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Ministry Status: Routine Monitoring and Engagement

Formulary

Exceptional Access Program (EAP)

The Individual Clinical Review process is being phased out and a more streamlined Exceptional Access Program (EAP) has been created to handle requests for drugs that are not listed in the Formulary. For more information please visit the EAP section.

Drug Benefit Prices (DBPs) for products reimbursed under the EAP

Pursuant to section 15 of O.Reg. 201/96 made under the Ontario Drug Benefit Act (ODBA), the Executive Officer (EO) has entered into agreements with manufacturers to establish Drug Benefit Prices (DBPs) for products reimbursed under the Exceptional Access Program (EAP).

For the following products reimbursed under the EAP, the Health Network System (HNS) will adjudicate claims at the DBP listed below.

 

DIN Trade Name Strength Dosage Form DBP
Effective date April 29, 2016
02339501 Afinitor 5mg Tab $200.0850
02339528 Afinitor 10mg Tab $200.0850
02369257 Afinitor 2.5mg Tab $200.0850
09857395 Avonex Pen 30mcg/0.5mL Pref AutoInj Pen $423.3925
02269201 Avonex PS 30mcg/0.5mL Pref Syr $423.3925
02419149 Bosulif 100mg Tab $37.6511
02419157 Bosulif 500mg Tab $150.5839
02252716 Ciprodex 0.3% & 0.1% Otic Susp-7.5mL Pk $28.8400
02299909 Cubicin 500mg/10mL Pd for Inj -10mL Vial Pk $182.5000
02242903 Enbrel 25mg/Vial Inj Pd-Vial Pk $202.9300
02274728 Enbrel 50mg/mL Inj Pref Syr $405.9850
09857394 Enbrel SureClick 50mg/mL Pref AutoInj $405.9850
02409267 Erivedge 150mg Cap $302.8089
02393751 Esbriet 267mg Cap $13.2908
02287420 Exjade 125mg Tab For Susp $10.8503
02287439 Exjade 250mg Tab For Susp $21.7003
02287447 Exjade 500mg Tab For Susp $43.4010
02337819 Extavia 0.3mg Pd for Inj - Vial Pk $102.3400
02287145 Fosrenol 250mg Chew Tab $1.1564
02287153 Fosrenol 500mg Chew Tab $2.3131
02287161 Fosrenol 750mg Chew Tab $3.4808
02287188 Fosrenol 1000mg Chew Tab $4.6148
02247725 Fuzeon 108mg/Vial Inj-3mL Vial Pk $40.9202
02389630 Inlyta 1mg Tab $19.4262
02389649 Inlyta 5mg Tab $97.1310
02388006 Jakavi 5mg Tab $84.0739
02388014 Jakavi 15mg Tab $84.0739
02388022 Jakavi 20mg Tab $84.0739
02245913 Kineret 150mg/mL Inj Pref Syr-0.67mL Pk $48.0571
02409623 Mekinist 0.5mg Tab $74.6750
02409658 Mekinist 2mg Tab $298.7000
02322854 Nplate 250mcg/0.5mL Pd for Inj-Vial Pk $970.8000
02322862 Nplate 500mcg/1mL Pd for Inj-Vial Pk $1,941.6100
02399083 Nutropin AQ
NuSpin 20
20mg/2mL Inj Sol-20mg Cart Pk $790.9400
02399091 Nutropin AQ
NuSpin 5
5mg/2mL Inj Sol-5mg Cart Pk $197.7400
02372525 OxyNEO 10mg CR Tab $0.9115
02372533 OxyNEO 15mg CR Tab $1.1010
02372797 OxyNEO 20mg CR Tab $1.3675
02372541 OxyNEO 30mg CR Tab $1.8070
02372568 OxyNEO 40mg CR Tab $2.3710
02248077 Pegasys 180mcg/0.5mL Pref Syr-0.5mL Pk $407.3900
09857505 Pegasys ProClick
Autoinjector
180mcg/0.5mL Pref AutoInj-0.5mL Pk $407.3900
02253429 Pegasys RBV 0.5mL Pref Syr & 42 Tabs Combination Pk $407.3900
09857418 Pegasys RBV 0.5mL Pref Syr & 28 Tabs Combination Pk $407.3900
09857420 Pegasys RBV 0.5mL Pref Syr & 35 Tabs Combination Pk $407.3900
09857421 Pegasys RBV 0.5mL 4 Pref Syr Pk & 196 Tabs Combination Pk $1,629.5600
09857506 Pegasys RBV ProClick
Autoinjector
180mcg/0.5mL & 200mg x 28 Tabs Combination Pk $407.3900
09857507 Pegasys RBV ProClick
Autoinjector
180mcg/0.5mL & 200mg X 35 Tabs Combination Pk $407.3900
09857509 Pegasys RBV ProClick
Autoinjector
180mcg/0.5mL & 200mg X 42 Tabs Combination Pk $407.3900
09857510 Pegasys RBV ProClick
Autoinjector
4X180mcg/0.5mL & 200mgX196 Tabs Combination Pk $1,629.5600
02046733 Pulmozyme 1mg/mL Inj-2.5mL Pk $39.3893
02361825 Revolade 25mg Tab $64.3121
02361833 Revolade 50mg Tab $128.6250
02241927 Rituxan 10mg/mL Inj-10mL Vial Pk $466.3200
09857407 Rituxan 10mg/mL Inj-50mL Vial Pk $2,331.6100
02257130 Sensipar 30mg Tab $11.9937
02257149 Sensipar 60mg Tab $21.8707
02257157 Sensipar 90mg Tab $31.8253
02409607 Tafinlar 50m Cap $43.4889
02409615 Tafinlar 75mg Cap $65.2333
02368250 Tasigna 150mg Cap $29.1180
02315874 Tasigna 200mg Cap $40.9129
02404508 Tecfidera 120mg DR Cap $16.8464
02420201 Tecfidera 240mg DR Cap $33.6929
02286386 Tysabri 300mg/15mL Inj Sol-15mL Vial Pk $3,295.8900
02240325 Xenical 120mg Cap $1.6574
02368153 Xgeva 120mg/1.7mL Inj Sol-Vial Pk $584.3500
02260565 Xolair 150mg Inj Pd-5mL Vial Pk $624.2400
02407329 Xtandi 40mg Tab $29.1954
02380242 Zelboraf 240mg Tab $34.1355
Effective date March 30, 2016
02298791 Emend 80mg Cap $32.4033
02298805 Emend 125mg Cap $32.4033
02330695 Eraxis 100mg/Vial Inj Pd-Vial Pk $213.8800
09854785 Humira (Pediatric) 40mg/0.8mL Inj Sol-Vial Pk Fo $769.9700
02254581 Pegetron Clearclick 80mcg/0.5mL & 200mg/Cap Inj Pd & 56 Caps Combination Kit $802.9900
02254603 Pegetron Clearclick 100mcg/0.5mL & 200mg/Cap Inj Pd & 56 Caps Combination Kit $802.9900
02254638 Pegetron Clearclick 120mcg/0.5mL & 200mg/Cap Inj Pd & 70 Caps Combination Kit $887.3000
02254646 Pegetron Clearclick 150mcg/0.5mL & 200mg/Cap Inj Pd & 84 Caps Combination Kit $887.3000
Effective date February 25, 2016
01968017 Neupogen 300mcg/mL 1mL Vial Injection 173.1890
09853464 Neupogen 480mcg/1.6mL 1.6mL Vial Injection 277.1020
Effective date January 28, 2016
02240521 Maxalt 10mg Tab $17.8665
02240518 Maxalt RPD 5mg Orally Disintegrating Tab $17.8665
02240519 Maxalt RPD 10mg Orally Disintegrating Tab $17.8665
02387174 Dificid 200mg Tab $94.60
02324784 Simponi 50mg/0.5mL Auto-Injector $1,555.17
02324776 Simponi 50mg/0.5mL Pre-Filled Syringe $1,555.17
Effective date December 11, 2015
02439212 Ibavyr 200mg Tab $7.2500
Effective date November 26, 2015
02416328 Aubagio 14mg Tab $55.6875
Effective date November 17, 2015
09857535 Forteo 250mcg/mL 2.4mL Pref Pen $897.2500
02237319 Rebif 22mcg Inj-Syr Pk $131.4202
02237320 Rebif 44mcg Inj-Syr Pk $159.9904
02318253 Rebif 66mcg Inj-Syr Pk $394.2530
02318261 Rebif 132mcg Inj-Syr Pk $479.9610
Effective date November 5, 2015
02425696 Firazyr 30mg/3mL Pre-filled syringe $2,700.0000
Effective date July 14, 2015
02434407 Imbruvica 140mg Cap $90.6500
Effective date July 10, 2015
02334852 Norditropin Nordiflex 5mg/1.5mg Inj Sol-Pref Pen $194.7000
02334860 Norditropin Nordiflex 10mg/1.5mg Inj Sol-Pref Pen $389.4000
02334879 Norditropin Nordiflex 15mg/1.5mg Inj Sol-Pref Pen $584.1000
Effective date June 29, 2015
02436027 Holkira Pak 12.5mg & 75mg & 50mg & 250mg 4 Tab Combi Pk $665.0000
Effective date June 22, 2015
02398958 Diacomit 250mg Cap $5.8984
02398966 Diacomit 500mg Cap $11.7783
02398974 Diacomit 250mg/Pk Pd for Oral Susp $5.8984
02398982 Diacomit 500mg/Pk Pd for Oral Susp $11.7783
Effective date April 30, 2015
02350092 Actemra 80mg/4mL Inj Sol-Vial Pk $180.8100
02350106 Actemra 200mg/10mL Inj Sol-Vial Pk $452.0300
02350114 Actemra 400mg/20mL Inj Sol-Vial Pk $904.0600
02365480 Gilenya 0.5mg Cap $85.1650
02293129 Sprycel 20mg Tab $38.6850
02293137 Sprycel 50mg Tab $77.8567
02293145 Sprycel 70mg Tab $85.8042
02320193 Sprycel 100mg Tab $155.6083
Effective date April 16, 2015
02424622 Posanol 100mg DR Tab $46.7230
Effective date March 31, 2015
02246026 Pegetron 50mcg & 0.5mL & 200mg/Cap Inj Pd & 56 Caps C $793.4700
02246030 Pegetron 150mcg & 0.5mL & 200mg/Cap Inj Pd & 84 Caps C $876.7800
Effective date March 24, 2015
02432226 Harvoni 90mg/400mg Tab $797.6190
Effective date March 20, 2015
02425890 Ibavyr 400mg Tab $14.5000
02425904 Ibavyr 600mg Tab $21.7500
Effective date February 26, 2015
02403390 Stivarga 40mg Tab $72.6200
Effective date February 23, 2015
02418355 Sovaldi 400mg Tab $654.7619
Effective date February 11, 2015
02412764 Adempas 0.5mg Tab $42.7500
02412772 Adempas 1mg Tab $42.7500
02412799 Adempas 1.5mg Tab $42.7500
02412802 Adempas 2mg Tab $42.7500
02412810 Adempas 2.5mg Tab $42.7500
Effective date February 6, 2015
02419580 Pomalyst 1mg Cap $500.0000
02419599 Pomalyst 2mg Cap $500.0000
02419602 Pomalyst 3mg Cap $500.0000
02419610 Pomalyst 4mg Cap $500.0000
Effective date January 28, 2015
02371065 Zytiga 250mg Tablet $29.5910
Effective date December 18, 2014
02322285 Soliris 10mg/mL 30mL vial for IV injection $6,742.0000
Effective date September 9, 2014
02416441 Galexos 150mg Cap $434.5500
Effective date August 19, 2014
02415666 Giotrif 20mg Tab $73.3000
02415674 Giotrif 30mg Tab $73.3000
02415682 Giotrif 40mg Tab $73.3000
Effective date July 6, 2014
02401703 Genotropin Go Quick 5.3mg powder for solution Pre-filled pen $147.8700
02401711 Genotropin Go Quick 12mg powder for solution Pre-filled pen $334.8000
02401762 Genotropin MiniQuick 0.6mg powder for solution Prefilled syringe $16.7400
02401770 Genotropin MiniQuick 0.8mg powder for solution Prefilled syringe $22.3200
02401789 Genotropin MiniQuick 1.0mg powder for solution Prefilled syringe $27.9000
02401797 Genotropin MiniQuick 1.2mg powder for solution Prefilled syringe $33.4800
02401800 Genotropin MiniQuick 1.4mg powder for solution Prefilled syringe $39.0600
02401819 Genotropin MiniQuick 1.6mg powder for solution Prefilled syringe $44.6400
02401827 Genotropin MiniQuick 1.8mg powder for solution Prefilled syringe $50.2200
02401835 Genotropin MiniQuick 2.0mg powder for solution Prefilled syringe $55.8000
Effective date June 20, 2014
02397412 Kalydeco 150mg Tab $420.0000
Effective date June 16, 2014
02292165 Duodopa 25mg/mL & 5mg/mL Intestinal Gel (100mL Cassette) $166.0000
Effective date May 29, 2014
02293404 Posanol 40mg/mL O/L $9.3446
Effective date May 2, 2014
00745626 Humatrope 1mg / mL 5mg Vial $233.3500
02243077 Humatrope 3.15mL 6mg Cartridge $280.0200
02243078 Humatrope 3.15mL 12mg Cartridge $560.0400
02243079 Humatrope 3.15mL 24mg Cartridge $1,120.0800
Effective date April 30, 2014
00800430 Vancocin 125mg Cap $5.3485
00788716 Vancocin 250mg Cap $10.6875
02338327 Adcirca 20mg Tab $13.4970
Effective date April 16, 2014
02371553 Incivek 375mg Tab $69.3810
Effective date January 30, 2014
02244016 Remicade 100mg/10mL Injection $987.5600
09852956 Remicade 100mg/10mL Injection
(Compounded)
$987.5600
02284227 Nexavar 200mg Tab $46.4689
02280795 Sutent 12.5mg Cap $64.4157
02280809 Sutent 25mg Cap $128.8303
02280817 Sutent 50mg Cap $257.6610
Effective date December 18, 2013
02397447 Caripul 0.5mg per Vial Powder for Sol $17.1760
02397455 Caripul 1.5mg per Vial Powder for Sol $34.4470
Effective date December 17, 2013
02352303 Votrient 200mg Tab $34.4100
Effective date October 01, 2013
02384256 Xalkori 200mg Tab $146.6667
02384264 Xalkori 250mg Tab $146.6667
Effective date April 30, 2013
02242572 Actos 15mg Tablet $2.5070
02242573 Actos 30mg Tablet $3.5124
02242574 Actos 45mg Tablet $5.2710
02245619 Copaxone 20mg/mL Inj Pref Syr-1mLPk $44.4960
02249002 Nutropin AQ 10mg/2mL Inj-10mg Pen Cart $395.4700
02376393 Nutropin AQ NuSpin 10 10mg/2mL Inj Disposable Pen $395.4700
02017733 PhisoHex 3% Top Emuls $0.0558
02215136 Saizen 3.33mg Inj Pd-3.33mg Vial Pk with diluent $149.2500
02237971 Saizen 5mg Inj Pd-5mg vial Pk with Diluent $224.0500
02272083 Saizen 8.8mg Inj Pd-8.8mg Vial Pk $358.4700
02350122 Saizen 6mg/Cart (5.83mg/mL) Inj Cart $268.8300
02350130 Saizen 12mg/Cart (8mg/mL) Inj Cart $537.6600
02350149 Saizen 20mg/Cart (8mg/mL) Inj Cart $896.1000
Effective date March 20, 2013
02241093 Temodal 5mg Cap $7.8000
02241094 Temodal 20mg Cap $31.2000
02241095 Temodal 100mg Cap $156.0060
02312794 Temodal 140mg Cap $218.4100
02241096 Temodal 250mg Cap $390.0040
Effective date February 28, 2013
02258595 Humira 40mg/0.8mL Prefilled Syringe $740.3600
09857294 Humira 40mg/0.8mL Prefilled Pen $740.3600
Effective date February 20, 2013
02350580 Kuvan 100mg Tab $33.0000
Effective date December 21, 2012
02369613 Banzel 100mg Tab $0.7182
02369621 Banzel 200mg Tab $1.4364
Effective date September 13, 2012
02355191 Thalomid 50mg Cap $29.4690
02355205 Thalomid 100mg Cap $58.9380
02355221 Thalomid 200mg Cap $117.8800
Effective date September 1, 2012
02329840 Cayston 75mg/vial Pd Inh Sol- Vial Pk $48.1564
Effective date August 27, 2012
02325063 Omnitrope 5mg/1.5mL Inj-5mg Pen Cart Pk $155.8000
02325071 Omnitrope 10mg/1.5mL Inj-10mg Pen Cart Pk $311.6000
Effective date July 10, 2012
02369648 Banzel 400mg Tab $3.1298
Effective date March 26, 2012
02357380 Uloric 80mg Tab $1.5900
Effective date March 19, 2012
02344939 Ilaris 150mg Powder for solution for sc injection (vial) $106.6667/mg
Effective date November 14, 2011
02326442 Tykerb 250mg Tablet $23.5000
Effective date October 28, 2011
02370816 Victrelis 200mg Cap $12.5000
02371448 Victrelis Triple 200mg Cap &
200mg Cap &
80mcg Inj Pd
168 Caps &
56 Caps &
2 Clearclicks, Combination Kit
$2,652.5500
02371456 Victrelis Triple 200mg Cap &
200mg Cap &
100mcg Inj Pd
168 Caps &
56 Caps &
2 Clearclicks, Combination Kit
$2,652.5500
02371464 Victrelis Triple 200mg Cap &
200mg Cap &
120mcg Inj Pd
168 Caps &
70 Caps &
2 Clearclicks, Combination Kit
2,726.0000
02371472 Victrelis Triple 200mg Cap &
200mg Cap &
150mcg Inj Pd
168 Caps &
84 Caps &
2 Clearclicks, Combination Kit
$2,726.0000
09857396 Victrelis Triple 200mg Cap &
200mg Cap &
150mcg Inj Pd
168 Caps & 98 Caps &
2 Clearclicks, Combination Kit
$2,726.0000
Effective date October 27, 2011
02357119 Vpriv® 400U Vial $1955.0000
Effective date September 16, 2011
02248676 Iressa 250mg Tablet $73.3000
Effective date September 30, 2010
02331675 Cimzia 200mg/mL Pre-Filled Syringe $664.5100
Effective date September 9, 2010
02250519 Zavesca 100mg Cap $108.5479
Effective date February 10, 2010
02284642 Azilect 0.5mg Tab $7.0000
02284650 Azilect 1mg Tab $7.0000
Effective date January 5, 2010
01981501 Botox 100U/Vial Pd Inj-100U
Vial Pk
$357.0000
Effective date October 8, 2009
02169649 Betaseron Inj Pref Syr - 0.3mg Injection $110.0000
Effective date July 22, 2009
02317699 Revlimid 15mg Cap $382.0000
02317710 Revlimid 25mg Cap $424.0000
Effective date June 11, 2009
02284863 Myozyme 50mg/vial Lyophylized Powder $840.3100
Effective date June 1, 2009
02241112 Avandia 2mg Tab $1.3755
02241113 Avandia 4mg Tab $2.1584
02241114 Avandia 8mg Tab $3.0866
Effective date May 27, 2009
02296314 Elaprase 2mg/mL 3mL Vial $3,800.00
Effective date January 19, 2009
02304899 Revlimid 5mg Capsule $340.0000
02304902 Revlimid 10mg Capsule $361.0000

Until further notice, for all other products reimbursed under the EAP, pharmacies will continue to be reimbursed their acquisition cost plus the applicable mark-up:

  • 8% when the total drug cost is less than $1,000.00;
  • 6% when the total drug cost is greater than or equal to $1,000.00.

See also:

For More Information

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