950 Oxycodone Pro Doc 100 14.21 0.142102319977 pms-Oxycodone Phmscience 100 14.21 0.142100789739 Supeudol Sandoz 100 14.21 0.1421

Tab. 10 mg PPB

02240131 Oxy IR Purdue 50 18.46 0.369202325969 Oxycodone Pro Doc 100 19.86 0.198602319985 pms-Oxycodone Phmscience 100 19.86 0.198600443948 Supeudol Sandoz 100 19.86 0.1986

Tab. 20 mg PPB

02240132 Oxy IR Purdue 50 32.07 0.641402325977 Oxycodone Pro Doc 50 17.24 0.344802319993 pms-Oxycodone Phmscience 50 17.24 0.344802262983 Supeudol 20 Sandoz 50 17.24 0.3448

28:08.12OPIATE PARTIAL AGONISTSBUTORPHANOL TARTRATE YYNas. spray 10 mg/mL

02242504 Apo-Butorphanol Apotex 2.5 ml 32.1302244508 pms-Butorphanol Phmscience 2.5 ml 32.1302113031 Stadol NS B.M.S. 2.5 ml 59.50

PENTAZOCINE HYDROCHLORIDE ZTab. 50 mg

02137984 Talwin SanofiAven 100 36.29 0.3629

PENTAZOCINE LACTATE ZInj. Sol. 30 mg/mL

02241976 Talwin Hospira 1 ml 0.79

28:08.92MISCELLANEOUS ANALGESICS AND ANTIPYRETICSACETAMINOPHENChew. Tab. 80 mg PPB

02017458 Acetaminophene Riva 24 2.40 0.100002245010 Jamp-Acetaminophen Jamp 24 2.40 0.100002263815 Pediaphen Euro-Pharm 24 2.40 0.1000


Page 146 2010-06

Chew. Tab. or Tab. 160 mg PPB

02017431 Acetaminophene Riva 20 2.95 0.147502021420 Cephanol Riva 20 2.95 0.147502246087 Jamp-Acetaminophen Jamp 20 2.95 0.147502263823 Pediaphen Euro-Pharm 20 2.95 0.1475

Liq. 80 mg/5 mL PPB

01905848 Acetaminophene Trianon 100 ml 3.10 0.031002263807 Pediaphen Euro-Pharm 100 ml 3.10 0.031000792713 pms-Acetaminophene Phmscience 100 ml 3.10 0.0310

Liq. 160 mg/5 mL PPB

01958836 Acetaminophene Trianon 100 ml 3.65 0.036501901389 Jamp-Acetaminophen Jamp 100 ml 3.65 0.036502263831 Pediaphen Euro-Pharm 100 ml 3.65 0.036500792691 pms-Acetaminophene Phmscience 100 ml 3.65 0.0365

Ped. Oral Sol. 80 mg/mL PPB

01905864 Acetaminophene Trianon 15 ml24 ml

2.502.87

01935275 Jamp-Acetaminophen Jamp 24 ml 2.8702263793 Pediaphen Euro-Pharm 15 ml

24 ml2.502.87

02027801 Pediatrix Rougier 24 ml 2.8700887587 pms-Acetaminophene Phmscience 24 ml 2.87

Supp. 120 mg PPB

01919385 Abenol Pendopharm 12 6.55 0.545802230434 Acet 120 Phmscience 12 6.44 0.5367

Supp. 160 mg

02230435 Acet 160 Phmscience 12 7.51 0.6258

Supp. 325 mg PPB


Supp. 650 mg PPB



2010-06 Page 147

Tab. 325 mg PPB

00718858 Acetaminophen Pharmel 1001000

1.1411.40

0.01140.0114

02022214 Acetaminophene Riva 1000 11.40 0.011400382752 Acetaminophene 325 Pro Doc 1000 11.40 0.011402241200 Acetaminophen-Odan Odan 1000 11.40 0.011400544981 Apo-Acetaminophene Apotex 100

10001.14

11.400.01140.0114

01938088 Jamp-Acetaminophen Jamp 1000 11.40 0.011400389218 Novo-Gesic Novopharm 100

10001.14

11.400.01140.0114

00891177 pms-Acetaminophene Phmscience 1000 11.40 0.0114

Tab. 500 mg PPB

00718866 Acetaminophen Pharmel 5001000

7.4514.90

0.01490.0149

02022222 Acetaminophene Riva 1000 14.90 0.014900386626 Acetaminophene 500 Pro Doc 1000 14.90 0.014902241201 Acetaminophen-Odan Odan 1000 14.90 0.014900545007 Apo-Acetaminophene Apotex 1000 14.90 0.014901939122 Jamp-Acetaminophen Jamp 1000 14.90 0.014902343371 Jamp-Acetaminophene E.F. Jamp 1000 14.90 0.014900482323 Novo-Gesic Forte Novopharm 100

10001.49

14.900.01490.0149

02313081 pms-Acetaminophen E Phmscience 500 7.45 0.014900892505 pms-Acetaminophene Phmscience 1000 14.90 0.0149

ACETAMINOPHEN/ CODEINE PHOSPHATE ZZElix. 160 mg -8 mg/5 mL PPB

00816027 pms-Acetaminophene avecCodeine

Phmscience 100 ml500 ml

5.8629.32

0.04670.0467

02163942 Tylenol a la codeine J.O.I. 500 ml 38.92 0.0778

Tab. 300 mg - 30 mg PPB

01999648 Acet codeine 30 Phmscience 500 65.00 0.130002254271 phl-Acet-Codeine 30 Pharmel 500 65.00 0.130002232658 Procet-30 Pro Doc 500 65.00 0.130000608882 ratio-Emtec Ratiopharm 500 65.00 0.130000789828 Triatec-30 Trianon 100

50013.0065.00

0.13000.1300

Tab. 300 mg - 60 mg PPB

01999656 Acet codeine 60 Phmscience 100 13.84 0.138402254263 phl-Acet-Codeine 60 Pharmel 100 13.84 0.138400621463 ratio-Lenoltec No 4 Ratiopharm 100 13.84 0.1384


Page 148 2010-06

28:10OPIATE ANTAGONISTSNALTREXONE HYDROCHLORIDE XXTab. 50 mg

02213826 Revia Apotex 50 263.77 5.2020

28:12.04BARBITURATESPHENOBARBITAL Y

Elix. 25 mg/5 mL

00645575 pms-Phenobarbital Phmscience 100 ml 8.49 0.0849

Tab. 15 mg

00178799 pms-Phenobarbital Phmscience 500 31.84 0.0637

Tab. 30 mg


Tab. 60 mg


Tab. 100 mg


PRIMIDONE XTab. 125 mg

00399310 Apo-Primidone Apotex 100 5.53 0.0553

Tab. 250 mg

00396761 Apo-Primidone Apotex 100 8.70 0.0870

28:12.08BENZODIAZEPINESCLOBAZAM VTab. 10 mg PPB

02244638 Apo-Clobazam Apotex 30 5.13 0.171002248454 Clobazam-10 Pro Doc 30 5.13 0.171002221799 Frisium Lundb Inc 30 10.25 0.341702238334 Novo-Clobazam Novopharm 30 5.13 0.171002244474 pms-Clobazam Phmscience 30 5.13 0.171002238797 ratio-Clobazam Ratiopharm 30 5.13 W


2010-06 Page 149

CLONAZEPAM VVTab. 0.25 mg

02179660 pms-Clonazepam Phmscience 100 6.64 0.0664

Tab. 0.5 mg PPB

02177889 Apo-Clonazepam Apotex 100500

9.2546.25

0.09250.0925

02270641 Co Clonazepam Cobalt 100500

9.2546.25

0.09250.0925

02230950 Mylan-Clonazepam Mylan 100500

9.2546.25

0.09250.0925

02239024 Novo-Clonazepam Novopharm 100500

9.2546.25

0.09250.0925

02236948 phl-Clonazepam-R Pharmel 100500

9.2546.25

0.09250.0925

02207818 pms-Clonazepam-R Phmscience 100500

9.2546.25

0.09250.0925

02311593 Pro-Clonazepam Pro Doc 500 46.25 0.092502103656 ratio-Clonazepam Ratiopharm 100

5009.25

46.250.09250.0925

02242077 Riva-Clonazepam Riva 100500

9.2546.25

0.09250.0925

00382825 Rivotril Roche 100 19.64 0.196402233960 Sandoz Clonazepam Sandoz 100

5009.25

46.250.09250.0925

02303310 Zym-Clonazepam Zymcan 100 9.25 W

Tab. 1 mg PPB

02270668 Co Clonazepam Cobalt 100 18.60 0.186002145235 phl-Clonazépam Pharmel 100

50018.6093.00

0.18600.1860

02048728 pms-Clonazepam Phmscience 100500

18.6093.00

0.18600.1860

02311607 Pro-Clonazepam Pro Doc 100500

18.6093.00

0.18600.1860

02233982 Sandoz Clonazepam Sandoz 100 18.60 0.186002303329 Zym-Clonazepam Zymcan 100 18.60 0.1860


Page 150 2010-06

Tab. 2 mg PPB

02177897 Apo-Clonazepam Apotex 100500

15.9579.75

0.15950.1595

02270676 Co Clonazepam Cobalt 100500

15.9579.75

0.15950.1595

02230951 Mylan-Clonazepam Mylan 100500

15.9579.75

0.15950.1595

02239025 Novo-Clonazepam Novopharm 100500

15.9579.75

0.15950.1595

02145243 phl-Clonazépam Pharmel 100500

15.9579.75

0.15950.1595

02048736 pms-Clonazepam Phmscience 100500

15.9579.75

0.15950.1595

02311615 Pro-Clonazepam Pro Doc 100500

15.9579.75

0.15950.1595

02103737 ratio-Clonazepam Ratiopharm 100500

15.9579.75

0.15950.1595

02242078 Riva-Clonazepam Riva 100500

15.9579.75

0.15950.1595

00382841 Rivotril Roche 100500

33.88169.40

0.33880.3388

02233985 Sandoz Clonazepam Sandoz 100500

15.9579.75

0.15950.1595

02303337 Zym-Clonazepam Zymcan 100 15.95 0.1595

28:12.12HYDANTOINSPHENYTOIN XX


00023442 Dilantin-30 Pfizer 250 ml 9.76 0.0390


00023450 Dilantin-125 Pfizer 250 ml 11.54 0.046202250896 Taro-Phenytoin Taro 237 ml 7.37 0.0277

Tab. 50 mg

00023698 Dilantin Pfizer 100 7.09 0.0709

PHENYTOIN SODIUM XCaps. 30 mg

00022772 Dilantin Pfizer 100 5.17 0.0517

Caps. 100 mg

00022780 Dilantin Pfizer 1001000

7.1964.58

0.07190.0646


2010-06 Page 151

28:12.20SUCCINIMIDESETHOSUXIMIDE XXCaps. 250 mg

00022799 Zarontin Erfa 100 29.25 0.2925

Syr. 250 mg/5 mL

00023485 Zarontin Erfa 500 ml 29.23 0.0585

METHSUXIMIDE XCaps. 300 mg

00022802 Celontin Erfa 100 32.35 0.3235

28:12.92MISCELLANEOUS ANTICONVULSANTSCARBAMAZEPINE XChew. Tab. 100 mg PPB

02231542 pms-CarbamazepineChewtabs

Phmscience 100 6.12 0.0612

02261855 Sandoz CarbamazepineChewtabs

Sandoz 100 6.12 0.0612

02244403 Taro-CarbamazepineChewable

Taro 100 6.12 0.0612

00369810 Tegretol Chewtabs Novartis 100 12.99 0.1299

Chew. Tab. 200 mg PPB

02231540 pms-CarbamazepineChewtabs

Phmscience 100 12.07 0.1207

02261863 Sandoz CarbamazepineChewtabs

Sandoz 100 12.07 0.1207

02244404 Taro-CarbamazepineChewable

Taro 100 12.07 0.1207

00665088 Tegretol Chewtabs Novartis 100 25.63 0.2563


02241882 Mylan-Carbamazepine CR Mylan 100500

14.9874.90

0.14980.1498

02231543 pms-Carbamazepine CR Phmscience 100500

14.9874.90

0.14980.1498

02261839 Sandoz Carbamazepine CR Sandoz 100 14.98 0.149800773611 Tegretol CR Novartis 100 31.82 0.3182


Page 152 2010-06


02241883 Mylan-Carbamazepine CR Mylan 100 29.96 0.299602231544 pms-Carbamazepine CR Phmscience 100

50029.96

149.800.29960.2996

02261847 Sandoz Carbamazepine CR Sandoz 100 29.96 0.299600755583 Tegretol CR Novartis 100 63.64 0.6364


02194333 Tegretol Novartis 450 ml 27.61 0.0614

Tab. 200 mg PPB

00402699 Apo-Carbamazepine Apotex 100500

7.9539.75

0.07950.0795

02247135 Bio-Carbamazepine Biomed 120 9.54 0.079500578460 Carbamazepine-200 Pro Doc 100

5007.95

39.750.07950.0795

00782718 Novo-Carbamaz Novopharm 100500

7.9539.75

0.07950.0795

00010405 Tegretol Novartis 100500

30.96150.34

0.30960.3007

DIVALPROEX SODIUM XXEnt. Tab. 125 mg PPB

02239698 Apo-Divalproex Apotex 100 10.93 0.109302240341 Divalproex-125 Pro Doc 100 10.93 0.109300596418 Epival 125 Abbott 100 23.22 0.232202265133 Mylan-Divalproex Mylan 100 10.93 0.109302239701 Novo-Divalproex Novopharm 100 10.93 0.109302239517 Nu-Divalproex Nu-Pharm 100 10.93 0.109302294109 phl-Divalproex Pharmel 100 10.93 0.109302244138 pms-Divalproex Phmscience 100 10.93 0.1093


02239699 Apo-Divalproex Apotex 100500

19.6498.20

0.19640.1964

02240342 Divalproex-250 Pro Doc 100500

19.6498.20

0.19640.1964

00596426 Epival 250 Abbott 100500

41.72208.60

0.41720.4172

02265141 Mylan-Divalproex Mylan 100500

19.6498.20

0.19640.1964

02239702 Novo-Divalproex Novopharm 100500

19.6498.20

0.19640.1964

02239518 Nu-Divalproex Nu-Pharm 100500

19.6498.20

0.19640.1964

02294117 phl-Divalproex Pharmel 100500

19.6498.20

0.19640.1964

02244139 pms-Divalproex Phmscience 100500

19.6498.20

0.19640.1964


2010-06 Page 153


02239700 Apo-Divalproex Apotex 100 39.31 0.393102240343 Divalproex-500 Pro Doc 100 39.31 0.393100596434 Epival 500 Abbott 100

50083.50

417.460.83500.8349

02265168 Mylan-Divalproex Mylan 100500

39.31196.55

0.39310.3931

02239703 Novo-Divalproex Novopharm 100500

39.31196.55

0.39310.3931

02239519 Nu-Divalproex Nu-Pharm 100500

39.31196.55

0.39310.3931

02294125 phl-Divalproex Pharmel 100500

39.31196.55

0.39310.3931

02244140 pms-Divalproex Phmscience 100500

39.31196.55

0.39310.3931

GABAPENTIN XXCaps. 100 mg PPB

02244304 Apo-Gabapentin Apotex 100500

20.00100.00

0.20000.2000

02256142 Co Gabapentin Cobalt 100500

20.00100.00

0.20000.2000

02248259 Mylan-Gabapentin Mylan 100500

20.00100.00

0.20000.2000

02084260 Neurontin Pfizer 100 40.99 0.409902244513 Novo-Gabapentin Novopharm 100

50020.00

100.000.20000.2000

02246314 phl-Gabapentin Pharmel 100500

20.00100.00

0.20000.2000

02243446 pms-Gabapentin Phmscience 100500

20.00100.00

0.20000.2000

02310449 Pro-Gabapentin Pro Doc 100500

20.00100.00

0.20000.2000

02260883 ratio-Gabapentin Ratiopharm 100500

20.00100.00

0.20000.2000

02251167 Riva-Gabapentin Riva 100500

20.00100.00

0.20000.2000

02304775 Zym-Gabapentin Zymcan 100 20.00 0.2000


Page 154 2010-06

Caps. 300 mg PPB


48.65243.25

0.48650.4865


48.65243.25

0.48650.4865


48.65243.25

0.48650.4865

02084279 Neurontin Pfizer 100 99.73 0.997302246315 phl-Gabapentin Pharmel 100

50048.65

243.250.48650.4865


48.65243.25

0.48650.4865


48.65243.25

0.48650.4865


48.65243.25

0.48650.4865


48.65243.25

0.48650.4865

02244514 Teva-Gabapentin Teva Can 100500

48.65243.25

0.48650.4865


Caps. 400 mg PPB


57.98289.90

0.57980.5798


57.98289.90

0.57980.5798


57.98289.90

0.57980.5798

02084287 Neurontin Pfizer 100 118.84 1.188402244515 Novo-Gabapentin Novopharm 100

50057.98

289.900.57980.5798

02246316 phl-Gabapentin Pharmel 100500

57.98289.90

0.57980.5798


57.98289.90

0.57980.5798


57.98289.90

0.57980.5798


57.98289.90

0.57980.5798


57.98289.90

0.57980.5798


Tab. 600 mg PPB

02293358 Apo-Gabapentin Apotex 100 95.80 0.958002239717 Neurontin Pfizer 100 178.26 1.782602248457 Novo-Gabapentin Novopharm 100 95.80 0.958002258005 phl-Gabapentin Pharmel 100 95.80 0.958002255898 pms-Gabapentin Phmscience 100 95.80 0.958002310473 Pro-Gabapentin Pro Doc 100 95.80 0.958002260913 ratio-Gabapentin Ratiopharm 100 95.80 0.958002259796 Riva-Gabapentin Riva 100

50095.80

479.000.95800.9580


2010-06 Page 155

Tab. 800 mg PPB

02293366 Apo-Gabapentin Apotex 100 127.73 1.277302239718 Neurontin Pfizer 100 237.67 2.376702247346 Novo-Gabapentin Novopharm 100 127.73 1.277302258013 phl-Gabapentin Pharmel 100 127.73 1.277302255901 pms-Gabapentin Phmscience 100 127.73 1.277302310481 Pro-Gabapentin Pro Doc 100 127.73 1.277302260921 ratio-Gabapentin Ratiopharm 100 127.73 1.277302259818 Riva-Gabapentin Riva 100

500127.73638.65

1.27731.2773

LAMOTRIGINE XXChew. Tab. 2 mg

02243803 Lamictal GSK 30 4.52 0.1507

Chew. Tab. 5 mg

02240115 Lamictal GSK 28 4.23 0.1511

Tab. 25 mg

02245208 Apo-Lamotrigine Apotex 100 16.58 0.165802142082 Lamictal GSK 100 35.04 0.350402343010 Lamotrigine Sanis 100 16.58 0.165802302969 Lamotrigine-25 Pro Doc 100 16.58 0.165802265494 Mylan-Lamotrigine Mylan 100 16.58 0.165802248232 Novo-Lamotrigine Novopharm 100 16.58 0.165802246897 pms-Lamotrigine Phmscience 100 16.58 0.165802243352 ratio-Lamotrigine Ratiopharm 100 16.58 0.1658

Tab. 100 mg

02245209 Apo-Lamotrigine Apotex 100 66.30 0.663002142104 Lamictal GSK 100 140.16 1.401602343029 Lamotrigine Sanis 100 66.30 0.663002302985 Lamotrigine-100 Pro Doc 100 66.30 0.663002265508 Mylan-Lamotrigine Mylan 100

50066.30

331.500.66300.6630

02248233 Novo-Lamotrigine Novopharm 100 66.30 0.663002246898 pms-Lamotrigine Phmscience 100 66.30 0.663002243353 ratio-Lamotrigine Ratiopharm 100 66.30 0.6630

Tab. 150 mg

02245210 Apo-Lamotrigine Apotex 100 99.45 0.994502142112 Lamictal GSK 60 123.24 2.054002343037 Lamotrigine Sanis 100 99.45 0.994502302993 Lamotrigine-150 Pro Doc 100 99.45 0.994502265516 Mylan-Lamotrigine Mylan 100 99.45 0.994502248234 Novo-Lamotrigine Novopharm 100 99.45 0.994502246899 pms-Lamotrigine Phmscience 100 99.45 0.994502246963 ratio-Lamotrigine Ratiopharm 60 59.67 0.9945


Page 156 2010-06

LEVETIRACETAM XXTab. 250 mg

02285924 Apo-Levetiracetam Apotex 100 82.10 0.821002274183 Co Levetiracetam Cobalt 100 82.10 0.821002247027 Keppra U.C.B. 120 187.64 1.563702297353 phl-Levetiracetam Pharmel 100 82.10 0.821002296101 pms-Levetiracetam Phmscience 100 82.10 0.8210

Tab. 500 mg

02285932 Apo-Levetiracetam Apotex 100 100.27 1.002702274191 Co Levetiracetam Cobalt 100

500100.27501.35

1.00271.0027

02247028 Keppra U.C.B. 120 229.18 1.909802297361 phl-Levetiracetam Pharmel 100

500100.27501.35

1.00271.0027

02296128 pms-Levetiracetam Phmscience 100500

100.27501.35

1.00271.0027

02311380 Pro-Levetiracetam-500 Pro Doc 100 100.27 1.0027

Tab. 750 mg

02285940 Apo-Levetiracetam Apotex 100 142.70 1.427002274205 Co Levetiracetam Cobalt 100 142.70 1.427002247029 Keppra U.C.B. 120 323.93 2.699402297388 phl-Levetiracetam Pharmel 100 142.70 1.427002296136 pms-Levetiracetam Phmscience 100 142.70 1.427002311399 Pro-Levetiracetam-750 Pro Doc 100 142.70 1.4270

PREGABALIN XCaps. 25 mg

02268418 Lyrica Pfizer 60 46.45 0.7742

Caps. 50 mg

02268426 Lyrica Pfizer 60 72.87 1.2145

Caps. 75 mg

02268434 Lyrica Pfizer 60 94.29 1.5715

Caps. 150 mg

02268450 Lyrica Pfizer 60 129.98 2.1663

Caps. 300 mg

02268485 Lyrica Pfizer 60 129.98 2.1663


2010-06 Page 157

TOPIRAMATE XXSprinkle caps. 15 mg

02239907 Topamax J.O.I. 60 63.42 1.0570

Sprinkle caps. 25 mg

02239908 Topamax J.O.I. 60 66.57 1.1095

Tab. 25 mg

02279614 Apo-Topiramate Apotex 100 52.50 0.525002287765 Co Topiramate Cobalt 100 52.50 0.525002315645 Mint-Topiramate Mint 100 52.50 0.525002263351 Mylan-Topiramate Mylan 100 52.50 0.525002248860 Novo-Topiramate Novopharm 100 52.50 0.525002271184 phl-Topiramate Pharmel 100

50052.50

262.500.52500.5250

02262991 pms-Topiramate Phmscience 100500

52.50262.50

0.52500.5250

02313650 Pro-Topiramate Pro Doc 100 52.50 0.525002256827 ratio-Topiramate Ratiopharm 100 52.50 0.525002260050 Sandoz Topiramate Sandoz 100 52.50 0.525002230893 Topamax J.O.I. 100 110.98 1.109802325136 Zym-Topiramate Zymcan 100 52.50 0.5250

Tab. 50 mg

02312085 pms-Topiramate Phmscience 100 75.00 0.7500

Tab. 100 mg

02279630 Apo-Topiramate Apotex 100 99.50 0.995002287773 Co Topiramate Cobalt 100 99.50 0.995002315653 Mint-Topiramate Mint 100 99.50 0.995002263378 Mylan-Topiramate Mylan 100 99.50 0.995002248861 Novo-Topiramate Novopharm 60 59.70 0.995002271192 phl-Topiramate Pharmel 100

50099.50

497.500.99500.9950

02263009 pms-Topiramate Phmscience 100500

99.50497.50

0.99500.9950

02313669 Pro-Topiramate Pro Doc 100 99.50 0.995002256835 ratio-Topiramate Ratiopharm 100 99.50 0.995002260069 Sandoz Topiramate Sandoz 100 99.50 0.995002230894 Topamax J.O.I. 60 126.18 2.103002325144 Zym-Topiramate Zymcan 100 99.50 0.9950


Page 158 2010-06

Tab. 200 mg

02279649 Apo-Topiramate Apotex 100 157.50 1.575002287781 Co Topiramate Cobalt 100 157.50 1.575002315661 Mint-Topiramate Mint 100 157.50 1.575002263386 Mylan-Topiramate Mylan 100 157.50 1.575002248862 Novo-Topiramate Novopharm 60 94.50 1.575002271206 phl-Topiramate Pharmel 100 157.50 1.575002263017 pms-Topiramate Phmscience 100 157.50 1.575002313677 Pro-Topiramate Pro Doc 100 157.50 1.575002256843 ratio-Topiramate Ratiopharm 100 157.50 1.575002267837 Sandoz Topiramate Sandoz 100 157.50 1.575002230896 Topamax J.O.I. 60 199.77 3.329502325152 Zym-Topiramate Zymcan 100 157.50 1.5750

VALPROATE SODIUM XXSyr. 250 mg/5 mL PPB

02238370 Apo-Valproic Apotex 450 ml 20.61 0.045800443832 Depakene Abbott 480 ml 43.81 0.091302236807 pms-Valproic acid Phmscience 450 ml 20.61 0.045802140063 ratio-Valproic Ratiopharm 480 ml 21.98 0.0458

VALPROIC ACID XCaps. 250 mg PPB

02238048 Apo-Valproic Apotex 100 20.62 0.206200443840 Depakene Abbott 100 43.81 0.438102184648 Mylan-Valproic Mylan 100

50020.62

103.100.20620.2062

02100630 Novo-Valproic Novopharm 100 20.62 0.206202237830 Nu-Valproic Nu-Pharm 100

50020.62

103.100.20620.2062

02230768 pms-Valproic acid Phmscience 100500

20.62103.10

0.20620.2062

02140047 ratio-Valproic Ratiopharm 100500

20.62103.10

0.20620.2062

02239714 Sandoz Valproic Sandoz 100 20.62 0.206202238546 Valproic-250 Pro Doc 100 20.62 0.2062

Ent. Caps. 500 mg PPB

02218321 Novo-Valproic Novopharm 100 41.25 0.412502229628 pms-Valproic Acid E.C. Phmscience 100

50041.25

206.250.41250.4125

02140055 ratio-Valproic Ratiopharm 100500

41.25206.25

W W

VIGABATRIN XOral Pd 500 mg/sac.

02068036 Sabril Lundb Inc 50 45.25 0.9050


2010-06 Page 159

Tab. 500 mg

02065819 Sabril Lundb Inc 100 90.50 0.9050

28:16.04ANTIDEPRESSANTSAMITRIPTYLINE HYDROCHLORIDE XXTab. 10 mg PPB

00370991 Amitriptyline-10 Pro Doc 1001000

4.3543.50

0.04350.0435

00335053 Apo-Amitriptyline Apotex 1001000

4.3543.50

0.04350.0435

02247166 Bio-Amitriptyline Biomed 500 21.75 0.043502247302 pms-Amitriptyline Biomed 500 21.75 0.0435

Tab. 25 mg PPB


8.2982.90

0.08290.0829


8.2982.90

0.08290.0829

02247167 Bio-Amitriptyline Biomed 500 41.45 0.082900037419 Novotriptyn Novopharm 100 8.29 W 02247303 pms-Amitriptyline Biomed 500 41.45 0.0829

Tab. 50 mg PPB


15.40154.00

0.15400.1540


15.40154.00

0.15400.1540

02247168 Bio-Amitriptyline Biomed 100 15.40 0.154000037427 Novotriptyn Novopharm 100

100015.40

154.00 W W

02247304 pms-Amitriptyline Biomed 100 15.40 0.1540

BUPROPION HYDROCHLORIDE XL.A. Tab. 100 mg

02331616 Bupropion SR Pro Doc 60 16.00 0.266702325373 pms-Bupropion SR Phmscience 60 16.00 0.266702285657 ratio-Bupropion SR Ratiopharm 30

608.00

16.000.26670.2667

02275074 Sandoz Bupropion SR Sandoz 3060

8.0016.00

0.26670.2667


Page 160 2010-06

L.A. Tab. 150 mg

02325357 Bupropion SR Pro Doc 60 24.00 0.400002313421 pms-Bupropion SR Phmscience 100 40.00 0.400002285665 ratio-Bupropion SR Ratiopharm 30

6012.0024.00

0.40000.4000

02275082 Sandoz Bupropion SR Sandoz 3060

12.0024.00

0.40000.4000

02237825 Wellbutrin SR Biovail 60 50.72 0.8453

L.A. Tab. (24 h) 150 mg

02275090 Wellbutrin XL Biovail 90 46.71 0.5190

L.A. Tab. (24 h) 300 mg

02275104 Wellbutrin XL Biovail 90 93.42 1.0380

CITALOPRAM HYDROMIDE XXTab. 10 mg

02325047 Citalopram-10 Pro Doc 100 44.64 0.446402312336 Novo-Citalopram Novopharm 100 44.64 0.446402273543 phl-Citalopram Pharmel 100 44.64 0.446402270609 pms-Citalopram Phmscience 100 44.64 0.446402303256 Riva-Citalopram Riva 100 44.64 0.446402301822 Zym-Citalopram Zymcan 100 44.64 0.4464


2010-06 Page 161

Tab. 20 mg

02246056 Apo-Citalopram Apotex 30500

18.75312.50

0.62500.6250

02239607 Celexa Lundbeck 30100

39.00130.01

1.30001.3001

02284847 Citalopram Genpharm 100500

62.50312.50

0.62500.6250

02306239 Citalopram Odan Odan 30500

18.75312.50

0.62500.6250

02257513 Citalopram-20 Pro Doc 30500

18.75312.50

0.62500.6250

02248050 Co Citalopram Cobalt 30250

18.75156.25

0.62500.6250

02313405 Jamp-Citalopram Jamp 30500

18.75312.50

0.62500.6250

02304686 Mint-Citalopram Mint 30500

18.75312.50

0.62500.6250

02246594 Mylan-Citalopram Mylan 30500

18.75312.50

0.62500.6250

02322781 NG-Citalopram NG Pharma 30500

18.75312.50

0.62500.6250

02293218 Novo-Citalopram Novopharm 30100

18.7562.50

0.62500.6250

02248944 phl-Citalopram Pharmel 30500

18.75312.50

0.62500.6250

02248010 pms-Citalopram Phmscience 30500

18.75312.50

0.62500.6250

02285622 Ran-Citalo Ranbaxy 30500

18.75312.50

0.62500.6250

02268000 Ran-Citalopram Ranbaxy 30500

18.75312.50

0.62500.6250

02252112 ratio-Citalopram Ratiopharm 30500

18.75312.50

0.62500.6250

02303264 Riva-Citalopram Riva 30500

18.75312.50

0.62500.6250

02248170 Sandoz Citalopram Sandoz 30500

18.75312.50

0.62500.6250

02301830 Zym-Citalopram Zymcan 100 62.50 0.6250

Tab. 30 mg

02296152 CTP 30 Sepracor 30 18.84 0.6280


Page 162 2010-06

Tab. 40 mg

02246057 Apo-Citalopram Apotex 30100

18.7562.50

0.62500.6250

02239608 Celexa Lundbeck 30 39.00 1.300002284855 Citalopram Genpharm 100 62.50 0.625002306247 Citalopram Odan Odan 30

10018.7562.50

0.62500.6250

02257521 Citalopram-40 Pro Doc 30100

18.7562.50

0.62500.6250

02248051 Co Citalopram Cobalt 30100

18.7562.50

0.62500.6250

02313413 Jamp-Citalopram Jamp 30100

18.7562.50

0.62500.6250

02304694 Mint-Citalopram Mint 30100

18.7562.50

0.62500.6250

02246595 Mylan-Citalopram Mylan 30100

18.7562.50

0.62500.6250

02322803 NG-Citalopram NG Pharma 30500

18.75312.50

0.62500.6250

02293226 Novo-Citalopram Novopharm 30100

18.7562.50

0.62500.6250

02248945 phl-Citalopram Pharmel 30100

18.7562.50

0.62500.6250

02248011 pms-Citalopram Phmscience 30100

18.7562.50

0.62500.6250

02285630 Ran-Citalo Ranbaxy 30100

18.7562.50

0.62500.6250

02268019 Ran-Citalopram Ranbaxy 100 62.50 0.625002252120 ratio-Citalopram Ratiopharm 30

10018.7562.50

0.62500.6250

02303272 Riva-Citalopram Riva 30100

18.7562.50

0.62500.6250

02248171 Sandoz Citalopram Sandoz 30100

18.7562.50

0.62500.6250

02301849 Zym-Citalopram Zymcan 100 62.50 0.6250

CLOMIPRAMINE HYDROCHLORIDE XXTab. 10 mg PPB

00330566 Anafranil Sepracor 100 25.81 0.258102040786 Apo-Clomipramine Apotex 100

50012.9064.50

0.12900.1290

02244816 Co Clomipramine Cobalt 100 12.90 0.1290

Tab. 25 mg PPB

00324019 Anafranil Sepracor 100 35.16 0.351602040778 Apo-Clomipramine Apotex 100

50017.5887.90

0.17580.1758

02244817 Co Clomipramine Cobalt 100 17.58 0.1758

Tab. 50 mg PPB

00402591 Anafranil Sepracor 100 64.74 0.647402040751 Apo-Clomipramine Apotex 100 32.37 0.323702244818 Co Clomipramine Cobalt 100 32.37 0.3237


2010-06 Page 163

DESIPRAMINE HYDROCHLORIDE XXTab. 10 mg PPB

02216248 Apo-Desipramine Apotex 100 38.04 0.191902211939 Nu-Desipramine Nu-Pharm 100 38.04 0.1919

Tab. 25 mg PPB

02216256 Apo-Desipramine Apotex 100500

17.2986.45

0.17290.1729

02211947 Nu-Desipramine Nu-Pharm 100500

17.2986.45

0.17290.1729

Tab. 50 mg PPB

02216264 Apo-Desipramine Apotex 100 30.48 0.304802211955 Nu-Desipramine Nu-Pharm 100 30.48 0.304801946277 pms-Desipramine Phmscience 100

50030.48

152.400.30480.3048

Tab. 75 mg PPB

02216272 Apo-Desipramine Apotex 100 46.96 0.469602211963 Nu-Desipramine Nu-Pharm 50 23.48 0.469601946242 pms-Desipramine Phmscience 50 23.48 0.4696

Tab. 100 mg

02216280 Apo-Desipramine Apotex 100 89.15 0.8915

DOXEPIN HYDROCHLORIDE XCaps. 10 mg PPB

02049996 Apo-Doxepin Apotex 100 18.89 0.125900024325 Sinequan Erfa 100 23.30 0.2330

Caps. 25 mg PPB

02050005 Apo-Doxepin Apotex 100 21.40 0.154401913425 Novo-Doxepin Novopharm 100 14.30 0.143000024333 Sinequan Erfa 100 28.59 0.2859

Caps. 50 mg PPB


Caps. 75 mg PPB



Page 164 2010-06

Caps. 100 mg PPB


Caps. 150 mg

01913476 Novo-Doxepin Novopharm 100 71.09 0.7109

FLUOXETINE HYDROCHLORIDE XXCaps. 10 mg PPB

02216353 Apo-Fluoxetine Apotex 100 86.50 0.865002242177 Co Fluoxetine Cobalt 100 86.50 0.865002286068 Fluoxetine Genpharm 100 86.50 0.865002237813 Mylan-Fluoxetine Mylan 100 86.50 0.865002216582 Novo-Fluoxetine Novopharm 100 86.50 0.865002192756 Nu-Fluoxetine Nu-Pharm 100 86.50 0.865002223481 phl-Fluoxetine Pharmel 100 86.50 0.865002177579 pms-Fluoxetine Phmscience 100 86.50 0.865002314991 Pro-Fluoxetine Pro Doc 100 86.50 0.865002018985 Prozac Lilly 100 165.96 1.659602241371 ratio-Fluoxetine Ratiopharm 100 86.50 0.865002242123 Riva-Fluoxetine Riva 100 86.50 0.865002243486 Sandoz Fluoxetine Sandoz 100 86.50 0.865002302659 Zym-Fluoxetine Zymcan 100 86.50 0.8650

Caps. 20 mg PPB

02216361 Apo-Fluoxetine Apotex 100500

80.25401.25

0.80250.8025

02242178 Co Fluoxetine Cobalt 100500

80.25401.25

0.80250.8025

02286076 Fluoxetine Genpharm 100500

80.25401.25

0.80250.8025

02237814 Mylan-Fluoxetine Mylan 100500

80.25401.25

0.80250.8025

02216590 Novo-Fluoxetine Novopharm 100500

80.25401.25

0.80250.8025

02223503 phl-Fluoxetine Pharmel 100500

80.25401.25

0.80250.8025

02177587 pms-Fluoxetine Phmscience 100500

80.25401.25

0.80250.8025

02315009 Pro-Fluoxetine Pro Doc 100500

80.25401.25

0.80250.8025

00636622 Prozac Lilly 100 169.65 1.696502241374 ratio-Fluoxetine Ratiopharm 100

50080.25

401.250.80250.8025

02305488 Riva-Fluoxetine Riva 100500

80.25401.25

0.80250.8025

02243487 Sandoz Fluoxetine Sandoz 100500

80.25401.25

0.80250.8025

02302667 Zym-Fluoxetine Zymcan 100 80.25 0.8025


2010-06 Page 165

Caps. 40 mg

02245283 FXT 40 Sepracor 100 202.67 2.0267

Oral Sol. 20 mg/5 mL

02231328 Apo-Fluoxetine Apotex 120 ml 70.31 0.4658

FLUVOXAMINE MALEATE XTab. 50 mg PPB

02231329 Apo-Fluvoxamine Apotex 100250

39.3098.25

0.39300.3930

02255529 Co Fluvoxamine Cobalt 100 39.30 0.393002236753 Fluvoxamine-50 Pro Doc 100 39.30 0.393001919342 Luvox Solvay 30 24.91 0.830302239953 Novo-Fluvoxamine Novopharm 100 39.30 0.393002262622 phl-Fluvoxamine Pharmel 100 39.30 0.393002240682 pms-Fluvoxamine Phmscience 100 39.30 0.393002218453 ratio-Fluvoxamine Ratiopharm 100 39.30 0.393002303345 Riva-Fluvox Riva 100

25039.3098.25

0.39300.3930

02247054 Sandoz Fluvoxamine Sandoz 100 39.30 0.3930

Tab. 100 mg PPB

02231330 Apo-Fluvoxamine Apotex 100250

70.65176.63

0.70650.7065

02255537 Co Fluvoxamine Cobalt 100 70.65 0.706502236754 Fluvoxamine-100 Pro Doc 100 70.65 0.706501919369 Luvox Solvay 30 44.80 1.493302239954 Novo-Fluvoxamine Novopharm 100 70.65 0.706502262630 phl-Fluvoxamine Pharmel 100 70.65 0.706502240683 pms-Fluvoxamine Phmscience 100 70.65 0.706502218461 ratio-Fluvoxamine Ratiopharm 100 70.65 0.706502303361 Riva-Fluvox Riva 100

25070.65

176.630.70650.7065

02247055 Sandoz Fluvoxamine Sandoz 100 70.65 0.7065

IMIPRAMINE HYDROCHLORIDE XTab. 10 mg

00360201 Apo-Imipramine Apotex 1001000

13.70137.00

0.10740.0896

Tab. 25 mg


23.53235.30

0.17090.1423


Page 166 2010-06

Tab. 50 mg PPB


38.07380.70

0.23740.2374

00010480 Tofranil Novartis 100 43.96 0.4396

Tab. 75 mg

00644579 Apo-Imipramine Apotex 100 55.29 0.3816

L-TRYPTOPHANE XCaps. or Tab. 500 mg PPB

02248540 Apo-Tryptophan (Caps.) Apotex 100 36.64 0.366402248538 Apo-Tryptophan (Tab.) Apotex 100 36.64 0.366402240445 pms-Tryptophan Phmscience 100

25036.6491.60

0.36640.3664

02241023 pms-Tryptophan (caps.) Phmscience 100 36.64 0.366402240333 ratio-Tryptophan Ratiopharm 100

25036.6491.60

0.36640.3664

02240334 ratio-Tryptophan Ratiopharm 100250

36.6491.60

0.36640.3664

00718149 Tryptan (Caps) Valeant 100 67.86 0.678602029456 Tryptan (Co.) Valeant 100 67.86 0.6786

Tab. 1 g PPB

02248539 Apo-Tryptophan (Tab.) Apotex 100 73.29 0.732902230202 pms-Tryptophan Phmscience 100

25073.29

183.220.73290.7329

02237250 ratio-Tryptophan Ratiopharm 100250

73.29183.22

0.73290.7329

00654531 Tryptan (Co.) Valeant 100 135.72 1.3572

Tab. 250 mg


Tab. 750 mg


MAPROTILIN HYDROCHLORIDE XTab. 25 mg

02158612 Novo-Maprotiline Novopharm 100 54.93 0.5493

Tab. 50 mg



2010-06 Page 167

Tab. 75 mg


MIRTAZAPINE XXTab. or Tab. Oral Disint. 15 mg

02286610 Apo-Mirtazapine Apotex 30 5.85 0.195002256096 Mylan-Mirtazapine Mylan 100 27.30 0.273002279894 Novo-Mirtazapine OD Novopharm 30 5.85 0.195002281732 phl-Mirtazapine Pharmel 100 27.30 0.273002273942 pms-Mirtazapine Phmscience 100 27.30 0.273002312778 Pro-Mirtazapine Pro Doc 100 27.30 0.273002248542 Remeron RD Schering 30 11.70 0.390002250594 Sandoz Mirtazapine Sandoz 50 9.75 0.195002325179 Zym-Mirtazapine Zymcan 100 27.30 0.2730

Tab. or Tab. Oral Disint. 30 mg

02286629 Apo-Mirtazapine Apotex 100 54.60 0.546002274361 Co Mirtazapine Cobalt 100 54.60 W 02256118 Mylan-Mirtazapine Mylan 500 273.00 0.546002259354 Novo-Mirtazapine Novopharm 30

10011.7054.60

0.39000.5460

02279908 Novo-Mirtazapine OD Novopharm 30 11.70 0.390002252279 phl-Mirtazapine Pharmel 30

10011.7054.60

0.39000.5460

02248762 pms-Mirtazapine Phmscience 30100

11.7054.60

0.39000.5460

02312786 Pro-Mirtazapine Pro Doc 30100

11.7054.60

0.39000.5460

02270927 ratio-Mirtazapine Ratiopharm 100 54.60 0.546002243910 Remeron Schering 30 37.20 1.240002248543 Remeron RD Schering 30 23.40 0.780002265265 Riva-Mirtazapine Riva 30

10011.7054.60

0.39000.5460

02250608 Sandoz Mirtazapine Sandoz 100 54.60 0.546002325187 Zym-Mirtazapine Zymcan 100 54.60 0.5460


02286637 Apo-Mirtazapine Apotex 30 17.55 0.585002256126 Mylan-Mirtazapine Mylan 100 81.90 0.819002279916 Novo-Mirtazapine OD Novopharm 30 17.55 0.585002248544 Remeron RD Schering 30 35.10 1.1700

MOCLOBÉMID XTab. 100 mg PPB

02232148 Apo-Moclobemide Apotex 100 25.20 0.252002239746 Novo-Moclobemide Novopharm 100 25.20 0.252002237111 Nu-Moclobemide Nu-Pharm 100 25.20 0.2520


Page 168 2010-06

Tab. 150 mg PPB

02232150 Apo-Moclobemide Apotex 100500

29.00145.00

0.29000.2900

00899356 Manerix Valeant 100 29.00 0.290002239747 Novo-Moclobemide Novopharm 100 29.00 0.290002243218 pms-Moclobemide Phmscience 100 29.00 0.2900

Tab. 300 mg PPB

02240456 Apo-Moclobemide Apotex 100 56.95 0.569502166747 Manerix Valeant 100 56.95 0.569502239748 Novo-Moclobemide Novopharm 100 56.95 0.569502243219 pms-Moclobemide Phmscience 100 56.95 0.5695

NORTRIPTYLINE HYDROCHLORIDE XXCaps. 10 mg PPB

02223511 Apo-Nortriptyline Apotex 100 10.00 0.100000015229 Aventyl MM Thera 100 20.00 0.101902229763 Nortriptyline-10 Pro Doc 100 10.00 0.100002231781 Novo-Nortriptyline Novopharm 100 10.00 0.100002177692 pms-Nortriptyline Phmscience 100 10.00 0.100002240789 ratio-Nortriptyline Ratiopharm 100 10.00 W

Caps. 25 mg PPB

02223538 Apo-Nortriptyline Apotex 100500

20.21101.10

0.20210.2022

00015237 Aventyl MM Thera 100 40.43 0.205802229764 Nortriptyline Pro Doc 100 20.21 0.202102231782 Novo-Nortriptyline Novopharm 100 20.21 0.202102177706 pms-Nortriptyline Phmscience 100 20.21 0.202102240790 ratio-Nortriptyline Ratiopharm 100 20.21 W

PAROXÉTINE HYDROCHLORIDE XTab. 10 mg PPB

02240907 Apo-Paroxetine Apotex 100 82.10 0.821002262746 Co Paroxetine Cobalt 100 82.10 0.821002248012 Mylan-Paroxetine Mylan 100 82.10 0.821002248556 Novo-Paroxetine Novopharm 30

10024.6382.10

0.82100.8210

02282844 * Paroxetine Sanis 100 82.10 0.821002248913 Paroxetine-10 Pro Doc 100 82.10 0.821002027887 Paxil GSK 30 47.25 1.575002248450 phl-Paroxetine Pharmel 100 82.10 0.821002247750 pms-Paroxetine Phmscience 30

10024.6382.10

0.82100.8210

02247810 ratio-Paroxetine Ratiopharm 30 24.63 0.821002248559 Riva-Paroxetine Riva 30

25024.63

205.250.82100.8210

02269422 Sandoz Paroxetine Sandoz 100 82.10 0.821002302012 Zym-Paroxetine Zymcan 100 82.10 0.8210


2010-06 Page 169

Tab. 20 mg PPB

02240908 Apo-Paroxetine Apotex 30500

23.85397.50

0.79500.7950

02262754 Co Paroxetine Cobalt 30500

23.85397.50

0.79500.7950

02248013 Mylan-Paroxetine Mylan 100500

79.50397.50

0.79500.7950

02248557 Novo-Paroxetine Novopharm 30500

23.85397.50

0.79500.7950

02282852 * Paroxetine Sanis 100500

79.50397.50

0.79500.7950

02248914 Paroxetine-20 Pro Doc 30500

23.85397.50

0.79500.7950

01940481 Paxil GSK 100 168.07 1.680702248451 phl-Paroxetine Pharmel 30

50023.85

397.500.79500.7950

02247751 pms-Paroxetine Phmscience 30500

23.85397.50

0.79500.7950

02247811 ratio-Paroxetine Ratiopharm 100180500

79.50143.10397.50

0.79500.79500.7950

02248560 Riva-Paroxetine Riva 100500

79.50397.50

0.79500.7950


Tab. 30 mg PPB

02240909 Apo-Paroxetine Apotex 100 84.50 0.845002262762 Co Paroxetine Cobalt 100 84.50 0.845002248014 Mylan-Paroxetine Mylan 100 84.50 0.845002248558 Novo-Paroxetine Novopharm 30

10025.3584.50

0.84500.8450

02282860 * Paroxetine Sanis 100 84.50 0.845002248915 Paroxetine-30 Pro Doc 100 84.50 0.845001940473 Paxil GSK 30 53.59 1.786302248452 phl-Paroxetine Pharmel 100 84.50 0.845002247752 pms-Paroxetine Phmscience 30

10025.3584.50

0.84500.8450

02247812 ratio-Paroxetine Ratiopharm 30 25.35 0.845002248561 Riva-Paroxetine Riva 30

25025.35

211.250.84500.8450


Tab. 40 mg

02293749 pms-Paroxetine Phmscience 100 159.00 1.5900

PHENELZINE SULFATE XXTab. 15 mg

00476552 Nardil Erfa 100 34.14 0.3414


Page 170 2010-06

SERTRALINE HYDROCHLORIDE XXCaps. 25 mg PPB

02238280 Apo-Sertraline Apotex 100 40.00 0.400002287390 Co Sertraline Cobalt 100 40.00 0.400002242519 Mylan-Sertraline Mylan 100 40.00 0.400002240485 Novo-Sertraline Novopharm 100 40.00 0.400002245824 phl-Sertraline Pharmel 100

25040.00

100.000.40000.4000

02244838 pms-Sertraline Phmscience 100 40.00 0.400002245787 ratio-Sertraline Ratiopharm 100 40.00 0.400002248496 Riva-Sertraline Riva 100

25040.00

100.000.40000.4000

02245159 Sandoz Sertraline Sandoz 100 40.00 0.400002284804 Sertraline Genpharm 100 40.00 0.400002241302 Sertraline-25 Pro Doc 100 40.00 0.400002132702 Zoloft Pfizer 100 80.00 0.800002303779 Zym-Sertraline Zymcan 100 40.00 0.4000

Caps. 50 mg PPB

02238281 Apo-Sertraline Apotex 100250

80.00200.00

0.80000.8000

02287404 Co Sertraline Cobalt 100250

80.00200.00

0.80000.8000

02242520 Mylan-Sertraline Mylan 100500

80.00400.00

0.80000.8000

02240484 Novo-Sertraline Novopharm 100250

80.00200.00

0.80000.8000

02245825 phl-Sertraline Pharmel 100250

80.00200.00

0.80000.8000

02244839 pms-Sertraline Phmscience 100250

80.00200.00

0.80000.8000

02245788 ratio-Sertraline Ratiopharm 100250

80.00200.00

0.80000.8000

02248497 Riva-Sertraline Riva 100250

80.00200.00

0.80000.8000

02245160 Sandoz Sertraline Sandoz 100250

80.00200.00

0.80000.8000

02284812 Sertraline Genpharm 100500

80.00400.00

0.80000.8000

02241303 Sertraline-50 Pro Doc 100250

80.00200.00

0.80000.8000

01962817 Zoloft Pfizer 100250

160.00400.00

1.60001.6000

02303809 Zym-Sertraline Zymcan 100 80.00 0.8000


2010-06 Page 171

Caps. 100 mg PPB

02238282 Apo-Sertraline Apotex 100250

87.50218.75

0.87500.8750

02287412 Co Sertraline Cobalt 100250

87.50218.75

0.87500.8750

02242521 Mylan-Sertraline Mylan 100 87.50 0.875002240481 Novo-Sertraline Novopharm 100 87.50 0.875002245826 phl-Sertraline Pharmel 100

25087.50

218.750.87500.8750

02244840 pms-Sertraline Phmscience 100250

87.50218.75

0.87500.8750

02245789 ratio-Sertraline Ratiopharm 100250

87.50218.75

0.87500.8750

02248498 Riva-Sertraline Riva 100250

87.50218.75

0.87500.8750

02245161 Sandoz Sertraline Sandoz 100 87.50 0.875002284820 Sertraline Genpharm 100 87.50 0.875002241304 Sertraline-100 Pro Doc 100

25087.50

218.750.87500.8750

01962779 Zoloft Pfizer 100 168.00 1.680002303817 Zym-Sertraline Zymcan 100 87.50 0.8750

TRANYLCYPROMINE SULFATE XXTab. 10 mg

01919598 Parnate GSK 100 35.31 0.3531

TRAZODONE HYDROCHLORIDE XTab. 50 mg PPB

02147637 Apo-Trazodone Apotex 100250

22.1455.35

0.22140.2214

00579351 Desyrel B.M.S. 100 22.14 0.221402231683 Mylan-Trazodone Mylan 100

25022.1455.35

0.22140.2214

02144263 Novo-Trazodone Novopharm 100500

22.14110.70

0.22140.2214

02236941 phl-Trazodone Pharmel 100500

22.14110.70

0.22140.2214

01937227 pms-Trazodone Phmscience 100500

22.14110.70

0.22140.2214

02277344 ratio-Trazodone Ratiopharm 100500

22.14110.70

0.22140.2214

02164353 Trazodone-50 Pro Doc 100250

22.1455.35

0.22140.2214

02325101 Zym-Trazodone Zymcan 100 22.14 0.2214

Tab. 75 mg

02237339 pms-Trazodone Phmscience 100 32.38 0.3238


Page 172 2010-06

Tab. 100 mg PPB

02147645 Apo-Trazodone Apotex 100500

39.56197.80

0.39560.3956

00579378 Desyrel B.M.S. 100 39.56 0.395602231684 Mylan-Trazodone Mylan 100 39.56 0.395602144271 Novo-Trazodone Novopharm 100

50039.56

197.800.39560.3956

02236942 phl-Trazodone Pharmel 100500

39.56197.80

0.39560.3956

01937235 pms-Trazodone Phmscience 100500

39.56197.80

0.39560.3956

02277352 ratio-Trazodone Ratiopharm 100 39.56 0.395602164361 Trazodone-100 Pro Doc 100

50039.56

197.800.39560.3956

02325128 Zym-Trazodone Zymcan 100 39.56 0.3956

Tab. 150 mg PPB

02147653 Apo-Trazodone D Apotex 100 58.12 0.581200702277 Desyrel B.M.S. 100 58.12 W 02144298 Novo-Trazodone Novopharm 100 58.12 0.581202165406 Nu-Trazodone-D Nu-Pharm 100 58.12 0.581202277360 ratio-Trazodone Ratiopharm 100 58.12 0.581202164388 Trazodone-150 D Pro Doc 100 58.12 0.5812

TRIMIPRAMINE XXCaps. 75 mg

02070987 Apo-Trimip Apotex 100 73.14 0.5381

Tab. 12.5 mg

00740799 Apo-Trimip Apotex 100 21.56 0.0850


2010-06 Page 173

VENLAFAXINE CHLORHYDRATE XXL.A. Caps. 37.5 mg

02331683 Apo-Venlafaxine XR Apotex 100500

42.00210.00

0.42000.4200

02304317 Co Venlafaxine XR Cobalt 100500

42.00210.00

0.42000.4200

02237279 Effexor XR Wyeth 1590

12.4374.56

0.82870.8284

02310279 Mylan-Venlafaxine XR Mylan 100500

42.00210.00

0.42000.4200

02275023 Novo-Venlafaxine XR Novopharm 100 42.00 0.420002278545 pms-Venlafaxine XR Phmscience 100

50042.00

210.000.42000.4200

02273969 ratio-Venlafaxine XR Ratiopharm 100500

42.00210.00

0.42000.4200

02307774 Riva-Venlafaxine XR Riva 100500

42.00210.00

0.42000.4200

02310317 Sandoz Venlafaxine XR Sandoz 100 42.00 0.420002339242 Venlafaxine XR Pro Doc 100

50042.00

210.000.42000.4200

L.A. Caps. 75 mg


83.99419.95

0.83990.8399


83.99419.95

0.83990.8399


24.86149.12

1.65731.6569


83.99419.95

0.83990.8399

02275031 Novo-Venlafaxine XR Novopharm 100500

83.99419.95

0.83990.8399

02278553 pms-Venlafaxine XR Phmscience 100500

83.99419.95

0.83990.8399


83.99419.95

0.83990.8399


83.99419.95

0.83990.8399

02310325 Sandoz Venlafaxine XR Sandoz 100500

83.99419.95

0.83990.8399

02339250 Venlafaxine XR Pro Doc 100500

83.99419.95

0.83990.8399


Page 174 2010-06

L.A. Caps. 150 mg


88.68443.40

0.88680.8868


88.68443.40

0.88680.8868


26.29157.72

1.75271.7524


88.68443.40

0.88680.8868

02275058 Novo-Venlafaxine XR Novopharm 100500

88.68443.40

0.88680.8868

02278561 pms-Venlafaxine XR Phmscience 100500

88.68443.40

0.88680.8868


88.68443.40

0.88680.8868


88.68443.40

0.88680.8868

02310333 Sandoz Venlafaxine XR Sandoz 100500

88.68443.40

0.88680.8868

02339269 Venlafaxine XR Pro Doc 100500

88.68443.40

0.88680.8868

28:16.08ANTIPSYCHOTIC AGENTSCHLORPROMAZINE HYDROCHLORIDE XXInj. Sol. 25 mg/mL

00743518 Chlorpromazine Sandoz 2 ml 1.39

Tab. 25 mg

00232823 Novo-Chlorpromazine Novopharm 100500

13.6568.25

0.13650.1365

Tab. 50 mg


15.6578.25

0.15650.1565

Tab. 100 mg


32.00160.00

0.32000.3200

CLOZAPIN XTab. 25 mg PPB

02248034 Apo-Clozapine Apotex 100 65.94 0.659400894737 Clozaril8 Novartis 100 94.20 0.942002247243 Gen-Clozapine Mylan 100 65.94 0.6594

8 Clozaril will be reimbursed at its guaranteed selling price for those persons insured with the RAMQ whose lastreimbursement for clozapin, by the RAMQ, in the last 365 days preceding 21 April 2008, was for Clozaril.


2010-06 Page 175

Tab. 50 mg

02305003 Gen-Clozapine Mylan 100 131.88 1.3188

Tab. 100 mg PPB

02248035 Apo-Clozapine Apotex 100 264.46 2.644600894745 Clozaril8 Novartis 100 377.80 3.778002247244 Gen-Clozapine Mylan 100 264.46 2.6446

Tab. 200 mg

02305011 Gen-Clozapine Mylan 100 528.92 5.2892

FLUPENTHIXOL DECANOATE XXI.M. Inj. Sol. 20 mg/mL

02156032 Fluanxol Depot 2% Lundbeck 1 ml 7.05

I.M. Inj. Sol. 100 mg/mL

02156040 Fluanxol Depot 10% Lundbeck 1 ml 35.23

FLUPENTHIXOL DIHYDROCHLORIDE XTab. 0.5 mg

02156008 Fluanxol Lundbeck 100 24.23 0.2423

Tab. 3 mg

02156016 Fluanxol Lundbeck 100 52.34 0.5234

FLUPHENAZINE DECANOATE XI.M. Inj. Sol. 25 mg/mL PPB

02239636 Fluphenazine Omega Oméga 5 ml 23.1602091275 pms-Fluphenazine

DecanoatePhmscience 5 ml 23.16

I.M. Inj. Sol. 100 mg/mL PPB

02242570 Fluphenazine Omega Oméga 1 ml 29.7800755575 Modecate Concentre B.M.S. 1 ml 29.7802241928 pms-Fluphenazine

DecanoatePhmscience 1 ml 29.78

8 Clozaril will be reimbursed at its guaranteed selling price for those persons insured with the RAMQ whose lastreimbursement for clozapin, by the RAMQ, in the last 365 days preceding 21 April 2008, was for Clozaril.


Page 176 2010-06

FLUPHENAZINE HYDROCHLORIDE XXElix. 2.5 mg/5 mL

00893420 pms-Fluphenazine Phmscience 500 ml 20.25 0.0405

Tab. 1 mg

00405345 Apo-Fluphenazine Apotex 100 17.39 0.1739

Tab. 2 mg

00410632 Apo-Fluphenazine Apotex 100 22.52 0.2113

Tab. 5 mg PPB

00405361 Apo-Fluphenazine Apotex 100 17.20 0.172000726354 pms-Fluphenazine Phmscience 100

50017.2086.00

0.17200.1720

HALOPERIDOL XI.M. Inj. Sol. 5 mg/mL

00808652 Haloperidol Sandoz 1 ml 3.96

Oral Sol. 2 mg/mL

00759503 pms-Haloperidol Phmscience 100 ml500 ml

10.7353.65

0.10730.1073

Tab. 0.5 mg PPB

00396796 Apo-Haloperidol Apotex 1001000

3.6036.00

0.03600.0360

00587796 Haloperidol-0.5 mg Pro Doc 100500

3.6018.00

W W

00363685 Novo-Peridol Novopharm 100 3.60 0.0360

Tab. 1 mg PPB


6.1461.40

0.06140.0614

00587788 Haloperidol-1 Pro Doc 100500

6.1430.70

W W

00363677 Novo-Peridol Novopharm 100500

6.1430.70

0.06140.0614


2010-06 Page 177

Tab. 2 mg PPB


10.50105.00

0.10500.1050


10.5052.50

W W


10.5052.50

0.10500.1050

Tab. 5 mg PPB


14.87148.70

0.14870.1487


14.8774.35

W W


14.8774.35

0.14870.1487

Tab. 10 mg PPB

00463698 Apo-Haloperidol Apotex 100 13.30 0.133000761761 Haloperidol-10 Pro Doc 100

50013.3066.50

W W


Tab. 20 mg


HALOPERIDOL (DECANOATE) XXI.M. Inj. Sol. 50 mg/mL PPB

02130297 Haloperidol LA Sandoz 5 ml 29.5202239639 Haloperidol-LA Omega Oméga 5 ml 28.03


02130300 Haloperidol LA Sandoz 1 ml5 ml

11.6758.33

02239640 Haloperidol-LA Omega Oméga 1 ml5 ml

11.0855.40

LOXAPINE HYDROCHLORIDE XI.M. Inj. Sol. 50 mg/mL

02169991 Loxapac I.M. Sandoz 1 ml 6.09

LOXAPINE SUCCINATE XTab. 2.5 mg

02242868 pms-Loxapine Phmscience 100 7.96 0.0796


Page 178 2010-06

Tab. 5 mg

02230837 pms-Loxapine Phmscience 100500

15.0075.00

0.15000.1500

Tab. 10 mg


24.98124.90

0.24980.2498

Tab. 25 mg


38.72193.60

0.38720.3872

Tab. 50 mg


51.62258.10

0.51620.5162

METHOTRIMEPRAZINE XXInj. Sol. 25 mg/mL

01927698 Nozinan SanofiAven 1 ml 3.20

Tab. 2 mg

02238403 Apo-Methoprazine Apotex 100 6.85 0.0523

Tab. 5 mg

02238404 Apo-Methoprazine Apotex 100500

5.2826.40

0.05280.0528

Tab. 25 mg


11.3156.55

0.11310.1131

Tab. 50 mg PPB


15.4177.05

0.15410.1541

02232905 pms-Methotrimeprazine Phmscience 100500

15.4177.05

0.15410.1541


2010-06 Page 179

OLANZAPINE XXTab. or Tab. Oral Disint. 2.5 mg

02281791 Apo-Olanzapine Apotex 100500

89.86449.30

0.89860.8986

02325659 Co Olanzapine Cobalt 100 89.86 0.898602276712 Novo-Olanzapine Novopharm 100 89.86 0.898602311968 Olanzapine Pro Doc 100 89.86 0.898602303116 pms-Olanzapine Phmscience 100 89.86 0.898602337126 Riva-Olanzapine Riva 100

50089.86

449.300.89860.8986

02310341 Sandoz Olanzapine Sandoz 100 89.86 0.898602229250 Zyprexa Lilly 100 171.82 1.7182



178.70893.50

1.78701.7870

02325667 Co Olanzapine Cobalt 100500

178.70893.50

1.78701.7870

02327562 Co Olanzapine ODT Cobalt 30 53.61 1.787002276720 Novo-Olanzapine Novopharm 100 178.70 1.787002321343 Novo-Olanzapine OD Novopharm 30 53.61 1.787002311976 Olanzapine Pro Doc 100 178.70 1.787002338645 Olanzapine ODT Pro Doc 30 53.61 1.787002303159 pms-Olanzapine Phmscience 100 178.70 1.787002303191 pms-Olanzapine ODT Phmscience 30 53.61 1.787002337134 Riva-Olanzapine Riva 100

500178.70893.50

1.78701.7870

02339811 Riva-Olanzapine ODT Riva 30 53.61 1.787002310368 Sandoz Olanzapine Sandoz 100 178.70 1.787002327775 Sandoz Olanzapine ODT Sandoz 30 53.61 1.787002229269 Zyprexa Lilly 100 343.64 3.436402243086 Zyprexa Zydis Lilly 28 98.49 3.5175

Tab. or Tab. Oral Disint. 7.5 mg

02281813 Apo-Olanzapine Apotex 100 269.58 2.695802325675 Co Olanzapine Cobalt 100 269.58 2.695802276739 Novo-Olanzapine Novopharm 100 269.58 2.695802311984 Olanzapine Pro Doc 100 269.58 2.695802303167 pms-Olanzapine Phmscience 100 269.58 2.695802337142 Riva-Olanzapine Riva 100

500269.58

1347.902.69582.6958

02310376 Sandoz Olanzapine Sandoz 100 269.58 2.695802229277 Zyprexa Lilly 100 515.46 5.1546


Page 180 2010-06



357.131785.65

3.57133.5713

02325683 Co Olanzapine Cobalt 100500

357.131785.65

3.57133.5713

02327570 Co Olanzapine ODT Cobalt 30 107.14 3.571302276747 Novo-Olanzapine Novopharm 100

500357.13

1785.653.57133.5713

02321351 Novo-Olanzapine OD Novopharm 30 107.14 3.571302311992 Olanzapine Pro Doc 100 357.13 3.571302338653 Olanzapine ODT Pro Doc 30 107.14 3.571302303175 pms-Olanzapine Phmscience 100 357.13 3.571302303205 pms-Olanzapine ODT Phmscience 30 107.14 3.571302337150 Riva-Olanzapine Riva 100

500357.13

1785.653.57133.5713



02281848 Apo-Olanzapine Apotex 100 535.53 5.355302325691 Co Olanzapine Cobalt 100 535.53 5.355302327589 Co Olanzapine ODT Cobalt 30 160.66 5.355302276755 Novo-Olanzapine Novopharm 100 535.53 5.355302321378 Novo-Olanzapine OD Novopharm 30 160.66 5.355302312018 Olanzapine Pro Doc 100 535.53 5.355302338661 Olanzapine ODT Pro Doc 30 160.66 5.355302303183 pms-Olanzapine Phmscience 100 535.53 5.355302303213 pms-Olanzapine ODT Phmscience 30 160.66 5.355302337169 Riva-Olanzapine Riva 100

500535.53

2677.655.35535.3553



02333015 Apo-Olanzapine Apotex 100 742.26 7.422602325713 Co Olanzapine Cobalt 100 742.26 7.422602327597 Co Olanzapine ODT Cobalt 30 227.93 7.597702321386 Novo-Olanzapine OD Novopharm 30 222.68 7.422602327805 Sandoz Olanzapine ODT Sandoz 30 222.68 7.422602238851 Zyprexa Lilly 100 1374.57 13.745702243089 Zyprexa Zydis Lilly 28 393.96 14.0700

PERICYAZINE XXCaps. 5 mg

01926780 Neuleptil Erfa 100 17.41 0.1741


2010-06 Page 181

Caps. 10 mg

01926772 Neuleptil Erfa 100 26.80 0.2680

Caps. 20 mg

01926764 Neuleptil Erfa 100 42.30 0.4230

Oral Sol. 10 mg/mL

01926756 Neuleptil Erfa 100 ml 29.48 0.2948

PERPHENAZINE XXTab. 2 mg

00335134 Apo-Perphenazine Apotex 100 6.26 0.0626

Tab. 4 mg


Tab. 8 mg


Tab. 16 mg


PIMOZIDE XTab. 2 mg PPB

02245432 Apo-Pimozide Apotex 100 22.79 0.227900313815 Orap MM Thera 100 22.79 0.2279

Tab. 4 mg PPB

02245433 Apo-Pimozide Apotex 100 41.36 0.413600313823 Orap MM Thera 100 41.36 0.4136

PIPOTIAZINE PALMITATE XI.M. Inj. Sol. 25 mg/mL

01926667 Piportil L4 25 SanofiAven 1 ml 12.89


01926675 Piportil L4 100 SanofiAven 2 ml 41.5200894672 Piportil L4 50 SanofiAven 1 ml 21.84


Page 182 2010-06

PROCHLORPERAZINE XXSupp. 10 mg PPB

00753688 pms-Prochlorperazine Phmscience 10 8.30 0.830000789720 Sandoz Prochlorperazine Sandoz 10 8.30 0.8300

PROCHLORPERAZINE MALEATE XTab. 5 mg PPB

00886440 Apo-Prochlorazine Apotex 100 10.55 0.105500753661 pms-Prochlorperazine Phmscience 100

50010.5552.75

0.10550.1055

Tab. 10 mg PPB


50012.9064.50

0.12900.1290

PROCHLORPERAZINE MESYLATE XInj. Sol. 5 mg/mL

00789747 Prochlorperazine Sandoz 2 ml 1.38

QUETIAPINE (FUMARATE) XL.A. Tab. 50 mg

02300184 Seroquel XR AZC 60 58.80 0.9800

L.A. Tab. 150 mg

02321513 Seroquel XR AZC 60 115.80 1.9300

L.A. Tab. 200 mg

02300192 Seroquel XR AZC 60 157.20 2.6200

L.A. Tab. 300 mg

02300206 Seroquel XR AZC 60 231.60 3.8600

L.A. Tab. 400 mg

02300214 Seroquel XR AZC 60 314.40 5.2400


2010-06 Page 183

Tab. 25 mg

02313901 Apo-Quetiapine Apotex 100500

24.70123.50

0.24700.2470

02316080 Co Quetiapine Cobalt 100500

24.70123.50

0.24700.2470

02330415 Jamp-Quetiapine Jamp 100500

24.70123.50

0.24700.2470

02307804 Mylan-Quetiapine Mylan 60100

14.8224.70

0.24700.2470

02284235 Novo-Quetiapine Novopharm 30500

7.41123.50

0.24700.2470

02296551 pms-Quetiapine Phmscience 60500

14.82123.50

0.24700.2470

02317346 Pro-Quetiapine Pro Doc 100500

24.70123.50

0.24700.2470

02317893 Quetiapine Zymcan 100 24.70 0.247002311704 ratio-Quetiapine Ratiopharm 100

50024.70

123.500.24700.2470

02316692 Riva-Quetiapine Riva 100500

24.70123.50

0.24700.2470

02313995 Sandoz Quetiapine Sandoz 60500

14.82123.50

0.24700.2470

02236951 Seroquel AZC 60100

29.6549.40

0.49420.4940

Tab. 100 mg


65.90329.50

0.65900.6590


65.90329.50

0.65900.6590

02330423 Jamp-Quetiapine Jamp 100500

65.90329.50

0.65900.6590

02307812 Mylan-Quetiapine Mylan 90100

59.3165.90

0.65900.6590


19.77329.50

0.65900.6590


59.31329.50

0.65900.6590


65.90329.50

0.65900.6590


50065.90

329.500.65900.6590


65.90329.50

0.65900.6590

02314002 Sandoz Quetiapine Sandoz 100500

65.90329.50

0.65900.6590

02236952 Seroquel AZC 90100

118.65131.80

1.31831.3180

Tab. 150 mg

02284251 Novo-Quetiapine Novopharm 100 96.56 0.9656


Page 184 2010-06

Tab. 200 mg


132.33661.65

1.32331.3233


132.33661.65

1.32331.3233

02330458 Jamp-Quetiapine Jamp 100 132.33 1.323302307839 Mylan-Quetiapine Mylan 90

100119.10132.33

1.32331.3233


39.70132.33

1.32331.3233


119.10661.65

1.32331.3233


132.33661.65

1.32331.3233


500132.33661.65

1.32331.3233


132.33661.65

1.32331.3233

02314010 Sandoz Quetiapine Sandoz 100 132.33 1.323302236953 Seroquel AZC 90

100238.20264.70

2.64672.6470

Tab. 300 mg


193.12965.60

1.93121.9312


193.12965.60

1.93121.9312

02330466 Jamp-Quetiapine Jamp 100 193.12 1.931202307847 Mylan-Quetiapine Mylan 100 193.12 1.931202284286 Novo-Quetiapine Novopharm 30

10057.94

193.121.93121.9312


193.12965.60

1.93121.9312


193.12965.60

1.93121.9312


500193.12965.60

1.93121.9312


193.12965.60

1.93121.9312

02314029 Sandoz Quetiapine Sandoz 100 193.12 1.931202244107 Seroquel AZC 100 386.25 3.8625


2010-06 Page 185

RISPERIDONE XXTab. 0.25 mg PPB

02282119 Apo-Risperidone Apotex 100500

20.75103.75

0.20750.2075

02282585 Co Risperidone Cobalt 100 20.75 0.207502282240 Mylan-Risperidone Mylan 60

10012.4520.75

0.20750.2075

02282690 Novo-Risperidone Novopharm 60100

12.4520.75

0.20750.2075

02258439 phl-Risperidone Pharmel 100500

20.75103.75

0.20750.2075

02252007 pms-Risperidone Phmscience 100500

20.75103.75

0.20750.2075

02312700 Pro-Risperidone Pro Doc 100 20.75 0.207502280906 Ran-Risperidone Ranbaxy 100 20.75 0.207502264757 ratio-Risperidone Ratiopharm 100 20.75 0.207502328305 RBX-Risperidone Ranbaxy 100

50020.75

103.750.20750.2075

02240551 Risperdal J.O.I. 100 20.75 0.207502283565 Riva-Risperidone Riva 100 20.75 0.207502303655 Sandoz Risperidone Sandoz 100 20.75 0.207502303485 Zym-Risperidone Zymcan 100 20.75 0.2075

Tab. Oral Disint. or Tab. 0.5 mg PPB


34.75173.75

0.34750.3475

02282593 Co Risperidone Cobalt 100 34.75 0.347502282259 Mylan-Risperidone Mylan 60

10020.8534.75

0.34750.3475


20.8534.75

0.34750.3475


34.75173.75

0.34750.3475


34.75173.75

0.34750.3475

02312719 Pro-Risperidone Pro Doc 100500

34.75173.75

0.34750.3475

02280914 Ran-Risperidone Ranbaxy 100 34.75 0.347502264765 ratio-Risperidone Ratiopharm 100 34.75 0.347502328313 RBX-Risperidone Ranbaxy 100

50034.75

173.750.34750.3475

02240552 Risperdal J.O.I. 100 34.75 0.347502247704 Risperdal M-Tab J.O.I. 28 19.97 0.713202283573 Riva-Risperidone Riva 100 34.75 0.347502303663 Sandoz Risperidone Sandoz 100 34.75 0.347502303493 Zym-Risperidone Zymcan 100 34.75 0.3475


Page 186 2010-06

Tab. Oral Disint. or Tab. 1 mg PPB


48.00240.00

0.48000.4800

02282607 Co Risperidone Cobalt 60500

28.80240.00

0.48000.4800

02282267 Mylan-Risperidone Mylan 60500

28.80240.00

0.48000.4800


28.8048.00

0.48000.4800


28.80240.00

0.48000.4800


28.80240.00

0.48000.4800


28.80240.00

0.48000.4800

02280922 Ran-Risperidone Ranbaxy 500 240.00 0.480002264773 ratio-Risperidone Ratiopharm 60

50028.80

240.000.48000.4800

02328321 RBX-Risperidone Ranbaxy 100500

48.00240.00

0.48000.4800

02025280 Risperdal J.O.I. 60500

28.80240.00

0.48000.4800

02247705 Risperdal M-Tab J.O.I. 28 27.64 0.987102283581 Riva-Risperidone Riva 100

50048.00

240.000.48000.4800

02279800 Sandoz Risperidone Sandoz 60500

28.80240.00

0.48000.4800

02303507 Zym-Risperidone Zymcan 100 48.00 0.4800



95.83479.15

0.95830.9583


57.50479.15

0.95830.9583


57.50479.15

0.95830.9583


57.50479.15

0.95830.9583


57.50479.15

0.95830.9583


57.50479.15

0.95830.9583


57.50479.15

0.95830.9583


50057.50

479.150.95830.9583

02328348 RBX-Risperidone Ranbaxy 100500

95.83479.15

0.95830.9583

02025299 Risperdal J.O.I. 60500

57.50479.15

0.95830.9583


50095.83

479.150.95830.9583


57.50479.15

0.95830.9583



2010-06 Page 187



143.75359.38

1.43751.4375


86.25359.38

1.43751.4375


86.25143.75

1.43751.4375


86.25718.75

1.43751.4375


86.25718.75

1.43751.4375


86.25718.75

1.43751.4375


86.25143.75

1.43751.4375


25086.25

359.381.43751.4375

02328364 RBX-Risperidone Ranbaxy 100 143.75 1.437502025302 Risperdal J.O.I. 60

25086.25

359.381.43751.4375


250143.75359.38

1.43751.4375


86.25359.38

1.43751.4375



02282178 Apo-Risperidone Apotex 100 191.67 1.916702282631 Co Risperidone Cobalt 60 115.00 1.916702282291 Mylan-Risperidone Mylan 60

100115.00191.67

1.91671.9167

02264234 Novo-Risperidone Novopharm 60 115.00 1.916702258498 phl-Risperidone Pharmel 100 191.67 1.916702252066 pms-Risperidone Phmscience 100 191.67 1.916702312751 Pro-Risperidone Pro Doc 100 191.67 1.916702280957 Ran-Risperidone Ranbaxy 60 115.00 1.916702264811 ratio-Risperidone Ratiopharm 100 191.67 1.916702328372 RBX-Risperidone Ranbaxy 100 191.67 1.916702025310 Risperdal J.O.I. 60 115.00 1.916702268094 Risperdal M-Tab J.O.I. 28 110.35 3.941102283638 Riva-Risperidone Riva 60 115.00 1.916702279835 Sandoz Risperidone Sandoz 60 115.00 1.916702303531 Zym-Risperidone Zymcan 100 191.67 1.9167

RISPERIDONE TARTRATE XXOral Sol. 1 mg/mL PPB

02280396 Apo-Risperidone Apotex 30 ml 16.56 0.552002279266 pms-Risperidone Phmscience 30 ml 16.56 0.552002236950 Risperdal J.O.I. 30 ml 16.56 0.5520


Page 188 2010-06

THIOPROPERAZINE MESYLATE XXTab. 10 mg

01927639 Majeptil Erfa 100 31.42 0.3142

THIOTHIXENE XCaps. 2 mg

00024430 Navane Erfa 100 18.42 0.1842

Caps. 5 mg

00024449 Navane Erfa 100 31.66 0.3166

Caps. 10 mg

00024457 Navane Erfa 100 40.76 0.4076

TRIFLUOPERAZINE HYDROCHLORIDE XOral Sol. 10 mg/mL

00751871 pms-Trifluoperazine Phmscience 50 ml 12.44 0.2488

Tab. 1 mg

00345539 Apo-Trifluoperazine Apotex 100 13.40 0.1051

Tab. 2 mg

00312754 Apo-Trifluoperazine Apotex 1001000

17.58175.80

0.13780.1149

Tab. 5 mg


23.28232.80

0.18280.1522

Tab. 10 mg


27.90279.00

0.21900.1824

Tab. 20 mg

00595942 Apo-Trifluoperazine Apotex 100 55.80 0.3728


2010-06 Page 189

ZIPRASIDONE XXCaps. 20 mg

02298597 Zeldox Pfizer 60100

99.00165.00

1.65001.6500

Caps. 40 mg


113.40189.00

1.89001.8900

Caps. 60 mg


113.40189.00

1.89001.8900

Caps. 80 mg


113.40189.00

1.89001.8900

ZUCLOPENTHIXOL ACETATE XI.M. Inj. Sol. 50 mg/mL

02230405 Clopixol-acuphase Lundbeck 1 ml 14.62

ZUCLOPENTHIXOL DECANOATE XI.M. Inj. Sol. 200 mg/mL

02230406 Clopixol depot Lundbeck 1 ml 14.62

ZUCLOPENTHIXOL DIHYDROCHLORIDE XTab. 10 mg

02230402 Clopixol Lundbeck 100 37.60 0.3760

Tab. 25 mg

02230403 Clopixol Lundbeck 100 94.00 0.9400

28:20.04AMPHETAMINESDEXAMPHETAMINE SULFATE Y

L.A. Caps. 10 mg

01924559 Dexedrine Paladin 100 78.72 0.6156


Page 190 2010-06

L.A. Caps. 15 mg


Tab. 5 mg


28:20.92CNS STIMULANTS, MISCELLANEOUSMETHYLPHENIDATE HYDROCHLORIDE YL.A. Tab. 20 mg PPB

02266687 Apo-Methylphenidate SR Apotex 100 28.20 0.275700632775 Ritalin SR Novartis 100 51.04 0.510402320312 Sandoz Methylphenidate SR Sandoz 100 28.20 0.2757

Tab. 5 mg PPB

02273950 Apo-Methylphenidate Apotex 100 9.47 0.094702326221 Methylphenidate Pro Doc 100 9.47 0.094702246991 phl-Methylphenidate Pharmel 100

5009.47

47.350.09470.0947

02234749 pms-Methylphenidate Phmscience 100500

9.4747.35

0.09470.0947

Tab. 10 mg PPB

02249324 Apo-Methylphenidate Apotex 100500

12.6263.10

0.12620.1262

02326248 Methylphenidate Pro Doc 100500

12.6263.10

0.12620.1262

02126494 phl-Methylphenidate Pharmel 100500

12.6263.10

0.12620.1262


12.6263.10

0.12620.1262

00005606 Ritalin Novartis 100500

27.71134.04

0.27710.2681

Tab. 20 mg PPB

02249332 Apo-Methylphenidate Apotex 100 24.35 0.243502326256 Methylphenidate Pro Doc 100 24.35 0.243502126486 phl-Methylphenidate Pharmel 100

50024.35

121.770.24350.2435


24.35121.77

0.24350.2435

00005614 Ritalin Novartis 100500

48.43234.73

0.48430.4695


2010-06 Page 191

28:24.08BENZODIAZEPINESALPRAZOLAM VVTab. 0.25 mg PPB

01908189 Alprazolam-0.25 Pro Doc 1001000

7.6076.00

0.07600.0760

00865397 Apo-Alpraz Apotex 1001000

7.6076.00

0.07600.0760

02137534 Mylan-Alprazolam Mylan 1001000

7.6076.00

0.07600.0760

01913484 Novo-Alprazol Novopharm 1001000

7.6076.00

0.07600.0760

00548359 Xanax Pfizer 1001000

18.73176.26

0.18730.1763

Tab. 0.5 mg PPB

01908170 Alprazolam-0.5 Pro Doc 1001000

9.2092.00

0.09200.0920

00865400 Apo-Alpraz Apotex 1001000

9.2092.00

0.09200.0920

02137542 Mylan-Alprazolam Mylan 1001000

9.2092.00

0.09200.0920

01913492 Novo-Alprazol Novopharm 1001000

9.2092.00

0.09200.0920

00548367 Xanax Pfizer 1001000

22.39211.12

0.22390.2111

Tab. 1 mg PPB

02248706 Alprazolam-1 Pro Doc 100 20.92 0.209202243611 Apo-Alpraz Apotex 100 20.92 0.209202229813 Mylan-Alprazolam Mylan 100 20.92 0.209200723770 Xanax Pfizer 100 40.30 0.4030

Tab. 2 mg PPB

02243612 Apo-Alpraz TS Apotex 100 37.18 0.371802229814 Mylan-Alprazolam Mylan 100 37.18 0.371800813958 Xanax TS Pfizer 100 71.64 0.7164

BROMAZEPAM VTab. 1.5 mg PPB

02177153 Apo-Bromazepam Apotex 100 5.15 0.051502192705 Gen-Bromazepam Genpharm 100 5.15 0.0515


Page 192 2010-06

Tab. 3 mg PPB

02177161 Apo-Bromazepam Apotex 100500

7.0035.00

0.07000.0700

02220520 Bromazepam-3 Pro Doc 100500

7.0035.00

0.07000.0700

02192713 Gen-Bromazepam Genpharm 100500

7.0035.00

0.07000.0700

00518123 Lectopam 3 Roche 100 14.87 0.148702230584 Novo-Bromazepam Novopharm 100

5007.00

35.000.07000.0700

Tab. 6 mg PPB

02177188 Apo-Bromazepam Apotex 100500

10.2251.10

0.10220.1022

02220539 Bromazepam-6 Pro Doc 100500

10.2251.10

0.10220.1022

02192721 Gen-Bromazepam Genpharm 100500

10.2251.10

0.10220.1022

00518131 Lectopam 6 Roche 100 21.72 0.217202230585 Novo-Bromazepam Novopharm 100

50010.2251.10

0.10220.1022

CHLORDIAZEPOXIDE HYDROCHLORIDE VVCaps. 5 mg

00522724 Apo-Chlordiazepoxide Apotex 100 6.79 0.0679

Caps. 10 mg


Caps. 25 mg


DIAZEPAM VInj. Sol. 5 mg/mL

00399728 Diazepam Sandoz 2 ml 1.14

Oral Sol. 1 mg/mL

00891797 pms-Diazepam Phmscience 500 ml 36.82 0.0736

Rectal Gel 5 mg/mL

02238162 Diastat Valeant 1 ml2 ml3 ml

71.0971.0971.09


2010-06 Page 193

Tab. 2 mg PPB

00405329 Apo-Diazepam Apotex 1001000

5.0850.80

0.05080.0508

02247173 Bio-Diazepam Biomed 100 5.08 0.050800434396 Diazepam-2 Pro Doc 100 5.08 0.050802247490 pms-Diazepam Biomed 100 5.08 0.0508

Tab. 5 mg PPB


6.5065.00

0.06500.0650

02247174 Bio-Diazepam Biomed 500 32.50 0.065000313580 Diazepam-5 Pro Doc 100

10006.50

65.000.06500.0650

02247491 pms-Diazepam Biomed 500 32.50 0.065000013285 Valium Roche 100 15.19 0.151900013765 Vivol Axxess 100

10006.50

65.000.06500.0650

Tab. 10 mg PPB


8.6786.70

0.08670.0867

02247176 Bio-Diazepam Biomed 500 43.35 0.086700434388 Diazepam-10 Pro Doc 100

10008.67

86.700.08670.0867

02247492 pms-Diazepam Biomed 500 43.35 0.086700013773 Vivol Axxess 100

10008.67

86.700.08670.0867

FLURAZEPAM HYDROCHLORIDE VVCaps. or Tab. 15 mg PPB

00521698 Apo-Flurazepam Apotex 100 8.10 0.081002248126 Bio-Flurazepam Biomed 120 8.10 0.067500578479 Flurazepam-15 Pro Doc 100 8.10 0.069900483826 Somnol Axxess 100 6.75 0.0675


00521701 Apo-Flurazepam Apotex 100 9.30 0.093002248127 Bio-Flurazepam Biomed 120 9.30 0.077500578487 Flurazepam-30 Pro Doc 100 9.30 0.080300483818 Somnol Axxess 100 7.75 0.0775


Page 194 2010-06

LORAZEPAM VVTab. 0.5 mg PPB

00655740 Apo-Lorazepam Apotex 100500

3.5917.95

0.03590.0359

02041413 Ativan Wyeth 500 17.95 0.035900711101 Novo-Lorazem Novopharm 100

10003.59

35.900.03590.0359

02298201 phl-Lorazepam Pharmel 1001000

3.5935.90

0.03590.0359

00728187 pms-Lorazepam Phmscience 1001000

3.5935.90

0.03590.0359

00655643 Pro-Lorazepam Pro Doc 100500

3.5917.95

0.03590.0359

Tab. 1 mg PPB


4.4744.70

0.04470.0447


10004.47

44.700.04470.0447


4.4744.70

0.04470.0447


4.4744.70

0.04470.0447


4.4744.70

0.04470.0447

Tab. 2 mg PPB


6.9969.90

0.06990.0699


10006.99

69.900.06990.0699


6.9969.90

0.06990.0699


6.9969.90

0.06990.0699


6.9969.90

0.06990.0699

MIDAZOLAM VInj. Sol. 1 mg/mL

02240285 Midazolam Sandoz 2 ml5 ml

10 ml

1.313.284.39

Inj. Sol. 5 mg/mL

02240286 Midazolam Sandoz 1 ml2 ml

10 ml

3.375.62

18.57


2010-06 Page 195

NITRAZEPAM VVTab. 5 mg PPB

02245230 Apo-Nitrazepam Apotex 100 6.80 0.068002229654 Nitrazadon Valeant 100 6.80 0.068002234003 Sandoz Nitrazepam Sandoz 100

5006.80

42.850.06800.0857

Tab. 10 mg PPB

02245231 Apo-Nitrazepam Apotex 100 10.17 0.101702229655 Nitrazadon Valeant 100 10.17 0.101702234007 Sandoz Nitrazepam Sandoz 100

50010.1764.10

0.10170.1282

OXAZEPAM VTab. 10 mg PPB

00402680 Apo-Oxazepam Apotex 1001000

3.5035.00

0.03500.0350

02247177 Bio-Oxazepam Biomed 100 3.50 0.035000497754 Oxazepam-10 Pro Doc 100

10003.50

35.000.03500.0350

00568392 Riva-Oxazepam Riva 1001000

3.5035.00

0.03500.0350

Tab. 15 mg PPB


5.5055.00

0.05500.0550


10005.50

55.000.05500.0550


5.5055.00

0.05500.0550

Tab. 30 mg PPB


7.5075.00

0.07500.0750


10007.50

75.000.07500.0750


7.5075.00

0.07500.0750


Page 196 2010-06

TEMAZEPAM VVCaps. 15 mg PPB

02225964 Apo-Temazepam Apotex 100500

8.7543.75

0.08750.0875

02244814 Co Temazepam Cobalt 100 8.75 0.087502230095 Novo-Temazepam Novopharm 100 8.75 0.087502297957 phl-Temazepam Pharmel 100

5008.75

43.750.08750.0875

02273039 pms-Temazepam Phmscience 100500

8.7543.75

0.08750.0875

02243023 ratio-Temazepam Ratiopharm 100500

8.7543.75

0.08750.0875

00604453 Restoril Sepracor 100 17.50 0.175002229760 Temazepam-15 Pro Doc 100

5008.75

43.750.08750.0875

Caps. 30 mg PPB

02225972 Apo-Temazepam Apotex 100500

10.5252.65

0.10520.1053

02244815 Co Temazepam Cobalt 100 10.52 0.105202230102 Novo-Temazepam Novopharm 100 10.52 0.105202297965 phl-Temazepam Pharmel 100

50010.5252.65

0.10520.1053

02273047 pms-Temazepam Phmscience 100500

10.5252.65

0.10520.1053

02243024 ratio-Temazepam Ratiopharm 100500

10.5252.65

0.10520.1053

00604461 Restoril Sepracor 100 21.05 0.210502229761 Temazepam-30 Pro Doc 100

50010.5252.65

0.10520.1053

TRIAZOLAM VTab. 0.125 mg PPB

00808563 Apo-Triazo Apotex 70 8.27 0.056701995227 Mylan-Triazolam Mylan 70 8.27 0.0567

Tab. 0.25 mg PPB

00808571 Apo-Triazo Apotex 70 14.60 0.071301913506 Mylan-Triazolam Mylan 70 14.60 0.0713

28:24.92MISCELLANEOUS ANXIOLYTICS, SEDATIVES, HYPNOTICSBUSPIRON HYDROCHLORIDE XTab. 5 mg

02230941 pms-Buspirone Phmscience 100 39.84 0.3984


2010-06 Page 197

Tab. 10 mg PPB

02211076 Apo-Buspirone Apotex 100 35.21 0.352100603821 BuSpar B.M.S. 100 35.21 0.352102223163 Buspirone-10 Pro Doc 100 35.21 0.352102230874 Mylan-Buspirone Mylan 100 35.21 0.352102231492 Novo-Buspirone Novopharm 100 35.21 0.352102207672 Nu-Buspirone Nu-Pharm 100 35.21 0.352102230942 pms-Buspirone Phmscience 100 35.21 0.352102237858 ratio-Buspirone Ratiopharm 100 35.21 0.352102242149 Riva-Buspirone Riva 100

50035.21

176.050.35210.3521

CHLORAL HYDRATE XXSyr. 500 mg/5 mL PPB

02247621 Chloral Hydrate-Odan Odan 500 ml 21.67 0.043300792659 pms-Chloral Hydrate Phmscience 500 ml 21.67 0.0433

HYDROXYZINE HYDROCHLORIDE XCaps. 10 mg PPB

00646059 Apo-Hydroxyzine Apotex 100 11.16 0.033900739618 Hydroxyzine-10 Pro Doc 100

50011.1655.80

0.03440.0344

00738824 Novo-Hydroxyzin Novopharm 100 3.32 0.033202241192 Riva-Hydroxyzin Riva 100

5003.32

16.600.03320.0332

Caps. 25 mg PPB

00646024 Apo-Hydroxyzine Apotex 100 14.25 0.054800739626 Hydroxyzine-25 Pro Doc 100

50014.2571.25

0.05580.0557

00738832 Novo-Hydroxyzin Novopharm 100 5.38 0.053802241193 Riva-Hydroxyzin Riva 100

5005.38

26.900.05380.0538

Caps. 50 mg PPB

00646016 Apo-Hydroxyzine Apotex 100 20.68 0.076400739634 Hydroxyzine-50 Pro Doc 100 20.68 0.077700738840 Novo-Hydroxyzin Novopharm 100 7.50 0.075002241194 Riva-Hydroxyzin Riva 100 7.50 0.0750


00742813 Hydroxyzine Sandoz 1 ml 3.81

Syr. 10 mg/5 mL PPB

00024694 Atarax Erfa 473 ml 21.90 0.046300741817 pms-Hydroxyzine Phmscience 500 ml 20.13 0.0278


Page 198 2010-06

PROMETHAZINE HYDROCHLORIDETab. 50 mg

00575186 Histantil Phmscience 100 16.43 0.1643

28:28ANTIMANIC AGENTSLITHIUM CARBONATE XXCaps. 150 mg

02242837 Apo-Lithium Carbonate Apotex 100 4.22 0.042200461733 Carbolith Valeant 100 11.41 0.114102304511 Euro-Lithium Euro-Pharm 100 4.22 0.042202013231 Lithane Erfa 100 8.70 0.087002237441 Pal-Lithium Paladin 100

10006.33

63.300.06330.0633

02237006 phl-Lithium Carbonate Pharmel 1001000

4.2242.20

0.04220.0422

02216132 pms-Lithium carbonate Phmscience 1001000

4.2242.20

0.04220.0422

Caps. 300 mg

02242838 Apo-Lithium Carbonate Apotex 1001000

4.4344.30

0.04430.0443

00236683 Carbolith Valeant 1001000

8.8688.61

0.08860.0886

02304538 Euro-Lithium Euro-Pharm 1000 44.30 0.044300406775 Lithane Erfa 1000 93.57 0.093602237442 Pal-Lithium Paladin 100

10006.64

66.400.06640.0664

02237007 phl-Lithium Carbonate Pharmel 1001000

4.4344.30

0.04430.0443

02216140 pms-Lithium carbonate Phmscience 1001000

4.4344.30

0.04430.0443

Caps. 600 mg

02011239 Carbolith Valeant 100 17.00 0.170002237443 Pal-Lithium Paladin 100 13.60 0.136002237008 phl-Lithium Carbonate Pharmel 100 9.18 0.091802216159 pms-Lithium carbonate Phmscience 100 9.18 0.0918

LITHIUM CITRATE XSyr. 300 mg/5 mL

02074834 pms-Lithium Citrate Phmscience 500 ml 15.55 0.0311

28:32.28SELECTIVE SEROTONIN AGONISTSALMOTRIPTAN MALATE XTab. 6.25 mg

02248128 Axert McNeil Co 6 78.26 13.0133


2010-06 Page 199

Tab. 12.5 mg

02248129 Axert McNeil Co 6 78.26 13.0133

ELETRIPTAN (HYDROBROMIDE) XTab. 20 mg

02256290 Relpax Pfizer 6 77.70 12.9500

Tab. 40 mg

02256304 Relpax Pfizer 6 77.70 12.9500

NARATRIPTAN HYDROCHLORIDE XTab. 1 mg

02237820 Amerge GSK 8 103.93 12.991302314290 Novo-Naratriptan Novopharm 8 62.36 7.7950

Tab. 2.5 mg

02237821 Amerge GSK 824

109.51328.52

13.688813.6883

02314304 Novo-Naratriptan Novopharm 8 59.13 7.391302322323 Sandoz Naratriptan Sandoz 8

2459.13

177.407.39137.3917

RIZATRIPTAN BENZOATE XTab. or Tab. Oral Disint. 5 mg

02240520 Maxalt Merck 6 82.13 13.688302240518 Maxalt RPD Merck 6 82.13 13.6883


02240521 Maxalt Merck 612

82.13164.27

13.688313.6892

02240519 Maxalt RPD Merck 612

82.13164.27

13.688313.6892

SUMATRIPTAN (HEMISULFATE) XNas. spray 20 mg

02230420 Imitrex GSK 2 26.75 13.3750

SUMATRIPTAN SUCCINATE XKit 6 mg/0.5 mL

02212188 Imitrex Stat Dose GSK 1 81.32


Page 200 2010-06

S.C. Inj. Sol. 6 mg/0.5 mL

99000598 Imitrex Stat Dose GSK 2 73.24 36.6200

Tab. 50 mg PPB

02268388 Apo-Sumatriptan Apotex 6 42.81 7.135002257890 Co Sumatriptan Cobalt 6 42.81 7.135002212153 Imitrex DF GSK 6 82.14 13.690002268914 Mylan-Sumatriptan Mylan 6 42.81 7.135002286823 Novo-Sumatriptan DF Novopharm 6 42.81 7.135002270722 phl-Sumatriptan Pharmel 6

3042.81

214.067.13507.1353

02256436 pms-Sumatriptan Phmscience 630

42.81214.06

7.13507.1353

02271583 ratio-Sumatriptan Ratiopharm 630

42.81214.06

W W

02271117 Riva-Sumatriptan Riva 6 42.81 7.135002263025 Sandoz Sumatriptan Sandoz 6 42.81 7.135002324652 Sumatriptan Pro Doc 6 42.81 7.135002286521 * Sumatriptan Sanis 6 42.81 7.1350

Tab. 100 mg PPB

02268396 Apo-Sumatriptan Apotex 6 47.16 7.860002257904 Co Sumatriptan Cobalt 6 47.16 7.860002212161 Imitrex DF GSK 6 90.48 15.080002268922 Mylan-Sumatriptan Mylan 6 47.16 7.860002239367 Novo-Sumatriptan Novopharm 6 47.16 7.860002286831 Novo-Sumatriptan DF Novopharm 6

5047.16

392.987.86007.8596

02270730 phl-Sumatriptan Pharmel 630

47.16235.79

7.86007.8596

02256444 pms-Sumatriptan Phmscience 630

47.16235.79

7.86007.8596

02271591 ratio-Sumatriptan Ratiopharm 630

47.16235.79

W W

02271125 Riva-Sumatriptan Riva 6 47.16 7.860002263033 Sandoz Sumatriptan Sandoz 6 47.16 7.860002324660 Sumatriptan Pro Doc 6 47.16 7.860002286548 * Sumatriptan Sanis 6 47.16 7.8600

ZOLMITRIPTAN XXNas. spray 5 mg

02248993 Zomig AZC 6 80.00 13.3333

Tab. or Tab. Oral Disint. 2.5 mg

02238660 Zomig AZC 36

40.0080.00

13.333313.3333

02243045 Zomig Rapimelt AZC 26

26.6880.00

13.340013.3333


2010-06 Page 201

28:32.92ANTIMIGRAINE AGENTS, MISCELLANEOUSPIZOTIFEN MALATE XX

Tab. 0.5 mg

00329320 Sandomigran Paladin 100 36.40 0.3640

Tab. 1 mg

00511552 Sandomigran DS Squire 100 60.43 0.6043

28:36.04ADAMANTANESAMANTADINE HYDROCHLORIDE XCaps. 100 mg PPB

02139200 Mylan-Amantadine Mylan 100 51.79 0.517901990403 pms-Amantadine Phmscience 100 51.79 0.5179

Syr. 50 mg/5 mL

02022826 pms-Amantadine Phmscience 500 ml 40.50 0.0810

28:36.08ANTICHOLINERGIC AGENTSBENZTROPINE MESYLATE X

Oral Sol. 0.4 mg/mL

02219727 pms-Benztropine Phmscience 500 ml 18.00 0.0360

Tab. 1 mg

00706531 pms-Benztropine Phmscience 1000 21.54 0.0215

Tab. 2 mg PPB

00426857 Apo-Benztropine Apotex 1001000

4.5045.00

0.04500.0450

00587265 pms-Benztropine Phmscience 1001000

4.5045.00

0.04500.0450

BIPERIDENE HYDROCHLORIDE XTab. 2 mg

00124982 Akineton Abbott 100 19.05 0.1905


Page 202 2010-06

PROCYCLIDINE HYDROCHLORIDE XXElix. 2.5 mg/5 mL

00587362 pms-Procyclidine Phmscience 500 ml 16.26 0.0325

Tab. 2.5 mg

00649392 pms-Procyclidine Phmscience 1001000

5.5555.50

0.05550.0555

Tab. 5 mg

00587354 pms-Procyclidine Phmscience 1001000

2.5525.50

0.02550.0255

TRIHEXYPHENIDYL HYDROCHLORIDE XTab. 2 mg

00545058 Apo-Trihex Apotex 100 3.69 0.0311

Tab. 5 mg

00545074 Apo-Trihex Apotex 100 6.68 0.0560

28:36.12CATECHOL-O-METHYLTRANSFERASE INHIBITORSENTACAPONE XTab. 200 mg

02243763 Comtan Novartis 100 147.98 1.4798

28:36.16DOPAMINE PRECURSORSLEVODOPA/ CARBIDOPA XL.A. Tab. 100 mg -25 mg PPB

02272873 Apo-Levocarb CR Apotex 100 51.26 0.394402028786 Sinemet CR B.M.S. 100 65.72 0.6572

L.A. Tab. 200 mg -50 mg

00870935 Sinemet CR B.M.S. 100250

119.77299.43

1.19771.1977


02195933 Apo-Levocarb Apotex 100 18.77 0.187702244494 Novo-Levocarbidopa Novopharm 100 18.77 0.187702182831 Nu-Levocarb Nu-Pharm 100 18.77 0.187700355658 Sinemet 100/10 B.M.S. 100 42.59 0.4259


2010-06 Page 203


02195941 Apo-Levocarb Apotex 100500

28.03140.15

0.28030.2803

02244495 Novo-Levocarbidopa Novopharm 100500

28.03140.15

0.28030.2803

02182823 Nu-Levocarb Nu-Pharm 100500

28.03140.15

0.28030.2803

02311178 Pro-Levocarb-100/25 Pro Doc 100500

28.03140.15

0.28030.2803

00513997 Sinemet 100/25 B.M.S. 100500

63.59317.95

0.63590.6359

28:36.20DOPAMINE RECEPTOR AGONISTSBROMOCRIPTIN MESYLATE XXCaps. 5 mg PPB

02230454 Apo-Bromocriptine Apotex 100 77.08 0.770802236949 pms-Bromocriptine Phmscience 100 77.08 0.7708

Tab. 2.5 mg PPB

02087324 Apo-Bromocriptine Apotex 100 43.28 0.432802231702 pms-Bromocriptine Phmscience 100 43.28 0.4328

PRAMIPEXOLE DIHYDROCHLORIDE XTab. 0.25 mg

02292378 Apo-Pramipexole Apotex 100 49.50 0.495002297302 Co Pramipexole Cobalt 100 49.50 0.495002237145 Mirapex Bo. Ing. 90 94.62 1.051302269309 Novo-Pramipexole Novopharm 90 44.55 0.495002309122 phl-Pramipexole Pharmel 100

50049.50

247.500.49500.4950

02290111 pms-Pramipexole Phmscience 100500

49.50247.50

0.49500.4950

02325802 Pramipexole Pro Doc 100 49.50 0.495002315262 Sandoz Pramipexole Sandoz 100 49.50 0.4950

Tab. 0.5 mg

02292386 Apo-Pramipexole Apotex 100 109.09 1.090902297310 Co Pramipexole Cobalt 100 109.09 1.090902241594 Mirapex Bo. Ing. 90 189.25 2.102802269317 Novo-Pramipexole Novopharm 90 98.18 1.090902309130 phl-Pramipexole Pharmel 100 109.09 1.090902290138 pms-Pramipexole Phmscience 100 109.09 1.090902325810 Pramipexole Pro Doc 100 109.09 1.090902315270 Sandoz Pramipexole Sandoz 100 109.90 1.0990


Page 204 2010-06

Tab. 1 mg


Tab. 1.5 mg


ROPINIROLE HYDROCHLORIDE XXTab. 0.25 mg

02337746 Apo-Ropinirole Apotex 100 14.19 0.141902316846 Co Ropinirole Cobalt 100 14.19 0.141902326590 pms-Ropinirole Phmscience 100 14.19 0.141902314037 Ran-Ropinirole Ranbaxy 100 14.19 0.141902232565 Requip GSK 100 26.43 0.2643

Tab. 1 mg


Tab. 2 mg


Tab. 5 mg



2010-06 Page 205

28:36.32MONOAMINE OXYDASE B INHIBITORSSELEGILINE HYDROCHLORIDE XXTab. 5 mg PPB

02230641 Apo-Selegiline Apotex 100500

100.43502.15

1.00431.0043

02231036 Mylan-Selegiline Mylan 60 60.26 1.004302068087 Novo-Selegiline Novopharm 60 60.26 1.004302238102 pms-Selegiline Phmscience 60

30060.26

301.291.00431.0043

02238319 Selegiline Pharmel 300 301.29 1.0043

28:36.92ANTIPARKINSONIAN AGENTS, MISCELLANEOUSETHOPROPAZINE HYDROCHLORIDE XTab. 50 mg

01927744 Parsitan Erfa 100 19.29 0.1929

LEVODOPA/ BENSERAZIDE HYDROCHLORIDE XCaps. 50 mg -12.5 mg

00522597 Prolopa 50/12.5 Roche 100 27.07 0.2707

Caps. 100 mg -25 mg

00386464 Prolopa 100/25 Roche 100 44.60 0.4460

LÉVODOPA/ CARBIDOPA/ ENTACAPONE XTab. 50 mg - 12.5 mg - 200 mg

02305933 Stalevo Novartis 100 156.09 1.5609

Tab. 75 mg - 18,75 mg - 200 mg


Tab. 100 mg - 25 mg - 200 mg


Tab. 125 mg - 31,25 mg - 200 mg


Tab. 150 mg - 37.5 mg - 200 mg



Page 206 2010-06

28:92MISCELLANEOUS CENTRAL NERVOUS SYSTEM AGENTSTETRABENAZINE XXTab. 25 mg

02199270 Nitoman Biovail 112 691.15 6.1710


2010-06 Page 207

36:00DIAGNOSTIC AGENTS

36:26 diabetes mellitus36:88 urine and feces contents36:88.12 ketones36:88.40 sugar36:88.92 urine and feces contents, miscellaneous

36:26DIABETES MELLITUSQUANTITATIVE GLUCOSE BLOOD TEST Strip

99002884 Accu-Chek Advantage Roche Diag 50100

40.2970.35

99100214 Accu-Chek Aviva Roche Diag 50100

40.2970.35

99004364 Accu-Chek Compact Roche Diag 51102

41.1071.76

00908193 Accutrend Glucose Roche Diag 50 34.4499100096 Contour Bayer 50

10040.8169.89

00920363 Elite Bayer 50100

40.5669.89

W W

00920371 Encore Bayer 50 33.7599002809 Fast Take Lifescan 50

10038.9569.43

99004704 Freestyle Ab Diabete 50100

37.0069.00

99100478 FreeStyle Lite Ab Diabete 50100

37.0069.00

99100332 iTest Auto.Cont. 50100

32.5063.00

99100497 Nova-Max NovaBiomed 50100

34.9569.90

99100479 On-Call Plus Acon 2550

100

17.5033.5063.00

00897655 One Touch Lifescan 50100

37.0069.43

99100516 Oracle TremHarr 50100

36.4572.90

00801135 Precision Plus Ab Diabete 100 68.9099004119 Precision Xtra Ab Diabete 50

10039.7568.90

99100412 Sidekick Home Diag 50 22.7899004577 Sof-Tact Ab Diabete 50

10039.7568.90

99000318 Surestep Lifescan 50100

37.0067.50

99100413 TrueTrack Home Diag 50100

22.7839.57

99004240 Ultra Lifescan 50100

39.7569.43

Strip Disc (10)

99002604 Ascensia Autodisc Bayer 510

40.5669.89

99100388 Breeze 2 Bayer 510

40.5669.89


2010-06 Page 211

QUANTITATIVE KETONE BLOOD TEST Strip

99004879 Precision Xtra (Cetone) Ab Diabete 10 15.06

36:88.12KETONESQUALITATIVE ACETONE TEST Strip

00035092 Ketostix Bayer 50 6.06

SEMI-QUANTITATIVE ACETONE TEST Tab.

00035106 Acetest Bayer 100 16.62

36:88.40SUGARSEMI-QUANTITATIVE GLUCOSE TEST Strip

00035130 Diastix Bayer 50 5.44

Tab.

00035122 Clinitest Bayer 100 9.60

36:88.92URINE AND FECES CONTENTS, MISCELLANEOUSSEMI-QUANTITATIVE ACETONE AND GLUCOSE TEST Strip

00647705 Chemstrip uG/K Roche Diag 50 6.5300035149 Keto-Diastix Bayer 100 13.03


Page 212 2010-06

40:00ELECTROLYTIC, CALORIC AND WATER BALANCE

40:08 alkalinizing agents40:12 replacement preparations40:18 ion-removing agents40:18.18 potassium-removing agents40:20 caloric agents40:28 diuretics40:28.08 loop diuretics40:28.16 potassium-sparing diuretics40:28.20 thiazide diuretics40:28.24 thiazide-like diuretics40:28.92 diuretics, miscellaneous40:36 irrigating solutions40:40 uricosuric agents

40:08ALKALINIZING AGENTSCITRIC ACID/ SODIUM CITRATE

Oral Sol. 334 mg -500 mg/5 mL

00721344 pms-Dicitrate Phmscience 500 ml 6.89 0.0138

SODIUM BICARBONATE I.V. Inj. Sol. 0.9 mmol/mL

00038083 Bicarbonate de sodium 7.4% Hospira 50 ml 13.75 0.2750

I.V. Inj. Sol. 1 mmol/mL

99100177 Bicarbonate de Sodium 8.4% Abbott 50 ml 3.27 0.0654

SODIUM BICARBONATE XXI.V. Inj. Sol. (syr) 1 mmol/mL

00261998 Bicarbonate de Sodium 8.4% Hospira 50 ml 13.75

40:12REPLACEMENT PREPARATIONSCALCIUM CARBONATE Tab. 500 mg PPB

00682039 Apo-Cal Apotex 500 20.50 0.021880017732 + Cal-500 Pro Doc 500 10.80 0.021680003773 Calcium 500 Trianon 100

5002.16

10.800.02160.0216

02237352 Euro-Cal Euro-Pharm 500 10.80 0.021602246040 Jamp-Calcium Jamp 500 10.80 0.021680001408 Novo-Calcium Novopharm 100

5002.16

10.800.02160.0216

00618098 Nu-Cal Odan 100500

2.1610.80

0.02160.0216

80004046 phl-Calcium Pharmel 5001000

10.8021.60

0.02160.0216

80001122 pms-Calcium Pendopharm 5001000

10.8021.60

0.02160.0216


2010-06 Page 215

CALCIUM CARBONATE/VITAMIN D Tab. 500 mg - 125 UI and 200 UI PPB

80004143 Biocal-D Biomed 500 34.00 0.068080017196 + Cal-500-D Pro Doc 500 34.00 0.068080004966 Calcite D 500 Riva 100 6.80 0.068080004968 Calcium D 500 Trianon 100

5006.80

34.000.06800.0680

02237351 Euro-Cal-D Euro-Pharm 100500

6.8034.00

0.06800.0680

02246041 Jamp-Calcium+Vitamin D125 U.I.

Jamp 100500

6.8034.00

0.06800.0680

00720798 Neo-Cal-D 500 Néolab 500 34.00 0.068002244477 Nu-Cal D Odan 100

5006.80

34.000.06800.0680

80007304 O-Calcium 500 mg withVitamin D

Novopharm 100500

6.8034.00

0.06800.0680

80005934 phl-Calcium 500 + D 200 IU Pharmel 5001000

34.0068.00

0.06800.0680

80004281 pms-Calcium 500 + D 125 UI Phmscience 500 34.00 0.068080001199 pms-Calcium 500 + D 200

U.I.Pendopharm 500 34.00 0.0680

Tab. or Chew. Tab.orCaps. 500 mg -400 UI PPB

80003919 Biocal-D Forte Biomed 500 60.00 0.120080000159 Calcia 400 Medexus 60 7.20 0.120080004963 Calcite 500 + D 400 Riva 60

5007.20

60.000.12000.1200

80004969 Calcium 500 + D 400 Trianon 100500

12.0060.00

0.12000.1200

80009628 Calodan D-400 Odan 60 7.20 0.120080002901 Carbocal D 400 (Co. croq) Euro-Pharm 60 7.20 0.120002245511 Carbocal D 400 UI (Co.) Euro-Pharm 60

5007.20

60.000.12000.1200

80002122 Jamp-Calcium+Vitamin D400 U.I.

Jamp 60500

7.2060.00

0.12000.1200

80002623 Jamp-Calcium+Vitamin D400 UI Chewable

Jamp 60300

7.2036.00

0.12000.1200

80000408 LiquiCal D 400 Mayaka 100 12.00 0.120080009412 M Cal (chew tab.) Mantra Ph. 60 7.20 0.120080013329 M Cal (tab.) Mantra Ph. 60

5007.20

60.000.12000.1200

02246984 Neo-Cal-D Forte Néolab 500 60.00 0.120080002703 Nu-Cal D 400 Odan 500 60.00 0.120080001248 Pharma-Cal D 400 UI Phmscience 500 60.00 0.120080003414 phl-Calcium 500 + D 400 IU Pharmel 100

50012.0060.00

0.12000.1200

80008566 Pro-Cal-D 400 Pro Doc 60500

7.2060.00

0.12000.1200


Page 216 2010-06

CALCIUM CITRATE/VITAMIN DChew. Tab. 500 mg -400 UI PPB

80004774 Biocal-D CR Biomed 60 7.44 0.124080000281 Ci-Cal D 400 Euro-Pharm 60 7.44 0.124080003262 Jamp-Calcium Citrate and

Vitamin D 400 UIJamp 60 7.44 0.1240

ELECTROLYTE (REPLACEMENT)/ DEXTROSE Oral Pd 4.9 g/sac.

01931563 Gastrolyte SanofiAven 10 7.01 0.7010

MAGNESIUM GLUCOHEPTONATEOral Sol. 500 mg/5 mL (Mg-25 mg/5 mL) PPB

80009357 Jamp-Magnesium Jamp 350 ml 6.99 0.020080004109 Magnesium-Odan Odan 500 ml

2000 ml9.99

39.950.02000.0200

00026697 Rougier Magnesium Rougier 500 ml2000 ml

9.9939.95

0.02000.0200

MAGNESIUM GLUCONATETab. 500 mg (Mg - 28 mg to 30 mg) PPB

80009539 Jamp-Magnesium Jamp 100 10.88 0.108800555126 Maglucate Phmscience 100 10.88 0.1088

POTASSIUM CHLORIDEL.A. Tab. 20 mmol (en K+) PPB

02242261 Euro-K 20 Euro-Pharm 100500

19.9599.75

0.19950.1995

80013007 Jamp-K 20 Jamp 500 99.75 0.199500713376 K-Dur Schering 100 19.95 0.199580004415 Odan K-20 Odan 100 19.95 0.199502243975 Riva-K 20 SR Riva 100

50019.9599.75

0.19950.1995


2010-06 Page 217

LA Caps or LA Tab 8 mmol (en K+) PPB

00602884 Apo-K Apotex 1001000

8.9974.90

0.08990.0749

02246734 Euro-K 600 Euro-Pharm 1001000

4.5045.00

0.04500.0450

02242291 Euro-K 8 Euro-Pharm 100500

6.1430.70

W W

80013005 Jamp-K 8 Jamp 1000 45.00 0.045002042304 Micro-K Paladin 100

5009.30

39.600.08110.0792

80008214 Odan K-8 Odan 1001000

7.4974.90

0.04540.0453

00613274 Pro-K Pro Doc 1001000

4.5045.00

0.04500.0450

02244068 Riva-K 8 SR Riva 100500

4.5022.50

0.04500.0450

Oral Sol. 6.65 mmol/5 mL (en K+) PPB

01918303 K-10 GSK 500 ml 7.38 0.014802238604 pms-Potassium Chloride Phmscience 500 ml 6.40 0.0128

POTASSIUM CITRATEEff. Tab. 25 mmol (en K+)

02085992 K-Lyte WellSpring 30 16.65 0.5550

L.A. Tab. 10 mmol (en K+)

02243768 K-Citra Seaford 100 15.45 0.1545

SODIUM ACID PHOSPHATEEff. Tab. 1.936 g

00225819 Phosphate-Novartis Novartis 20 8.81 0.4405

SODIUM CHLORIDEI.V. Inj. Sol. 50 mg/mL

00060240 Chlorure de Sodium 5% Baxter 250 ml 5.25

I.V. Inj. Sol. 234 mg/mL

99100498 30 ml

40:18.18POTASSIUM-REMOVING AGENTSCALCIUM POLYSTYRENE SULPHONATEOral Pd Exchange capacity: 1.6 mmol de k/g

02017741 Resonium Calcium SanofiAven 300 g 88.97


Page 218 2010-06

POLYSTYRENE SODIUM SULFONATE XXOral Pd Exchange capacity: 1 mmol de k/g PPB

02026961 Kayexalate SanofiAven 454 g 69.7000755338 pms-Sodium Polystyrene

SulfonatePhmscience 454 g 66.30

Oral Susp. Exchange capacity: 1 mmol de k/4mL

00769541 pms-Sodium PolystyreneSulfonate

Phmscience 500 ml 50.20 0.1004

Rect. Susp. Exchange capacity: 1 mmol de k/4mL

00769533 pms-Sodium PolystyreneSulfonate

Phmscience 120 ml 14.48

40:20CALORIC AGENTSLEVOCARNITINE XI.V. Inj. Sol. 1 g/5 mL

02144344 Carnitor Sigma-Tau 5 ml UE

Oral Sol. 100 mg/mL

02144336 Carnitor Sigma-Tau 118 ml UE

Tab. 330 mg

02144328 Carnitor Sigma-Tau 90 UE

40:28.08LOOP DIURETICSETHACRYNIC ACID XTab. 25 mg

02258528 Edecrin Valeo 100 30.96 0.3096

FUROSEMIDE XInj. Sol. 10 mg/mL

00527033 Furosemide Sandoz 2 ml4 ml

1.202.40

Oral Sol. 10 mg/mL

02224720 Lasix SanofiAven 120 ml 27.68 0.2307


2010-06 Page 219

Tab. 20 mg PPB

00396788 Apo-Furosemide Apotex 1001000

3.7337.25

0.03730.0373

02247371 Bio-Furosemide Biomed 500 18.63 0.037300496723 Furosemide-20 Pro Doc 1000 37.25 0.037302224690 Lasix SanofiAven 30 2.21 0.073700337730 Novo-Semide Novopharm 100

10003.73

37.250.03730.0373

02247493 pms-Furosemide Biomed 500 18.63 0.0373

Tab. 40 mg PPB


5.5855.80

0.05580.0558

02247372 Bio-Furosemide Biomed 500 27.90 0.055800397792 Furosemide -40 Pro Doc 1000 55.80 0.055802224704 Lasix SanofiAven 30 3.37 0.112300337749 Novo-Semide Novopharm 100

10005.58

55.800.05580.0558

02247494 pms-Furosemide Biomed 500 27.90 0.0558

Tab. 80 mg PPB


12.2061.00

0.12200.1220

00667080 Furosemide-80 Pro Doc 100500

12.2061.00

0.12200.1220

00765953 Novo-Semide Novopharm 100 12.20 0.1220

Tab. 500 mg

02224755 Lasix Special SanofiAven 20 50.46 2.5230

40:28.16POTASSIUM-SPARING DIURETICSAMILORIDE HYDROCHLORIDE XXTab. 5 mg

02249510 Apo-Amiloride Apotex 100 27.17 0.2717

40:28.20THIAZIDE DIURETICSHYDROCHLOROTHIAZIDE XTab. 12.5 mg PPB

02327856 Apo-Hydro Apotex 500 16.12 0.032202274086 pms-Hydrochlorothiazide Phmscience 500 16.12 0.0322


Page 220 2010-06

Tab. 25 mg PPB

00326844 Apo-Hydro Apotex 1001000

3.1331.30

0.03130.0313

02247170 Bio-Hydrochlorothiazide Biomed 500 15.65 0.031300341975 Hydrochlorothiazide-25 Pro Doc 1000 31.30 0.031300021474 Novo-Hydrazide Novopharm 100

10003.13

31.300.03130.0313

02247386 pms-Hydrochlorothiazide Biomed 500 15.65 0.0313

Tab. 50 mg PPB

00312800 Apo-Hydro Apotex 1001000

4.3443.40

0.04340.0434

02247171 Bio-Hydrochlorothiazide Biomed 100 4.34 0.043400021482 Novo-Hydrazide Novopharm 100

10004.34

43.400.04340.0434

02247387 pms-Hydrochlorothiazide Biomed 100 4.34 0.0434

40:28.24THIAZIDE-LIKE DIURETICSCHLORTHALIDONE XXTab. 50 mg

00360279 Apo-Chlorthalidone Apotex 100 12.42 0.0813

INDAPAMIDE XTab. 1.25 mg PPB

02245246 Apo-Indapamide Apotex 100 14.90 0.149002179709 Lozide Servier 30

1008.94

29.790.29800.2979

02240067 Mylan-Indapamide Mylan 30100

4.4714.90

0.14900.1490

02239619 pms-Indapamide Phmscience 30100

4.4714.90

0.14900.1490

02312530 Pro-Indapamide Pro Doc 30100

4.4714.90

0.14900.1490

02247245 Riva-Indapamide Riva 30500

4.4774.50

0.14900.1490


2010-06 Page 221

Tab. 2.5 mg PPB

02223678 Apo-Indapamide Apotex 100 23.63 0.236300564966 Lozide Servier 30

10014.6247.27

0.48730.4727

02153483 Mylan-Indapamide Mylan 30500

7.09118.15

0.23630.2363

02231184 Novo-Indapamide Novopharm 30100

7.0923.63

0.23630.2363

02223597 Nu-Indapamide Nu-Pharm 100 23.64 0.236402240350 phl-Indapamide Pharmel 30

1007.09

23.630.23630.2363

02239620 pms-Indapamide Phmscience 30100

7.0923.63

0.23630.2363

02312549 Pro-Indapamide Pro Doc 30100

7.0923.63

0.23630.2363

02242125 Riva-Indapamide Riva 30100

7.0923.63

0.23630.2363

02188910 Tria-Indapamide Trianon 30 7.09 0.2363

METOLAZONE XXTab. 2.5 mg

00888400 Zaroxolyn SanofiAven 100 15.52 0.1552

40:28.92DIURETICS, MISCELLANEOUSAMILORIDE HYDROCHLORIDE HYDROCHLOROTHIAZIDE XTab. 5 mg -50 mg PPB

00870943 Ami-Hydro Pro Doc 100 19.17 0.191700784400 Apo-Amilzide Apotex 100

100019.17

191.700.19170.1917

02257378 Mylan-Amilazide Mylan 1001000

19.17191.70

0.19170.1917

01937219 Novamilor Novopharm 1001000

19.17191.70

0.19170.1917

SPIRONOLACTONE/ HYDROCHLOROTHIAZIDE XTab. 25 mg -25 mg PPB

00180408 Aldactazide Pfizer 100 8.93 0.089300613231 Novo-Spirozine Novopharm 100 8.58 0.0519


00594377 Aldactazide 50 Pfizer 100 23.26 0.232600657182 Novo-Spirozine-50 Novopharm 100 22.36 0.1352


Page 222 2010-06

TRIAMTERENE/ HYDROCHLOROTHIAZIDE XXTab. 50 mg -25 mg PPB

00441775 Apo-Triazide Apotex 1001000

6.0860.80

0.06080.0608

00532657 Novo-Triamzide Novopharm 1001000

6.0860.80

0.06080.0608

00519367 Pro-Triazide Pro Doc 1000 60.80 0.060802240846 Riva-Zide Riva 500

100030.4060.80

0.06080.0608

40:36IRRIGATING SOLUTIONSDIMETHYLSULFOXIDE XIrr. Sol. 500 mg/g PPB

02243231 Dimethylsulfoxide pourIrrigation

Sandoz 50 ml 49.95 0.6796

00493392 Rimso-50 Bioniche 50 ml 56.90

POLYMYXIN B SULFATE/ NEOMYCIN SULFATE XUrol. Sol. 200 000 U-57 mg/mL

00666157 Neosporine GSK 20 ml 31.21

SODIUM CHLORIDEIrr. Sol. 0.9 %

00037834 Solution de Chlorure deSodium 0.9%

Hospira 1 l1.5 l

6.697.49

40:40URICOSURIC AGENTSPROBENECID XTab. 500 mg

00294926 Benuryl Valeant 100 18.84 0.1884

SULFINPYRAZONE XTab. 200 mg

00441767 Apo-Sulfinpyrazone Apotex 100 29.97 0.2997


2010-06 Page 223

48:00ANTITUSSIVES, EXPECTORANTS AND MUCOLYTICAGENTS

48:10 anti-inflammatory agents48:10.24 leukotriene modifiers48:10.32 mast-cell stabilizers48:24 mucolytic agents

48:10.24LEUKOTRIENE MODIFIERSMONTELUKAST SODIUM XXChew. Tab. 4 mg

02243602 Singulair Merck 30 40.21 1.3403

Gran. 4 mg/packet

02247997 Singulair Merck 30 40.21 1.3403

Tab. 5 mg

02238216 Singulair Merck 30 44.39 1.4797

Tab. 10 mg

02238217 Singulair Merck 30 65.32 2.1773

ZAFIRLUKAST XTab. 20 mg

02236606 Accolate AZC 60 43.25 0.7208

48:10.32MAST-CELL STABILIZERSCROMOGLICATE (SODIUM)Nas. spray 2 %

01950541 Rhinaris CS Anti-allergique Phmscience 13 ml26 ml

9.5713.86

Sol. Inh. 1 % (2 mL)

02046113 pms-Sodium cromoglycate Phmscience 50 24.23 0.4846

48:24MUCOLYTIC AGENTSACETYLCYSTEINESol. 200 mg/mL PPB

02243098 Acetylcysteine Sandoz 10 ml30 ml

5.8014.23

0.43200.3530

02091526 Mucomyst WellSpring 10 ml30 ml

7.2017.65


2010-06 Page 227

52:00E. N. T. AGENTS

52:02 antiallergic agents52:04 anti-infectives52:04.04 antibiotics52:04.20 antivirals52:08 anti-inflammatory agents52:08.08 corticosteroids52:16 local anesthetics52:24 mydriatics52:40 antiglaucoma agents52:40.04 alfa-adrenergic agonists52:40.08 beta-adrenergic agonists52:40.12 carbonic anhydrase inhibators52:40.20 miotics52:40.28 prostaglandin analogs52:40.92 antiglaucoma agents, miscellaneous52:92 miscellaneous EENT drugs

52:02ANTIALLERGIC AGENTSCROMOGLICATE (SODIUM) Oph. Sol. 2 % PPB

02009277 Cromolyn Phmscience 5 ml10 ml

5.709.50

02230621 Opticrom Allergan 10 ml 9.98 0.9840

LODOXAMIDE TROMETHAMIDE XOph. Sol. 0.1 %

00893560 Alomide Alcon 10 ml 10.25

52:04.04ANTIBIOTICSCHLORAMPHENICOL XOph. Oint. 1 %

01980564 Pentamycetin Sandoz 3.5 g 5.24

Oph. Sol. 0.25 %

01980556 Pentamycetin Sandoz 10 ml 5.28

Oph. Sol. 0.5 %

02164051 Pentamycetin Sandoz 10 ml 4.42

CIPROFLOXACIN HYDROCHLORIDE XOph. Oint. 0.3 %

02200864 Ciloxan Alcon 3.5 g 9.70

Oph. Sol. 0.3 % PPB

02263130 Apo-Ciproflox Apotex 5 ml 3.8101945270 Ciloxan Alcon 5 ml 7.0502253933 pms-Ciprofloxacin Phmscience 5 ml 3.81

ERYTHROMYCIN XOph. Oint. 0.5 % PPB

02326663 Erythromycin Sterigen 3.5 g 3.8301912755 pms-Erythromycine Phmscience 3.5 g 3.83

FRAMYCETIN SULFATE XOph. Sol. 0.5 %

02224887 Soframycine Erfa 8 ml 7.90


2010-06 Page 231

FUSIDIC (ACID) XXOph. Sol. 1 %

02243862 Fucithalmic Leo 5 g 8.61

GENTAMICIN SULFATE XOph. Oint. 0.3 % PPB

00028339 Garamycin Schering 3.5 g 4.0002230888 Sandoz Gentamicine Sandoz 3.5 g 4.00

Oph. Sol. 0.3 % PPB

00512192 Garamycin Schering 5 ml 2.0302229440 Sandoz Gentamicine Sandoz 5 ml 2.03

Ot. Sol. 0.3 % PPB

00512184 Garamycin Schering 7.5 ml 7.7402230889 pms-Gentamicine Phmscience 5 ml 5.1602229441 Sandoz Gentamicine Sandoz 7.5 ml 7.74

OFLOXACINE XOph. Sol. 0.3 % PPB

02248398 Apo-Ofloxacin Apotex 5 ml 3.5402143291 Ocuflox Allergan 5 ml 12.23 1.442002252570 pms-Ofloxacin Phmscience 5 ml 3.54

POLYMYXIN B SULFATE/ NEOMYCIN SULFATE/ GRAMICIDIN XOph./Ot. Sol. 10 000 U -2.5 mg -0.025 mg/mL PPB

00694371 Neosporine GSK 10 ml 7.3500807435 Optimyxin Plus Sandoz 10 ml 7.25

SULFACETAMIDE (SODIUM) XOph. Sol. 10 %

00028053 Sulamyd sodium Sandoz 15 ml 5.25

TOBRAMYCIN XOph. Oint. 0.3 %

00614254 Tobrex Alcon 3.5 g 8.27

Oph. Sol. 0.3 % PPB

02239577 pms-Tobramycin Phmscience 5 ml 4.1702241755 Sandoz Tobramycine Sandoz 5 ml 4.1700513962 Tobrex 0.3% Alcon 5 ml 8.33


Page 232 2010-06

52:04.20ANTIVIRALSTRIFLURIDINE XXOph. Sol. 1 % PPB

02248529 Sandoz Trifluridine Sandoz 7.5 ml 22.7900687456 Viroptic Theramed 7.5 ml 22.79

52:08.08CORTICOSTEROIDSBECLOMETHASONE DIPROPIONATE XAéro ou Vap Nasal 0.05 mg/dose PPB

02238796 Apo-Beclomethasone AQ Apotex 200 dose(s) 12.2602172712 Mylan-Beclo AQ Mylan 200 dose(s) 12.2602228300 Rivanase AQ Riva 200 dose(s) 9.80

BUDESONIDE XNas. Inh. Pd 100 mcg/dose

02035324 Rhinocort Turbuhaler AZC 200 dose(s) 22.70

Nas. spray 64 mcg/dose PPB

02241003 Mylan-Budesonide AQ Mylan 120 dose(s) 10.12 0.051002231923 Rhinocort Aqua AZC 120 dose(s) 10.20

Nas. spray 100 mcg/dose

02230648 Mylan-Budesonide AQ Mylan 165 dose(s) 15.81

DEXAMETHASONE XOph. Oint. 0.1 %

00042579 Maxidex Alcon 3.5 g 8.35

Oph. Sol. 0.1 %

00042560 Maxidex Alcon 5 ml 7.70

DEXAMETHASONE SODIUM PHOSPHATE XOph./Ot. Sol. 0.1 %

00739839 Sandoz Dexamethasone Sandoz 5 ml 5.94

FLUNISOLIDE XNas. spray 0.025 % PPB

02239288 Apo-Flunisolide Nu-Pharm 25 ml 14.85 0.399200878790 ratio-Flunisolide Ratiopharm 25 ml 9.90 W


2010-06 Page 233

FLUOROMETHOLONE XXOph. Susp. 0.1 % PPB

00247855 FML Allergan 5 ml10 ml

12.7425.48

2.06001.5360

02238568 pms-Fluorometholone Phmscience 5 ml 8.09 1.5300

Oph. Susp. 0.25 %

00707511 FML Forte Allergan 5 ml10 ml

13.1326.26

FLUOROMETHOLONE ACETATE XOph. Susp. 0.1 %

00756784 Flarex Alcon 5 ml 8.70

FLUTICASONE FUROATE XNas. spray 27.5 mcg/dose

02298589 Avamys GSK 120 dose(s) 20.30

FLUTICASONE PROPIONATE XNas. spray 50 mcg/dose PPB

02294745 Apo-Fluticasone Apotex 120 dose(s) 21.97 0.105402213672 Flonase GSK 120 dose(s) 23.4202296071 ratio-Fluticasone Ratiopharm 120 dose(s) 21.97 0.1054

HYDROCORTISONE ACETATE X

Oph. Oint. 2.5 %

01980661 Cortamed Sandoz 3.5 g 16.32

MOMETASONE FUROATE MONOHYDRATE XNas. spray 50 mcg/dose

02238465 Nasonex Schering 140 dose(s) 25.84

PREDNISOLONE ACETATE XOph. Susp. 0.12 % PPB

00299405 Pred Mild Allergan 10 ml 17.96 1.318001916181 Sandoz Prednisolone Sandoz 10 ml 11.40 1.0050


Page 234 2010-06

Oph. Susp. 1 % PPB

00700401 ratio-Prednisolone Ratiopharm 5 ml10 ml

8.5017.00

01916203 Sandoz Prednisolone Sandoz 5 ml10 ml

8.5017.00

TRIAMCINOLONE ACETONIDE XXNas. spray 55 mcg/dose

02213834 Nasacort AQ SanofiAven 120 dose(s) 22.37

52:16LOCAL ANESTHETICSLIDOCAINE HYDROCHLORIDE Oral Top. Jel. 2 % PPB

01968823 Lidodan Visqueuse Odan 50 ml100 ml

4.505.25

0.09000.0525

00811874 pms-Lidocaine Viscous Phmscience 50 ml100 ml

4.505.25

0.09000.0525

52:24MYDRIATICSATROPINE SULFATE XOph. Sol. 1 %

00035017 Isopto Atropine Alcon 5 ml 2.35

CYCLOPENTOLATE HYDROCHLORIDE XOph. Sol. 1 %

00252506 Cyclogyl Alcon 15 ml 5.88

HOMATROPINE HYDROBROMIDEOph. Sol. 2 %

00000779 Isopto Homatropine Alcon 15 ml 8.70

Oph. Sol. 5 %

00000787 Isopto Homatropine Alcon 15 ml 10.35

PHENYLEPHRINE HYDROCHLORIDE Oph. Sol. 2.5 %

00465763 Mydfrin 2.5% Alcon 5 ml 4.63


2010-06 Page 235

TROPICAMIDE XXOph. Sol. 0.5 %

00000981 Mydriacyl Alcon 15 ml 11.95

Oph. Sol. 1 %

00001007 Mydriacyl Alcon 15 ml 8.00

52:40.04ALFA-ADRENERGIC AGONISTSBRIMONIDINE TARTRATE XOph. Sol. 0.15 %

02248151 Alphagan P Allergan 5 ml10 ml

11.5523.10

02301334 Apo-Brimonidine P Apotex 5 ml10 ml

8.6617.33 1.3860

Oph. Sol. 0.2 %

02236876 Alphagan Allergan 5 ml10 ml

16.5033.00

02260077 Apo-Brimonidine Apotex 5 ml10 ml

8.2516.50

02246284 pms-Brimonidine Phmscience 5 ml10 ml

8.2516.50

02243026 ratio-Brimonidine Ratiopharm 5 ml10 ml

8.2516.50

02305429 Sandoz Brimonidine Sandoz 5 ml10 ml

8.2516.50

52:40.08BETA-ADRENERGIC AGONISTSBETOXALOL HYDROCHLORIDE XOph. Sol. 0.5 %

02235971 Sandoz Betaxolol Sandoz 5 ml10 ml

9.1118.22

Oph. Susp. 0.25 %

01908448 Betoptic S Alcon 5 ml10 ml

11.2722.28

LEVOBUNOLOL HYDROCHLORIDE XOph. Sol. 0.25 % PPB

02031159 ratio-Levobunolol Ratiopharm 10 ml 9.3302241715 Sandoz Levobunolol Sandoz 5 ml

10 ml15 ml

4.679.33

14.00


Page 236 2010-06

Oph. Sol. 0.5 % PPB

02237991 pms-Levobunolol Phmscience 5 ml10 ml

6.1712.35

02031167 ratio-Levobunolol Ratiopharm 5 ml10 ml15 ml

6.1712.3518.52

02241716 Sandoz Levobunolol Sandoz 5 ml10 ml15 ml

6.1712.3518.52

TIMOLOL MALEATE XXOph. Sol. 0.25 % PPB

00755826 Apo-Timop Apotex 5 ml10 ml

6.3912.78

00893773 Mylan-Timolol Mylan 5 ml10 ml

6.3912.78

02083353 pms-Timolol Phmscience 10 ml 12.7802166712 Sandoz Timolol Sandoz 5 ml

10 ml15 ml

6.3912.7819.17

Oph. Sol. 0.5 % PPB

00755834 Apo-Timop Apotex 5 ml10 ml

7.5615.13

00893781 Mylan-Timolol Mylan 5 ml10 ml

7.5615.13

02083345 pms-Timolol Phmscience 5 ml10 ml

7.5615.13

02166720 Sandoz Timolol Sandoz 5 ml10 ml15 ml

7.5615.1322.69

00451207 Timoptic Merck 10 ml 31.97

Oph. Sol. Gel 0.25 % PPB

02242275 Timolol Maleate-EX Alcon 5 ml 11.4102171880 Timoptic-XE Merck 5 ml 17.23

Oph. Sol. Gel 0.5 % PPB

02290812 Apo-Timop Gel Apotex 5 ml 10.7602242276 Timolol Maleate-EX Alcon 5 ml 10.7602171899 Timoptic-XE Merck 5 ml 20.62

52:40.12CARBONIC ANHYDRASE INHIBATORSACETAZOLAMIDE XTab. 250 mg

00545015 Apo-Acetazolamide 250 mg Apotex 100500

12.3761.85

0.12370.1237


2010-06 Page 237

BRINZOLAMIDE XXOph. Susp. 1 %

02238873 Azopt Alcon 5 ml 15.70

DORZOLAMIDE (HYDROCHLORIDE) XOph. Sol. 2 %

02216205 Trusopt Merck 5 ml 17.43

METHAZOLAMIDE XTab. 50 mg

02245882 Apo-Methazolamide Apotex 100 48.17 0.4817

52:40.20MIOTICSCARBACHOL XOph. Sol. 1.5 %

00000655 Isopto Carbachol Alcon 15 ml 10.10

Oph. Sol. 3 %

00000663 Isopto Carbachol Alcon 15 ml 12.15

PILOCARPINE HYDROCHLORIDE XOph. gel 4 %

00575240 Pilopine HS Alcon 5 g 12.49

Oph. Sol. 1 %

00000841 Isopto Carpine Alcon 15 ml 3.07

Oph. Sol. 2 %


Oph. Sol. 4 %


52:40.28PROSTAGLANDIN ANALOGSBIMATOPROST XOph. Sol. 0.01 %

02324997 Lumigan RC Allergan 3 ml5 ml

32.4354.05


Page 238 2010-06

Oph. Sol. 0.03 %

02245860 Lumigan Allergan 3 ml5 ml

7.5 ml

32.4354.0581.08

LATANOPROST XXOph. Sol. 0.005 %

02231493 Xalatan Pfizer 2.5 ml 27.04

TRAVOPROST XOph. Sol. 0.004 %

02244896 Travatan Alcon 2.5 ml5 ml

26.5053.00

02318008 Travatan Z Alcon 2.5 ml5 ml

26.5053.00

52:40.92ANTIGLAUCOMA AGENTS, MISCELLANEOUSBRIMONIDINE TARTRATE/ TIMOLOL MALEATE XOph. Sol. 0.2 % - 0.5 %

02248347 Combigan Allergan 10 ml 40.12

DORZOLAMIDE HYDROCHLORIDE/ TIMOLOL MALEATE XOph. Sol. 2 % -0.5 %

02240113 Cosopt Merck 10 ml 52.86

52:92MISCELLANEOUS EENT DRUGSAPRACLONIDINE (HYDROCHLORIDE) XOph. Sol. 0.5 %

02076306 Iopidine Alcon 5 ml 21.27

BRINZOLAMIDE/TIMOLOL MALEATE XOph. Susp. 1 % -0.5 %

02331624 Azarga Alcon 5 ml 21.00

IPRATROPIUM BROMIDE XNas. spray 0.03 % PPB

02163705 Atrovent Bo. Ing. 30 ml 29.4302239627 pms-Ipratropium Phmscience 30 ml 13.92


2010-06 Page 239

SODIUM CHLORIDEOph. Sol. 5 %

02245735 Sandoz Sodium Chloride Sandoz 15 ml 7.25


Page 240 2010-06

56:00GASTRO-INTESTINAL DRUGS

56:04 antacids-absorbents56:08 antidiarrhea agents56:14 cholelitholytic agents56:16 digestants56:22 antiemetics56:22.08 antihistamines56:22.92 miscellaneous antiemetics56:28 antiulcer agents and acid suppressants56:28.12 histamine H2-antagonists56:28.28 prostaglandins56:28.32 protectants56:28.36 proton-pump inhibitors56:32 prokinetic agents56:36 anti-inflammatory agents56:92 GI drugs, miscellaneous

56:04ANTACIDS-ABSORBENTSALUMINUM HYDROXIDE Caps. 500 mg

02135620 Basaljel Aurium 100 15.00 0.1088

Tab. 600 mg

02124971 Amphojel Aurium 50 6.25 0.1250

56:08ANTIDIARRHEA AGENTSDIPHENOXYLATE HYDROCHLORHYDE/ ATROPINE SULFATE ZTab. 2.5 mg -0.025 mg

00036323 Lomotil Pfizer 250 108.95 0.4358

LOPERAMIDE HYDROCHLORIDEOral Sol. 0.2 mg/mL

02016095 pms-Loperamide Phmscience 230 ml 20.49 0.0891

Tab. 2 mg PPB

02212005 Apo-Loperamide Apotex 100500

19.0395.15

0.19030.1903

02256452 Jamp-Loperamide Jamp 120 22.84 0.190302225182 Loperamide-2 Pro Doc 100

50019.0395.15

0.19030.1903

02132591 Novo-Loperamide Novopharm 500 95.15 0.190302298198 phl-Loperamide Pharmel 100

50019.0395.15

0.19030.1903

02228351 pms-Loperamide Phmscience 100500

19.0395.15

0.19030.1903

02238211 Riva-Loperamide Riva 100500

19.0395.15

0.19030.1903

02257564 Sandoz Loperamide Sandoz 100500

19.0395.15

0.19030.1903

56:14CHOLELITHOLYTIC AGENTSURSODIOL XTab. 250 mg PPB

02273497 pms-Ursodiol C Phmscience 100500

86.35431.75

0.75370.7537

02238984 Urso Axcan 100 125.61 1.2561

Tab. 500 mg PPB

02273500 pms-Ursodiol C Phmscience 100 163.80 1.429602245894 Urso DS Axcan 100 238.26 2.3826


2010-06 Page 243

56:16DIGESTANTSLACTASEChew. Tab. 3 000 U

02017512 Dairy-Free Sterimax 100 9.75 0.097502239139 Jamp-Lactase Enzyme

RegularJamp 100 9.75 0.0975

Chew. Tab. 4 500 U

02224909 Dairy-Free extra fort Sterimax 80 9.75 0.121902239140 Jamp-Lactase Enzyme Extra

strenghtJamp 80 9.75 0.1219

Drops 80 U/5 Drops

99100157 Lacteeze Aurium 15.5 ml 11.00

PANCRELIPASE (LIPASE-AMYLASE-PROTEASE)Caps. 8 000 U -30 000 U -30 000 U

00263818 Cotazym Schering 1001000

25.09182.75

0.25090.1828

Ent. Caps. 4 000 U - 11 000 U - 11 000 U

02181215 Cotazym ECS 4 Schering 100 17.95 0.1795

Ent. Caps. 4 000 U -12 000 U -12 000 U

00789445 Pancrease MT 4 J.O.I. 100 36.52 0.3652

Ent. Caps. 4 500 U - 20 000 U - 25 000 U

02203324 Ultrase Axcan 100 20.77 0.2077

Ent. Caps. 5 000 U - 16 600 U - 18 750 U

02239007 Creon 5 Solvay 100 17.03 0.1703

Ent. Caps. 8 000 U -30 000 U -30 000 U

00502790 Cotazym ECS 8 Schering 100500

34.43164.95

0.34430.3299

Ent. Caps. 10 000 U -30 000 U -30 000 U

00789437 Pancrease MT 10 J.O.I. 100 91.31 0.9131


Page 244 2010-06

Ent. Caps. 10 000 U - 33 200 U - 37 500 U

02200104 Creon 10 Solvay 100 27.23 0.2723

Ent. Caps. 12 000 U -39 000 U -39 000 U

02045834 Ultrase MT 12 Axcan 100 40.63 0.4063

Ent. Caps. 16 000 U -48 000 U -48 000 U

00789429 Pancrease MT 16 J.O.I. 100 146.08 1.4608

Ent. Caps. 20 000 U -55 000 U -55 000 U

00821373 Cotazym ECS 20 Schering 100250

88.91216.20

0.88910.8648

Ent. Caps. 20 000 U -65 000 U -65 000 U

02045869 Ultrase MT 20 Axcan 100 70.41 0.7041

Ent. Caps. 20 000 U -66 400 U -75 000 U

02239008 Creon 20 Solvay 100 79.23 0.7923

Ent. Caps. 25 000 U -74 000 U -62 500 U

01985205 Creon 25 Solvay 100 85.07 0.8507

Tab. 8 000 U -30 000 U -30 000 U

02230019 Viokase 8 Axcan 100 16.28 0.1628

Tab. 16 000 U -60 000 U -60 000 U

02241933 Viokase 16 Axcan 100 32.56 0.3256

56:22.08ANTIHISTAMINESDIMENHYDRINATEI.M. Inj. Sol. 50 mg/mL PPB

02061732 Dimenhydrinate Bioniche 1 ml 1.1000392537 Dimenhydrinate Sandoz 1 ml

5 ml1.043.59

I.V. Inj. Sol. 10 mg/mL

00392731 Dimenhydrinate Sandoz 5 ml 1.42


2010-06 Page 245

PROCHLORPERAZINE XXSupp. 10 mg PPB

00753688 pms-Prochlorperazine Phmscience 10 8.30 0.830000789720 Sandoz Prochlorperazine Sandoz 10 8.30 0.8300

PROCHLORPERAZINE MALEATE XTab. 5 mg PPB


50010.5552.75

0.10550.1055

Tab. 10 mg PPB


50012.9064.50

0.12900.1290

PROCHLORPERAZINE MESYLATE XInj. Sol. 5 mg/mL

00789747 Prochlorperazine Sandoz 2 ml 1.38

56:22.92MISCELLANEOUS ANTIEMETICSDOXYLAMINE SUCCINATE/ PYRIDOXINE HYDROCHLORIDE XL.A. Tab. 10 mg -10 mg

00609129 Diclectin Duchesnay 100 120.00 1.2000

NABILONE ZCaps. 0.5 mg

02256193 Cesamet Valeant 50 155.13 3.1026

Caps. 1 mg

00548375 Cesamet Valeant 50 310.25 6.2050

56:28.12HISTAMINE H2-ANTAGONISTSCIMETIDINE XTab. 200 mg

00584215 Apo-Cimetidine Apotex 100 7.37 0.0737


Page 246 2010-06

Tab. 300 mg PPB

00487872 Apo-Cimetidine Apotex 1001000

8.6086.00

0.08600.0860

02227444 Mylan-Cimetidine Mylan 1001000

8.6086.00

0.08600.0860

00582417 Novo-Cimetine Novopharm 100 8.60 0.0860

Tab. 400 mg PPB


13.5067.50

0.13500.1350


13.5067.50

0.13500.1350


Tab. 600 mg PPB


17.2086.00

0.17200.1720

00618705 Cimetidine-600 Pro Doc 100500

17.2086.00

0.17200.1720


17.2086.00

0.17200.1720


Tab. 800 mg PPB

00749494 Apo-Cimetidine Apotex 100 25.30 0.253002227479 Mylan-Cimetidine Mylan 100 25.30 0.2530

FAMOTIDINETab. 20 mg PPB

01953842 Apo-Famotidine Apotex 100 46.79 0.467902196018 Mylan-Famotidine Mylan 30

50014.04

233.950.46790.4679

02022133 Novo-Famotidine Novopharm 100500

46.79233.95

0.46790.4679

00710121 Pepcid Merck 28 27.69 0.9889

FAMOTIDINE XXTab. 40 mg PPB

01953834 Apo-Famotidine Apotex 100500

84.23421.15

0.84230.8423

02196026 Mylan-Famotidine Mylan 30500

25.27421.15

0.84230.8423

02022141 Novo-Famotidine Novopharm 100500

84.23421.15

0.84230.8423

00710113 Pepcid Merck 28 50.36 1.7986


2010-06 Page 247

NIZATIDINE XXCaps. 150 mg PPB

02220156 Apo-Nizatidine Apotex 100500

41.96209.80

0.41960.4196

00778338 Axid MM Thera 100 83.92 0.427302246046 Gen-Nizatidine Genpharm 100 41.96 0.419602240457 Novo-Nizatidine Novopharm 100 41.96 0.419602177714 pms-Nizatidine Phmscience 100 41.96 0.4196

Caps. 300 mg PPB

02220164 Apo-Nizatidine Apotex 100 76.03 0.760300778346 Axid MM Thera 100 152.06 0.774202246047 Gen-Nizatidine Genpharm 100 76.03 0.760302240458 Novo-Nizatidine Novopharm 100 76.03 0.760302177722 pms-Nizatidine Phmscience 100 76.03 0.7603

RANITIDINE HYDROCHLORIDE XOral Sol. 150 mg/10 mL PPB

02280833 Apo-Ranitidine Apotex 300 ml 27.96 0.093202242940 Novo-Ranidine Novopharm 300 ml 27.96 0.093202212374 Zantac GSK 300 ml 59.11 0.1970

RANITIDINE HYDROCHLORIDETab. 150 mg PPB

00733059 Apo-Ranitidine Apotex 60500

10.8090.00

0.18000.1800

02248570 Co Ranitidine Cobalt 60500

10.8090.00

0.18000.1800

02207761 Mylan-Ranitidine Mylan 60500

24.25202.10

0.40420.4042

00828564 Novo-Ranidine Novopharm 60500

10.8090.00

0.18000.1800

02245782 phl-Ranitidine Pharmel 500 202.10 0.404202242453 pms-Ranitidine Phmscience 60

50010.8090.00

0.18000.1800

00740748 Ranitidine-150 Pro Doc 60500

10.8090.00

0.18000.1800

00828823 ratio-Ranitidine Ratiopharm 60500

10.8090.00

0.18000.1800

02247814 Riva-Ranitidine Riva 60250

10.8045.00

0.18000.1800

02243229 Sandoz Ranitidine Sandoz 60500

10.8090.00

0.18000.1800

02212331 Zantac GSK 100500

18.0090.00

0.18000.1800

02303353 Zym-Ranitidine Zymcan 100 18.00 0.1800


Page 248 2010-06

RANITIDINE HYDROCHLORIDE XXTab. 300 mg PPB

00733067 Apo-Ranitidine Apotex 30500

23.36389.35

0.77870.7787

02248571 Co Ranitidine Cobalt 30100

10.8077.87

0.36000.7787

02207788 Mylan-Ranitidine Mylan 30500

23.36389.35

0.77870.7787

00828556 Novo-Ranidine Novopharm 30500

10.80389.34

0.36000.7787

02245783 phl-Ranitidine Pharmel 250 194.67 0.778702242454 pms-Ranitidine Phmscience 250 194.67 0.778702286114 Ranitidine Genpharm 500 389.35 0.778700740756 Ranitidine-300 Pro Doc 30

10010.8077.87

0.36000.7787

00828688 ratio-Ranitidine Ratiopharm 30 10.80 0.360002247815 Riva-Ranitidine Riva 30

10010.8077.87

0.36000.7787

02243230 Sandoz Ranitidine Sandoz 30100

10.8077.87

0.36000.7787

02212358 Zantac GSK 60 21.60 0.360002303388 Zym-Ranitidine Zymcan 100 77.87 0.7787

56:28.28PROSTAGLANDINSMISOPROSTOL XTab. 100 mcg

02244022 Apo-Misoprostol Apotex 100 25.84 0.2584

Tab. 200 mcg

02244023 Apo-Misoprostol Apotex 100 43.03 0.4303

56:28.32PROTECTANTSSUCRALFATE XOral Susp. 1 g/5 mL

02103567 Sulcrate Plus Axcan 500 ml 47.55 0.0951

Tab. 1 g PPB

02125250 Apo-Sucralfate Apotex 100500

23.35116.75

0.23350.2335

02045702 Novo-Sucralate Novopharm 100500

23.35116.75

0.23350.2335

02238209 pms-Sucralfate Phmscience 100500

23.35116.75

W W

02130939 Sucralfate-1 Pro Doc 100 23.35 0.233502100622 Sulcrate Axcan 100 52.35 0.5235


2010-06 Page 249

56:28.36PROTON-PUMP INHIBITORSESOMEPRAZOLE (MAGNESIUM TRIHYDRATED) XXL.A. Tab. 20 mg

02244521 Nexium AZC 30 63.00 2.1000

L.A. Tab. 40 mg

02244522 Nexium AZC 3060

63.00126.00

2.10002.1000

LANSOPRAZOLE XLA Caps or LA Tab 15 mg

02293811 Apo-Lansoprazole Apotex 100 100.00 1.000002280515 Novo-Lansoprazole Novopharm 30

10030.00

100.001.00001.0000

02165503 Prevacid Abbott 30100

60.00200.00

2.00002.0000

02249464 Prevacid FasTab Abbott 30 60.00 2.0000

LA Caps or LA Tab 30 mg

02293838 Apo-Lansoprazole Apotex 100500

100.00500.00

1.00001.0000

02280523 Novo-Lansoprazole Novopharm 30500

30.00500.00

1.00001.0000

02165511 Prevacid Abbott 30100

60.00200.00

2.00002.0000

02249472 Prevacid FasTab Abbott 30 60.00 2.0000

OMEPRAZOLE (BASE OR MAGNESIUM) XCaps. or Tab. 20 mg PPB

02245058 Apo-Omeprazole (caps.) Apotex 100500

110.00550.00

1.10001.1000

00846503 Losec (caps.) AZC 30 33.00 1.100002190915 Losec (tab.) AZC 30

10066.00

220.002.20002.2000

02329433 Mylan-Omeprazole (caps.) Mylan 30500

33.00550.00

1.10001.1000

02339927 Omeprazole (caps.) Pro Doc 100500

110.00550.00

1.10001.1000

02320851 pms-Omeprazole (caps.) Phmscience 100500

110.00550.00

1.10001.1000

02310260 pms-Omeprazole DR (tab.) Phmscience 30500

33.00550.00

1.10001.1000

02260867 ratio-Omeprazole (tab.) Ratiopharm 100 110.00 1.100002296446 Sandoz Omeprazole (Caps.) Sandoz 30

50033.00

550.001.10001.1000


Page 250 2010-06

PANTOPRAZOLE (SODIUM) XXEnt. Tab. 40 mg

02292920 Apo-Pantoprazole Apotex 100500

97.83489.25

0.97830.9785

02300486 Co Pantoprazole Cobalt 100 97.83 0.978302299585 Mylan-Pantoprazole Mylan 100

50097.83

489.250.97830.9785

02285487 Novo-Pantoprazole Novopharm 100 97.83 0.978302229453 Pantoloc Nycomed 100 198.99 1.989902318695 Pantoprazole Pro Doc 100

50097.83

489.250.97830.9785

02309866 phl-Pantoprazole Pharmel 100500

97.83489.25

0.97830.9785

02307871 pms-Pantoprazole Phmscience 100500

97.83489.25

0.97830.9785

02305046 Ran-Pantoprazole Ranbaxy 100 97.83 0.978302308703 ratio-Pantoprazole Ratiopharm 100

50097.83

489.250.97830.9785

02316463 Riva-Pantoprazole Riva 100500

97.83489.25

0.97830.9785

02301083 Sandoz Pantoprazole Sandoz 30500

29.35489.25

0.97830.9785

02310201 Zym-Pantoprazole Zymcan 100 97.83 0.9783

RABEPRAZOLE SODIUM XEnt. Tab. 10 mg

02296632 Novo-Rabeprazole EC Novopharm 100 32.50 0.325002243796 Pariet J.O.I. 30

10019.5065.00

0.65000.6500

02320614 phl-Rabeprazole EC Pharmel 30500

9.75162.50

0.32500.3250

02310805 pms-Rabeprazole EC Phmscience 30500

9.75162.50

0.32500.3250

02315181 Pro-Rabeprazole Pro Doc 100 32.50 0.325002298074 Ran-Rabeprazole Ranbaxy 100 32.50 0.325002330083 Riva-Rabeprazole EC Riva 100

50032.50

162.500.32500.3250

02314177 Sandoz Rabeprazole Sandoz 30100

9.7532.50

0.32500.3250

02320592 Zym-Rabeprazole EC Zymcan 100 32.50 0.3250


2010-06 Page 251

Ent. Tab. 20 mg

02296640 Novo-Rabeprazole EC Novopharm 30100

19.5065.00

0.65000.6500

02243797 Pariet J.O.I. 30100

39.00130.00

1.30001.3000

02320622 phl-Rabeprazole EC Pharmel 30500

19.50325.00

0.65000.6500

02310813 pms-Rabeprazole EC Phmscience 30500

19.50325.00

0.65000.6500

02315203 Pro-Rabeprazole Pro Doc 100 65.00 0.650002298082 Ran-Rabeprazole Ranbaxy 100 65.00 0.650002330091 Riva-Rabeprazole EC Riva 100

50065.00

325.000.65000.6500

02314185 Sandoz Rabeprazole Sandoz 30100

19.5065.00

0.65000.6500

02320606 Zym-Rabeprazole EC Zymcan 100 65.00 0.6500

56:32PROKINETIC AGENTSDOMPERIDONE MALEATE XXTab. 10 mg PPB

02103613 Apo-Domperidone Apotex 500 74.80 0.149602236857 Domperidone-10 Pro Doc 500 74.80 0.149602278669 Mylan-Domperidone Mylan 500 74.80 0.149602157195 Novo-Domperidone Novopharm 500 74.80 0.149602231477 Nu-Domperidone Nu-Pharm 100

50014.9674.80

0.14960.1496

02238341 phl-Domperidone Pharmel 500 74.80 0.149602236466 pms-Domperidone Phmscience 500 74.80 0.149602268078 Ran-Domperidone Ranbaxy 500 74.80 0.149601912070 ratio-Domperidone Ratiopharm 500 74.80 0.1496

METOCLOPRAMIDE HYDROCHLORIDE XInj. Sol. 5 mg/mL

02185431 Metoclopramide injection Sandoz 2 ml10 ml30 ml

2.4711.0331.17

Oral Sol. 1 mg/mL

02230433 pms-Metoclopramide Phmscience 500 ml 18.78 0.0376

Tab. 5 mg PPB

00842826 Apo-Metoclop Apotex 100500

5.5627.80

0.05560.0556

00871001 Metoclopramide-5 Pro Doc 100 5.56 0.055602143275 Nu-Metoclopramide Nu-Pharm 100 5.56 0.055602230431 pms-Metoclopramide Phmscience 100

5005.56

27.800.05560.0556


Page 252 2010-06

Tab. 10 mg PPB

00842834 Apo-Metoclop Apotex 100500

5.8329.15

0.05830.0583

00870994 Metoclopramide-10 Pro Doc 100500

5.8329.15

0.05830.0583

02143283 Nu-Metoclopramide Nu-Pharm 100 5.83 0.058302230432 pms-Metoclopramide Phmscience 100

5005.83

29.150.05830.0583

56:36ANTI-INFLAMMATORY AGENTS5-AMINOSALICYLIC ACID XXEnt. Tab. 400 mg

01997580 Asacol Warner 180 92.21 0.512302171929 Novo-5-ASA Novopharm 100

50039.60

198.000.39600.3960

Ent. Tab. 500 mg

01914030 Mesasal GSK 100 56.13 0.561302099683 Pentasa Ferring 240

500133.65278.44

0.55690.5569

02112787 Salofalk Axcan 150500

73.92246.40

0.49280.4928

Ent. Tab. 800 mg

02267217 Asacol Warner 180 179.05 0.9947

L.A. Tab. 1.2 g

02297558 Mezavant Shire 120 178.80 1.4900

Rect. Susp. 2 g

02112795 Salofalk (58,2 mL) Axcan 1 3.51

Rect. Susp. 4 g PPB

02153556 Pentasa (100 mL) Ferring 1 4.4602112809 Salofalk (58,2 mL) Axcan 1 5.96

Supp. 1 g PPB

02153564 Pentasa Ferring 30 48.00 1.600002242146 Salofalk Axcan 30 48.00 1.6000

Supp. 500 mg

02112760 Salofalk Axcan 30 32.68 1.0893


2010-06 Page 253

OLSALAZINE SODIUM XXCaps. 250 mg

02063808 Dipentum U.C.B. 100 48.04 0.4793

56:92GI DRUGS, MISCELLANEOUSLANSOPRAZOLE/ AMOXICILLIN/ CLARITHROMYCINE XKit 30 mg-2 x 500 mg-500 mg

02238525 Hp-PAC Abbott 7 77.79


Page 254 2010-06

60:00GOLD COMPOUNDS

60:00GOLD COMPOUNDSAURANOFIN XXCaps. 3 mg

01916823 Ridaura Paladin 60 119.54 1.9923

SODIUM AUROTHIOMALATE XI.M. Inj. Sol. 10 mg/mL PPB

02245456 Aurothiomalate de sodium Sandoz 1 ml 6.31 5.740001927620 Myochrysine SanofiAven 1 ml 9.56






2010-06 Page 257

64:00HEAVY METALS ANTAGONISTS

64:00HEAVY METALS ANTAGONISTSDEFEROXAMINE MESYLATE XX

Inj. Pd 2 g PPB

01981250 Desferal Novartis 1 53.7402247022 Mesylate de desfer-

rioxamine pour injectionHospira 1 28.35

02243450 pms-Deferoxamine Phmscience 1 28.35

Inj. Pd 500 mg PPB

01981242 Desferal Novartis 1 13.3802241600 Mesylate de desfer-

rioxamine pour injectionHospira 1 7.06

02242055 pms-Deferoxamine Phmscience 1 7.06

PENICILLAMINE XCaps. 250 mg

00016055 Cuprimine Valeo 100 74.92 0.7492


2010-06 Page 261

68:00HORMONES AND SYNTHETIC SUBSTITUTES

68:04 adrenals68:08 androgens68:12 contraceptives68:16 estrogens and antiestrogens68:16.04 estrogens68:16.12 estrogen agonist-antagonists68:18 gonadotropins68:20 antidiabetic agents68:20.02 alpha-glucosidase inhibitors68:20.04 biguanides68:20.08 insulins68:20.20 sulfonylureas68:22 antihypoglycemic agents68:22.12 glycogenolytic agents68:24 parathyroid68:28 pituitary68:32 progestins68:36 thyroid and antithyroid agents68:36.04 thyroid agents68:36.08 antithyroid agents

68:04ADRENALSBECLOMETHASONE DIPROPIONATE XXOral aerosol 50 mcg/dose

02242029 Qvar Graceway 200 dose(s) 29.28

Oral aerosol 100 mcg/dose

02242030 Qvar Graceway 200 dose(s) 58.56

BETAMETHASONE ACETATE/ BETAMETHASONE SODIUM PHOSPHATE XInj. Susp. 3 mg -3 mg/mL

02237835 Betaject Sandoz 1 ml5 ml

6.9734.85

BUDESONIDE XInh. Pd 100 mcg/dose

00852074 Pulmicort Turbuhaler AZC 200 dose(s) 30.40

Inh. Pd 200 mcg/dose


Inh. Pd 400 mcg/dose


Sol. Inh. 0.125 mg/mL (2 mL)

02229099 Pulmicort nebuamp AZC 20 8.25 0.4125

Sol. Inh. 0.25 mg/mL (2 mL)


Sol. Inh. 0.5 mg/mL (2mL)


CICLESONIDE XOral aerosol 100 mcg/dose

02285606 Alvesco Nycomed 1 42.58


02285614 Alvesco Nycomed 1 70.35


2010-06 Page 265

CORTISONE ACETATE XXTab. 25 mg

00280437 Cortisone Acetate-ICN Valeant 100 30.66 0.3066

DEXAMETHASONE XElix. 0.5 mg/5 mL

01946897 pms-Dexamethasone Phmscience 100 ml 29.67 0.2967

Tab. 0.5 mg PPB

02261081 Apo-Dexamethasone Apotex 100 15.64 0.156402237044 phl-Dexamethasone Pharmel 100 15.64 0.156401964976 pms-Dexamethasone Phmscience 100 15.64 0.156402240684 ratio-Dexamethasone Ratiopharm 100 15.64 0.1564

Tab. 0.75 mg PPB

02237045 phl-Dexamethasone Pharmel 100 45.00 0.450001964968 pms-Dexamethasone Phmscience 100 45.00 0.4500

Tab. 2 mg

02279363 pms-Dexamethasone Phmscience 100 40.74 0.4074

Tab. 4 mg PPB

02250055 Apo-Dexamethasone Apotex 100 60.92 0.414400489158 Dexasone Valeant 100 76.73 0.767302237046 phl-Dexamethasone Pharmel 100 60.92 0.414401964070 pms-Dexamethasone Phmscience 100 60.92 0.414402311267 Pro-Dexamethasone-4 Pro Doc 100 60.92 0.414402240687 ratio-Dexamethasone Ratiopharm 50

10030.4660.92

0.41440.4144

DEXAMETHASONE SODIUM PHOSPHATE XInj. Sol. 4 mg/mL PPB

01977547 Dexamethasone Cytex 5 ml 8.0300664227 Dexamethasone Sandoz 5 ml 8.0302204266 Dexamethasone Omega Oméga 5 ml 8.03


00874582 Dexamethasone Sandoz 1 ml 4.2302204274 Dexamethasone Omega Oméga 1 ml

10 ml4.23

12.8302260301 phl-Dexamethasone Pharmel 10 ml 12.8300783900 pms-Dexamethasone Phmscience 10 ml 12.83


Page 266 2010-06

FLUDROCORTISONE ACETATE XXTab. 0.1 mg

02086026 Florinef Paladin 100 23.05 0.2305

FLUTICASONE PROPIONATE XInh. Pd 50 mcg/coque

02237244 Flovent Diskus GSK 60 dose(s) 13.95

Inh. Pd 100 mcg/coque







02244291 Flovent HFA GSK 120 dose(s) 22.61





HYDROCORTISONE X

Tab. 10 mg

00030910 Cortef Pfizer 100 14.08 0.1408

Tab. 20 mg

00030929 Cortef Pfizer 100 25.44 0.2544

HYDROCORTISONE SODIUM SUCCINATE XInj. Pd 1 g PPB

00878626 Hydrocortisone Novopharm 1 8.60 8.310000030635 Solu-Cortef Pfizer 1 13.85


2010-06 Page 267

Inj. Pd 100 mg PPB


Inj. Pd 250 mg PPB


Inj. Pd 500 mg PPB


METHYLPREDNISOLONE XTab. 4 mg

00030988 Medrol Pfizer 100 32.52 0.3252

Tab. 16 mg

00036129 Medrol Pfizer 100 93.84 0.9384

METHYLPREDNISOLONE ACETATE XInj. Susp. 20 mg/mL

01934325 Depo-Medrol Pfizer 5 ml 10.35

Inj. Susp. 40 mg/mL PPB

01934333 Depo-Medrol Pfizer 2 ml5 ml

9.0016.25

00030759 Depo-Medrol (sanspreservatif)

Pfizer 1 ml 4.69

02245407 Methylprednisolone Sandoz 2 ml5 ml

8.2014.52

2.70001.9500

02245400 Methylprednisolone (sanspreservatif)

Sandoz 1 ml 4.10 2.8200


00030767 Depo-Medrol Pfizer 1 ml 9.0002245408 Methylprednisolone Sandoz 5 ml 31.6802245406 Methylprednisolone (sans

preservatif)Sandoz 1 ml 8.20 5.4000


Page 268 2010-06

METHYLPREDNISOLONE ACETATE/ LIDOCAINE HYDROCHLORIDE XXInj. Susp. 40 mg -10 mg/mL

00260428 Depo-Medrol & Lidocaine Pfizer 1 ml2 ml5 ml

5.279.04

20.59

METHYLPREDNISOLONE SODIUM SUCCINATE XInj. Pd 1 g PPB

02241229 Methylprednisolone Novopharm 1 31.00 26.000002063697 Solu-Medrol Pfizer 1 43.33

Inj. Pd 40 mg PPB


Inj. Pd 125 mg PPB


Inj. Pd 500 mg PPB


PREDNISOLONE SODIUM PHOSPHATE XOral Sol. 5 mg/5 mL PPB

02230619 Pediapred SanofiAven 120 ml 12.21 0.101802245532 pms-Prednisolone Phmscience 120 8.05 0.0611

PREDNISONE XTab. 1 mg PPB

00598194 Apo-Prednisone Apotex 100 10.72 0.107200271373 Winpred Valeant 100 10.35 0.1035

Tab. 5 mg PPB

00312770 Apo-Prednisone Apotex 1001000

2.2021.95

0.02200.0220

00021695 Novo-Prednisone Novopharm 1001000

2.2021.95

0.02200.0220

00156876 Prednisone-5 Pro Doc 1000 21.95 0.0220


2010-06 Page 269

Tab. 50 mg PPB

00550957 Apo-Prednisone Apotex 100 9.13 0.091300232378 Novo-Prednisone Novopharm 100 9.13 0.091300607517 Prednisone-50 Pro Doc 100 9.13 0.0913

TRIAMCINOLONE ACETONIDE XXI.M. Inj. Susp. 40 mg/mL PPB

01999869 Kenalog-40 B.M.S. 1 ml5 ml

7.0124.55

01977563 Triamcinolone Cytex 1 ml 4.77 3.790002229550 Triamcinolone Sandoz 1 ml

5 ml4.77

16.713.79002.9460


01999761 Kenalog-10 B.M.S. 5 ml 15.1102229540 Triamcinolone Sandoz 5 ml 10.28 1.8140

TRIAMCINOLONE DIACETATE XInj. Susp. 40 mg/mL

01977555 Triamcinolone Cytex 5 ml 14.95

TRIAMCINOLONE HEXACETONIDE XInj. Susp. 20 mg/mL

02194155 Aristospan Valeo 1 ml5 ml

6.1726.94

68:08ANDROGENSDANAZOL XCaps. 50 mg

02018144 Cyclomen SanofiAven 100 75.71 0.7571

Caps. 100 mg


Caps. 200 mg


NANDROLONE DECANOATE YOily Inj. Sol. 100 mg/mL

00270687 Deca-Durabolin 100 Schering 2 ml 70.47


Page 270 2010-06

TESTOSTERONE YYPatch 2.5 mg/24 h

02239653 Androderm Paladin 60 115.68 1.9280

Patch 5 mg/24 h

02245972 Androderm Paladin 30 115.68 3.8560

Top. Jel. 1% (2.5 g)

02245345 AndroGel Solvay 30 63.79 2.1263

Top. Jel. 1 % (5.0 g) PPB

02245346 AndroGel Solvay 30 112.80 3.760002280248 Testim 1% Paladin 30 101.52 3.3840

TESTOSTERONE CYPIONATE YOily Inj. Sol. 100 mg/mL

00030783 Depo-Testosterone Pfizer 10 ml 24.14

TESTOSTERONE ENANTHATE YOily Inj. Sol. 200 mg/mL

00029246 Delatestryl Theramed 5 ml 24.42

TESTOSTERONE UNDECANOATE YCaps. 40 mg PPB

00782327 Andriol Schering 120 112.80 0.940002322498 pms-Testosterone Phmscience 100

12056.4067.68

0.56400.5640

68:12CONTRACEPTIVESETHINYLESTRADIOL DESOGESTREL XTab. 0.025 mg/0.1 mg-0.025 mg/0.125 mg-0.025 mg/

0.15 mg

02272903 Linessa 21 Schering 1 11.9302257238 Linessa 28 Schering 1 11.93

Tab. 0.030 mg -0.15 mg PPB

02317192 Apri 21 Apotex 1 9.19 7.480002317206 Apri 28 Apotex 1 9.19 7.480002042487 Marvelon 21 Schering 1 12.4602042479 Marvelon 28 Schering 1 12.4602042533 Ortho-Cept (28) J.O.I. 1 12.21


2010-06 Page 271

ETHINYLESTRADIOL/ D-NORGESTREL XXTab. 0.05 mg -0.25 mg

02043033 Ovral 21 Wyeth 1 12.41 12.4100

ETHINYLESTRADIOL/ DROSPIRENONE XTab. 0.02 mg -3 mg

02321157 Yaz Bayer 1 11.60

Tab. 0.03 mg - 3 mg

02261723 Yasmin 21 Bayer 1 11.6002261731 Yasmin 28 Bayer 1 11.60

ETHINYLESTRADIOL/ ETHYNODIOL DIACETATE XTab. 0.03 mg -2 mg

00469327 Demulen 30 (21) Pfizer 1 11.7600471526 Demulen 30 (28) Pfizer 1 12.58

ETHINYLESTRADIOL/ ETONOGESTREL XVaginal ring 2.6mg -11.4mg

02253186 Nuvaring Schering 13

14.3443.02

14.340014.3400

ETHINYLESTRADIOL/ NORELGESTROMIN XPatch (3) 0.60 mg - 6 mg

02248297 Evra J.O.I. 1 14.56

ETHINYLESTRADIOL/ NORETHINDRONE XTab. 0.035 mg -0.5 mg PPB

02187086 Brevicon 0.5/35 (21) Pfizer 1 10.7802187094 Brevicon 0.5/35 (28) Pfizer 1 10.7800317047 Ortho 0.5/35 (21) J.O.I. 1 12.2100340731 Ortho 0.5/35 (28) J.O.I. 1 12.21

Tab. 0.035 mg -0.5 mg -0.035 mg -0.75 mg -0.035 mg-1 mg

00602957 Ortho 7/7/7 (21) J.O.I. 1 12.2100602965 Ortho 7/7/7 (28) J.O.I. 1 12.21


Page 272 2010-06

Tab. 0.035 mg -0.5 mg -0.035 mg -1 mg -0.035 mg -0.5mg

02187108 Synphasic 21 Pfizer 1 10.2202187116 Synphasic 28 Pfizer 1 10.22

Tab. 0.035 mg -1 mg PPB

02189054 Brevicon 1/35 (21) Pfizer 1 10.7802189062 Brevicon 1/35 (28) Pfizer 1 10.7800372846 Ortho 1/35 (21) J.O.I. 1 12.0700372838 Ortho 1/35 (28) J.O.I. 1 12.0702197502 Select 1/35 (21) Pfizer 1 7.2802199297 Select 1/35 (28) Pfizer 1 7.28

ETHINYLESTRADIOL/ NORETHINDRONE ACETATE XXTab. 0.02 mg -1 mg

00315966 Minestrin 1/20 (21) Paladin 1 12.2400343838 Minestrin 1/20 (28) Paladin 1 12.24

Tab. 0.03 mg -1.5 mg

00297143 Loestrin 1.5/30 (21) Paladin 1 12.2400353027 Loestrin 1.5/30 (28) Paladin 1 12.24

ETHINYLOESTRADIOL NORGESTIMATE XTab. 0.025 mg/0.180 mg - 0.215 mg -0.250 mg

02258560 Tri-Cyclen LO (21) J.O.I. 1 11.8302258587 Tri-Cyclen LO (28) J.O.I. 1 11.83

Tab. 0.035 mg -0.180 mg -0.035 mg -0.215 mg -0.035mg -0.25 mg

02028700 Tri-Cyclen (21) J.O.I. 1 12.2102029421 Tri-Cyclen (28) J.O.I. 1 12.21

Tab. 0.035 mg -0.25 mg

01968440 Cyclen (21) J.O.I. 1 12.2101992872 Cyclen (28) J.O.I. 1 12.21

ETHYNYLOESTRADIOL/ LEVONORGESTREL XTab. 0.020 mg -0.10 mg PPB

02236974 Alesse 21 Wyeth 1 12.2102236975 Alesse 28 Wyeth 1 12.2102298538 Aviane 21 Apotex 1 9.74 7.330002298546 Aviane 28 Apotex 1 9.74 7.3300


2010-06 Page 273

Tab. 0.03 mg -0.05 mg -0.04 mg -0.075 mg -0.03 mg-0.125 mg

00707600 Triquilar 21 Bayer 1 14.15 11.400000707503 Triquilar 28 Bayer 1 14.15 11.4000

Tab. 0.03 mg -0.15 mg PPB

02042320 Min-Ovral 21 Wyeth 1 11.9802042339 Min-Ovral 28 Wyeth 1 11.9802295946 Portia 21 Apotex 1 9.74 7.190002295954 Portia 28 Apotex 1 9.74 7.1900

Tab. (91) 0.03 mg -0.15 mg

02296659 Seasonale Paladin 1 52.00

LEVONORGESTREL XIntra-Uter. Dev. 52 mg

02243005 Mirena Bayer 1 306.54

LEVONORGESTREL Tab. 0.75 mg PPB

02285576 Norlevo Bayer 2 16.24 8.120002241674 Plan B Paladin 2 16.24 8.1200

NORETHINDRONE XTab. (28) 0.35 mg

00037605 Micronor J.O.I. 1 12.21

68:16.04ESTROGENSCONJUGATED ESTROGENS (BIOLOGICS) XVag. Cr. 0.625 mg/g

02043440 Premarin Wyeth 14 g 8.45

CONJUGATED ESTROGENS (SYNTHETIC) XTab. 0.625 mg

00265470 C.E.S. Valeant 1001000

7.7477.40

0.07740.0774

ESTRADIOL-17B XTab. 0.5 mg

02225190 Estrace Shire 100 10.88 0.1088


Page 274 2010-06

Tab. 1 mg

02148587 Estrace Shire 100 21.03 0.2103

Tab. 2 mg

02148595 Estrace Shire 100 37.12 0.3712

Vag. Tab. 25 mcg

02241332 Vagifem N.Nordisk 15 35.06

Vaginal ring 2 mg

02168898 Estring Squire 1 60.00

ESTRONE XXVag. Cr. 1 mg/g

00727369 Neo-Estrone Néolab 45 g 14.97

ESTROPIPATE XTab. 0.625 mg

02089793 Ogen Pfizer 100 15.70 W

Tab. 1.25 mg

02089769 Ogen Pfizer 100 28.04 W

Tab. 2.5 mg

02089777 Ogen Pfizer 100 44.35 W

68:16.12ESTROGEN AGONIST-ANTAGONISTSRALOXIFENE HYDROCHLORIDE XTab. 60 mg

02279215 Apo-Raloxifene Apotex 100 84.57 0.845702239028 Evista Lilly 28 46.15 1.648202312298 Novo-Raloxifène Novopharm 30 25.37 0.8457

68:18GONADOTROPINSNAFARELIN ACETATE XNas. spray 2 mg/mL

02188783 Synarel Pfizer 8 ml 280.00


2010-06 Page 275

68:20.02ALPHA-GLUCOSIDASE INHIBITORSACARBOSE XXTab. 50 mg

02190885 Glucobay Bayer 120 28.65 0.2388

Tab. 100 mg

02190893 Glucobay Bayer 120 39.61 0.3301

68:20.04BIGUANIDESMETFORMIN HYDROCHLORIDE XTab. 500 mg PPB

02167786 Apo-Metformin Apotex 100500

9.6548.25

0.09650.0965

02257726 Co Metformin Cobalt 100500

9.6548.25

0.09650.0965

02099233 Glucophage SanofiAven 100500

23.38102.45

0.23380.2049

02284782 Metformin Genpharm 100500

9.6548.25

0.09650.0965

02148765 Mylan-Metformin Mylan 100500

9.6548.25

0.09650.0965

02045710 Novo-Metformin Novopharm 100500

9.6548.25

0.09650.0965

02246964 phl-Metformin Pharmel 100500

9.6548.25

0.09650.0965

02223562 pms-Metformin Phmscience 100500

9.6548.25

0.09650.0965

02314908 Pro-Metformin Pro Doc 100500

9.6548.25

0.09650.0965

02269031 Ran-Metformin Ranbaxy 100500

9.6548.25

0.09650.0965

02242974 ratio-Metformin Ratiopharm 100500

9.6548.25

0.09650.0965

02239081 Riva-Metformin Riva 100500

9.6548.25

0.09650.0965

02246820 Sandoz Metformin FC Sandoz 100500

9.6548.25

0.09650.0965

02242794 Zym-Metformin Zymcan 100 9.65 W


Page 276 2010-06

Tab. 850 mg PPB

02229785 Apo-Metformin Apotex 100500

15.3676.80

0.15360.1536

02257734 Co Metformin Cobalt 100500

15.3676.80

0.15360.1536

02162849 Glucophage SanofiAven 100 29.62 0.296202284790 Metformin Genpharm 100

50015.3676.80

0.15360.1536

02229656 Mylan-Metformin Mylan 100500

15.3676.80

0.15360.1536

02230475 Novo-Metformin Novopharm 100500

15.3676.80

0.15360.1536

02246965 phl-Metformin Pharmel 100500

15.3676.80

0.15360.1536

02242589 pms-Metformin Phmscience 100500

15.3676.80

0.15360.1536

02314894 Pro-Metformin Pro Doc 100500

15.3676.80

0.15360.1536

02269058 Ran-Metformin Ranbaxy 100 15.36 0.153602242931 ratio-Metformin Ratiopharm 100

50015.3676.80

0.15360.1536

02242783 Riva-Metformin Riva 100500

15.3676.80

0.15360.1536

02246821 Sandoz Metformin FC Sandoz 100500

15.3676.80

0.15360.1536

02242793 Zym-Metformin Zymcan 100 15.36 W

68:20.08INSULINSASPART INSULINS.C. Inj. Sol. 100 U/mL

02245397 NovoRapid N.Nordisk 10 ml 24.40

S.C. Inj. Sol. 100 U/mL (3 mL)

02244353 NovoRapid N.Nordisk 5 48.84

INSULIN CRISTAL ZINC (BIOSYNTHETIC OF HUMAN SEQUENCE)S.C. Inj. Sol. 100 U/mL

00586714 Humulin R Lilly 10 ml 16.4702024233 Novolin ge Toronto N.Nordisk 10 ml 17.68


01959220 Humulin R Lilly 5 34.1502024284 Novolin ge Toronto Penfill N.Nordisk 5 35.34

INSULIN GLULISINE S.C. Inj. Sol. 100 U/mL

02279460 Apidra SanofiAven 10 ml 23.72


2010-06 Page 277


02279479 Apidra SanofiAven 5 47.4702294346 Apidra Solostar SanofiAven 5 47.47

INSULIN ISOPHANE (BIOSYNTHETIC OF HUMAN SEQUENCE)S.C. Inj. Susp. 100 U/mL

00587737 Humulin N Lilly 10 ml 16.4702024225 Novolin ge NPH N.Nordisk 10 ml 17.68

S.C. Inj. Susp. 100 U/mL (3 mL)

01959239 Humulin N Lilly 5 34.1502241310 Humulin N Pen Lilly 5 33.9902024268 Novolin ge NPH Penfill N.Nordisk 5 35.34

INSULINS ZINC CRISTALLINE AND ISOPHANE BIOSYNTHETIC OF HUMAN SEQUENCES.C. Inj. Susp. 30 U -70 U/mL

00795879 Humulin 30/70 Lilly 10 ml 16.4702024217 Novolin ge 30/70 N.Nordisk 10 ml 17.68

S.C. Inj. Susp. 30 U -70 U/mL (3 mL)

01959212 Humulin 30/70 Lilly 5 34.1502025248 Novolin ge 30/70 Penfill N.Nordisk 5 35.34

S.C. Inj. Susp. 40 U -60 U/mL (3 mL)

02024314 Novolin ge 40/60 Penfill N.Nordisk 5 35.34

S.C. Inj. Susp. 50 U -50 U/mL(3 mL)

02024322 Novolin ge 50/50 Penfill N.Nordisk 5 35.34

LISPRO INSULIN S.C. Inj. Sol. 100 U/mL

02229704 Humalog Lilly 10 ml 25.05


02229705 Humalog Lilly 5 50.1199100630 + Humalog KwikPen Lilly 5 50.11


Page 278 2010-06

68:20.20SULFONYLUREASCHLORPROPAMIDE XXTab. 100 mg

00399302 Apo-Chlorpropamide Apotex 100 7.45 0.0745

Tab. 250 mg

00312711 Apo-Chlorpropamide Apotex 100 4.32 0.0432

GLYBURIDE XTab. 2.5 mg PPB

01913654 Apo-Glyburide Apotex 100500

3.9319.65

0.03930.0393

02224550 Diabeta SanofiAven 30 3.36 0.112000720933 Euglucon 2.5 Phmscience 30

5001.18

19.650.03930.0393

01959352 Glyburide-2.5 Pro Doc 100500

3.9319.65

0.03930.0393

00808733 Mylan-Glybe Mylan 30500

1.1819.65

0.03930.0393

01913670 Novo-Glyburide Novopharm 100500

3.9319.65

0.03930.0393

02236733 pms-Glyburide Phmscience 100500

3.9319.65

0.03930.0393

01900927 ratio-Glyburide Ratiopharm 300 11.79 0.039302236543 Riva-Glyburide Pharmel 500 19.65 0.039302248008 Sandoz Glyburide Sandoz 500 19.65 0.0393

Tab. 5 mg PPB

01913662 Apo-Glyburide Apotex 100500

6.8334.15

0.06830.0683

02224569 Diabeta SanofiAven 30300

6.0260.20

0.20070.2007

00720941 Euglucon Phmscience 30500

2.0534.15

0.06830.0683

00808741 Mylan-Glybe Mylan 30500

2.0534.15

0.06830.0683

01913689 Novo-Glyburide Novopharm 100500

6.8334.15

0.06830.0683

02236734 pms-Glyburide Phmscience 100500

6.8334.15

0.06830.0683

02316544 Pro-Glyburide Pro Doc 30500

2.0534.15

0.06830.0683

01900935 ratio-Glyburide Ratiopharm 30300

2.0520.49

0.06830.0683

02236548 Riva-Glyburide Pharmel 500 34.15 0.068302248009 Sandoz Glyburide Sandoz 100

5006.83

34.150.06830.0683


2010-06 Page 279

TOLBUTAMIDE XXTab. 500 mg

00312762 Apo-Tolbutamide Apotex 1001000

10.89108.90

0.08550.0712

68:22.12GLYCOGENOLYTIC AGENTSGLUCAGON XInj. Pd 1 mg PPB

02333619 GlucaGen Paladin 1 77.1002333627 GlucaGen HypoKit Paladin 1 77.1002243297 Glucagon Lilly 1 85.67

68:24PARATHYROIDCALCITONIN SALMON (SYNTHETIC) XInj. Sol. 100 UI

02007134 Caltine Ferring 1 ml 7.82

Inj. Sol. 200 U/mL

01926691 Calcimar Solution SanofiAven 2 ml 44.27

Nas. spray 200 UI/dose PPB

02247585 Apo-Calcitonin Apotex 28 dose(s) 39.20 1.003602240775 Miacalcin NS Novartis 28 dose(s) 52.0302261766 Sandoz Calcitonin NS Sandoz 28 dose(s) 39.20 1.0036

68:28PITUITARYCOSYNTROPIN ZINC HYDROXIDEI.M. Inj. Susp. 1 mg/mL

00253952 Synacthen Depot Novartis 1 ml 22.59

DESMOPRESSIN ACETATE XInj. Sol. 4 mcg/mL

00873993 DDAVP Ferring 1 ml 10.06

Inj. Sol. 15 mcg/mL

02024179 Octostim Ferring 1 ml 34.56

Nas. Sol. 0.1 mg/mL

00402516 DDAVP Ferring 2.5 ml 47.20


Page 280 2010-06

Nas. spray 10 mcg/dose PPB

02242465 Apo-Desmopressin Apotex 25 dose(s)50 dose(s)

35.4070.80

1.13281.1328

00836362 DDAVP Ferring 25 dose(s)50 dose(s)

47.2094.40

Nas. spray 150 mcg/dose

02237860 Octostim Ferring 25 dose(s) 386.00

Tab. or Tab. Oral Disint. 0.1 mg or 0.06 mg PPB

02284030 Apo-Desmopressin Apotex 100 66.09 0.660900824305 DDAVP Ferring 30 39.65 1.321702284995 DDAVP Melt Ferring 30 29.73 0.991002287730 Novo-Desmopressin Novopharm 30 19.83 0.660902304368 pms-Desmopressin Phmscience 100 66.09 0.6609

Tab. or Tab. Oral Disint. 0.2 mg ou 0.12 mg PPB

02284049 Apo-Desmopressin Apotex 100 132.17 1.321700824143 DDAVP Ferring 30

10079.30

264.322.64332.6432

02285002 DDAVP Melt Ferring 30 59.47 1.982302287749 Novo-Desmopressin Novopharm 30

10039.65

132.171.32171.3217

02304376 pms-Desmopressin Phmscience 100 132.17 1.3217

68:32PROGESTINSMEDROXYPROGESTERONE ACETATE XI.M. Inj. Susp. 50 mg/mL

00030848 Depo-Provera Pfizer 5 ml 23.71

I.M. Inj. Susp. 150 mg/mL PPB

00585092 Depo-Provera Pfizer 1 ml 25.9502322250 Medroxyprogesterone

acetate injectionSandoz 1 ml 18.00 15.5700

Tab. 2.5 mg PPB

02244726 Apo-Medroxy Apotex 100500

6.3031.50

0.06300.0630

02229838 Gen-Medroxy Genpharm 100500

6.3031.50

0.06300.0630

02253550 Medroxy-2.5 Pro Doc 100500

6.3031.50

0.06300.0630

02221284 Novo-Medrone Novopharm 100 6.30 0.063002246627 pms-Medroxyprogesterone Phmscience 100

5006.30

31.500.06300.0630

00708917 Provera Pfizer 100500

13.1165.54

0.13110.1311


2010-06 Page 281

Tab. 5 mg PPB

02244727 Apo-Medroxy Apotex 100 12.46 0.124602229839 Gen-Medroxy Genpharm 100

50012.4662.30

0.12460.1246

02253577 Medroxy-5 Pro Doc 100 12.46 0.124602221292 Novo-Medrone Novopharm 100 12.46 0.124602246628 pms-Medroxyprogesterone Phmscience 100

50012.4662.30

0.12460.1246

00030937 Provera Pfizer 100 25.92 0.2592

Tab. 10 mg PPB

02277298 Apo-Medroxy Apotex 100 25.15 0.251502229840 Gen-Medroxy Genpharm 100 25.15 0.251502221306 Novo-Medrone Novopharm 100 25.15 0.251502246629 pms-Medroxyprogesterone Phmscience 100

50025.15

125.750.25150.2515

00729973 Provera Pfizer 100 52.34 0.5234

Tab. 100 mg PPB

02267640 Apo-Medroxy Apotex 100 91.53 0.732300030945 Provera Pfizer 100 122.04 1.2204

PROGESTERONE XOily Inj. Sol. 50 mg/mL

01977652 Progesterone Cytex 10 ml 63.00

68:36.04THYROID AGENTSLEVOTHYROXINE (SODIUM) XTab. 0.025 mg

02264323 Euthyrox Serono 1000 56.44 0.056402172062 Synthroid Abbott 100

10007.46

68.380.07460.0684

Tab. 0.05 mg

02213192 Eltroxin Triton 500 13.17 0.026302264331 Euthyrox Serono 1000 24.92 0.024902172070 Synthroid Abbott 100

10004.50

40.910.04500.0409

Tab. 0.075 mg


10008.04

73.820.08040.0738


Page 282 2010-06

Tab. 0.088 mg


10008.04

73.820.08040.0738

Tab. 0.1 mg


10005.96

54.450.05960.0545

Tab. 0.112 mg


10008.50

77.950.08500.0780

Tab. 0.125 mg


10008.65

79.260.08650.0793

Tab. 0.137 mg


100015.30

153.000.15300.1530

Tab. 0.15 mg


10006.40

58.500.06400.0585

Tab. 0.175 mg


10009.24

84.700.09240.0847

Tab. 0.2 mg


10006.84

62.340.06840.0623


2010-06 Page 283

Tab. 0.3 mg

02213230 Eltroxin Triton 500 28.47 0.056902264455 Euthyrox Serono 100 7.85 0.078502172151 Synthroid Abbott 100 9.43 0.0943

LIOTHYRONINE (SODIUM) XXTab. 5 mcg

01919458 Cytomel King 100 98.18 0.9818

Tab. 25 mcg

01919466 Cytomel King 100 106.73 1.0673

68:36.08ANTITHYROID AGENTSMETHIMAZOL XTab. 5 mg

00015741 Tapazole Paladin 100 23.79 0.2379

PROPYLTHIOURACIL XTab. 50 mg

00010200 Propyl-Thyracil Paladin 100 20.56 0.2056

Tab. 100 mg

00010219 Propyl-Thyracil Paladin 100 32.17 0.3217


Page 284 2010-06

84:00SKIN AND MUCOUS MEMBRANE AGENTS

84:04 anti-infectieux84:04.04 antibiotics84:04.08 antifungals84:04.12 scabicides and pediculicides84:04.92 local anti-infectives, miscellaneous84:06 anti-inflammatory agents84:28 keratolytic agents84:32 keratoplastic agents84:50 demelanisant agent and melanisant84:50.06 pigmenting agents84:92 skin and mucous membrane agents,

miscellaneous

84:04.04ANTIBIOTICSBACITRACIN Inj./Top. Pd 50 000 U

00030708 Bacitracine Pfizer 50 ml 8.99

Top. Oint. 500 U/g

00584908 Bacitin Phmscience 450 g 44.72 0.0994

CLINDAMYCIN PHOSPHATE XXTop. Sol. 1 % PPB

02243659 Clinda-T Valeo 60 ml 9.1500582301 Dalacin T Pfizer 30 ml

60 ml8.82

17.6402266938 Taro-Clindamycin Taro 30 ml

60 ml6.789.15

0.1767

FUSIDIC (ACID) XTop. Cr. 2 %

00586668 Fucidin Leo 15 g30 g

8.7417.02

0.58270.5673

GENTAMICIN SULFATE XTop. Cr. 0.1 %

00805386 ratio-Gentamicin Ratiopharm 15 g 3.66 0.2440

Top. Oint. 0.1 %

00805025 ratio-Gentamicin Ratiopharm 15 g 3.66 0.2440

METRONIDAZOLE XLot. 0.75 %

02248206 Metrolotion Galderma 120 ml 59.20

Top. Cr. 0.75 %

02226839 Metrocreme Galderma 60 g 29.60 0.4933

Top. Cr. 1 % PPB

02156091 Noritate SanofiAven 45 g 23.10 0.513302242919 Rosasol Stiefel 30 g 15.23 0.5077


2010-06 Page 287

Top. Jel. 0.75 %

02092832 Metrogel Galderma 60 g 36.00 0.6000

Top. Jel. 1 %

02297809 Metrogel Galderma 60 g 36.00 0.6000

MUPIROCINTop. Oint. 2 % PPB

01916947 Bactroban GSK CONS 15 g30 g

7.4314.87

0.49530.4957

02279983 Taro-Mupirocin Taro 15 g30 g

5.1810.36

0.29730.2977

MUPIROCIN CALCIUMTop. Cr. 2 %

02239757 Bactroban GSK CONS 15 g 7.43 0.4953

POLYMYXIN B SULFATE/ BACITRACIN (ZINC)Top. Oint. 10 000 U -500 U/g

00621366 Bioderm Odan 15 g30 g

4.986.29

0.33200.2097

SODIUM FUSIDATE XTop. Oint. 2 %

00586676 Fucidin Leo 15 g30 g

8.7417.02

0.58270.5673

84:04.08ANTIFUNGALSCICLOPIROX OLAMINE XLot. 1 %

02221810 Loprox SanofiAven 60 ml 30.40

Top. Cr. 1 %

02221802 Loprox SanofiAven 45 g 21.29 0.4731

CLOTRIMAZOLE Top. Cr. 10 mg/g

00812382 Clotrimaderm Taro 20 g50 g

500 g

4.209.00

44.20

0.21000.18000.0884


Page 288 2010-06

Vag. Cr. (App.) 1 % PPB

00812366 Clotrimaderm Taro 50 g 8.7500874051 Neo-Zol Néolab 50 g 8.75

Vag. Cr. (App.) 2 %

00812374 Clotrimaderm Taro 25 g 8.75

KETOCONAZOLE XXTop. Cr. 2 %

02245662 Ketoderm Taro 30 g 9.50 0.3167

MICONAZOLE NITRATEVag. Cr. (App.) 2 %

02231106 Micozole Taro 45 g 6.80

NYSTATINTop. Cr. 100 000 U/g PPB

00716871 Nyaderm Taro 454 g 28.60 0.063002194236 ratio-Nystatin Ratiopharm 15 g

30 g450 g

0.951.89

28.35

0.06330.06300.0630

Top. Oint. 100 000 U/g

02194228 ratio-Nystatin Ratiopharm 30 g 2.71 0.0903

NYSTATIN XVag. Cr. (App.) 25 000 U/g

00716901 Nyaderm Taro 120 g 5.90

TERBINAFIN HYDROCHLORIDE XTop. Cr. 1 %

02031094 Lamisil Novartis 30 g 14.27 0.4757

Top. vap. 1 %

02238703 Lamisil Novartis 30 ml 14.27

TERCONAZOL XTop.Cr./Ov.(App.) 0.8 % -80 mg (9g -3)

02130874 Terazol 3 Duo Pak J.O.I. 1 18.61


2010-06 Page 289

Vag. Cr. (App.) 0.4 % PPB

02247651 Taro-Terconazole Taro 45 g 12.27 0.248200894729 Terazol 7 J.O.I. 45 g 18.61

84:04.12SCABICIDES AND PEDICULICIDESGAMMA-BENZENE HEXACHLORIDE Lot. 1 % PPB

02245872 Hexit Odan 50 ml500 ml

3.6522.75 0.0455

00703591 pms-Lindane Phmscience 500 ml 22.75 0.0455

Shamp. 1 % PPB

00430617 Hexit Odan 50 ml 3.6500703605 pms-Lindane Phmscience 50 ml 3.65

ISOPROPYL MYRISTATE Top. Sol. 50 %

02279592 Resultz Nycomed 120 ml240 ml

11.5022.42

PERMETHRINCr. Rinse 1 %

02231480 Kwellada-P GSK CONS 50 ml200 ml

4.4315.67

Lot. 5 %

02231348 Kwellada-P GSK CONS 100 ml 24.74

Top. Cr. 5 %

02219905 Nix GSK CONS 30 g 13.86 0.4620

PYRETHRINS/ PIPERONYL BUTOXYDEShamp. 0.33 % -3 % à 4 % PPB

02229642 Pronto Shampooing Del 59 ml 4.4502125447 R & C Shampooing GSK CONS 50 ml

200 ml4.10

14.53 0.0727


Page 290 2010-06

84:04.92LOCAL ANTI-INFECTIVES, MISCELLANEOUSALUMINUM ACETATE Pd 2.36 g/sac.

00579947 Buro-Sol T C D 10 7.17 0.7170

SULFADIAZINE (SILVER) XXTop. Cr. 1 %

00323098 Flamazine S. & N. 20 g50 g

500 g

4.8610.9666.01

0.24300.21920.1320

84:06ANTI-INFLAMMATORY AGENTSAMCINONIDE XLot. 0.1 % PPB

02192276 Cyclocort Stiefel 20 ml60 ml

8.9520.28

02247097 ratio-Amcinonide Ratiopharm 20 ml60 ml

4.5413.63 0.2028

Top. Cr. 0.1 % PPB

02192284 Cyclocort Stiefel 15 g30 g60 g

7.9913.2024.42

0.53270.44000.4070

02247098 ratio-Amcinonide Ratiopharm 15 g30 g60 g

2.935.87

11.73

0.19530.19570.1955

02246714 Taro-Amcinonide Taro 15 g30 g60 g

2.935.87

11.73

0.19530.19570.1955

Top. Oint. 0.1 % PPB

02192268 Cyclocort Stiefel 15 g30 g60 g

7.9913.2024.42

0.53270.44000.4070

02247096 ratio-Amcinonide Ratiopharm 15 g30 g60 g

4.118.21

16.42

0.27400.26400.2443

BECLOMETHASONE DIPROPIONATE XTop. Cr. 0.025 %

02089602 Propaderm Squire 45 g 19.13 0.4251


2010-06 Page 291

BETAMETHASONE DIPROPIONATE XXLot. 0.05 % PPB

00417246 Diprosone Schering 30 ml75 ml

5.9414.85

00809187 ratio-Topisone Ratiopharm 30 ml75 ml

5.9414.85

Top. Cr. 0.05 % PPB

00323071 Diprosone Schering 15 g50 g

3.0710.24

0.20470.2048

00804991 ratio-Topisone Ratiopharm 15 g50 g

3.0710.24

0.20470.2048

01925350 Taro-Sone Taro 50 g 10.24 0.2048


00344923 Diprosone Schering 15 g50 g

3.2310.76

0.21530.2152

00805009 ratio-Topisone Ratiopharm 15 g50 g

450 g

3.2310.7696.89

0.21530.21520.2153

BETAMETHASONE DIPROPIONATE/ GLYCOL BASE XLot. 0.05 % PPB

00862975 Diprolene Schering 30 ml60 ml

14.0516.18

01927914 ratio-Topilene Ratiopharm 30 ml60 ml

14.0516.18

Top. Cr. 0.05 % PPB

00688622 Diprolene Schering 15 g50 g

7.7825.93

0.51870.5186

00849650 ratio-Topilene Ratiopharm 15 g50 g

7.7825.93

0.51870.5186


00629367 Diprolene Schering 15 g50 g

7.7825.93

0.51870.5186

00849669 ratio-Topilene Ratiopharm 15 g50 g

7.7825.93

0.51870.5186

BETAMETHASONE DIPROPIONATE/ SALICYLIC ACID XLot. 0.05 % -2 % PPB

00578428 Diprosalic Lotion Schering 30 ml60 ml

10.5721.14

02245688 ratio-Topisalic Ratiopharm 30 ml60 ml

10.5721.14


Page 292 2010-06

Top. Oint. 0.05 % -3 %

00578436 Diprosalic Pommade Schering 15 g50 g

11.3033.63

0.75330.6726

BETAMETHASONE DISODIUM PHOSPHATE XXRect. Sol. 5 mg/ 100 mL

02060884 Betnesol Paladin 100 ml 8.45

BETAMETHASONE VALERATE XLot. 0.05 %

00653209 ratio-Ectosone Ratiopharm 60 ml 11.40

Lot. 0.1 %

00750050 ratio-Ectosone Ratiopharm 60 ml 15.00

Scalp Lot. 0.1 % PPB

00716634 Betaderm Taro 75 ml 6.4000653217 ratio-Ectosone Ratiopharm 30 ml

75 ml2.566.40

01940112 Rivasone Riva 30 ml75 ml

2.566.40

00027944 Valisone Valeo 75 ml 6.40

Top. Cr. 0.05 %

00716618 Betaderm Taro 454 g 27.50 0.0606

Top. Cr. 0.1 %

00716626 Betaderm Taro 454 g 41.00 0.0903

Top. Oint. 0.05 %

00716642 Betaderm Taro 454 g 27.50 0.0606

Top. Oint. 0.1 %

00716650 Betaderm Taro 454 g 41.00 0.0903

BUDESONIDE XRect. Sol. 0.02 mg/mL

02052431 Entocort AZC 115 ml 7.93


2010-06 Page 293

CLOBETASOL PROPIONATE XXScalp Lot. 0.05 % PPB

02213281 Dermovate Capillaire Taro 60 ml 34.1102216213 Mylan-Clobetasol Mylan 60 ml 17.0602232195 pms-Clobetasol Phmscience 60 ml 17.0601910299 ratio-Clobetasol Ratiopharm 20 ml

60 ml5.69

17.0602245522 Taro-Clobetasol Taro 60 ml 17.06

Top. Cr. 0.05 % PPB

02213265 Dermovate Taro 15 g50 g

11.2432.56

0.74930.6512

02024187 Mylan-Clobetasol Mylan 15 g50 g

4.8816.28

0.32530.3256

02093162 Novo-Clobetasol Novopharm 50 g 16.28 0.325602232191 pms-Clobetasol Phmscience 15 g

50 g4.88

16.280.32530.3256

01910272 ratio-Clobetasol Ratiopharm 15 g50 g

450 g

4.8816.28

146.52

0.32530.32560.3256

02245523 Taro-Clobetasol Taro 15 g50 g

454 g

4.8816.28

147.82

0.32530.32560.3256


02213273 Dermovate Taro 15 g50 g

11.2432.56

0.74930.6512

02026767 Mylan-Clobetasol Mylan 15 g50 g

4.8816.28

0.32530.3256

02126192 Novo-Clobetasol Novopharm 50 g 16.28 0.325602232193 pms-Clobetasol Phmscience 15 g

50 g4.88

16.280.32530.3256

01910280 ratio-Clobetasol Ratiopharm 15 g50 g

450 g

4.8816.28

146.52

0.32530.32560.3256

02245524 Taro-Clobetasol Taro 15 g50 g

4.8816.28

0.32530.3256

CLOBETASONE BUTYRATETop. Cr. 0.05 %

02214415 Spectro Eczemacaremedicated cream

GSK CONS 30 g 11.45 0.3817

DESONIDE XLot. 0.05 %

02115514 Desocort Galderma 60 ml120 ml

8.7017.40


Page 294 2010-06

Top. Cr. 0.05 %

02229315 pms-Desonide Phmscience 15 g60 g

454 g

3.9215.66

118.49

0.26130.26100.2610


02115522 Desocort Galderma 15 g60 g

4.3517.40

0.29000.2900

02229323 pms-Desonide Phmscience 60 g 15.66 0.2610

DESOXIMETASONE XXEmol. Top. Cr. 0.05 %

02221918 Topicort Doux SanofiAven 20 g60 g

8.6721.95

0.43350.3658

Emol. Top. Cr. 0.25 %

02221896 Topicort SanofiAven 20 g60 g

12.5033.05

0.62500.5508

Top. Jel. 0.05 %

02221926 Topicort SanofiAven 60 g 25.63 0.4272

Top. Oint. 0.25 %

02221934 Topicort SanofiAven 60 g 33.05 0.5508

DIFLUCORTOLONE VALERATE XOil. Top. Cr. 0.1 %

00587818 Nerisone Stiefel 30 g60 g

11.3422.69

0.37800.3782

Top. Cr. 0.1 %

00587826 Nerisone Stiefel 30 g 11.34 0.3780

Top. Oint. 0.1 %

00587834 Nerisone Stiefel 30 g 11.34 0.3780

DIFLUCORTOLONE VALERATE SALICYLIQUE ACID XOil. Top. Cr. 0.1 % -3 %

02028719 Nerisalic Stiefel 30 g 15.60 0.5200


2010-06 Page 295

FLUOCINOLONE ACETONIDE XXTop. Oint. 0.025 %

02162512 Synalar Regulier Medicis 60 g 25.85 0.4308

Top. Sol. 0.01 %

02162504 Synalar Solution Medicis 60 ml 24.55

Topical oil 0.01 %

00873292 Derma-Smoothe/FS Hill 118 ml 29.15

FLUOCINONIDE XEmol. Top. Cr. 0.05 % PPB

02163152 Lidemol Medicis 15 g60 g

8.3529.40

0.55670.4900

00598933 Tiamol Taro 25 g100 g

5.4519.80

0.21800.1980

02240269 Topactin Emolliente Néolab 60 g225 g

12.3944.55

0.20650.1980

Top. Cr. 0.05 % PPB

02161923 Lidex Medicis 60 g 27.70 0.461700716863 Lyderm Taro 15 g

60 g400 g

5.1514.6697.78

0.34330.24430.2445

00816132 Topactin Néolab 30 g450 g

10.30110.00

0.34330.2445

Top. Jel. 0.05 % PPB

02236997 Lyderm Taro 15 g60 g

5.1320.51

0.34200.3075

02161974 Topsyn Medicis 60 g 30.75 0.5125


02161966 Lidex Medicis 60 g 30.35 0.505802236996 Lyderm Taro 60 g 18.21 0.3035

HYDROCORTISONE X

Lot. 1 % PPB

00192600 Emo-Cort T C D 60 ml 8.9200578541 Sarna HC Stiefel 150 ml 13.47


Page 296 2010-06

Lot. 2.5 % PPB

00595802 Emo-Cort T C D 60 ml 12.0700856711 Sarna HC Stiefel 75 ml 13.02

Rect. Sol. 100 mg PPB

02112736 Cortenema Axcan 60 ml 6.1600230316 Hycort Valeant 60 ml 5.14

Scalp Sol. 2.5 %

00641154 Emo-Cort T C D 60 ml 11.41

Top. Cr. 1 %

00192597 Emo-Cort T C D 45 g 7.42 0.164900804533 Prevex HC T C D 30 g 7.70 0.2567

Top. Cr. 2.5 %

00595799 Emo-Cort Cream 2.5% T C D 45 g225 g

9.9443.04

0.22090.1913

Top. Oint. 1 %

00716693 Cortoderm Taro 454 g 17.70 0.0390

HYDROCORTISONE ACETATE XX

Rect. Oint. (App.) 0.5 % to 0.75 % PPB

02128446 Anodan-HC Odan 15 g30 g

6.2412.39

0.41600.4130

02209764 Egozinc-HC Phmscience 15 g30 g

6.2412.39

0.41600.4130

00607789 ratio-Hemcort HC Ratiopharm 15 g30 g

6.2412.39

0.41600.4130

02179547 Riva-sol HC Riva 15 g30 g

6.2412.39

0.41600.4130

02247691 Sandoz Anuzinc HC Sandoz 15 g30 g

6.2412.39

0.41600.4130

Rectal foam (app.) 10 %

00579335 Cortifoam Paladin 15 g 75.78


2010-06 Page 297

Supp. 10 mg PPB

02236399 Anodan-HC Odan 1224

7.2914.58

0.60750.6075

02210517 Egozinc-HC Phmscience 12 7.29 0.607500607797 ratio-Hemcort HC Ratiopharm 12 7.29 0.607502240112 Riva-sol HC Riva 12 7.29 0.607502242798 Sandoz Anuzinc HC Sandoz 12

247.29

14.580.60750.6075

Top. Cr. 1 %

00716839 Hyderm Taro 15 g500 g

3.2018.20

0.21330.0364

Top. Cr. 2 %

00749834 Neo-HC Néolab 30 g 7.81 0.2603

HYDROCORTISONE ACETATE/ UREA XXLot. 1 % -10 % PPB

00681997 Dermaflex HC Néolab 150 ml 12.75 0.055600560022 Uremol-HC T C D 150 ml 13.96

Top. Cr. 1 % -10 % PPB

00681989 Dermaflex HC Néolab 225 g 27.70 0.095800503134 Uremol-HC T C D 50 g

225 g8.24

35.910.16480.1596

HYDROCORTISONE VALERATE XTop. Cr. 0.2 %

02242984 Hydroval Taro 15 g60 g

500 g

2.507.27

60.58

0.16670.12120.1212

Top. Oint. 0.2 %

02242985 Hydroval Taro 15 g60 g

2.507.27

0.16670.1212

MOMETASON FUROATE XLot. 0.1 % PPB

00871095 Elocom Schering 30 ml75 ml

13.4331.69

02266385 Taro-Mometasone Lotion Taro 30 ml75 ml

9.3723.43

0.26870.2536


Page 298 2010-06

Top. Cr. 0.1 %

00851744 Elocom Schering 15 g50 g

9.3429.43

0.62270.5886


00851736 Elocom Schering 15 g50 g

9.0128.41

0.60070.5682

02270862 pms-Mometasone Phmscience 15 g50 g

4.1613.86

0.27730.2772

02248130 ratio-Mometasone Ratiopharm 15 g50 g

4.1613.86

0.27730.2772

02264749 Taro-Mometasone Taro 15 g50 g

4.1613.86

0.27730.2772

TRIAMCINOLONE ACETONIDE XXOral Top. Oint. 0.1 %

01964054 Oracort Taro 7.5 g 6.83

Top. Cr. 0.1 % PPB

02194058 Aristocort R Valeo 30 g500 g

3.9026.65

0.13000.0533

00716960 Triaderm Taro 500 g 25.32 0.0320

Top. Cr. 0.5 %

02194066 Aristocort C Valeo 15 g50 g

17.2857.60

1.15201.1520

Top. Oint. 0.1 %

02194031 Aristocort R Valeo 30 g 3.90 0.1300

84:28KERATOLYTIC AGENTSBENZOYL PEROXIDE XLot. 10 %

00370568 BenOxyl 10 Stiefel 60 ml 10.85

Lot. 20 %

00187585 BenOxyl 20 Stiefel 60 ml 12.06

BENZOYLE PEROXIDE, ALCOHOL BASE XTop. Jel. 10 %

00263699 Panoxyl 10 Stiefel 60 g 8.58 0.1430


2010-06 Page 299

Top. Jel. 20 %

00373036 Panoxyl 20 Stiefel 60 g 11.18 0.1863

LACTIC (ACID)/ SALICYLIC (ACID)/ GLACIAL ACETIC (ACID)Liq. 10.2 % -10 % -9.8 %

00609501 Viron Lotion Odan 15 ml 6.90 0.3627

LACTIC ACID/ SALICYLIC ACID/ FORMALIN Top. Oint. 10 % -25 % -5 %

00513091 Duoplant Stiefel 30 g 11.67 0.3890

SALICYLIC ACID SODIUM THIOSULFATE Top. Jel. 2 % -8 %

00326577 Adasept Gel Odan 50 ml 6.90 0.1068

UREA

Top. Cr. 20 % to 22 % PPB

00781266 Dermaflex Néolab 120 g 5.75 0.047902048574 Uree Riva 120 g

450 g5.75

12.000.04790.0267

00398179 Uremol T C D 100 g225 g

6.1111.69

0.06110.0520

00396125 Urisec Odan 120 g454 g

5.7512.11

0.04790.0267

84:32KERATOPLASTIC AGENTSTAR (MINERAL)Top. Emuls. 2 %

00579955 Doak Oil T C D 250 ml 7.26

Top. Emuls. 10 %

00579971 Doak-Oil Forte T C D 250 ml 9.66

Top. Jel. 10 %

00344508 Targel Odan 100 g 13.50 0.1265

TAR (MINERAL)/ SALICYLIC ACIDTop. Jel. 10 % -3 %

00510335 Targel S.A. Odan 100 g 14.90 0.1401


Page 300 2010-06

84:50.06PIGMENTING AGENTSMETHOXSALEN XXCaps. 10 mg PPB

00252654 Oxsoralen Ultra Valeant 100 43.00 0.430000646237 UltraMOP Canderm 100 47.55 W

Lot. 1 %

01907476 Oxsoralen Valeant 30 ml 44.07

84:92SKIN AND MUCOUS MEMBRANE AGENTS, MISCELLANEOUSACITRETINE XCaps. 10 mg

02070847 Soriatane Tribute 30 47.91 1.5970

Caps. 25 mg

02070863 Soriatane Tribute 30 84.16 2.8053

CALCIPOTRIOL XScalp Lot. 50 mcg/mL

02194341 Dovonex Leo 60 ml120 ml

44.0587.82

Top. Cr. 50 mcg/g

02150956 Dovonex Leo 120 g 87.82 0.7318

Top. Oint. 50 mcg/g

01976133 Dovonex Leo 60 g 42.90 0.7150

FLUOROURACIL XTop. Cr. 5 %

00330582 Efudex Valeant 40 g 32.00 0.8000

HYDROCOLLOIDAL GEL Top. Jel.

00921084 DuoDERM Gel Convatec 30 g 6.39 0.2130


2010-06 Page 301

HYDROGELGel

99100365 Nu-Gel Systagenix 15 g25 g

2.484.14

0.16530.1656

99100152 Purilon Gel Coloplast 8 g15 g

2.253.15

0.28130.2100

99100192 Tegaderm 3M - Hydrogelwound filler

3M Canada 15 g 2.74

99100300 Woun'dres Coloplast 28 g84 g

3.708.98

0.13210.1069

ISOTRETINOIN XXCaps. 10 mg PPB

00582344 Accutane 10 Roche 30 27.94 0.931302257955 Clarus Mylan 30 27.94 0.9313

Caps. 40 mg PPB

00582352 Accutane 40 Roche 30 57.01 1.900302257963 Clarus Mylan 30 57.01 1.9003

PODOFILOX XTop. Sol. 0.5 % PPB

01945149 Condyline Canderm 3.5 ml 37.0002074788 Wartec Paladin 3 ml 33.67

PROPYLENE GLYCOL/ CARBOXYMETHYLCELLULOSE Top. Jel. 20 % -3 %

00907936 Intrasite S. & N. 8 g15 g25 g

2.733.705.74

0.34130.24670.2296

SODIUM CHLORIDEGel 0.9 %

00920533 Normlgel Mölnlycke 5 g15 g

1.502.92

Gel 20 %

00920517 Hypergel Mölnlycke 5 g15 g

2.304.49


Page 302 2010-06

ZINC OXIDEBand. 7,5 cm X 6 m

01907603 Viscopaste PB7 S. & N. 1 8.69


2010-06 Page 303

86:00SPASMOLYTICS

86:12 genitourinary smooth muscle relaxants86:16 respiratory smooth muscle relaxants

86:12GENITOURINARY SMOOTH MUSCLE RELAXANTSOXYBUTYNINE CHLORIDE XXSyr. 5 mg/5 mL

02223376 pms-Oxybutynin Phmscience 500 ml 35.70 0.0714

Tab. 2.5 mg

02240549 pms-Oxybutynin Phmscience 100 13.19 0.1319

Tab. 5 mg PPB

02163543 Apo-Oxybutynin Apotex 100500

19.7398.63

0.19730.1973

02230800 Mylan-Oxybutynine Mylan 100500

19.7398.63

0.19730.1973

02230394 Novo-Oxybutynin Novopharm 100500

19.7398.63

0.19730.1973

02220636 Oxybutynine-5 Pro Doc 100500

19.7398.63

0.19730.1973

02245827 phl-Oxybutynin Pharmel 100500

19.7398.63

0.19730.1973

02240550 pms-Oxybutynin Phmscience 100500

19.7398.63

0.19730.1973

02299364 Riva-Oxybutynin Riva 100500

19.7398.63

0.19730.1973

86:16RESPIRATORY SMOOTH MUSCLE RELAXANTSAMINOPHYLLINE XL.A. Tab. 225 mg

02014270 Phyllocontin Purdue 100 21.13 0.2113

L.A. Tab. 350 mg

02014289 Phyllocontin-350 Purdue 100 26.91 0.2691

OXTRIPHYLLINE X

Elix. 100 mg/5 mL PPB

00476366 Choledyl Erfa 500 ml 17.03 0.034100792942 pms-Oxtriphylline Phmscience 500 ml 11.45 0.0204

THEOPHYLLINE XAlcohol free Sol. 80 mg/15 mL

01966219 Theolair Graceway 500 ml 9.81 0.0196


2010-06 Page 307

Elix. 80 mg/15 mL

00627410 Theophylline Atlas 500 ml 1.76 0.0035

Elix. sugar less 80 mg/15 mL

00466409 Pulmophylline Riva 500 ml 4.30 0.0086

L.A. Tab. 100 mg

00692689 Apo-Theo LA Apotex 100 13.00 0.130002230085 Novo-Theophyl SR Novopharm 100 13.00 0.1300

L.A. Tab. 200 mg

00692697 Apo-Theo LA Apotex 100 9.07 0.090702230086 Novo-Theophyl SR Novopharm 100

5009.07

45.350.09070.0907

00631701 Theochron Riva 100500

9.0745.35

0.09070.0907

L.A. Tab. 300 mg

00692700 Apo-Theo LA Apotex 100 14.00 0.140002230087 Novo-Theophyl SR Novopharm 100

50014.0070.00

0.14000.1400

00599905 Theochron Riva 100500

14.0070.00

0.14000.1400

L.A. Tab. 400 mg

02014165 Uniphyl Purdue 50 24.26 0.4852

L.A. Tab. 600 mg

02014181 Uniphyl Purdue 50 29.38 0.5876


Page 308 2010-06

88:00VITAMINS

88:08 vitamin b complex88:16 vitamin d88:24 vitamin k88:28 multivitamins

88:08VITAMIN B COMPLEXCYANOCOBALAMIN

Inj. Sol. 0.1 mg/mL

02241500 Vitamine B 12 Sandoz 1 ml 1.22


01987003 Cyanocobalamine Cytex 10 ml 3.1000626112 Vitamine B 12 Oméga 10 ml 3.1000521515 Vitamine B 12 Sandoz 1 ml

10 ml1.293.10

FOLIC ACIDInj. Sol. 5 mg/mL

00816086 Acide Folique Sandoz 10 ml 16.40

FOLIC ACID XXTab. 5 mg PPB

00426849 Apo-Folic Apotex 1001000

4.0425.86

0.02400.0201

02285673 Euro-Folic Euro-Pharm 1000 19.80 0.0198

NIACIN

Tab. 100 mg

00268585 Niacine-ICN Valeant 500 12.00 0.0240

Tab. 500 mg PPB

00557412 Jamp-Niacin Jamp 100 4.50 0.045001939130 Niacine Odan 100 4.50 0.045000294950 Niacine-ICN Valeant 500 22.78 0.0456

PYRIDOXINE HYDROCHLORIDE

Tab. 25 mg PPB

80002890 Jamp Vitamin B6 Jamp 1000 18.00 0.018001943200 Vitamine B 6 Odan 100 1.80 0.0180


2010-06 Page 311

THIAMINE HYDROCHLORIDE


02241983 Betaxin Hospira 10 ml 13.7902193221 Thiamiject Oméga 10 ml 11.8802243525 Thiamine Cytex 10 ml 11.88 0.745000816078 Vitamine B 1 Sandoz 1 ml

10 ml1.42

11.88 0.7450

Tab. 50 mg PPB

02245506 Euro-B1 Euro-Pharm 100 7.00 0.070080009633 Jamp-Vitamin B1 Jamp 500 35.00 0.0700

Tab. 100 mg

80009588 Jamp-Vitamin B1 Jamp 500 63.00 0.1260

88:16VITAMIN DALFACALCIDOL XCaps. 0.25 mcg

00474517 One-Alpha Leo 100 41.72 0.4172

Caps. 1 mcg

00474525 One-Alpha Leo 100 124.88 1.2488

I.V. Inj. Sol. 2 mcg/mL

02242502 One-Alpha Leo 0.5 ml1 ml

7.6515.30

Oral Sol. 2 mcg/mL

02240329 One-Alpha Leo 10 ml 47.71 4.7710

CALCITRIOL XCaps. 0.25 mcg

00481823 Rocaltrol Roche 100 92.80 0.9280

Caps. 0.50 mcg

00481815 Rocaltrol Roche 100 147.58 1.4758

Oral Sol. 1 mcg/mL

00824291 Rocaltrol Roche 10 ml 29.56 2.9560


Page 312 2010-06

CHOLECALCIFEROL XX

Caps. or Tab. 10 000 UI PPB

00821772 D-Tabs Riva 60 12.60 0.210002253178 Euro D 10 000 Euro-Pharm 60 12.60 0.2100

ERGOCALCIFEROL XCaps. 50 000 U

02237450 D-Forte Euro-Pharm 100 19.30 0.1930

Oral Sol. 8 288 UI/mL PPB

02017598 Drisdol SanofiAven 60 ml 23.7080003615 Erdol Odan 60 ml 19.85 0.2388

VITAMIN DCaps. 800 UI PPB

80003010 Euro D 800 Euro-Pharm 100 6.00 0.060080007769 Jamp-Vitamine D Jamp 500 30.00 0.060080008446 Vitamin D 800 UI Biomed 100 6.00 0.0600

Caps. or Tab. 400 UI PPB

80001125 Calciferol (tablet) Pendopharm 500 15.00 0.030002242651 Euro D 400 Euro-Pharm 100

5003.00

15.000.03000.0300

80006629 Jamp-Vitamine D (Caps.) Jamp 500 15.00 0.030002240624 Jamp-Vitamine D (Co.) Jamp 500 15.00 0.030080002228 Odan-D Odan 500 15.00 0.030080001145 Pharma-D 400 IU Pendopharm 500 15.00 0.030080005560 Riva-D Riva 100

5003.00

15.000.03000.0300

80008590 Vitamin D 400 UI Biomed 500 15.00 0.030000765384 Vitamine D Lalco 100 3.00 0.0300

Oral Sol. 400 UI/dose PPB

80001869 Baby Ddrops D Drops 90 dose(s) 9.9000762881 D-VI-SOL M.J. 50 dose(s) 5.5080003038 Jamp-Vitamine D Jamp 50 dose(s) 5.5002231624 Pediavit D Euro-Pharm 50 dose(s) 5.5080003285 Pediavit D Euro-Pharm 100 dose(s) 11.00


2010-06 Page 313

88:24VITAMIN KPHYTONADIONE XX


00781878 Vitamine K 1 Sandoz 0.5 ml 1.93


00804312 Vitamine K 1 Sandoz 1 ml 2.22

88:28MULTIVITAMINSVITAMINS A, D AND COral Sol. 1 500 U -400 U -30 mg/mL PPB

80008471 Jamp-Vitamins A-D-C Jamp 50 ml 9.3602229790 Pediavit Euro-Pharm 50 ml 9.3600762903 Tri-Vi-Sol M.J. 50 ml 9.36


Page 314 2010-06

92:00UNCLASSIFIED THERAPEUTIC AGENTS

92:00.02 other miscellaneous92:08 5-alfa-Reductase inhibitors92:12 Antidotes92:16 Antigout Agents92:24 Bone Resorption Inhibitors92:28 Cariostatic Agents92:44 Immunosuppressive Agents92:92 Other Miscellaneous Therapeutic

Agents

92:00UNCLASSIFIED THERAPEUTIC AGENTSALBUMINE DILUENTSol. 0.03 %

00541486 Albumine Diluent Oméga 1.8 ml4.5 ml20 ml

1.452.073.73

02283735 Diluent albumin AllergiLab 4.5 ml9 ml

1.751.96

ALLERGENIC EXTRACTS, AQUEOUS, GLYCERINATEDInj. Sol. Maintenance Treatment (10 mL)

99003813 Monovalent AllergiLab 1 79.0699003791 Polyvalent AllergiLab 1 79.06

Inj. Sol. Complete Treatment Set (10 mL)

99003856 Monovalent AllergiLab 34

106.78106.78

99003805 Polyvalent AllergiLab 34

106.78106.78

ALLERGENIC EXTRACTS, AQUEOUS, GLYCERINATED, STANDARDIZEDInj. Sol. Maintenance Treatment (10 mL)

02247757 Monovalent non-Pollen Oméga 1 103.5499003996 Monovalent standardise AllergiLab 1 103.7099100062 Monovalent-Acariens Oméga 1 103.5499003880 Monovalent-Acariens

standardiseAllergiLab 1 103.70

99100063 Monovalent-Chat Oméga 1 103.5499003899 Monovalent-Chat


02247754 Monovalent-Pollen Oméga 1 103.5499100067 Polyvalent - Pollen Oméga 1 103.5499100068 Polyvalent - Pollens -

AcariensOméga 1 103.54

99100066 Polyvalent non-Pollen Oméga 1 103.5499004100 Polyvalent standardise AllergiLab 1 103.7099100064 Polyvalent-Acariens Oméga 1 103.5499003910 Polyvalent-Acariens


99100065 Polyvalent-Chat Oméga 1 103.5499003929 Polyvalent-Chat standardise AllergiLab 1 103.7099003902 Polyvalent-Pollens- Acariens



2010-06 Page 317


99100074 Monovalent non-Pollen Oméga 4 146.0699004003 Monovalent standardise AllergiLab 3

4147.84147.84

99100061 Monovalent-Acariens Oméga 3 148.0699003937 Monovalent-Acariens


99100073 Monovalent-Chat Oméga 3 148.0699003945 Monovalent-Chat


99100075 Monovalent-Pollen Oméga 4 148.0699100079 Polyvalent - Pollen Oméga 4 148.0699100080 Polyvalent - Pollens -


99100078 Polyvalent non-Pollen Oméga 4 148.0699004097 Polyvalent standardise AllergiLab 3

4147.84147.84

99100076 Polyvalent-Acariens Oméga 3 148.0699003961 Polyvalent-Acariens


99100077 Polyvalent-Chat Oméga 4 148.0699003988 Polyvalent-Chat standardise AllergiLab 3

4147.84147.84

99003953 Polyvalent-Pollens- Acariensstandardise

AllergiLab 34

147.84147.84

ALLERGENIC EXTRACTS,AQUEOUS, GLYCERINATED, NON STANDARDIZED AND STANDARDIZED Inj. Sol. Maintenance Treatment (10 mL)

99003821 Polyvalent-Pollens nonstand.-Acariens stand.

AllergiLab 1 96.51


99003864 Polyvalent-Pollens nonstand.-Acariens stand.

AllergiLab 34

135.53135.53


Page 318 2010-06

ALLERGENS (ALUM-PRECIPITATED EXTRACTS OF)Inj. Sol. Maintenance Treatment (5 mL)

99003694 Presaisonnier- Arbres etGraminees

AllergiLab 1 90.35


AllergiLab 3 108.84 36.2800

99003716 Presaisonnier- Arbres,Graminees, Herbe a poux

AllergiLab 1 90.35


Oméga 3 109.75 36.5833

99003708 Presaisonnier- Graminees etHerbe a poux

AllergiLab 1 90.35


Oméga 3 109.75 36.5833

99003686 Presaisonnier- Herbe a poux AllergiLab 1 90.3599100072 Presaisonnier- Herbe a poux Oméga 3 109.75 36.583399003651 Presaisonnier-Arbres AllergiLab 1 90.3599003678 Presaisonnier-Graminees AllergiLab 1 90.3500889784 Suspal- Monovalent-


00889792 Suspal- Polyvalent-Acariens Oméga 1 97.3300861367 Suspal-Monovalent Oméga 1 98.3600861375 Suspal-Polyvalent Oméga 1 97.33

Inj. Sol. Maintenance Treatment (10 mL)

00908614 Suspal- Monovalent-Acariens

Oméga 1 115.96




AllergiLab 3 109.86


AllergiLab 3 109.86


AllergiLab 3 109.86

99003740 Presaisonnier- Herbe a poux AllergiLab 3 109.8699003724 Presaisonnier-Arbres AllergiLab 3 109.8699003732 Presaisonnier-Graminees AllergiLab 3 109.8600889822 Suspal- Monovalent-




2010-06 Page 319


00896942 Presaisonnier- Arbres Oméga 1 102.5099100625 + Presaisonnier- Arbres et

GramineesOméga 1 102.50 102.5000


Oméga 1 102.50 102.5000


Oméga 1 102.50

00896934 Presaisonnier- Gramines Oméga 1 102.5000896950 Presaisonnier- Herbes-a-

pouxOméga 1 102.50


00889849 Suspal- Monovalent-Acariens

Oméga 3 133.57


ALLERGENS (AQUEOUS EXTRACTS OF) Inj. Sol. Maintenance Treatment (5 mL)

00861170 Monovalent Oméga 1 79.7399000415 Monovalent-Acariens Oméga 1 83.8700861189 Polyvalent Oméga 1 80.7699000423 Polyvalent-Acariens Oméga 1 83.87

Inj. Sol. Maintenance Treatment (10 mL)







Page 320 2010-06

HYMENOPTERA VENOMInj. Pd 1.1 mg

00894346 Venin d'abeille (apismellifera)

Oméga 1 166.70

Inj. Pd 1.3 mg


Oméga 1 198.13

Inj. Pd 100 mcg


Oméga 6 110.79 18.4650

HYMENOPTERA VENOM PROTEINInj. Pd 1.1 mg

99100226 Frelon a tete blanche AllergiLab 1 224.8499004607 Frelon a tete blanche Oméga 1 211.22 211.220001948997 Frelon a tete blanche

(Dolichovespula Maculata)Allergy 1 220.00

99004593 Frelon a tete jaune Oméga 1 211.22 211.220099100227 Frelon Jaune AllergiLab 1 224.8401948938 Frelon jaune (Dolichoves

pula Arenaria)Allergy 1 220.00

01948970 Guepe (Polistes Spp.) Allergy 1 240.0000894362 Guepe (Polistes Spp.) Oméga 1 236.0700894354 Guepe de l'est (vespula

maculifrons)Oméga 1 211.22

01948954 Guepe jaune (Vespula Spp.) Allergy 1 220.0099100225 Honey Bee Venom AllergiLab 1 177.6201948903 Venin d'abeille (apis

mellifera)Allergy 1 174.00

99100229 Wasp Venon AllergiLab 1 245.3799100228 Yellow Jacket Venom AllergiLab 1 224.84

Inj. Pd 1.3 mg

99100016 Frelon a tete blanche Oméga 1 249.53 249.530099100017 Guepe (Polistes Spp.) Oméga 1 278.5299100018 Guepe de l'est (vespula


Inj. Pd 3.3 mg

99100230 Vespides combines AllergiLab 1 444.5501948873 Vespides combines Allergy 1 434.0000895245 Vespides combines Oméga 1 415.20

Inj. Pd 3.9 mg

99100026 Vespides combines Oméga 1 490.69


2010-06 Page 321

Inj. Pd 100 mcg

00541451 Guepe (Polistes Spp.) Oméga 6 144.96 24.160000541427 Guepe a taches blanches

dolichovespula maculataOméga 6 133.57 22.2617

00541478 Guepe de l'est (vespulamaculifrons)

Oméga 6 133.57 22.2617

00541443 Guepe jaune dolichovespulaarenaria

Oméga 6 133.57 22.2617

Inj. Pd 120 mcg

99004038 Frelon a tete blanche AllergiLab 6 154.00 25.666701949004 Frelon a tete blanche Allergy 6 140.00 23.333399004011 Frelon Jaune AllergiLab 6 154.00 25.666701948946 Frelon jaune (Dolichoves

pula Arenaria)Allergy 6 140.00

99004046 Guepe AllergiLab 6 165.29 27.548301948989 Guepe (Polistes Spp.) Allergy 6 148.0099100278 Guepe (Polistes Spp.) Oméga 6 165.66 27.610099100279 Guepe a taches blanches

dolichovespula maculataOméga 6 154.27 25.7117

99100280 Guepe de l'est (vespulamaculifrons)

Oméga 6 156.35 26.0583

99004054 Guepe jaune AllergiLab 6 156.06 26.010001948962 Guepe jaune (Vespula Spp.) Allergy 6 140.0099100270 Guepe jaune dolichovespula

arenariaOméga 6 156.35 26.0583

99004062 Venin d'abeille AllergiLab 6 114.99 19.165001948911 Venin d'abeille (apis

mellifera)Allergy 6 105.00

Inj. Pd 300 mcg

00614424 Vespides combines Oméga 6 257.81 42.9683

Inj. Pd 360 mcg

99004070 Vespides combines AllergiLab 6 296.71 49.451701948881 Vespides combines Allergy 6 260.0099100281 Vespides combines Oméga 6 298.20 49.7000

Inj. Pd 550 mcg

99100266 Frelon a tete blanche Oméga 1 119.0799100267 Frelon a tete jaune Oméga 1 119.0799100268 Guepe (Polistes Spp.) Oméga 1 125.2899100269 Guepe de l'est (vespula



Oméga 1 98.36

Inj. Pd 1 650 mcg

99100284 Vespides combines Oméga 1 224.68


Page 322 2010-06

92:00.02OTHER MISCELLANEOUSZINC OXIDE/ ICHTHAMMOL Band. 7,5 cm X 6 m

01948466 Ichthopaste S. & N. 1 6.93

92:085-ALFA-REDUCTASE INHIBITORSDUTASTERIDE XXCaps. 0.5 mg

02247813 Avodart GSK 30 48.12 1.6040

FINASTERIDE XTab. 5 mg PPB

02010909 Proscar Merck 30 51.68 1.722702322579 Sandoz Finasteride Sandoz 30

50027.79

463.250.92630.9265

92:12ANTIDOTESFOLINIC ACID XTab. 5 mg

02170493 Leucovorin Wyeth 24100

138.00550.93

5.75005.5093

92:16ANTIGOUT AGENTSALLOPURINOL XTab. 100 mg PPB

00555681 Allopurinol-100 Pro Doc 1001000

7.8078.00

0.07800.0780

00402818 Apo-Allopurinol Apotex 1001000

7.8078.00

0.07800.0780

00364282 Novo-Purol Novopharm 100500

7.8039.00

0.07800.0780

Tab. 200 mg PPB


13.0065.00

0.13000.1300

00479799 Apo-Allopurinol Apotex 100500

13.0065.00

0.13000.1300


13.0065.00

0.13000.1300


2010-06 Page 323

Tab. 300 mg PPB


21.25106.25

0.21250.2125

00402796 Apo-Allopurinol-300 Apotex 100500

21.25106.25

0.21250.2125


21.25212.50

0.21250.2125

COLCHICINE XXTab. 0.6 mg PPB

00287873 Colchicine Euro-Pharm 100 25.65 0.256500572349 Colchicine Odan 100

50025.65

128.250.25650.2565

Tab. 1 mg PPB

00206032 Colchicine Euro-Pharm 100 50.80 0.508000621374 Colchicine Odan 100 50.80 0.5080

92:24BONE RESORPTION INHIBITORSALENDRONATE MONOSODIUM XOral Sol. 70 mg/75 ml

02248625 Fosamax Merck 4 36.68 9.1700

Tab. 5 mg

02248727 Apo-Alendronate Apotex 30100

22.8576.18

0.76170.7618

02233055 Fosamax Merck 30 43.84 W 02248251 Novo-Alendronate Novopharm 30

10022.8576.18

0.76170.7618

02288079 Sandoz Alendronate Sandoz 30 22.85 0.7617

Tab. 10 mg

02248728 Apo-Alendronate Apotex 30100

26.3387.75

0.87770.8775

02201011 Fosamax Merck 28 51.95 1.855402270129 Mylan-Alendronate Mylan 30

10026.3387.75

0.87770.8775

02247373 Novo-Alendronate Novopharm 30100

26.3387.75

0.87770.8775

02288087 Sandoz Alendronate Sandoz 3090

26.3378.98

0.87770.8775

Tab. 40 mg

02258102 Co Alendronate Cobalt 30 65.84 2.194702201038 Fosamax Merck 28 106.10 3.7893


Page 324 2010-06

Tab. 70 mg

02303078 Alendronate-70 Pro Doc 4 17.70 4.425002248730 Apo-Alendronate Apotex 4

10017.70

442.504.42504.4250

02258110 Co Alendronate Cobalt 4100

17.70442.50

4.42504.4250

02245329 Fosamax Merck 4 37.42 9.355002286335 Mylan-Alendronate Mylan 4 17.70 4.425002261715 Novo-Alendronate Novopharm 4

5017.70

221.254.42504.4250

02299712 phl-Alendronate FC Pharmel 430

17.70132.75

4.42504.4250

02284006 pms-Alendronate FC Phmscience 430

17.70132.75

4.42504.4250

02275279 ratio-Alendronate Ratiopharm 4100

17.70442.50

4.42504.4250

02270889 Riva-Alendronate Riva 4100

17.70442.50

4.42504.4250

02288109 Sandoz Alendronate Sandoz 430

17.70132.75

4.42504.4250

02302004 Zym-Alendronate FC Zymcan 30 132.75 4.4250

ALENDRONATE/CHOLECALCIFEROL XXTab. 70 mg - 140 mcg (5 600 UI)

02314940 Fosavance Merck 4 17.70 4.4250

DISODIC CLODRONATE XCaps. 400 mg PPB

01984845 Bonefos Bayer 120 215.99 1.799902245828 Clasteon Sepracor 120 145.00 1.2083

I.V. Perf. Sol. 60 mg/mL (5 mL)

01984837 Bonefos Bayer 1 60.68

ETIDRONATE DISODIUM XTab. 200 mg PPB

02248686 Co Etidronate Cobalt 100 65.53 0.655302245330 Mylan-Etidronate Mylan 60 39.32 0.6553

ETIDRONATE DISODIUM/ CALCIUM CARBONATE XTab. 400 mg - Ca+500 mg (14 tab. - 76 tab.) PPB

02263866 Co Etidrocal Cobalt 90 19.99 0.222102176017 Didrocal Warner 90 38.96 0.432902247323 Mylan-Eti-Cal Carepac Mylan 90 19.99 0.222102324199 Novo-EtidronateCal Novopharm 90 19.99 0.2221


2010-06 Page 325

PAMIDRONATE DISODIUM XXI.V. inf. pd/sol. 30 mg

02059762 Aredia Novartis 1 162.2302244550 Pamidronate Disodique pour


02246597 Pamidronate DisodiumInjection

PPC 1 86.78

02249669 Pamidronate DisodiumOmega

Oméga 1 86.78

02245998 pms-Pamidronate Phmscience 2 173.56 86.780002264951 Sandoz Pamidronate Sandoz 1 86.78

I.V. inf. pd/sol. 60 mg

02244551 Pamidronate Disodique pourinjection

Hospira 1 176.70


PPC 1 176.70


Oméga 1 176.70

02264978 Sandoz Pamidronate Sandoz 1 176.70

I.V. inf. pd/sol. 90 mg

02059789 Aredia Novartis 1 486.6802244552 Pamidronate Disodique pour



PPC 1 260.33


Oméga 1 260.33

02245999 pms-Pamidronate Phmscience 1 260.3302264986 Sandoz Pamidronate Sandoz 1 260.33

RISEDRONATE SODIUM XTab. 5 mg

02242518 Actonel Warner 28 49.35 1.762502298376 Novo-Risedronate Novopharm 30 31.58 1.0527

Tab. 30 mg

02239146 Actonel Warner 30 342.42 11.414002298384 Novo-Risedronate Novopharm 30 204.48 6.8160

Tab. 35 mg

02246896 Actonel Warner 4 37.58 9.395002298392 Novo-Risedronate Novopharm 4

3022.44

168.305.61005.6100


Page 326 2010-06

RISEDRONATE SODIUM/ CALCIUM CARBONATE XXTab. 35 mg - Ca+500 mg (4 tab. - 24 tab.)

02279657 Actonel Plus Calcium Warner 28 36.22 1.2936

92:28CARIOSTATIC AGENTSSODIUM FLUORIDEOral Sol. 5.56 mg/mL (F-2.5 mg/mL) PPB

00610100 Fluor-A-Day Phmscience 60 ml 3.9802245747 Pediafluor Euro-Pharm 60 ml 3.98

Tab. or Chew. Tab. 2.2 mg (F-1 mg)

00575569 Fluor-A-Day Phmscience 120 6.01 0.0501

92:44IMMUNOSUPPRESSIVE AGENTSAZATHIOPRINE XTab. 50 mg PPB

02242907 Apo-Azathioprine Apotex 100 43.00 0.430002343002 Azathioprine Sanis 100 43.00 0.430002243371 Azathioprine-50 Pro Doc 100 43.00 0.430000004596 Imuran Triton 100 90.90 0.909002231491 Mylan-Azathioprine Mylan 100 43.00 0.430002236819 Novo-Azathioprine Novopharm 100

50043.00

215.000.43000.4300

CYCLOSPORINE XCaps. 10 mg

02237671 Neoral Novartis 60 37.43 0.6238

Caps. 25 mg

02150689 Neoral Novartis 30 43.50 1.450002247073 Sandoz Cyclosporine Sandoz 30 29.85 0.9950

Caps. 50 mg


Caps. 100 mg



2010-06 Page 327

Oral Sol. 100 mg/mL

02244324 Apo-Cyclosporine Apotex 50 ml 188.54 3.770802150697 Neoral Novartis 50 ml 251.38 5.0276

MYCOPHENOLATE MOFETIL XXCaps. 250 mg

02192748 Cellcept Roche 100 206.20 2.0620

Oral Susp. 200 mg/mL

02242145 Cellcept Roche 175 ml 288.68

Tab. 500 mg

02237484 Cellcept Roche 50 206.20 4.1240

MYCOPHÉNOLATE SODIUM XEnt. Tab. 180 mg

02264560 Myfortic Novartis 120 239.72 1.9977

Ent. Tab. 360 mg

02264579 Myfortic Novartis 120 479.44 3.9953

SIROLIMUS XOral Sol. 1 mg/mL

02243237 Rapamune Wyeth 60 ml 433.96 7.2327

Tab. 1 mg

02247111 Rapamune Wyeth 100 723.29 7.2329

TACROLIMUS XCaps. 0.5 mg

02243144 Prograf Astellas 100 197.00 1.9700

Caps. 1 mg


Caps. 5 mg



Page 328 2010-06

L.A. Caps. 0.5 mg

02296462 Advagraf Astellas 50 98.50 1.9700

L.A. Caps. 1 mg


L.A. Caps. 5 mg


92:92OTHER MISCELLANEOUS THERAPEUTIC AGENTSBÉTAINE ANHYDROUS XXOral Pd 1 g/1.7 mL

02238526 Cystadane RDT 180 g 600.00

BUPROPION HYDROCHLORIDE XL. A tab 150 mg

02238441 Zyban4 Biovail 60 50.72 0.8453

CYPROTERONE ACETATE XI.M. Inj. Pd 100 mg/mL

00704423 Androcur Depot Bayer 3 ml 75.85

Tab. 50 mg PPB

00704431 Androcur Bayer 60 84.51 1.408502245898 Apo-Cyproterone Apotex 100 140.85 1.408502229723 Mylan-Cyproterone Mylan 60 84.51 1.4085

LACTOSETab. 100 mg

00501190 Placebo Odan 1001000

7.0070.00

0.06250.0624

LANREOTIDE (AS ACETATE) XS.C. Inj.Sol (syr) 60 mg/0.3 mL

02283395 Somatuline Autogel Tercica 1 1102.00

4 The duration of reimbursements for anti-smoking treatments with this drug is limited to 12 consecutive weeksper 12-month period.


2010-06 Page 329





OCTREOTIDE XXI.M. Inj. Susp. 10 mg

02239323 Sandostatin LAR Novartis 1 1164.83

I.M. Inj. Susp. 20 mg


I.M. Inj. Susp. 30 mg


Inj. Sol. 50 mcg/mL PPB

02248639 Octreotide Acetate Omega Oméga 1 ml 3.99 3.000000839191 Sandostatin Novartis 1 ml 4.99





Inj. Sol. 500 mcg /mL PPB


QUINAGOLIDE HYDROCHLORIDE XTab. 75 mcg

02223767 Norprolac Ferring 30 32.70 1.0900

Tab. 150 mcg

02223775 Norprolac Ferring 30 48.90 1.6300


Page 330 2010-06

SODIUM PENTOSAN POLYSULFATE XXCaps. 100 mg

02029448 Elmiron J.O.I. 100 126.39 1.2639


2010-06 Page 331

EXCEPTIONAL MEDICATIONS

EXCEPTIONAL MEDICATIONS

ABATACEPT XXI.V. Perf. Pd 250 mg

02282097 Orencia B.M.S. 1 440.00

ABSORPTIVE DRESSING - GELLING FIBRE Dressing 100 cm² to 200 cm² (active surface)

99003481 3M Tegaderm High IntegrityAlginate Dressing(10x10-100 cm²)

3M Canada 10 38.97 3.8970

99100285 3M Tegaderm High IntegrityAlginate Dressing(10x20-200 cm²)

3M Canada 1 7.53

00920223 Algosteril (10 cm x 10 cm -100 cm²)

Erfa 16 68.00 4.2500

00921092 Algosteril (10 cm x 20 cm -200 cm²)

Erfa 16 105.50 6.5938

99001772 Aquacel hydrofiber (10 cm x10 cm - 100 cm²)

Convatec 10 58.82 5.8820

00898643 Kaltostat (10 cm x 20 cm -200 cm²)

Convatec 10 81.95 8.1950

99003007 Melgisorb (10 cm x 10 cm -100 cm²)

Mölnlycke 50 182.33 3.6466

99003023 Melgisorb (10 cm x 20 cm -200 cm²)

Mölnlycke 50 342.47 6.8494

99100004 Nu-Derm Alginate (10 cm x10 cm - 100 cm²)

Systagenix 50 197.60 3.9520

99100005 Nu-Derm Alginate (10 cm x20 cm - 200 cm²)

Systagenix 25 181.72 7.2688

99100153 SeaSorb Soft (10 cm x 10 cm- 100 cm²)

Coloplast 10 34.20 3.4200

99100467 Versiva XC Non-Adhesive(11 cm x 11 cm - 121 cm²)

Convatec 10 49.58 4.9580

Dressing 201 cm² to 500 cm² (active surface)

99003279 Algisite M (15 cm x 20 cm -300 cm²)

S. & N. 10 99.02 9.9020

99001764 Aquacel hydrofiber (15 cm x15 cm - 225 cm²)

Convatec 5 62.57 12.5140


Convatec 5 50.25 10.0500


Convatec 5 92.59 18.5180


2010-06 Page 335

Dressing Less than 100 cm² (active surface)

00920266 Algosteril (5 cm x 5 cm - 25cm²)

Erfa 10 17.04 1.7040

99001780 Aquacel hydrofiber (5 cm x 5cm - 25 cm²)

Convatec 10 23.90 2.3900

00898627 Kaltotstat (5 cm x 5 cm - 25cm²)

Convatec 10 18.21 1.8210

00898635 Kaltotstat (7.5 cm x 12 cm -90 cm²)

Convatec 10 53.45 5.3450

99003066 Melgisorb (5 cm x 5 cm - 25cm²)

Mölnlycke 50 89.23 1.7846

99100006 Nu-Derm Alginate (5 cm x 5cm - 25 cm²)

Systagenix 50 90.73 1.8146

99100156 SeaSorb Soft (5 cm x 5 cm -25 cm²)

Coloplast 30 52.50 1.7500

99100466 Versiva XC Non-Adhesive(7.5 cm x 7.5 cm - 56 cm²)

Convatec 10 32.50 3.2500

Strip 30 cm to 90 cm

99003260 Algisite M 30 cm S. & N. 5 24.50 4.900000921157 Algosteril (30 cm) Erfa 10 49.97 4.997099001705 Aquacel hydrofiber (45 cm) Convatec 5 39.82 7.964099100100 Curasorb 30 cm Tyco 1 4.1799100101 Curasorb 60 cm Tyco 1 5.9799100102 Curasorb 90 cm Tyco 1 10.5000898899 Kaltostat 40 cm Convatec 5 33.98 6.796099003015 Melgisorb 30 cm Mölnlycke 50 215.18 4.303699100003 Nu-Derm Alginate 30 cm Systagenix 25 128.03 5.121299100155 SeaSorb Soft 44 cm Coloplast 6 41.22 6.8700


Page 336 2010-06

ABSORPTIVE DRESSING - HYDROPHILIC FOAM ALONE OR IN ASSOCIATION Dressing 100 cm² to 200 cm² (active surface)

99100193 3M Tegaderm FoamDressing (nonadhesive)(10cm x 10cm-100cm²)

3M Canada 1 4.41

99100052 Allevyn Compression (10 cmx 10 cm - 100 cm²)

S. & N. 1 4.94

99100537 Allevyn Gentle (10 cm x 10cm - 100 cm²)

S. & N. 10 49.50 4.9500


S. & N. 10 98.80 9.8800

00907863 Allevyn Non-Adhesive (10cm x 10 cm - 100 cm²)

S. & N. 1 4.95


S. & N. 1 9.88

99100135 Biatain (10 cm x 10 cm - 100cm²)

Coloplast 10 39.50 3.9500

99100601 Biatain (10 cm x 20 cm - 200cm²)

Coloplast 5 39.50 7.9000

99100298 Biatain Soft-Hold (10 cm x 10cm - 100 cm²)

Coloplast 5 19.75 3.9500


Coloplast 5 39.50 7.9000

99002787 Combiderm Non-Adhesive(13 cm x 13 cm - 169 cm²)

Convatec 10 52.78 5.2780

99004801 Copa (10 cm x 10 cm - 100cm²)

Tyco 50 94.88 1.8976

99003244 Mepilex (10 cm x 10 cm - 100cm²)

Mölnlycke 5 24.70 4.9400

99003252 Mepilex (10 cm x 20 cm - 179cm²)

Mölnlycke 5 46.70 9.3400

99100566 Restore Foam Dressing Non-Adhesive (10 cm x 10 cm 100 cm²)

Hollister 10 33.31 3.3310

99100000 Tielle Max (11 cm x 11 cm -121 cm²)

Systagenix 10 60.06 6.0060


2010-06 Page 337



3M Canada 30 492.37 16.4123


S. & N. 10 95.60 9.5600


S. & N. 10 170.00 17.0000


S. & N. 1 9.56


S. & N. 1 17.00

99100571 * Biatain (15 cm x 15 cm - 225cm²)

Coloplast 5 44.50 8.9000

99100603 Biatain (20 cm x 20 cm - 400cm²)

Coloplast 5 79.00 15.8000


Coloplast 5 44.50 8.9000

99005034 Combiderm Non-Adhesive(15 cm x 25 cm - 375 cm²)

Convatec 1 10.73

99004836 Curafoam (15 cm x 20 cm -300 cm²)

Tyco 25 285.51 11.4204

99100602 Mepilex (15 cm x 15 cm - 225cm²)

Mölnlycke 5 47.00 9.4000

99003538 Mepilex (20 cm x 20 cm - 400cm²)

Mölnlycke 5 92.60 18.5200

99100567 Restore Foam Dressing Non-Adhesive (15 cm x 20 cm 300 cm²)

Hollister 10 90.77 9.0770


Systagenix 10 91.35 9.1350


Systagenix 5 55.99 11.1980


99100241 Allevyn Compression (5 cm x6 cm - 30 cm²)

S. & N. 1 1.92

99100570 Allevyn Gentle (5 cm x 5 cm- 25 cm²)

S. & N. 1 1.75

00920711 Allevyn Non-Adhesive (5 cmx 5 cm - 25 cm²)

S. & N. 1 1.75

99100599 Biatain (5 cm x 7 cm - 35 cm²) Coloplast 10 13.83 1.383099004534 Combiderm Non-Adhesive

(7.5 cm x 7.5 cm - 56 cm²)Convatec 10 32.26 3.2260

99004852 Copa (5 cm x 5 cm - 25 cm²) Tyco 25 36.25 1.4500

Dressing More than 500 cm² (active surface)


3M Canada 1 25.78

99100604 Mepilex (20 cm x 50 cm - 1000 cm²)

Mölnlycke 2 86.00 43.0000


Page 338 2010-06

Dressing Sacrum or triangular

99004259 Allevyn Sacrum (17 cm x 17cm - 123 cm²)

S. & N. 1 9.27

99002957 Allevyn Sacrum (23 cm x 23cm - 237 cm²)

S. & N. 1 16.83

99005018 Combiderm ACD (Triangular15 cm x 18 cm - 96 cm²)

Convatec 1 8.26

99100105 Combiderm ACD (Triangular20 cm x 22.5 cm - 216 cm²)

Convatec 1 13.84

99100447 Mepilex Border Sacrum (18cm x 18 cm - 120 cm²)

Mölnlycke 5 47.90 9.5800

99100448 Mepilex Border Sacrum (23cm x 23 cm - 238 cm²)

Mölnlycke 5 69.80 13.9600

99100001 Tielle Plus (Sacrum 15 cm x15 cm - 70 cm²)

Systagenix 10 60.91 6.0910

Thin dr. 100 cm² to 200 cm² (active surface)

99100034 Allevyn Thin (10 cm x 10 cm- 100 cm²)

S. & N. 1 4.05

99100133 Mepilex Lite (10 cm x 10 cm- 100 cm²)

Mölnlycke 1 3.54


99100035 Allevyn Thin (15 cm x 20 cm- 300 cm²)

S. & N. 1 10.02

99100134 Mepilex Lite (15 cm x 15 cm- 225 cm²)

Mölnlycke 1 6.37

Thin dr. Less than 100 cm² (active surface)

99100036 Allevyn Thin (5 cm x 6 cm -30 cm²)

S. & N. 1 1.30

99100132 Mepilex Lite (6.8 cm x 8.5 cm- 58 cm²)

Mölnlycke 1 2.11

Thin dr. More than 500 cm² (active surface)

99100605 Mepilex Lite (20 cm x 50 cm- 1 000 cm²)

Mölnlycke 2 77.38 38.6900

ABSORPTIVE DRESSING - SODIUM CHLORIDEDressing 100 cm² to 200 cm² (active surface)

00899496 Mesalt (10 cm x 10 cm - 100cm²)

Mölnlycke 30 27.29 0.9097


99004712 Curasalt (15 cm x 17 cm - 255cm²)

Tyco 96 202.04 2.1046


2010-06 Page 339


00899429 Mesalt (5 cm x 5 cm - 25 cm²) Mölnlycke 30 21.25 0.708300899518 Mesalt (7.5 cm X 7.5 cm - 56

cm²)Mölnlycke 30 22.99 0.7663

Strip 1 m

00920525 Mesalt (1 m) Mölnlycke 10 44.70 4.4700

ACAMPROSATE XXL.A. Tab. 333 mg

02293269 Campral Mylan 84 67.20 0.8000

ADALIMUMAB XS.C. Inj.Sol (syr) 40 mg

02258595 Humira Abbott 2 1374.03 687.015099100385 Humira (pen) Abbott 2 1374.03 687.0150

ADEFOVIR DIPIVOXIL XTab. 10 mg

02247823 Hepsera Gilead 30 675.30 22.5100

ALGLUCOSIDASE ALFA XI.V. Perf. Pd 50 mg

02284863 Myozyme Genzyme 1 840.31

ALISKIREN XTab. 150 mg

02302063 Rasilez Novartis 28 31.08 1.1100

Tab. 300 mg

02302071 Rasilez Novartis 28 31.08 1.1100

ALISKIRENE/HYDROCHLOROTHIAZIDE XTab. 150 mg- 12.5 mg

02332728 Rasilez HCT Novartis 28 31.08 1.1100

Tab. 150 mg - 25 mg



Page 340 2010-06

Tab. 300 mg- 12.5 mg


Tab. 300 mg - 25 mg


AMBRISENTAN XXTab. 5 mg

02307065 Volibris GSK 30 3600.00 120.0000

Tab. 10 mg

02307073 Volibris GSK 30 3600.00 120.0000

AMLODIPINE (BESYLATE)/ ATORVASTATIN CALCIUM XTab. 5 mg -10 mg

02273233 Caduet Pfizer 90 208.85 2.3206

Tab. 5 mg - 20 mg

02273241 Caduet Pfizer 90 246.29 2.7366

Tab. 5 mg - 40 mg

02273268 Caduet Pfizer 90 260.33 2.8926

Tab. 5 mg - 80 mg

02273276 Caduet Pfizer 90 260.33 2.8926

Tab. 10 mg -10 mg

02273284 Caduet Pfizer 90 220.50 2.4500

Tab. 10 mg - 20 mg

02273292 Caduet Pfizer 90 274.90 3.0544

Tab. 10 mg - 40 mg

02273306 Caduet Pfizer 90 288.00 3.2000

Tab. 10 mg - 80 mg

02273314 Caduet Pfizer 90 288.00 3.2000


2010-06 Page 341

AMPHETAMINE (MIXED SALTS) YYL.A. Caps. 5 mg

02248808 Adderall XR Shire 100 197.00 1.9700

L.A. Caps. 10 mg


L.A. Caps. 15 mg


L.A. Caps. 20 mg


L.A. Caps. 25 mg


L.A. Caps. 30 mg


ANETHOLE TRITHIONETab. 25 mg

02240344 Sialor Phmscience 60 15.69 0.2615

ANTIMICROBIAL DRESSING - IODINE Paste

99100098 Iodosorb S. & N. 5 g10 g17 g

8.3816.7728.50

Top. Oint.

99100099 Iodosorb S. & N. 10 g20 g40 g

13.5527.1054.19


Page 342 2010-06

ANTIMICROBIAL DRESSING - SILVER Dressing 100 cm² to 200 cm² (active surface)

99100348 3M - Tegaderm Ag Mesh (10cm x 12.7 cm - 127cm²)

3M Canada 1 5.24

99100349 3M Tegaderm Ag Mesh (10cm x 20 cm - 200 cm²)

3M Canada 1 7.94

99100559 Allevyn Ag Gentle (10 cm x10 cm - 100 cm²)

S. & N. 10 74.10 7.4100

99100456 Allevyn Ag Non-Adhesive (10cm x 10 cm - 100 cm²)

S. & N. 10 74.10 7.4100

99100324 Biatain Ag Non-Adhesive (10cm x 10 cm - 100 cm²)

Coloplast 5 33.25 6.6500


Coloplast 5 66.50 13.3000

99100545 Melgisorb Ag (10 cm x 10 cm- 100 cm²)

Mölnlycke 10 59.74 5.9740

99100366 Mepilex Ag (10 cm x 10 cm -100 cm²)

Mölnlycke 5 34.33 6.8660


Mölnlycke 5 64.67 12.9340

99100579 Restore Dressing alginatecalcium Silver 10.2x12-122cm²

Hollister 10 89.33 8.9330

99100562 Restore Foam DressingSilver sulphate 10 cm x 10cm 100 cm²

Hollister 10 83.27 8.3270

99100541 SeaSorb Ag (10 cm x 10 cm- 100 cm²)

Coloplast 10 52.50 5.2500

99100288 Silvercel (10 cm x 20 cm -200 cm²)

Systagenix 5 77.37 15.4740

99100289 Silvercel (11 cm x 11 cm -121 cm²)

Systagenix 10 92.34 9.2340



3M Canada 1 15.52


S. & N. 10 157.50 15.7500


S. & N. 10 280.40 28.0400

99100457 Allevyn Ag Non-Adhesif (20cm x 20 cm - 400 cm²)

S. & N. 10 280.40 28.0400


S. & N. 10 157.50 15.7500

99100326 Aquacel AG (14.5 cm x 14.5cm - 210 cm²)

Convatec 5 89.05 17.8100


Coloplast 5 74.81 14.9620


Coloplast 5 124.80 24.9600

99100543 Melgisorb Ag (15 cm x 15 cm- 225 cm²)

Mölnlycke 10 102.29 10.2290


Mölnlycke 5 77.06 15.4120


Mölnlycke 5 124.83 24.9660


2010-06 Page 343



3M Canada 1 2.55

99100557 Allevyn Ag Gentle (5 cm x 5cm - 25 cm²)

S. & N. 10 43.02 4.3020


S. & N. 10 43.02 4.3020

99100338 Aquacel AG (9.5 cm x 9.5 cm- 90 cm²)

Convatec 10 98.40 9.8400


Coloplast 5 11.64 2.3280

99100544 Melgisorb Ag (5 cm x 5 cm -25 cm²)

Mölnlycke 10 27.75 2.7750

99100287 Silvercel (5 cm x 5 cm - 25cm²)

Systagenix 10 30.50 3.0500


99100235 Acticoat (20 cm x 40 cm - 600cm2)

S. & N. 1 66.28

99100236 Acticoat (40 cm x 40 cm - 1600 cm²)

S. & N. 1 130.27

99100593 Acticoat Flex 3 (40 cm x 40cm - 1 600 cm²)

S. & N. 6 781.62 130.2700

99100328 Aquacel AG (19.5 cm x 29.5cm - 575 cm²)

Convatec 5 214.45 42.8900

99100596 Mepilex Ag (20 cm x 50 cm -1 000 cm²)

Mölnlycke 2 106.20 53.1000

Dressing Sacrum

99100451 Allevyn Ag Adhesive Sacrum(17 cm x 17 cm - 123 cm²)

S. & N. 10 149.50 14.9500

99100452 Allevyn Ag Adhesive Sacrum(23 cm x 23 cm - 237 cm²)

S. & N. 10 244.30 24.4300

99100247 * Biatain Ag Adhesive (sacrum23 cm x 23 cm - 200 cm²)

Coloplast 5 100.00 20.0000

APREPITANT XXCaps. 80 mg

02298791 Emend Merck 2 60.36 30.1800

Caps. 125 mg

02298805 Emend Merck 6 181.08 30.1800

Caps. 125mg (1 caps.) and 80mg (2 caps.)

02298813 Emend Tri-Pack Merck 3 90.54


Page 344 2010-06

ATOMOXETINE HYDROCHLORIDE XXCaps. 10 mg

02262800 Strattera Lilly 28 72.80 2.6000

Caps. 18 mg

02262819 Strattera Lilly 28 83.44 2.9800

Caps. 25 mg

02262827 Strattera Lilly 28 92.12 3.2900

Caps. 40 mg

02262835 Strattera Lilly 28 105.00 3.7500

Caps. 60 mg

02262843 Strattera Lilly 28 116.48 4.1600

BECAPLERMIN XTop. Jel. 0.01 %

02239405 Regranex J.O.I. 15 g 530.00

BETAHISTINE DIHYDROCHLORIDE XTab. 16 mg

02280191 Novo-Betahistine Novopharm 100 29.40 0.262102243878 Serc Solvay 100 44.24 0.4424

Tab. 24 mg

02280205 Novo-Betahistine Novopharm 100 44.10 0.393302247998 Serc Solvay 100 66.36 0.6636

BISACODYLEnt. Tab. 5 mg PPB

02273411 Bisacodyl-Odan Odan 1001000

4.0540.50

0.04050.0405

02246039 Jamp-Bisacodyl Jamp 2501000

10.1340.50

0.04050.0405

00587273 pms-Bisacodyl Phmscience 1001000

4.0540.50

0.04050.0405

Supp. 10 mg PPB

00582883 pms-Bisacodyl Phmscience 100 50.14 0.5014


2010-06 Page 345

BORDERED ABSORPTIVE DRESSING - GELLING FIBRE Dressing 100 cm² to 200 cm² (active surface)

99100469 Versiva XC Adhesive (14cmx 14cm - 100 cm²)

Convatec 10 67.50 6.7500

99100470 Versiva XC Adhesive (19 cmx 19 cm - 196 cm²)

Convatec 5 66.20 13.2400



Convatec 5 89.50 17.9000



Convatec 10 39.90 3.9900

Dressing Sacrum

99100465 Versiva XC - Sacrum (21 cmx 25 cm - 218 cm²)

Convatec 5 86.75 17.3500


Page 346 2010-06

BORDERED ABSORPTIVE DRESSING - HYDROPHILIC FOAM ALONE OR IN ASSOCIATION Dressing 100 cm² to 200 cm² (active surface)

99100199 3M Tegaderm FoamAdhesive Dressing (14.3cm x14.3cm-100 cm²)

3M Canada 1 6.87

99001667 Allevyn Adhesive (12.5 cm x12.5 cm - 100 cm²)

S. & N. 10 57.91 5.7910


S. & N. 10 108.80 10.8800

99100476 Allevyn Gentle Border (12.5cm x 12.5 cm - 100 cm²)

S. & N. 10 59.00 5.9000

99100032 Allevyn Plus Adhesif (12.5cm x 22.5 cm - 200 cm²)

S. & N. 1 12.41

99100031 Allevyn Plus Adhesive (12.5cm x 12.5 xcm - 100 cm²)

S. & N. 1 6.39

99100139 Biatain Adhesive (18 cm x 18cm - 196 cm²)

Coloplast 5 52.92 10.5840

99005026 Combiderm ACD (15 cm x 25cm - 200 cm²)

Convatec 1 11.54

99004321 Mepilex Border (15 cm x 15cm - 121 cm²)

Mölnlycke 1 7.96


Mölnlycke 1 11.77

99100568 Restore Foam DressingAdhesive (15 cm x 15 cm 100 cm²)

Hollister 10 59.57 5.9570

99100569 Restore Foam DressingAdhesive (15 cm x 20 cm 123 cm²)

Hollister 10 76.96 7.6960

99004623 Tielle (15 cm x 15 cm - 121cm²)

Systagenix 10 85.11 8.5110

99001799 Tielle (15 cm x 20 cm - 176cm²)

Systagenix 5 60.90 12.1800

99001675 Tielle (18 cm x 18 cm - 196cm²)

Systagenix 5 53.99 10.7980

99100012 Tielle Plus (15 cm x 15 cm -121 cm²)

Systagenix 10 85.11 8.5110

99004895 Tielle Plus (15 cm x 20 cm -176 cm²)

Systagenix 5 61.90 12.3800


99001659 Allevyn Adhesive (17,5 cm x17,5 cm - 225 cm2)

S. & N. 1 11.57


S. & N. 1 22.12

99100477 Allevyn Gentle Border (17.5cm x 17.5 cm - 225 cm²)

S. & N. 10 118.00 11.8000

99100033 Allevyn Plus Adhesive (17.5cm x 17.5 cm - 225 cm²)

S. & N. 1 12.44


Convatec 5 49.57 9.9140


2010-06 Page 347


99100198 3M Tegaderm FoamAdhesive Dressing (10 cm x11 cm - 46 cm²)

3M Canada 1 4.41

99100197 3M Tegaderm FoamAdhesive Dressing (8.8 cm x8.8 cm-25 cm²)

3M Canada 1 2.68


S. & N. 10 23.84 2.3840

99100474 Allevyn Gentle Border (10 cmx 10 cm - 56 cm²)

S. & N. 10 49.00 4.9000

99100612 Biatain Adhesif (10 cm x 10cm - 28,3 cm²)

Coloplast 10 27.10 2.7100

99100613 Biatain Adhesif (7,5 cm x 7,5cm - 12,6 cm²)

Coloplast 10 12.10 1.2100

99100137 Biatain Adhesive (12.5 cm x12.5 cm - 64 cm²)

Coloplast 10 44.80 4.4800


Convatec 1 3.08


Convatec 10 44.08 4.4080


Mölnlycke 1 4.55


Mölnlycke 5 44.17 8.8340

99100355 Mepilex Border (12.5 cm x12.5 cm - 72 cm²)

Mölnlycke 5 29.45 5.8900

99100606 Mepilex Border (7,5 cm x 7,5cm - 25 cm²)

Mölnlycke 5 11.90 2.3800

99001683 Tielle (11 cm x 11 cm - 49cm²)

Systagenix 10 52.69 5.2690

99100538 Tielle (7 cm x 9 cm - 15 cm²) Systagenix 10 16.14 1.614099004887 Tielle Plus (11 cm x 11 cm -

49 cm²)Systagenix 10 52.97 5.2970


99100297 Mepilex Border Lite (15 cm x15 cm - 121 cm²)

Mölnlycke 5 24.88 4.9760


99100296 Mepilex Border Lite (10 cm x10 cm - 42 cm²)

Mölnlycke 5 14.94 2.9880

99100293 Mepilex Border Lite (4 cm x 5cm - 6 cm²)

Mölnlycke 10 13.89 1.3890

99100294 Mepilex Border Lite (5 cm x12.5 cm - 21 cm²)

Mölnlycke 5 10.68 2.1360

99100295 Mepilex Border Lite (7.5 cm x7.5 cm - 20 cm²)

Mölnlycke 5 8.90 1.7800


Page 348 2010-06

BORDERED ABSORPTIVE DRESSING - POLYESTER AND RAYON FIBREDressing 100 cm² to 200 cm² (active surface)

00920509 Alldress (15 cm x 15 cm - 100cm²)

Mölnlycke 10 28.80 2.8800


Mölnlycke 10 36.70 3.6700



Mölnlycke 10 23.80 2.3800

BORDERED ANTIMICROBIAL DRESSING - SILVERDressing 100 cm² to 200 cm² (active surface)

99100453 Allevyn Ag Adhesive (12.5cm x 12.5 cm - 100 cm²)

S. & N. 10 118.19 11.8190

99100564 Allevyn Ag Gentle Border(12.5 cm x 12.5 cm - 100 cm²)

S. & N. 10 118.19 11.8190

99100597 Biatain Ag Adhesive (18 cm x18 cm - 169 cm²)

Coloplast 5 92.95 18.5900


99100454 Allevyn Ag Adhesive (17.5cm x 17.5 cm - 225 cm²)

S. & N. 10 276.70 27.6700


S. & N. 10 276.70 27.6700


99100449 Allevyn Ag Adhesive (7.5 cmx 7.5 cm - 25 cm²)

S. & N. 10 53.00 5.3000


S. & N. 10 53.00 5.3000

99100245 Biatain Ag Adhesive (12.5 cmx 12.5 cm - 64 cm²)

Coloplast 5 35.20 7.0400

99100598 Biatain Ag Adhesive (7,5 cmx 7,5 cm - 12,6 cm²)

Coloplast 5 13.20 2.6400

BORDERED MOISTURE-RETENTIVE DRESSING - HYDROCOLLOIDAL OR POLYURETHANEDressing 100 cm² to 200 cm² (active surface)

00800961 3M Tegaderm HydrocolloidDressing (17 cm x 20 cm -187 cm²)

3M Canada 1 6.50

00907707 DuoDERM CGF Border (14cm x 14 cm - 100 cm²)

Convatec 1 4.21


2010-06 Page 349



Convatec 1 10.92


00801038 3M Tegaderm HydrocolloidDressing (10 cm x 12 cm - 50cm²)

3M Canada 1 2.99

00801003 3M Tegaderm HydrocolloidDressing (13 cm x 15 cm - 94cm²)

3M Canada 1 4.00


Convatec 1 2.21


99100292 3M Tegaderm HydrocolloidThin Dressing (17cm x20cm-187cm²)

3M Canada 1 5.61


99100291 3M Tegaderm HydrocolloidThin Dressing (13 cm x 15cm-94cm²)

3M Canada 1 3.38

BOSENTAN XXTab. 62.5 mg

02244981 Tracleer Actelion 56 3594.00 64.1786

Tab. 125 mg

02244982 Tracleer Actelion 56 3594.00 64.1786

BOTULINUM TOXIN TYPE A XI.M. Inj. Pd 100 UI

01981501 Botox Allergan 1 357.00

BOTULINUM TOXIN TYPE A FREE FROM COMPLEXING PROTEINS XI.M. Inj. Pd 100 UI

02324032 Xeomin Merz 1 330.00

BUPRENORPHINE/NALOXONE ZS-Ling. Tab. 2 mg - 0.5 mg

02295695 Suboxone Schering 7 18.69 2.6700


Page 350 2010-06

S-Ling. Tab. 8 mg - 2 mg

02295709 Suboxone Schering 7 33.11 4.7300

CABERGOLINE XXTab. 0.5 mg

02301407 Co Cabergoline Cobalt 8 60.72 7.590002242471 Dostinex Squire 8 101.69 12.7113

CALCIPOTRIOL/ BETAMETHASONE DIPROPIONATE XTop. Jel. 50 mcg/g -0.5 mg/g

02319012 Xamiol Leo 60 g 82.80 1.3800

Top. Oint. 50 mcg/g -0.5 mg/g

02244126 Dovobet Leo 60 g120 g

82.80165.60

1.38001.3800

CALCIUM GLUCONATE/CALCIUM LACTATEOral Sol. 100 mg/5 mL

80002626 SoluCAL Jamp 350 ml 15.00 0.0429

CAPECITABINE XTab. 150 mg

02238453 Xeloda Roche 60 109.80 1.8300

Tab. 500 mg

02238454 Xeloda Roche 120 732.00 6.1000

CARBOXYMETHYLCELLULOSE SODIUMOph. Sol. 0.5 % (0.4 mL)

02049260 Refresh plus Allergan 30 8.51 0.2837

Oph. Sol. 1 % (0.4 mL)

00870153 Celluvisc Allergan 30 9.21 0.3070

CARBOXYMETHYLCELLULOSE SODIUM/ PURITE Oph. Sol. 0.5 %

02231008 Refresh tears Allergan 15 ml 6.01


2010-06 Page 351

CASPOFUNGIN ACETATE XXI.V. Inj. Pd 50 mg

02244265 Cancidas Merck 1 222.00

I.V. Inj. Pd 70 mg

02244266 Cancidas Merck 1 222.00

CINACALCET HYDROCHLORIDE XTab. 30 mg

02257130 Sensipar Amgen 30 323.52 10.7840

Tab. 60 mg

02257149 Sensipar Amgen 30 589.81 19.6603

Tab. 90 mg

02257157 Sensipar Amgen 30 858.43 28.6143

CIPROFLOXACIN HYDROCHLORIDE XI.V. Perf. Sol. 2 mg/mL

02267462 Ciprofloxacine PerfusionIntravenous

Novopharm 100 ml200 ml

10.2720.50

CLINDAMYCIN PHOSPHATE XVag. Cr. 20 mg/g

02060604 Dalacin C Squire 40 g 25.26

Vag. cr. (single-dose) 2 %

02306514 Clindesse Ferring 1 20.98

CLOPIDOGREL BISULFATE XTab. 75 mg

02238682 Plavix SanofiAven 28500

71.071269.06

2.53822.5381

CODEINE PHOSPHATE ZSyr. 25 mg/5 mL

00050024 Codeine Atlas 500 ml2000 ml

19.4362.71

0.03890.0314


Page 352 2010-06

DARBEPOETINE ALFA XXSyringe 10 mcg/0.4 mL

02246354 Aranesp Amgen 4 107.20 26.8000

Syringe 20 mcg/0.5 mL

02246355 Aranesp Amgen 4 214.40 53.6000


02246357 Aranesp Amgen 4 321.60 80.4000


99004917 Aranesp Amgen 4 428.80 107.2000


99004925 Aranesp Amgen 4 536.00 134.0000


02246358 Aranesp Amgen 4 643.20 160.8000


99004933 Aranesp Amgen 4 857.60 214.4000


99004909 Aranesp Amgen 4 1072.00 268.0000


99100364 Aranesp Amgen 4 1393.60 348.4000


02246360 Aranesp Amgen 4 1608.00 402.0000


99100209 Aranesp Amgen 1 536.00


99100210 Aranesp Amgen 1 804.00


2010-06 Page 353


99100211 Aranesp Amgen 1 1340.00

DARUNAVIR XXTab. 300 mg

02284057 Prezista J.O.I. 120 854.88 7.1240

Tab. 600 mg

02324024 Prezista J.O.I. 60 854.88 14.2480

DASATINIB XTab. 20 mg

02293129 Sprycel B.M.S. 60 2101.42 35.0237

Tab. 50 mg

02293137 Sprycel B.M.S. 60 4202.83 70.0472

Tab. 70 mg

02293145 Sprycel B.M.S. 60 4634.89 77.2482

Tab. 100 mg

02320193 Sprycel B.M.S. 30 4202.83 140.0943

DELTA-9-TETRAHYDROCANNABINOL ZCaps. 2.5 mg

00611190 Marinol Solvay 60 118.31 1.9718

Caps. 5 mg

00611204 Marinol Solvay 60 236.61 3.9435

DICLOFENAC SODIUM XOph. Sol. 0.1 %

01940414 Voltaren Ophta Novartis 2.5 ml5 ml

10 ml

6.0612.1324.26


Page 354 2010-06

DIPHENHYDRAMINE HYDROCHLORIDE Caps. or Tab. 25 mg PPB

02257548 Jamp-Diphenhydramine Jamp 250500

13.3526.70

0.05340.0534

02239029 Nadryl 25 Riva 100 5.34 0.053400757683 pms-Diphenhydramine Phmscience 100

5005.34

26.700.05340.0534

Elix. 12.5 mg/5 mL PPB

02298503 Jamp-Diphenhydramine Jamp 120 ml500 ml

2.8111.70

0.02340.0234

00792705 pms-Diphenhydramine Phmscience 100 ml500 ml

2.3411.70

0.02340.0234

Tab. 50 mg PPB

02257556 Jamp-Diphenhydramine Jamp 100500

7.0435.20

0.07040.0704

00757691 pms-Diphenhydramine Phmscience 100500

7.0435.20

0.07040.0704

DIPYRIDAMOLE/ ACETYLSALICYLIC ACID XXCaps. 200 mg L.A. - 25 mg

02242119 Aggrenox Bo. Ing. 60 49.38 0.8230

DOCUSATE CALCIUM Caps. 240 mg PPB

00806226 Calax Odan 100500

8.1640.80

0.08160.0816

00830275 Docusate Calcium Trianon 1001000

8.1681.60

0.08160.0816

02283255 Jamp-Docusate Calcium Jamp 2501000

20.4081.60

0.08160.0816

00842044 Novo-Docusate Calcium Novopharm 100500

8.1640.80

0.08160.0816

00664553 pms-Docusate-Calcium Phmscience 3001000

24.4881.60

0.08160.0816


2010-06 Page 355

DOCUSATE SODIUMCaps. 100 mg PPB

02245079 Apo-Docusate Sodium Apotex 1000 25.00 0.025000830267 Docusate de Sodium Trianon 100

10003.83

25.000.03830.0250

00716731 Docusate Sodique Taro 1001000

3.8325.00

0.03830.0250

02326086 Docusate sodium Pro Doc 1000 25.00 0.025002247385 Euro-Docusate Euro-Pharm 1000 25.00 0.025002303825 Euro-Docusate C Euro-Pharm 1000 25.00 0.025002245946 Jamp-Docusate Sodium Jamp 1000 25.00 0.025002020084 Novo-Docusate Novopharm 100

10003.83

25.000.03830.0250

02298163 phl-Docusate Sodium Pharmel 1001000

3.8325.00

0.03830.0250

00703494 pms-Docusate Sodium Phmscience 1001000

3.8325.00

0.03830.0250

00870196 ratio-Docusate Sodium Ratiopharm 1000 25.00 0.025000514888 Selax Odan 100

10003.83

25.000.03830.0250

Caps. 200 mg PPB

02335077 Jamp-Docusate Sodium Jamp 100 8.39 0.083902029529 Soflax Phmscience 100

10008.39

83.870.08390.0839

Caps. 250 mg PPB

02335085 Jamp-Docusate Sodium Jamp 100 9.50 0.095002006596 Selax Odan 100 9.50 0.0950

Syr. 20 mg/5 mL PPB

02238283 Docusate de Sodium Atlas 225 ml500 ml

4.955.95

0.02200.0119

02024624 Docusate de Sodium Trianon 250 ml 5.50 0.022002283239 Jamp-Docusate Sodium Jamp 250 ml 5.50 0.022000703508 pms-Docusate Sodium Phmscience 500 ml 5.95 0.011900870226 ratio-Docusate Sodium Ratiopharm 500 ml 5.95 0.011900695033 Selax Odan 250 ml

500 ml5.505.95

0.02200.0119

Syr. 50 mg/mL PPB

02283220 Jamp-Docusate Sodium Jamp 500 ml 429.19 0.858400848417 pms-Docusate Phmscience 500 ml 429.19 0.8584

Syr. or Oral Sol. 10 mg/mL

02332485 Jamp-Docusate Sodium Jamp 500 ml 86.60 0.173200880140 pms-Docusate Sodium Phmscience 500 ml 89.67 0.179302006723 Soflax Phmscience 25 ml 4.33 0.1732


Page 356 2010-06

DOLASETRON MESYLATE XXTab. 50 mg

02231378 Anzemet SanofiAven 15 205.39 W

Tab. 100 mg

02231379 Anzemet SanofiAven 15 410.79 27.3860

DONEPEZIL HYDROCHLORIDE XTab. or Tab. Oral Disint. 5 mg

02232043 Aricept Pfizer 2830

128.41137.59

4.58614.5863

02269457 Aricept RDT Pfizer 28 128.41 4.5861


02232044 Aricept Pfizer 2830

128.41137.59

4.58614.5863

02269465 Aricept RDT Pfizer 28 128.41 4.5861

DORNASE ALFA XSol. Inh. 1 mg/mL (2.5 mL)

02046733 Pulmozyme Roche 30 1108.49 36.9497

DORZOLAMIDE HYDROCHLORIDE/ TIMOLOL MALEATE XOph. Sol. 2 % - 0.5 % (0.2mL)

02258692 Cosopt sans preservateur Merck 60 28.41 0.4735

DULOXETINE XL.A. Caps. 30 mg

02301482 Cymbalta Lilly 28 49.84 1.7800

L.A. Caps. 60 mg

02301490 Cymbalta Lilly 28 99.68 3.5600

ENFUVIRTIDE XS.C. Inj. Pd 108 mg

02247725 Fuzeon Roche 60 2385.60 39.7600


2010-06 Page 357

ENTECAVIR XXOral Sol. 0.05 mg/mL

02282232 Baraclude B.M.S. 210 ml 462.00 2.2000

Tab. 0.5 mg

02282224 Baraclude B.M.S. 30 660.00 22.0000

EPLERENONE XTab. 25 mg

02323052 Inspra Pfizer 30 74.70 2.4900

Tab. 50 mg

02323060 Inspra Pfizer 30 74.70 2.4900

EPOETIN ALFA XSyringe 1 000 UI/0.5 mL

02231583 Eprex J.O.I. 6 85.50 14.2500

Syringe 2 000 UI/0.5 mL

02231584 Eprex J.O.I. 6 171.00 28.5000


02231585 Eprex J.O.I. 6 256.50 42.7500


02231586 Eprex J.O.I. 6 342.00 57.0000


02243400 Eprex J.O.I. 6 427.50 71.2500


02243401 Eprex J.O.I. 6 513.00 85.5000


02243403 Eprex J.O.I. 6 684.00 114.0000


02231587 Eprex J.O.I. 6 803.70 133.9500


Page 358 2010-06


02243239 Eprex J.O.I. 1 267.90


02288680 Eprex J.O.I. 1 401.85

Syringe 40 000 UI/mL (1 mL)

02240722 Eprex J.O.I. 1 401.85

EPOPROSTENOL SODIUM XXInj. Pd 0.5 mg

02230845 Flolan GSK 1 18.13

Inj. Pd 1.5 mg

02230848 Flolan GSK 1 36.26

ERLOTINIB (HYDROCHLORIDE) XTab. 100 mg

02269015 Tarceva Roche 30 1600.00 53.3333

Tab. 150 mg

02269023 Tarceva Roche 30 2400.00 80.0000

ESTRADIOL-17B XPatch 0.025 mg/24 h (4) and (8) PPB

02247499 Climara-25 Bayer 4 19.28 4.820000756849 Estraderm 25 Novartis 8 19.28 2.410002245676 Estradot Novartis 8 19.28 2.410002243722 Oesclim 25 Triton 8 19.28 2.4100

Patch 0.0375 mg/24 h

02243999 Estradot Novartis 8 19.28 2.4100

Patch 0.05 mg/24 h (4) and (8) PPB

02231509 Climara -50 Bayer 4 20.62 5.155000756857 Estraderm 50 Novartis 8 20.14 W 02244000 Estradot Novartis 8 20.62 2.577502243724 Oesclim 50 Triton 8 19.85 2.481302246967 Sandoz Estradiol Derm 50 Sandoz 8 13.64 1.7050


2010-06 Page 359

Patch 0.075 mg/24 h (4) et (8) PPB

02247500 Climara-75 Bayer 4 21.94 5.485002244001 Estradot Novartis 8 22.12 2.765002246968 Sandoz Estradiol Derm 75 Sandoz 8 14.64 1.8300

Patch 0.1 mg/24 h (4) et (8) PPB

02231510 Climara -100 Bayer 4 23.26 5.815000756792 Estraderm 100 Novartis 8 23.26 2.907502244002 Estradot Novartis 8 23.26 2.907502246969 Sandoz Estradiol Derm 100 Sandoz 8 15.40 1.9250

Top. Jel. 0.06 %

02238704 Estrogel Schering 80 g 20.72

ESTRADIOL-17B/ NORETHINDRONE ACETATE XXPatch 0.05 mg -0.14 mg/24 h

02241835 Estalis 140/50 Novartis 8 23.04 2.8800

Patch 0.05 mg -0.25 mg/24 h

02241837 Estalis 250/50 Novartis 8 23.04 2.8800

ESTRADIOL-17B/LEVONORGESTREL XPatch 0.045 mg - 0.015 mg/24 h

02250616 Climara Pro Bayer 4 22.51 5.6275

ÉTANERCEPT XS.C. Inj. Pd 25 mg

02242903 Enbrel Amgen 4 700.77 175.1925

S.C. Inj.Sol (syr) 50 mg/mL

02274728 Enbrel Amgen 4 1382.33 345.582599100373 Enbrel SureClick Amgen 4 1382.33 345.5825

ETRAVIRINE XTab. 100 mg

02306778 Intelence J.O.I. 120 654.00 5.4500


Page 360 2010-06

EZETIMIBE XXTab. 10 mg

02247521 Ezetrol Merck-Sch 30100

50.11167.01

1.67031.6701

FILGRASTIM XInj. Sol. 300 mcg/mL (1.0 mL)

01968017 Neupogen Amgen 10 1699.43 169.9430

Inj. Sol. 300 mcg/mL (1.6mL)

99001454 Neupogen Amgen 10 2719.09 271.9090

FLUCONAZOLE XOral Susp. 50 mg/5 mL

02024152 Diflucan Pfizer 35 ml 33.23 0.9494

FLUDARABINE PHOPHATE XTab. 10 mg

02246226 Fludara Genzyme 1520

100

574.98766.63

3833.15

38.332038.331538.3315

FORMOTEROL (FUMARATE)/ BUDESONIDE XInh. Pd 6 mcg -100 mcg/dose

02245385 Symbicort 100 Turbuhaler AZC 120 dose(s) 60.00

Inh. Pd 6 mcg -200 mcg/dose

02245386 Symbicort 200 Turbuhaler AZC 120 dose(s) 78.00

GALANTAMINE HYDROBROMIDE XL.A. Caps. 8 mg

02266717 Reminyl ER J.O.I. 30 137.70 4.5900

L.A. Caps. 16 mg

02266725 Reminyl ER J.O.I. 30 137.70 4.5900

L.A. Caps. 24 mg

02266733 Reminyl ER J.O.I. 30 137.70 4.5900


2010-06 Page 361

GLARGINE INSULINS.C. Inj. Sol. 100 U/mL

02245689 Lantus SanofiAven 10 ml 56.17


02251930 Lantus SanofiAven 5 86.8702294338 Lantus SoloStar SanofiAven 5 85.17

GLATIRAMER ACETATE XXS.C. Inj.Sol (syr) 20 mg/mL

02245619 Copaxone Teva 30 1296.00 43.2000

GLICLAZIDE XL.A. Tab. 30 mg

02297795 Apo-Gliclazide MR Apotex 100 14.05 0.140502242987 Diamicron MR Servier 60 8.43 0.1405

Tab. 80 mg

02245247 Apo-Gliclazide Apotex 60100

11.1818.63

0.18630.1863

00765996 Diamicron Servier 60 22.35 0.372502155850 Gliclazide Proval 60 11.18 W 02287072 * Gliclazide Sanis 100 18.63 0.186302248453 Gliclazide-80 Pro Doc 60

10011.1818.63

0.18630.1863

02229519 Mylan-Gliclazide Mylan 60100

11.1818.63

0.18630.1863

02238103 Novo-Gliclazide Novopharm 100500

18.6393.15

0.18630.1863

02294400 pms-Gliclazide Phmscience 100 18.63 0.186302254719 Sandoz Gliclazide Sandoz 100 18.63 0.1863

GLIMEPIRIDE XTab. 1 mg

02245272 Amaryl SanofiAven 30 22.31 0.743702295377 Apo-Glimepiride Apotex 100 38.57 0.385702273756 Novo-Glimepiride Novopharm 30 11.57 0.385702284545 pms-Glimepiride Phmscience 100 38.57 0.385702273101 ratio-Glimepiride Ratiopharm 30 11.57 0.385702269589 Sandoz Glimepiride Sandoz 30 11.57 0.3857


Page 362 2010-06

Tab. 2 mg

02245273 Amaryl SanofiAven 30 22.31 0.743702295385 Apo-Glimepiride Apotex 100 38.57 0.385702273764 Novo-Glimepiride Novopharm 30 11.57 0.385702284553 pms-Glimepiride Phmscience 100 38.57 0.385702273128 ratio-Glimepiride Ratiopharm 30 11.57 0.385702269597 Sandoz Glimepiride Sandoz 30 11.57 0.3857

Tab. 4 mg

02245274 Amaryl SanofiAven 30 22.31 0.743702295393 Apo-Glimepiride Apotex 100 38.57 0.385702273772 Novo-Glimepiride Novopharm 30 11.57 0.385702273136 ratio-Glimepiride Ratiopharm 30 11.57 0.385702269619 Sandoz Glimepiride Sandoz 30 11.57 0.3857

GLYCERIN 5Supp.

99100357 12

GOLIMUMAB XXS.C. Inj.Sol (App.) 50 mg/0.5 ml

02324784 Simponi Schering 1 1447.00

S.C. Inj.Sol (syr) 50 mg/0.5 ml

02324776 Simponi Schering 1 1447.00

GRANISETRON HYDROCHLORIDE XTab. 1 mg

02308894 Apo-Granisetron Apotex 10 135.00 10.800002185881 Kytril Roche 2

1036.00

180.0018.000018.0000

HYDROXYPROPYLMETHYLCELLULOSEOph. Sol. 0.5 % PPB

00000809 Isopto Tears Alcon 15 ml 4.1600889806 Sandoz Eyelube Sandoz 15 ml 4.16

Oph. Sol. 1 % PPB

00000817 Isopto Tears Alcon 15 ml 4.7000874965 Sandoz Eyelube Sandoz 15 ml 4.70

5 Where no price is indicated, pharmacists may purchase the product of their choice. The product thus obtainedis considered insured and the price payable by the Régie is the pharmacist's cost price.


2010-06 Page 363

HYDROXYPROPYLMETHYLCELLULOSE/ DEXTRAN 70Oph. Sol. 0.3 % -0.1 %

00390291 Tears Naturale Alcon 15 ml30 ml

5.288.16

00743445 Tears Naturale II Alcon 15 ml30 ml

5.107.99

IMATINIB MESYLATE XXTab. 100 mg

02253275 Gleevec Novartis 120 3142.30 26.1858

Tab. 400 mg

02253283 Gleevec Novartis 30 3142.30 104.7433

IMIQUIMOD XTop. Cr. 250 mg/sac.

02239505 Aldara Graceway 1224

143.76287.52

11.980011.9800

INFLIXIMAB XI.V. Perf. Pd 100 mg

02244016 Remicade Schering 1 940.00

INSULIN ASPART/ INSULIN ASPART PROTAMINES.C. Inj. Susp. 30 % - 70 % (3 mL)

02265435 NovoMix30 N.Nordisk 5 50.20

INSULIN DETEMIRS.C. Inj. Sol. 100 U/mL (3 mL)

02271842 Levemir N.Nordisk 5 94.92

INSULIN LISPRO/ INSULIN LISPRO PROTAMINE S.C. Inj. Susp. 25 % - 75 % (3mL)

02240294 Humalog Mix 25 Lilly 5 50.1199100631 + Humalog Mix 25 KwikPen Lilly 5 50.11


Page 364 2010-06

INTERFACE DRESSING - POLYAMIDE OR SILICONE Dressing 100 cm² to 200 cm² (active surface)

99100353 3M Tegaderm Non-AdherentContact Layer 7.5 cm x 20cm-150cm²

3M Canada 1 5.23

99100239 Mepitel (10 cm x 18 cm - 180cm²)

Mölnlycke 1 7.40


99100354 3M Tegaderm Non-AdherentContact Layer 20 cm x 25cm-500 cm²

3M Canada 1 15.84


99100352 3M Tegaderm Non-AdherentContact Layer 7.5 cm x 10cm-75 cm²

3M Canada 1 3.39

99100237 Mepitel (5 cm X 7.5 cm - 38cm²)

Mölnlycke 1 3.48

99100238 Mepitel (7.5 cm x 10 cm - 75cm²)

Mölnlycke 1 4.52


99100240 Mepitel (20 cm x 30 cm - 600cm²)

Mölnlycke 1 21.36

INTERFERON ALFA-2B (PEGYLATED) XXS.C. Inj. Pd 50 mcg/0.5 mL

02242966 Unitron-Peg Schering 2 791.70 395.8500

S.C. Inj. Pd 80 mcg/0.5 mL






INTERFERON BETA-1A XI.M. Inj. Pd 30 mcg (6 MUI)

02237770 Avonex Biogen 4 1356.10 339.0250


2010-06 Page 365

I.M. Inj. Sol. 30 mcg (6 MUI)

02269201 Avonex PS Biogen 4 1356.10 339.0250

S.C. Inj. Sol. 22 mcg/0.5 mL (1,5 mL)

02318253 Rebif Serono 4 1380.00 345.0000

S.C. Inj. Sol. 44 mcg/0.5 mL (1,5 mL)

02318261 Rebif Serono 4 1680.00 420.0000

S.C. Inj.Sol (syr) 22 mcg (6 MUI)

02237319 Rebif Serono 3 345.00 115.0000

S.C. Inj.Sol (syr) 44 mcg (12 MUI)

02237320 Rebif Serono 3 420.00 140.0000

INTERFERON BETA-1B XXInj. Pd 0.3 mg

02169649 Betaseron Bayer 1545

1497.544471.17

99.836099.3593

99100555 Betaseron - Initiation pack Bayer 1 1192.31

KETOROLAC TROMETHAMINE XOph. Sol. 0.5 % PPB

01968300 Acular Allergan 5 ml10 ml

16.8033.60

3.31403.3140

02245821 Apo-Ketorolac Apotex 5 ml10 ml

8.0016.00

02247461 ratio-Ketorolac Ratiopharm 5 ml10 ml

8.0016.00

LACTULOSESyr. or Oral Sol. 667 mg/mL PPB

02242814 Apo-Lactulose Apotex 500 ml1000 ml

7.2514.50

0.01450.0145

02247383 Euro-Lac Euro-Pharm 500 ml1000 ml

7.2514.50

0.01450.0145

02295881 Jamp-Lactulose Jamp 500 ml1000 ml

7.2514.50

0.01450.0145

00703486 pms-Lactulose Phmscience 1000 ml 14.50 0.014502311275 Pro-Lactulose-667 Pro Doc 500 ml

1000 ml7.25

14.500.01450.0145

00854409 ratio-Lactulose Ratiopharm 500 ml1000 ml

7.2514.50

0.01450.0145


Page 366 2010-06

LANTHANUM HYDRATE XXChew. Tab. 250 mg

02287145 Fosrenol Shire 90 92.70 1.0300

Chew. Tab. 500 mg

02287153 Fosrenol Shire 90 185.40 2.0600

Chew. Tab. 750 mg

02287161 Fosrenol Shire 90 279.00 3.1000

Chew. Tab. 1000 mg

02287188 Fosrenol Shire 90 369.90 4.1100

LATANOPROST/ TIMOLOL MALEATE XOph. Sol. 0.005 % - 0.5 %

02246619 Xalacom Pfizer 2.5 ml 30.60

LEFLUNOMIDE XTab. 10 mg

02256495 Apo-Leflunomide Apotex 30 143.85 4.795002241888 Arava SanofiAven 30 293.54 9.784702319225 Mylan-Leflunomide Mylan 30 143.85 4.795002261251 Novo-Leflunomide Novopharm 30

100143.85479.50

4.79504.7950

02309327 phl-Leflunomide Pharmel 30 143.85 4.795002288265 pms-Leflunomide Phmscience 30

100143.85479.50

4.79504.7950

02283964 Sandoz Leflunomide Sandoz 30 143.85 4.7950

Tab. 20 mg

02256509 Apo-Leflunomide Apotex 30 143.85 4.795002241889 Arava SanofiAven 30 293.54 9.784702319233 Mylan-Leflunomide Mylan 30 143.85 4.795002261278 Novo-Leflunomide Novopharm 30

100143.85479.50

4.79504.7950

02309335 phl-Leflunomide Pharmel 30 143.85 4.795002288273 pms-Leflunomide Phmscience 30

100143.85479.50

4.79504.7950

02283972 Sandoz Leflunomide Sandoz 30 143.85 4.7950

LENALIDOMIDE XCaps. 5 mg

02304899 Revlimid Celgene 28 9520.00 340.0000


2010-06 Page 367

Caps. 10 mg


Caps. 15 mg


Caps. 25 mg


LEVOFLOXACIN XXI.V. Perf. Sol. 5 mg/mL

02236839 Levaquin J.O.I. 50 ml100 ml150 ml

22.5745.1445.14

LINEZOLID XI.V. Perf. Sol. 2 mg/mL

02243685 Zyvoxam Pfizer 300 ml 95.51

Tab. 600 mg

02243684 Zyvoxam Pfizer 20 1412.78 70.6390

MAGNESIUM HYDROXIDEOral Susp. 400 mg/5 mL

00468401 Lait de Magnesie Atlas 500 ml 2.49 0.0050

MAGNESIUM HYDROXIDE/ ALUMINUM HYDROXIDE 5Oral Susp. 300 mg - 300 mg/5 mL

99002574 500 ml

Oral Susp. 300 mg -600 mg/5 mL

99002442 350 ml

Tab. 100 mg -184 mg

99002868 50



Page 368 2010-06

Tab. 300 mg -600 mg

99002450 40

Tab. 400 mg - 400 mg

99002434 36

MARAVIROC XXTab. 150 mg

02299844 Celsentri Pfizer 60 990.00 16.5000

Tab. 300 mg

02299852 Celsentri Pfizer 60 990.00 16.5000

MEGESTROL ACETATE XTab. 40 mg

02195917 Apo-Megestrol Apotex 100 100.73 1.0073

MEMANTINE HYDROCHLORIDE XTab. 10 mg

02324067 Co Memantine Cobalt 30100

37.85126.18

1.26171.2618

02260638 Ebixa Lundbeck 30 70.10 2.336702321130 pms-Memantine Phmscience 30

10037.85

126.181.26171.2618

02320908 ratio-Memantine Ratiopharm 100 126.17 1.2617

METHYLPHENIDATE HYDROCHLORIDE YL.A. Caps. 10 mg

02277166 Biphentin Purdue 100 65.00 0.6500

L.A. Caps. 15 mg


L.A. Caps. 20 mg


L.A. Caps. 30 mg



2010-06 Page 369

L.A. Caps. 40 mg


L.A. Caps. 50 mg


L.A. Caps. 60 mg


L.A. Caps. 80 mg


L.A. Tab. (12 h) 18 mg

02247732 Concerta J.O.I. 100 203.64 2.0364

L.A. Tab. (12 h) 27 mg

02250241 Concerta J.O.I. 100 235.01 2.3501

L.A. Tab. (12 h) 36 mg

02247733 Concerta J.O.I. 100 266.38 2.6638

L.A. Tab. (12 h) 54 mg

02247734 Concerta J.O.I. 100 329.12 3.2912

METRONIDAZOLE XXVag. Jel. 0.75 %

02125226 Nidagel Graceway 70 g 18.62

MICAFUNGIN SODIUM XI.V. Perf. Pd 50 mg

02294222 Mycamine Astellas 1 98.00

I.V. Perf. Pd 100 mg

02311054 Mycamine Astellas 1 196.00


Page 370 2010-06

MICRONIZED PROGESTERONE XXCaps. 100 mg

02166704 Prometrium Schering 28100

24.3887.05

0.87070.8705

MINERAL OILLiq. 100 %

00704172 Huile Minerale Atlas 250 ml500 ml

2.153.11

0.00860.0062

Liq. (Rect.)

00107875 Fleet Huileux J&J Merck 130 ml 5.40

Oral Jel. 78 %

00608734 Lansoyl Aurium 225 g 8.00 0.031402186926 Lansoyl sans sucre Aurium 215 g 8.00 0.0328

MODAFINIL XTab. 100 mg

02239665 Alertec Shire 30 38.16 1.272002285398 Apo-Modafinil Apotex 100 92.93 0.7610

MOISTURE-RETENTIVE DRESSING - HYDROCOLLOIDAL OR POLYURETHANE Dressing 100 cm² to 200 cm² (active surface)


3M Canada 1 3.55

99100609 Comfeel Plus Ulcer (10 cm x10 cm - 100 cm²)

Coloplast 5 14.00 2.8000

99000040 Cutinova hydro (10 cm x 10cm - 100 cm²)

S. & N. 5 19.65 3.9300

00899666 DuoDERM CGF (10 cm x 10cm - 100 cm²)

Convatec 520

20.7883.12

4.15604.1560

99004984 DuoDERM Signal (14 cm x14 cm - 188 cm²)

Convatec 1 7.80

99100010 Nu-Derm HydrocolloidBorder (10 cm x 10 cm - 100cm²)

Systagenix 160 554.43 3.4652

99100007 Nu-Derm HydrocolloidStandard (10 cm x 10 cm -100 cm²)

Systagenix 50 194.79 3.8958

99004720 Ultec (10.2 cm x 10.2 cm -104 cm²)

Tyco 5 18.00 3.6000


2010-06 Page 371



3M Canada 1 8.50


Coloplast 5 31.50 6.3000


Coloplast 5 56.00 11.2000

99000059 Cutinova hydro (15 cm x 20cm - 300 cm²)

S. & N. 3 35.10 11.7000


Convatec 1 9.09


Convatec 1 12.11


Convatec 1 16.15


Convatec 1 15.67

99100011 Nu-Derm HydrocolloidBorder (15 cm x 15 cm - 225cm²)

Systagenix 20 166.08 8.3040

99100008 Nu-Derm HydrocolloidStandard (20 cm x 20 cm -400 cm²)

Systagenix 20 245.02 12.2510

99004747 Ultec (15.2 cm x 20.3 cm -309 cm²)

Tyco 30 229.90 7.6633

99004755 Ultec (20.3 cm x 20.3 cm -412 cm²)

Tyco 30 273.20 9.1067


99100608 Comfeel Plus Ulcer (4 cm x 6cm - 24 cm²)

Coloplast 30 20.16 0.6720

99000032 Cutinova hydro (5 cm x 6 cm- 30 cm²)

S. & N. 1 2.30


Convatec 1 3.93

99100022 Nu-Derm HydrocolloidBorder (5 cm x 5 cm - 25 cm²)

Systagenix 100 160.96 1.6096


00800988 DuoDERM CGF (20 cm x 30cm - 600 cm2)

Convatec 1 17.24


Page 372 2010-06

Dressing Sacrum or triangular

99100148 Comfeel Plus Triangle (18cm x 20 cm - 180 cm²)

Coloplast 5 46.75 9.3500

00907758 DuoDERM CGF Border(Triangular 15 cm x 18 cm -99 cm²)

Convatec 1 5.22

00907782 DuoDERM CGF Border(Triangular 20 cm x 23 cm -270 cm²)

Convatec 1 10.74

99100108 DuoDERM Signal (Sacrum20 cm x 23 cm - 258 cm²)

Convatec 1 13.59

99100107 DuoDERM Signal(Triangular 15 cm x 18 cm -216 cm²)

Convatec 1 10.24

99100106 DuoDERM Signal(Triangular 20 cm x 23 cm -322 cm²)

Convatec 1 15.71

99100110 Nu-Derm HydrocolloidBorder (Sacrum 18 cm x 18cm - 135 cm²)

Systagenix 1 13.84


99100290 3M Tegaderm HydrocolloidThin Dressing (10cm x10cm-100 cm²)

3M Canada 1 3.10

99100143 Comfeel Plus Clear (10 cm x10 cm - 100 cm²)

Coloplast 10 28.10 2.8100


Coloplast 10 36.60 3.6600

99000261 DuoDERM CGF Extra Thin(10 cm x 10 cm - 100 cm²)

Convatec 1 2.87


Convatec 1 3.66


Convatec 1 3.11

99100009 Nu-Derm Hydrocolloid Thin(10 cm x 10 cm - 100 cm²)

Systagenix 100 285.00 2.8500



Coloplast 5 27.30 5.4600


Coloplast 5 38.22 7.6440


Convatec 1 5.52


99100146 Comfeel Plus Clear (5 cm x 7cm - 35 cm²)

Coloplast 10 15.80 1.5800

00920010 DuoDERM CGF Extra Thin(7.5 cm x 7.5 cm - 56 cm²)

Convatec 1 2.49

00920231 DuoDERM CGF Extra-Thin(5 cm x 10 cm - 50 cm²)

Convatec 1 1.89


2010-06 Page 373

Thin dr. Sacrum

00920037 DuoDERM CGF Extra-Thin(Sacrum 15 cm x 18 cm - 216cm²)

Convatec 1 8.11

MOXIFLOXACIN HYDROCHLORIDE XXI.V. Perf. Sol. 400 mg/250 mL

02246414 Avelox I.V. Bayer 12 420.24 35.0200

MULTIVITAMINS 5Caps. or Tab. Vit A 5000 UI - Vit D 400 UI et autres

99002493 100

Chew. Tab. Vit A 5000 UI - Vit D 400 UI et autres

99002507 100

Tab. Vit A 4000 UI -Beta Carotene 3 mg - Vit D 400 UIand others

02031388 Adeks Axcan 60 18.33 0.3055

NATALIZUMAB XI.V. Inj. Sol. 300mg/15ml

02286386 Tysabri Biogen 1 2387.80

NUTRITIONAL FORMULAS - FAT EMULSION (INFANTS AND CHILDREN) Liq. 89 mL suppl.

99100401 Microlipid Nestlé-Nut 48 137.46 2.8638

NUTRITIONAL FORMULAS - CASEIN HYDROLYSATE (INFANTS AND CHILDREN)Liq. 237 mL suppl.

99100206 Alimentum Abbott 1 1.36

Liq. 945 mL suppl.

00898562 Nutramigen M.J. 1 5.3199100531 Nutramigen A+ M.J. 1 5.31

Ped. Oral Pd 400 g suppl.

00881104 Nutramigen M.J. 1 14.56



Page 374 2010-06


99100532 Nutramigen A+ M.J. 1 16.5300881112 Pregestimil M.J. 1 17.7299100533 Pregestimil A+ M.J. 1 17.72

NUTRITIONAL FORMULAS - FRACTIONATED COCONUT OIL Liq. suppl.

99100217 Medium chain triglycerides Nestlé-Nut 946 ml 34.49

NUTRITIONAL FORMULAS - MONOMERIC Oral Pd 48.7 g/sachet suppl.

99000229 Vivonex Pediatrique Nestlé-Nut 6 39.42 6.5700

Oral Pd 79.5 g/ sac. suppl.

00921017 Vivonex Plus Nestlé-Nut 6 39.39 6.5650

Oral Pd 80 g/sac. suppl.

00861464 Tolerex Nestlé-Nut 6 23.40 3.9000

Oral Pd 80.4 g/sac. suppl.

00895229 Vivonex T.E.N. Nestlé-Nut 10 65.60 6.5600

NUTRITIONAL FORMULAS - MONOMERIC WITH IRON (INFANTS OR CHILDREN) Liq. 237 mL suppl.

99100463 EO28 Splash Nutricia 27 172.00 6.3704


99003368 Neocate Nutricia 4 174.00 43.500099004402 Neocate Junior Nutricia 4 184.00 46.0000

NUTRITIONAL FORMULAS - POLYMERIC LOW-RESIDUE Liq. 1 L suppl.

99100244 Novasource Renal Nestlé-Nut 1 8.1699100395 Nutren 2.0 Nestlé-Nut 1 10.0800908428 Osmolite 1.0 cal Abbott 1 5.22 W 99004208 Osmolite 1.2 cal Abbott 1 5.22 W 99004615 Promote Abbott 1 5.5499100462 TwoCal HN Abbott 1 9.72


2010-06 Page 375

Liq. 1.5 L suppl.

99000164 Isosource HN Nestlé-Nut 1 7.5099002000 Nutren 1.5 Nestlé-Nut 1 11.2899003570 Osmolite 1.0 cal Abbott 1 7.7799004216 Osmolite 1.2 cal Abbott 1 7.77

Liq. 235 mL à 250 mL suppl.

00898694 Boost 1.0 Nestlé-Nut 1 1.1500898708 Boost 1.5 Nestlé-Nut 1 1.4599000512 Isosource HN Nestlé-Nut 1 1.1299002639 Nepro Abbott 1 2.0999003546 Novasource Renal Nestlé-Nut 1 1.9200907766 Nutren 1.5 Nestlé-Nut 1 1.7799003406 Nutren Junior Nestlé-Nut 1 1.5400895350 Osmolite 1.0 cal Abbott 1 1.2099004224 Osmolite 1.2 cal Abbott 1 1.2099000474 Pediasure Abbott 1 1.5099001543 Promote Abbott 1 1.3000896969 Pulmocare Abbott 1 3.1899003554 Resource 2.0 Nestlé-Nut 1 1.9299002647 Suplena Abbott 1 1.9399004690 TwoCal HN Abbott 1 2.29

NUTRITIONAL FORMULAS - POLYMERIC WITH RESIDUE Liq. 1 L suppl.

99003635 Compleat modifie Nestlé-Nut 1 7.4599004267 Glucerna 1.0 Cal Abbott 1 6.5900921009 Jevity 1 cal Abbott 1 6.8599003597 Jevity 1.2 cal Abbott 1 7.7599100393 Jevity 1.5 Cal Abbott 1 9.69

Liq. 1.5 L suppl.

99004127 Isosource 1.5 Cal Nestlé-Nut 1 10.5399000202 Isosource HN Avec Fibres Nestlé-Nut 1 10.2999004496 Isosource VHN Nestlé-Nut 1 11.8899003600 Jevity 1.2 cal Abbott 1 11.6399100402 Jevity 1.5 Cal Abbott 1 14.5399100042 Resource pour diabetiques Nestlé-Nut 1 9.79


Page 376 2010-06


99000504 Compleat modifie Nestlé-Nut 1 1.9099004658 Compleat Pediatrique Nestlé-Nut 1 2.4200920347 Glucerna 1.0 Cal Abbott 1 1.5599004135 Isosource 1.5 Cal Nestlé-Nut 1 1.7500801194 Isosource HN Avec Fibres Nestlé-Nut 1 1.7299000180 Isosource VHN Nestlé-Nut 1 1.9899000482 Jevity 1 cal Abbott 1 1.5999003392 Jevity 1.2 cal Abbott 1 1.8299100417 Jevity 1.5 Cal Abbott 1 2.2999003414 Nutren Junior Fibres avec

PrebioNestlé-Nut 1 1.54

99001381 Pediasure avec fibres Abbott 1 1.5099005050 Pediasure Plus avec fibres Abbott 1 2.2699100216 Resource just for kids 1.5 cal Nestlé-Nut 1 2.1799002019 Resource pour diabetiques Nestlé-Nut 1 1.63


99003236 Scandishake Aromatisee Axcan 4 11.50 2.8750

NUTRITIONAL FORMULAS - POLYMERIZED GLUCOSE Oral Pd 350 g suppl.

00860891 Polycose Abbott 1 8.58

Oral Pd 400 mg suppl.

99100414 Polycal Nutricia 12 71.40 5.9500

NUTRITIONAL FORMULAS - POST-DISCHARGE PRETERM FORMULA (INFANTS) Ped. Oral Pd 363 g suppl.

99100122 Enfamil Enfacare A+ M.J. 1 14.4599100123 Similac Advance Neosure Abbott 1 14.41

NUTRITIONAL FORMULAS - PROTEINS Oral Pd 225 g suppl.

99100415 Protifar Nutricia 12 136.20 11.3500

Oral Pd 227 g suppl.

99003783 Beneprotein Nestlé-Nut 6 89.50 14.9167

NUTRITIONAL FORMULAS - SEMI-ELEMENIAL Liq. 1 L suppl.

99002922 Peptamen 1.5 Nestlé-Nut 1 38.3699003562 Perative Abbott 1 11.08


2010-06 Page 377

Liq. 1.5 L suppl.

99100094 Peptamen avec Prebio 1 Nestlé-Nut 1 39.90


99004283 Optimental Abbott 1 6.1700908444 Peptamen Nestlé-Nut 1 6.6599003031 Peptamen 1.5 Nestlé-Nut 1 9.5999100309 Peptamen AF Nestlé-Nut 1 9.5299004631 Peptamen avec Prebio 1 Nestlé-Nut 1 6.6599000296 Peptamen Junior Nestlé-Nut 1 6.6599003511 Perative Abbott 1 2.61


00889962 Vital H.N. Abbott 24 181.32 7.5550

NUTRITIONAL FORMULAS - SKIM MILK/ COCONUT OIL Oral Pd 454 g suppl.

00881201 Portagen M.J. 1 20.22

ODOUR-CONTROL DRESSING - ACTIVATED CHARCOALDressing 100 cm² to 200 cm² (active surface)

99001802 Actisorb Silver (10.5 cm x10.5 cm - 110 cm²)

Systagenix 50 91.50 1.8300

99001810 Actisorb Silver (10.5 cm x 19cm - 200 cm²)

Systagenix 50 204.78 4.0956


99100103 Actisorb Silver (6.5 cm x 9.5cm - 62 cm²)

Systagenix 1 2.59

ONDANSETRON XXOral Sol. 4 mg/5 mL PPB

02291967 Apo-Ondansetron Apotex 50 ml 73.07 1.159402229639 Zofran GSK 50 ml 96.61 1.9322


Page 378 2010-06


02288184 Apo-Ondansetron Apotex 1030

59.88179.64

5.98805.9880

02296349 Co Ondansetron Cobalt 10 59.88 5.988002313685 Jamp-Ondansetron Jamp 10

10059.88

598.805.98805.9880

02305259 Mint-Ondansetron Mint 1030

59.88179.64

5.98805.9880

02297868 Mylan-Ondansetron Mylan 10100

59.88598.80

5.98805.9880

02264056 Novo-Ondansetron Novopharm 10 59.88 5.988002306212 Ondansetron Odan Odan 10

10059.88

598.805.98805.9880

02278618 phl-Ondansetron Pharmel 10100

59.88598.80

5.98805.9880

02258188 pms-Ondansetron Phmscience 10100

59.88598.80

5.98805.9880

02312247 Ran-Ondansetron Ranbaxy 10100

59.88598.80

5.98805.9880

02278529 ratio-Ondansetron Ratiopharm 10100

59.88598.80

5.98805.9880

02274310 Sandoz Ondansetron Sandoz 10100

59.88598.80

5.98805.9880

02213567 Zofran GSK 10100

126.601265.96

12.660012.6596

02239372 Zofran ODT GSK 10 123.71 12.3710


02288192 Apo-Ondansetron Apotex 1030

91.40274.20

9.14009.1400

02296357 Co Ondansetron Cobalt 10 91.40 9.140002313693 Jamp-Ondansetron Jamp 10

3091.40

274.209.14009.1400

02305267 Mint-Ondansetron Mint 1030

91.40274.20

9.14009.1400

02297876 Mylan-Ondansetron Mylan 10100

91.40914.00

9.14009.1400

02264064 Novo-Ondansetron Novopharm 10100

91.40914.00

9.14009.1400

02325160 Ondansetron Pro Doc 10 91.40 9.140002306220 Ondansetron Odan Odan 10

10091.40

914.009.14009.1400

02278626 phl-Ondansetron Pharmel 10100

91.40914.00

9.14009.1400

02258196 pms-Ondansetron Phmscience 10100

91.40914.00

9.14009.1400

02312255 Ran-Ondansetron Ranbaxy 10100

91.40914.00

9.14009.1400

02278537 ratio-Ondansetron Ratiopharm 10100

91.40914.00

9.14009.1400

02274329 Sandoz Ondansetron Sandoz 10100

91.40914.00

9.14009.1400

02213575 Zofran GSK 10100

193.221932.26

19.322019.3226

02239373 Zofran ODT GSK 10 188.77 18.8770


2010-06 Page 379

OXCARBAZEPINE XXOral Susp. 60 mg/mL

02244673 Trileptal Novartis 250 ml 77.45 0.3098

Tab. 150 mg

02284294 Apo-Oxcarbazepine Apotex 100 62.09 0.464702242067 Trileptal Novartis 50 38.72 0.7744

Tab. 300 mg


Tab. 600 mg


OXYBUTYNIN XPatch 36 mg

02254735 Oxytrol Paladin 8 50.52 6.3150

OXYBUTYNINE CHLORIDE XL.A. Tab. 5 mg

02243960 Ditropan XL J.O.I. 100 178.55 1.7855

L.A. Tab. 10 mg PPB

02243961 Ditropan XL J.O.I. 100 178.55 1.785502273578 Uromax Purdue 100 130.62 1.3062

L.A. Tab. 15 mg

02273586 Uromax Purdue 100 140.67 1.4067

PARAFFIN/MINERAL OILOph. Oint. 57.3 % - 42.5 %

00210889 Lacrilube Allergan 3.5 g7 g

6.989.85

1.86291.3157

Oph. Oint. 94 % -3 %

02082519 Tears Naturale Alcon 3.5 g 4.25


Page 380 2010-06

PEGAPTANIB (SODIUM) XXSyringe 0.3 mg

02267225 Macugen Pfizer 1 995.00

PEGINTERFERON ALFA-2A XS.C. Inj.Sol (syr) 180 mcg/0.5 mL

02248077 Pegasys Roche 1 395.84

S.C. Inj.Sol (syr) 180 mcg/1 mL

02248078 Pegasys Roche 1 395.84

PENTOXIFYLLINE XL.A. Tab. 400 mg PPB

02230090 Apo-Pentoxifylline SR Apotex 100500

30.46152.30

0.30460.3046

02230401 Nu-Pentoxifylline-SR Nu-Pharm 100500

30.46152.30

0.30460.3046

01968432 ratio-Pentoxifylline Ratiopharm 60500

18.28152.30

0.30460.3046

02221977 Trental SanofiAven 60 38.93 0.6488

PILOCARPINE HYDROCHLORIDE XTab. 5 mg

02216345 Salagen Pfizer 100 104.00 1.0400

PIMECROLIMUS XTop. Cr. 1 %

02247238 Elidel Novartis 30 g60 g

62.15124.31

2.07172.0718


2010-06 Page 381

PIOGLITAZONE HYDROCHLORIDE XXTab. 15 mg

02242572 Actos Takeda 90 183.97 2.044102302942 Apo-Pioglitazone Apotex 100 108.54 1.085402302861 Co Pioglitazone Cobalt 100 108.54 1.085402326477 Mint-Pioglitazone Mint 100 108.54 1.085402298279 Mylan-Pioglitazone Mylan 90 97.69 1.085402274914 Novo-Pioglitazone Novopharm 100 108.54 1.085402307669 phl-Pioglitazone Pharmel 100 108.54 1.085402303124 pms-Pioglitazone Phmscience 100 108.54 1.085402312050 Pro-Pioglitazone Pro Doc 100 108.54 1.085402301423 ratio-Pioglitazone Ratiopharm 100

500108.54542.70

1.08541.0854

02297906 Sandoz Pioglitazone Sandoz 100 108.54 1.085402320754 Zym-Pioglitazone Zymcan 100 108.54 1.0854

Tab. 30 mg

02242573 Actos Takeda 90 257.74 2.863802302950 Apo-Pioglitazone Apotex 100 152.06 1.520602302888 Co Pioglitazone Cobalt 100 152.06 1.520602326485 Mint-Pioglitazone Mint 100 152.06 1.520602298287 Mylan-Pioglitazone Mylan 90 136.85 1.520602274922 Novo-Pioglitazone Novopharm 100

500152.06760.30

1.52061.5206

02307677 phl-Pioglitazone Pharmel 100 152.06 1.520602303132 pms-Pioglitazone Phmscience 100 152.06 1.520602312069 Pro-Pioglitazone Pro Doc 100 152.06 1.520602301431 ratio-Pioglitazone Ratiopharm 100

500152.06760.30

1.52061.5206


Tab. 45 mg

02242574 Actos Takeda 90 387.54 4.306002302977 Apo-Pioglitazone Apotex 100 228.65 2.286502302896 Co Pioglitazone Cobalt 100 228.65 2.286502326493 Mint-Pioglitazone Mint 100 228.65 2.286502298295 Mylan-Pioglitazone Mylan 90 205.79 2.286502274930 Novo-Pioglitazone Novopharm 100

500228.65

1143.252.28652.2865

02307723 phl-Pioglitazone Pharmel 100 228.65 2.286502303140 pms-Pioglitazone Phmscience 100 228.65 2.286502312077 Pro-Pioglitazone Pro Doc 100 228.65 2.286502301458 ratio-Pioglitazone Ratiopharm 100

500228.65

1143.252.28652.2865


POLYETHYLENE GLYCOL Oral Pd 1 g/g

02317680 Lax-A-Day Pendopharm 510 g 21.19 0.0415


Page 382 2010-06

POLYETHYLENE GLYCOL/ SODIUM SULFATE/ SODIUM BICARBONATE/ SODIUM CHLORIDE/ POTASSIUMCHLORIDEOral Pd 59.55 g - 5.74 g -1.69 g - 1.46 g - 0.76 g/pack of

70 g

00777838 PegLyte Phmscience 4 12.42 3.1050

POLYVINYL ALCOHOL Oph. Sol. 1.4 % (0.4 mL)

02138670 Refresh Allergan 30 9.39 0.3130

POLYVINYL ALCOHOL/ POVIDONE Oph. Sol. 1.4 % -0.6 %

00579408 Tears Plus Allergan 15 ml30 ml

6.6610.66

POSACONAZOLE XXOral Susp. 40 mg/mL

02293404 Posanol Schering 1 988.00

PSYLLIUM MUCILLOID 5Oral Pd

99002876 504 g

QUANTITATIVE PROTHROMBIN-TIME BLOOD TEST Strip

99100060 CoaguChek S Roche Diag 1248

65.00245.00

99100333 CoaguChek XS Roche Diag 62448

37.20148.80297.60

RALTEGRAVIR XTab. 400 mg

02301881 Isentress Merck 60 810.00 13.5000

RANIBIZUMAB XInj. Sol. 2.3 mg / 0.23 mL

02296810 Lucentis Novartis 1 1575.00



2010-06 Page 383

RASAGILINE MESYLATE XXTab. 0.5 mg

02284642 Azilect Teva 30 210.00 7.0000

Tab. 1 mg

02284650 Azilect Teva 30 210.00 7.0000

REPAGLINIDE XTab. 0.5 mg

02239924 GlucoNorm N.Nordisk 100 26.56 0.2656

Tab. 1 mg


Tab. 2 mg


RIBAVIRIN/ PEGINTERFERON ALFA-2A XKit 200mg -180 mcg/0.5ml

02253429 Pegasys RBV (28) Roche 1 395.8499100171 Pegasys RBV (35) Roche 1 395.8499100173 Pegasys RBV (42) Roche 1 395.84

Kit 200 mg -180 mcg/1ml

02253410 Pegasys RBV (28) Roche 1 395.8499100172 Pegasys RBV (35) Roche 1 395.8499100174 Pegasys RBV (42) Roche 1 395.84

RIBAVIRINE/ INTERFERON ALFA-2B (PEGYLATED) XKit 200 mg-50 mcg/0.5 mL

02246026 Pegetron Schering 1 752.20

Kit 200 mg-80 mcg/0.5 mL

02246027 Pegetron Schering 1 752.2002254581 Pegetron Redipen Schering 1 752.20




Page 384 2010-06





RILUZOLE XXTab. 50 mg

02242763 Rilutek SanofiAven 60 566.14 9.4357

RISPERIDONE XI.M. Inj. Pd 25 mg

02255707 Risperdal Consta J.O.I. 1 152.05

I.M. Inj. Pd 37.5 mg


I.M. Inj. Pd 50 mg


RITUXIMAB XI.V. Perf. Sol. 10 mg/mL

02241927 Rituxan Roche 10 ml50 ml

453.102265.50

RIVAROXABAN XTab. 10 mg

02316986 Xarelto Bayer 50 442.99 8.8598


2010-06 Page 385

RIVASTIGMINE XXCaps. 1.5 mg

02336715 Apo-Rivastigmine Apotex 100 130.29 1.302902242115 Exelon Novartis 56 136.50 2.437502333280 Mylan-Rivastigmine Mylan 100 130.29 1.302902305984 Novo-Rivastigmine Novopharm 56

10072.96

130.291.30281.3029

02306034 pms-Rivastigmine Phmscience 60100

78.17130.29

1.30281.3029

02311283 ratio-Rivastigmine Ratiopharm 60100

78.17130.29

1.30281.3029

02324563 Sandoz Rivastigmine Sandoz 56100

72.96130.29

1.30281.3029

Caps. 3 mg


10072.96

130.291.30281.3029


78.17130.29

1.30281.3029


78.17130.29

1.30281.3029


72.96130.29

1.30281.3029

Caps. 4.5 mg


10072.96

130.291.30281.3029


78.17130.29

1.30281.3029


78.17130.29

1.30281.3029


72.96130.29

1.30281.3029

Caps. 6 mg


10072.96

130.291.30281.3029


78.17130.29

1.30281.3029


78.17130.29

1.30281.3029


72.96130.29

1.30281.3029


Page 386 2010-06

Oral Sol. 2 mg/mL

02245240 Exelon Novartis 120 ml 153.02 1.2752

Patch 4.6 mg/24H

02302845 Exelon Patch 5 Novartis 30 128.70 4.2900

Patch 9.5 mg/24H

02302853 Exelon Patch 10 Novartis 30 128.70 4.2900

ROSIGLITAZONE MALEATE XXTab. 2 mg

02241112 Avandia GSK 60 76.76 1.2793

Tab. 4 mg

02241113 Avandia GSK 100 200.73 2.0073

Tab. 8 mg

02241114 Avandia GSK 60 172.24 2.8707

ROSIGLITAZONE MALEATE/ METFORMIN HYDROCHLORIDE XTab. 1 mg - 500 mg

02247085 Avandamet GSK 100 62.16 0.6216

Tab. 2 mg - 500 mg

02247086 Avandamet GSK 100 112.40 1.1240

Tab. 2 mg - 1000 mg

02248440 Avandamet GSK 100 122.76 1.2276

Tab. 4 mg - 500 mg

02247087 Avandamet GSK 100 153.33 1.5333

Tab. 4 mg - 1000 mg

02248441 Avandamet GSK 100 167.31 1.6731

SALBUTAMOL SULFATE XInh. Pd 200 mcg/coque

02243115 Ventolin Diskus GSK 60 dose(s) 13.17


2010-06 Page 387

SALMETEROL XINAFOATE/ FLUTICASONE PROPIONATE XXInh. Pd 50 mcg-100 mcg/coque

02240835 Advair 100 Diskus GSK 60 dose(s) 75.79

Inh. Pd 50 mcg-250 mcg/coque


Inh. Pd 50 mcg-500 mcg/coque


Oral aerosol 25 mcg -125 mcg/dose

02245126 Advair 125 GSK 120 dose(s) 90.69

Oral aerosol 25 mcg -250 mcg/dose

02245127 Advair 250 GSK 120 dose(s) 128.74

SAXAGLIPTIN XTab. 5 mg

02333554 Onglyza B.M.S. 30100

69.00230.00

2.30002.3000

SENNOSIDES A & BSyr. 8.5 mg/5 mL

00367729 Senokot Purdue 250 ml500 ml

7.9616.91

0.03180.0338

Tab. 8.6 mg PPB

02247389 Euro-Senna Euro-Pharm 1000 46.40 0.046480009595 Jamp-Senna Jamp 100

5004.64

23.200.04640.0464

80009182 Jamp-Sennosides Coated Jamp 500 23.20 0.046402298090 phl-Sennosides Pharmel 100

10004.64

46.400.04640.0464

00896411 pms-Sennosides Phmscience 1001000

4.6446.40

0.04640.0464

01949292 Riva-Senna Riva 1001000

4.6446.40

0.04640.0464

02068109 Sennatab Phmscience 1000 46.40 0.046402089653 Sennosides Sandoz 500 23.20 0.0464


Page 388 2010-06

Tab. 12 mg PPB

80009183 Jamp-Sennosides Coated Jamp 500 27.75 0.055502298104 phl-Sennosides Pharmel 100

10006.93

55.500.06930.0555

00896403 pms-Sennosides Phmscience 1001000

6.9355.50

0.06930.0555

02089645 Sennosides Sandoz 500 27.75 0.0555

SEVELAMER HYDROCHLORIDE XXTab. 800 mg

02244310 Renagel Genzyme 180 269.83 1.4991

SILDENAFIL CITRATE XTab. 20 mg

02279401 Revatio Pfizer 90 937.80 10.4200

SITAGLIPTIN XTab. 100 mg

02303922 Januvia Merck 30100

76.50255.00

2.55002.5500

SITAGLIPTIN/METFORMIN XTab. 50 mg -500 mg

02333856 Janumet Merck 60 82.20 1.3700

Tab. 50 mg -850 mg

02333864 Janumet Merck 60 82.20 1.3700

Tab. 50 mg -1000 mg

02333872 Janumet Merck 60 82.20 1.3700

SITAXSENTAN SODIUM XTab. 100 mg

02295636 Thelin Pfizer 28 3528.00 126.0000

SODIUM CITRATE/ SODIUM LAURYLSULFOACETATE/ SORBITOL Rect. Sol. 90 mg/mL - 9 mg/mL - 625 mg/mL

02063905 Microlax McNeil Co 1250

12.5044.00

1.04170.8800


2010-06 Page 389

SODIUM PHOSPHATE MONOBASIC/ SODIUM PHOSPHATE DIBASICPed. Rect. Sol. 160 mg -60 mg/mL

00108065 Fleet Pediatrique J&J Merck 65 ml 3.77

Rect. Sol. 16 g -6 g/100 mL

00009911 Fleet J&J Merck 130 ml 3.75

SOLIFENACIN SUCCINATE XXTab. 5 mg

02277263 Vesicare Astellas 3090

45.00135.00

1.50001.5000

Tab. 10 mg

02277271 Vesicare Astellas 3090

45.00135.00

1.50001.5000

SOMATOTROPHIN XCartridge 6 mg

02243077 Humatrope Lilly 1 280.02

Cartridge 10 mg

02249002 Nutropin AQ Pen Roche 1 389.44

Cartridge 12 mg


Cartridge 24 mg


Inj. Pd 3.33 mg

02215136 Saizen Serono 1 133.75

Inj. Pd 5 mg

00745626 Humatrope Lilly 1 233.3502216183 Nutropin Roche 1 194.7202237971 Saizen Serono 1 204.34

Inj. Pd 8.8 mg

02272083 Saizen Serono 1 348.03


Page 390 2010-06

Inj. Pd 10 mg

02216191 Nutropin Roche 1 389.44

Inj. Sol. 5 mg/mL (2 mL)

02229722 Nutropin AQ Roche 1 389.44 389.4400

SOMATROPIN XXCartridge 5 mg/1.5 mL

02325063 Omnitrope Sandoz 15

155.80779.00 155.8000

Cartridge 10 mg/1.5 mL

02325071 Omnitrope Sandoz 15

311.601558.00 311.6000

SUNITINIB (MALATE) XCaps. 12.5 mg

02280795 Sutent Pfizer 28 1737.00 62.0357

Caps. 25 mg

02280809 Sutent Pfizer 28 3473.99 124.0711

Caps. 50 mg

02280817 Sutent Pfizer 28 6947.99 248.1425

TACROLIMUS XTop. Oint. 0.03 %

02244149 Protopic Astellas 30 g60 g

64.50129.00

2.15002.1500

Top. Oint. 0.1 %

02244148 Protopic Astellas 30 g60 g

69.00138.00

2.30002.3000

TADALAFIL XTab. 20 mg

02338327 Adcirca Lilly 56 732.06 13.0725


2010-06 Page 391

TEMOZOLOMIDE XXCaps. 5 mg

02241093 Temodal Schering 5 36.72 7.3440

Caps. 20 mg


Caps. 100 mg


Caps. 140 mg

02312794 Temodal Schering 520

1028.154112.58

205.6300205.6290

Caps. 180 mg

02312816 Temodal Schering 520

1321.905287.61

264.3800264.3805

Caps. 250 mg


TERIPARATIDE XS.C. Inj. Sol. 250 mcg/mL (2.4 mL or 3 mL)

02254689 * Forteo Lilly 1 788.75

TIGECYCLINE XI.V. Perf. Pd 50 mg

02285401 Tygacil Wyeth 10 827.32 82.7320

TIPRANAVIR XCaps. 250 mg

02273322 Aptivus Bo. Ing. 120 990.00 8.2500

TIZANIDINE HYDROCHLORIDE XTab. 4 mg

02259893 Apo-Tizanidine Apotex 100 37.51 0.375102272059 Mylan-Tizanidine Mylan 150 56.26 0.375102239170 Zanaflex Paladin 150 108.46 0.7231


Page 392 2010-06

TOBRAMYCIN SULFATE XXSol. Inh. 300 mg/5 mL

02239630 Tobi Novartis 56 2835.00 50.6250

TOCOPHERYL ACETATE (DL-ALPHA) 5Caps. 100 UI

99002396 100

Caps. 200 UI

99002418 100

Caps. 400 UI

99002426 100

Chew. Tab. 200 UI

99100202 90

Oral Sol. 50 UI/mL

99002469 25 ml

Oral Sol. 77 UI/mL

99002477 150 ml

TOLTERODINE L-TARTRATE XL.A. Caps. 2 mg

02244612 Detrol LA Pfizer 3090

54.60163.80

1.82001.8200

L.A. Caps. 4 mg

02244613 Detrol LA Pfizer 3090

54.60163.80

1.82001.8200

Tab. 1 mg

02239064 Detrol Pfizer 60500

54.60455.00

0.91000.9100



2010-06 Page 393

Tab. 2 mg

02239065 Detrol Pfizer 60500

54.60455.00

0.91000.9100

TRANDOLAPRIL/ VERAPAMIL HYDROCHLORIDE XXTab. 2 mg -240 mg

02240946 Tarka Abbott 100 168.76 1.6876

Tab. 4 mg -240 mg

02238097 Tarka Abbott 100 187.28 1.8728

TRAVOPROST/ TIMOLOL (MALEATE OF) XOph. Sol. 0.004 % - 0.5 %

02278251 DuoTrav Alcon 2.5 ml5 ml

30.6061.20

TREPROSTINIL SODIUM XInj. Sol. 1 mg/mL

02246552 Remodulin U.T.C. 20 ml 900.00

Inj. Sol. 2.5 mg/mL

02246553 Remodulin U.T.C. 20 ml 2250.00

Inj. Sol. 5 mg/mL

02246554 Remodulin U.T.C. 20 ml 4500.00

Inj. Sol. 10 mg/mL

02246555 Remodulin U.T.C. 20 ml 9000.00

TRETINOIN X

Top. Cr. 0.01 % PPB

00897329 Retin-A J.O.I. 30 g 10.68 0.356000657204 Stieva-A Stiefel 45 g 13.13 0.2918

Top. Cr. 0.025 % PPB



Page 394 2010-06

Top. Cr. 0.05 % PPB


Top. Cr. 0.1 % PPB

00870021 Retin-A J.O.I. 30 g 10.68 0.356000662348 Stieva-A Forte Stiefel 45 g 13.13 0.2918


00870013 Retin-A J.O.I. 30 g 10.36 0.345301926462 Vitamin A Acid Gel Doux SanofiAven 25 g 7.10 0.2840


00443816 Retin-A J.O.I. 30 g 10.36 0.345300587966 Stieva-A Stiefel 45 g 13.13 0.291801926470 Vitamin A Acid Gel SanofiAven 25 g 7.10 0.2840


00641863 Stieva-A Stiefel 45 g 13.13 0.291801926489 Vitamin A Acid Gel SanofiAven 25 g 7.10 0.2840

Top. Sol. 0.025 %

00578568 Stieva-A Stiefel 50 ml 9.15

TROSPIUM CHLORIDE XXTab. 20 mg

02275066 Trosec Sepracor 60 45.00 0.7500

USTEKINUMAB XS.C. Inj. Sol. 45 mg/0.5 mL

02320673 Stelara J.O.I. 1 4200.00

VALGANCICLOVIR HYDROCHLORIDE XOral Susp. 50 mg/mL

02306085 Valcyte Roche 100 ml 249.00 2.4900

Tab. 450 mg

02245777 Valcyte Roche 60 1344.60 22.4100


2010-06 Page 395

VERTEPORFIN XXI.V. Inj. Pd 15 mg

02242367 Visudyne Novartis 1 1791.30

VORICONAZOLE XI.V. Perf. Pd 10 mg/mL

02256487 Vfend Pfizer 1 140.00 140.0000

Tab. 50 mg

02256460 Vfend Pfizer 30 356.40 11.8800

Tab. 200 mg

02256479 Vfend Pfizer 30 1425.00 47.5000

ZOLEDRONIC ACID XI.V. Perf. Sol. 4 mg/5 mL

02248296 Zometa Novartis 5 ml 538.45

I.V. Perf. Sol. 5 mg/ 100 mL

02269198 Aclasta Novartis 1 660.22


Page 396 2010-06

SUPPLIES

SUPPLIES 6

AEROSOL HOLDING CHAMBER

99002116 1

AEROSOL HOLDING CHAMBER AND MASK

99002124 1

DISPOSABLE NEEDLE FOR INSULIN AUTO-INJECTOR

99002108 1

DISPOSABLE NEEDLE WITH SAFETY DEVICE FOR INSULIN AUTO-INJECTOR 9

99100517 1

DISPOSABLE SYRINGE (WITHOUT NEEDLE) 1.0 cc

99002337 1

2.0 cc

99002531 1

3 cc

99002175 1

5 cc

99002183 1

10 cc

99002191 1


9 This type of supply is reimbursable for persons carrying a blood-borne infection.


2010-06 Page 399

DISPOSABLE SYRINGE WITH NEEDLE FOR INSULIN 0.25 cc

99002132 1

0.3 cc

99002140 1

0.5 cc

99002159 1

1.0 cc

99002167 1

DISPOSABLE SYRINGE WITH NEEDLE(S) 1.0 cc

99002345 1

2.0 cc

99002558 1

3 cc

99002205 1

5 cc

99002213 1

10 cc

99002221 1

MASK FOR AEROSOL HOLDING CHAMBER

99003643 1


Page 400 2010-06

PRODUCTS FOR EXTEMPORANEOUSPREPARATIONS

PRODUCTS FOR EXTEMPORANEOUS PREPARATIONS 6

AMPHOTERICIN B XXInj. Pd 50 mg

99100416 20 ml

COLLOIDAL SULFUR

00901725 50 g

CYCLOSPORINE XInj. Sol.

99100387 1

ERYTHROMYCIN XPd (external use)

99100163 2 g

HYDROCORTISONE

00900761 5 g

HYDROCORTISONE ACETATE X

00906689 10 g

LIQUOR CARBONIS DETERGENS

00903256 500 ml

METHADONE HYDROCHLORIDE Z

00907561 Methadone 25 g100 g



2010-06 Page 403

MITOMYCINE XXInj. Pd

99004518 1

PRECIPITATED SULFUR

00901733 500 g

SALICYLIC ACID

00901164 50 g

SUBLIMED SULFUR

00896217 125 g

TAR (MINERAL)

00897361 25 g

TAR (WOOD)

00908169 100 ml

VANCOMYCIN HYDROCHLORIDE XPd

99100176 1 g


Page 404 2010-06

VEHICLES, SOLVENTS OR ADJUVANTS

VEHICLES, SOLVENTS OR ADJUVANTS 6

ANHYDROUS SODIUM CITRATE

99002779 100 g

ARTIFICIELOph. Sol.

00921270 15 ml

BASES/ EMULSIONS

02009609 Aquaphor 396 g99002825 Cliniderm 85 g

454 g00896624 Cold Cream 450 g00902918 Dermabase (creme) 460 g99000385 Glaxal Base (creme) 50 g

100 g450 g

00837776 Schering Base (creme) 450 g00403342 Surfa Base (creme) 500 g

CARBOXYMETHYLCELLULOSE SODIUM

00897175 100 g

CASSETTE OR BAG FOR ADMINISTRATION DEVICE

99002248 1

CHLOROFORM

99002752 100 ml

CITRIC ACIDPd

99001500 50 g



2010-06 Page 407

DEXTROSEInj. Sol. 5 %

99002256 500 ml1000 ml

DEXTROSE (MINI-BAGS)Inj. Sol. 5 %

00921289 25 ml50 ml

100 ml250 ml

DISPOSABLE NEEDLE FOR SYRINGUES XX

99005077 100

DISTILLED WATER

00906719 4550 ml

ELASTOMERIC INFUSOR (CONTINUOUS)

99002280 1

ELASTOMERIC INFUSOR (INTERMITENT)

99002272 1

EMPTY BAG FOR IV SOLUTIONS Bag

99002299 1

ETHANOLLiq. 95 %

99002388 750 ml


Page 408 2010-06

GELATIN (EMPTY CAPSULE) Caps.

99001519 1

GLYCERIN 5

00903159 100 ml

GLYCINE/ SODIUM CHLORIDE 94 mg -73.3 mg

02230857 Flolan (diluant pour) GSK 50 ml 10.36

HYDRATED LANOLIN

00902659 450 g

LACTOSE

00900834 500 g

MAGNESIUM HYDROXIDE / ALUMINUM HYDROXIDEOral Susp. 400 mg -400 mg/5 mL

99003376 350 ml

MAGNESIUM HYDROXIDE/ ALUMINIUM HYDROXIDE/ SIMETHICONEOral Susp. 400 mg - 400 mg - 40 mg/5 mL

99100243 350 ml

METHYLCELLULOSE

00902365 100 g

Pd 1 500 cps

99001527 500 g



2010-06 Page 409

MINERAL OIL

00906654 500 ml

PROPYLENE GLYCOL

00903353 500 ml

SIMPLE SYRUP

00905038 500 ml

SODIUM BENZOATEPd

99001535 100 g

SODIUM BICARBONATE Pd

99100058 100 g

SODIUM CHLORIDEFlush. sol. 0.9 %

99100499 BD Saline SP NaCl 0.9 % B-D 3 ml5 ml

10 ml

0.900.951.00

Inj. Sol. 0.9 %

99002310 500 ml1000 ml

SODIUM CHLORIDE (SMALL VOLUMES) Inj. Sol. 0.9 %

99002329 5 ml10 ml20 ml50 ml


Page 410 2010-06

SODIUM CHLORIDE INHALATION THERAPY0.9 %

00801267 3 ml

SODIUM CHLORURE MINI-SACInj. Sol. 0.9 %

00921300 25 ml50 ml

100 ml250 ml

SOFT WHITE PARAFFIN

00902691 450 g

SOFT YELLOW PARAFFIN

00902683 454 g

SORBITOL

99000555 100 g

STERILE WATER FOR INJECTION PPB

99100407 250 ml500 ml

1000 ml2000 ml

STERILE WATER FOR INJECTION (SMALL VOLUMES)

99002264 5 ml10 ml20 ml50 ml


2010-06 Page 411

STERILE WATER INHALATION THERAPY

00920282 3 ml5 ml

SWEET ALMOND OIL

00907448 100 ml

SWEETENERS (VARIOUS FLAVOURS)

99002353 500 ml

SYRINGE FOR ADMINISTRATION DEVICE

99002302 1

TRAGACANTH Pd

99002361 100 g

VEHICLES FOR ORAL SUSPENSIONS Oral Susp.

99003171 Ora-Plus 473 ml99003198 Ora-Sweet 473 ml99003201 Ora-Sweet SF 473 ml99003228 Vehicule H.S.C. 250 ml

WATER FOR INJECTION (INHALATION THERAPY)

00905178 2 ml10 ml30 ml50 ml

00905186 5 ml

WATER FOR INJECTION/ BENZYL ALCOHOL 0.9%

00906077 30 ml


Page 412 2010-06

WATER FOR INJECTION/ BENZYL ALCOHOL 1.5 %

00402257 30 ml50 ml

WATER FOR INJECTION/ PARABENS

00905445 30 ml

XANTHAN GUM

99002760 100 g


2010-06 Page 413

List of Medications - BAnQ

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