maximum allowable price (map) list for nb drug plans liste ... · maximum allowable price (map)...

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Maximum Allowable Price (MAP) list for NB Drug Plans Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B. Generic Name Nom Générique Strength Dosage Tradename Marque de Commerce DIN PIN MFR FAB MAP PAM Unit Unité Abacavir / Abacavir Tab/Co. Orl 300 mg Ziagen 02240357 VIV 3.4828 Tablet / comprime Apo-Abacavir 02396769 APX 3.4828 Tablet / comprime Mint-Abacavir 02480956 MNT 3.4828 Tablet / comprime Acamprosate / Acamprosate SRT/Co.L.L. Orl 333 mg Campral 02293269 MYL 0.8000 Tablet / comprime Acarbose / Acarbose Tab/Co. Orl 50 mg Glucobay 02190885 BAY 0.2021 Tablet / comprime Mar-Acarbose 02494078 MAR 0.2021 Tablet / comprime Tab/Co. Orl 100 mg Glucobay 02190893 BAY 0.2799 Tablet / comprime Mar-Acarbose 02494086 MAR 0.2799 Tablet / comprime Acebutolol / Acebutolol Tab/Co. Orl 100 mg Apo-Acebutolol 02147602 APX 0.0787 Tablet / comprime Teva-Acebutolol 02204517 TEV 0.0787 Tablet / comprime Tab/Co. Orl 200 mg Apo-Acebutolol 02147610 APX 0.1177 Tablet / comprime Teva-Acebutolol 02204525 TEV 0.1177 Tablet / comprime Tab/Co. Orl 400 mg Apo-Acebutolol 02147629 APX 0.2466 Tablet / comprime Teva-Acebutolol 02204533 TEV 0.2466 Tablet / comprime Acetaminophen / Caffeine / Codeine / Acetaminophene / Cafeine / Codeine Tab/Co. Orl 300 mg / 15 mg / 15 mg Tylenol No.2 02163934 JAN 0.0847 Tablet / comprime Teva-Lenoltec #2 00653241 TEV 0.0847 Tablet / comprime Tab/Co. Orl 300 mg / 15 mg / 30 mg Tylenol No.3 02163926 JAN 0.1625 Tablet / comprime Teva-Lenoltec #3 00653276 TEV 0.0889 Tablet / comprime Acetaminophen / Codeine / Acetaminophene / Codeine Tab/Co. Orl 300 mg / 30 mg Teva-Emtec-30 00608882 TEV 0.1300 Tablet / comprime Tab/Co. Orl 300 mg / 60 mg Tylenol No.4 02163918 JAN 0.1605 Tablet / comprime Teva-Lenoltec #4 00621463 TEV 0.1605 Tablet / comprime Acetaminophen / Oxycodone / Acetaminophene / Oxycodone Tab/Co. Orl 325 mg / 5 mg Apo-Oxycodone/Acet 02324628 APX 0.1285 Tablet / comprime Oxycodone/Acet 02361361 SAS 0.1285 Tablet / comprime Sandoz Oxycodone/Acetaminophen 02307898 SDZ 0.1285 Tablet / comprime Teva-Oxycocet 00608165 TEV 0.1285 Tablet / comprime Acetazolamide / Acetazolamide Tab/Co. Orl 250 mg Acetazolamide 00545015 AAP 0.1262 Tablet / comprime Acetylcysteine / Acetylcysteine Liq/Liq Inh 200 mg/mL Acetylcysteine 02243098 SDZ 0.7000 Millilitre / millilitre Acetylsalicylic Acid / Acide Acetylsalicylique ECT/Co.Ent Orl 81 mg ASA 02449277 TLI 0.0530 Tablet / comprime ASA EC 02426811 SAS 0.0530 Tablet / comprime ASA EC 02244993 PMS 0.0530 Tablet / comprime Equate daily low-dose EC 02243801 PMS 0.0530 Tablet / comprime Exact Coated daily low dose ASA 02243896 PMS 0.0530 Tablet / comprime Praxis ASA 02283700 PDP 0.0530 Tablet / comprime ECT/Co.Ent Orl 325 mg ASATAB EC 02352427 ODN 0.0280 Tablet / comprime Enteric Coated ASA 02010526 TAN 0.0280 Tablet / comprime Novasen 00216666 TEV 0.0280 Tablet / comprime Acetylsalicylic Acid / Caffeine / Butalbital / Acide Acetylsalicylique / Cafeine / Butalbital Cap/Caps Orl 330 mg / 40 mg / 50 mg Fiorinal 00226327 TRB 1.4687 Capsule / capsule Teva-Tecnal 00608238 TEV 1.4687 Capsule / capsule Tab/Co. Orl 330 mg / 40 mg / 50 mg Teva-Tecnal 00608211 TEV 1.0397 Tablet / comprime Acetylsalicylic Acid / Caffeine / Codeine / Butalbital / Acide Acetylsalicylique / Cafeine / Codeine / Butalbital Cap/Caps Orl 330 mg / 40 mg / 15mg / 50 mg Fiorinal C1/4 00176192 TRB 1.5749 Capsule / capsule Teva-Tecnal C1/4 00608203 TEV 1.5749 Capsule / capsule Cap/Caps Orl 330 mg / 40 mg / 30mg / 50 mg Fiorinal C1/2 00176206 TRB 1.9285 Capsule / capsule Teva-Tecnal C1/2 00608181 TEV 1.9285 Capsule / capsule Acitretin / Acitretine Cap/Caps Orl 10 mg Soriatane 02070847 ALL 1.2965 Capsule / capsule Mint-Acitretin 02468840 MNT 1.2965 Capsule / capsule Taro-Acitretin 02466074 TAR 1.2965 Capsule / capsule Cap/Caps Orl 25 mg Soriatane 02070863 ALL 2.2770 Capsule / capsule Mint-Acitretin 02468859 MNT 2.2770 Capsule / capsule Taro-Acitretin 02466082 TAR 2.2770 Capsule / capsule Acyclovir / Acyclovir Ont/Ont Top 5% Zovirax 00569771 VLN 12.3114 Gram / gramme Apo-Acyclovir 02477130 APX 12.3114 Gram / gramme Tab/Co. Orl 200 mg Apo-Acyclovir 02207621 APX 0.6397 Tablet / comprime Mylan-Acyclovir 02242784 MYL 0.6397 Tablet / comprime Teva-Acyclovir 02285959 TEV 0.6397 Tablet / comprime Tab/Co. Orl 400 mg Apo-Acyclovir 02207648 APX 1.2700 Tablet / comprime Mylan-Acyclovir 02242463 MYL 1.2700 Tablet / comprime Teva-Acyclovir 02285967 TEV 1.2700 Tablet / comprime Tab/Co. Orl 800 mg Apo-Acyclovir 02207656 APX 1.2673 Tablet / comprime Mylan-Acyclovir 02242464 MYL 1.2673 Tablet / comprime Teva-Acyclovir 02285975 TEV 1.2673 Tablet / comprime Adefovir Dipivoxil / Adefovir Dipivoxil Tab/Co. Orl 10 mg Hepsera 02247823 GIL 18.2518 Tablet / comprime Apo-Adefovir 02420333 APX 18.2518 Tablet / comprime Alendronic Acid / Acide Alendronique Tab/Co. Orl 10 mg Alendronate Sodium 02381486 AHI 0.4987 Tablet / comprime Apo-Alendronate 02248728 APX 0.4987 Tablet / comprime Auro-Alendronate 02388545 ARO 0.4987 Tablet / comprime Ran-Alendronate 02384701 RAN 0.4987 Tablet / comprime Legend on last page / Légende à la dernière page September / septembre 2020 Page 1

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Page 1: Maximum Allowable Price (MAP) list for NB Drug Plans Liste ... · Maximum Allowable Price (MAP) list for NB Drug Plans Liste des prix admissibles maximums (PAM) pour régimes médicaments

Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Generic Name

Nom Générique

Strength

Dosage

Tradename

Marque de Commerce

DIN

PIN

MFR

FAB

MAP

PAM

Unit

UnitéAbacavir / Abacavir Tab/Co. Orl 300 mg Ziagen 02240357 VIV 3.4828 Tablet / comprime

Apo-Abacavir 02396769 APX 3.4828 Tablet / comprime

Mint-Abacavir 02480956 MNT 3.4828 Tablet / comprime

Acamprosate / Acamprosate SRT/Co.L.L. Orl 333 mg Campral 02293269 MYL 0.8000 Tablet / comprime

Acarbose / Acarbose Tab/Co. Orl 50 mg Glucobay 02190885 BAY 0.2021 Tablet / comprime

Mar-Acarbose 02494078 MAR 0.2021 Tablet / comprime

Tab/Co. Orl 100 mg Glucobay 02190893 BAY 0.2799 Tablet / comprime

Mar-Acarbose 02494086 MAR 0.2799 Tablet / comprime

Acebutolol / Acebutolol Tab/Co. Orl 100 mg Apo-Acebutolol 02147602 APX 0.0787 Tablet / comprime

Teva-Acebutolol 02204517 TEV 0.0787 Tablet / comprime

Tab/Co. Orl 200 mg Apo-Acebutolol 02147610 APX 0.1177 Tablet / comprime

Teva-Acebutolol 02204525 TEV 0.1177 Tablet / comprime

Tab/Co. Orl 400 mg Apo-Acebutolol 02147629 APX 0.2466 Tablet / comprime

Teva-Acebutolol 02204533 TEV 0.2466 Tablet / comprime

Acetaminophen / Caffeine / Codeine / Acetaminophene /

Cafeine / Codeine

Tab/Co. Orl 300 mg / 15 mg / 15 mg Tylenol No.2 02163934 JAN 0.0847 Tablet / comprime

Teva-Lenoltec #2 00653241 TEV 0.0847 Tablet / comprime

Tab/Co. Orl 300 mg / 15 mg / 30 mg Tylenol No.3 02163926 JAN 0.1625 Tablet / comprime

Teva-Lenoltec #3 00653276 TEV 0.0889 Tablet / comprime

Acetaminophen / Codeine / Acetaminophene / Codeine Tab/Co. Orl 300 mg / 30 mg Teva-Emtec-30 00608882 TEV 0.1300 Tablet / comprime

Tab/Co. Orl 300 mg / 60 mg Tylenol No.4 02163918 JAN 0.1605 Tablet / comprime

Teva-Lenoltec #4 00621463 TEV 0.1605 Tablet / comprime

Acetaminophen / Oxycodone / Acetaminophene / Oxycodone Tab/Co. Orl 325 mg / 5 mg Apo-Oxycodone/Acet 02324628 APX 0.1285 Tablet / comprime

Oxycodone/Acet 02361361 SAS 0.1285 Tablet / comprime

Sandoz Oxycodone/Acetaminophen 02307898 SDZ 0.1285 Tablet / comprime

Teva-Oxycocet 00608165 TEV 0.1285 Tablet / comprime

Acetazolamide / Acetazolamide Tab/Co. Orl 250 mg Acetazolamide 00545015 AAP 0.1262 Tablet / comprime

Acetylcysteine / Acetylcysteine Liq/Liq Inh 200 mg/mL Acetylcysteine 02243098 SDZ 0.7000 Millilitre / millilitre

Acetylsalicylic Acid / Acide Acetylsalicylique ECT/Co.Ent Orl 81 mg ASA 02449277 TLI 0.0530 Tablet / comprime

ASA EC 02426811 SAS 0.0530 Tablet / comprime

ASA EC 02244993 PMS 0.0530 Tablet / comprime

Equate daily low-dose EC 02243801 PMS 0.0530 Tablet / comprime

Exact Coated daily low dose ASA 02243896 PMS 0.0530 Tablet / comprime

Praxis ASA 02283700 PDP 0.0530 Tablet / comprime

ECT/Co.Ent Orl 325 mg ASATAB EC 02352427 ODN 0.0280 Tablet / comprime

Enteric Coated ASA 02010526 TAN 0.0280 Tablet / comprime

Novasen 00216666 TEV 0.0280 Tablet / comprime

Acetylsalicylic Acid / Caffeine / Butalbital / Acide

Acetylsalicylique / Cafeine / Butalbital

Cap/Caps Orl 330 mg / 40 mg / 50 mg Fiorinal 00226327 TRB 1.4687 Capsule / capsule

Teva-Tecnal 00608238 TEV 1.4687 Capsule / capsule

Tab/Co. Orl 330 mg / 40 mg / 50 mg Teva-Tecnal 00608211 TEV 1.0397 Tablet / comprime

Acetylsalicylic Acid / Caffeine / Codeine / Butalbital / Acide

Acetylsalicylique / Cafeine / Codeine / Butalbital

Cap/Caps Orl 330 mg / 40 mg / 15mg

/ 50 mg

Fiorinal C1/4 00176192 TRB 1.5749 Capsule / capsule

Teva-Tecnal C1/4 00608203 TEV 1.5749 Capsule / capsule

Cap/Caps Orl 330 mg / 40 mg / 30mg

/ 50 mg

Fiorinal C1/2 00176206 TRB 1.9285 Capsule / capsule

Teva-Tecnal C1/2 00608181 TEV 1.9285 Capsule / capsule

Acitretin / Acitretine Cap/Caps Orl 10 mg Soriatane 02070847 ALL 1.2965 Capsule / capsule

Mint-Acitretin 02468840 MNT 1.2965 Capsule / capsule

Taro-Acitretin 02466074 TAR 1.2965 Capsule / capsule

Cap/Caps Orl 25 mg Soriatane 02070863 ALL 2.2770 Capsule / capsule

Mint-Acitretin 02468859 MNT 2.2770 Capsule / capsule

Taro-Acitretin 02466082 TAR 2.2770 Capsule / capsule

Acyclovir / Acyclovir Ont/Ont Top 5% Zovirax 00569771 VLN 12.3114 Gram / gramme

Apo-Acyclovir 02477130 APX 12.3114 Gram / gramme

Tab/Co. Orl 200 mg Apo-Acyclovir 02207621 APX 0.6397 Tablet / comprime

Mylan-Acyclovir 02242784 MYL 0.6397 Tablet / comprime

Teva-Acyclovir 02285959 TEV 0.6397 Tablet / comprime

Tab/Co. Orl 400 mg Apo-Acyclovir 02207648 APX 1.2700 Tablet / comprime

Mylan-Acyclovir 02242463 MYL 1.2700 Tablet / comprime

Teva-Acyclovir 02285967 TEV 1.2700 Tablet / comprime

Tab/Co. Orl 800 mg Apo-Acyclovir 02207656 APX 1.2673 Tablet / comprime

Mylan-Acyclovir 02242464 MYL 1.2673 Tablet / comprime

Teva-Acyclovir 02285975 TEV 1.2673 Tablet / comprime

Adefovir Dipivoxil / Adefovir Dipivoxil Tab/Co. Orl 10 mg Hepsera 02247823 GIL 18.2518 Tablet / comprime

Apo-Adefovir 02420333 APX 18.2518 Tablet / comprime

Alendronic Acid / Acide Alendronique Tab/Co. Orl 10 mg Alendronate Sodium 02381486 AHI 0.4987 Tablet / comprime

Apo-Alendronate 02248728 APX 0.4987 Tablet / comprime

Auro-Alendronate 02388545 ARO 0.4987 Tablet / comprime

Ran-Alendronate 02384701 RAN 0.4987 Tablet / comprime

Legend on last page / Légende à la dernière page

September / septembre 2020 Page 1

Page 2: Maximum Allowable Price (MAP) list for NB Drug Plans Liste ... · Maximum Allowable Price (MAP) list for NB Drug Plans Liste des prix admissibles maximums (PAM) pour régimes médicaments

Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Sandoz Alendronate 02288087 SDZ 0.4987 Tablet / comprime

Teva-Alendronate 02247373 TEV 0.4987 Tablet / comprime

Tab/Co. Orl 70 mg Fosamax 02245329 FRS 2.1014 Tablet / comprime

Alendronate 02299712 SIV 2.1014 Tablet / comprime

Alendronate 02352966 SAS 2.1014 Tablet / comprime

Alendronate Sodium 02381494 AHI 2.1014 Tablet / comprime

Alendronate-70 02303078 PDL 2.1014 Tablet / comprime

Apo-Alendronate 02248730 APX 2.1014 Tablet / comprime

Auro-Alendronate 02388553 ARO 2.1014 Tablet / comprime

Jamp-Alendronate 02385031 JPC 2.1014 Tablet / comprime

Mint-Alendronate 02394871 MNT 2.1014 Tablet / comprime

Sandoz Alendronate 02288109 SDZ 2.1014 Tablet / comprime

Teva-Alendronate 02261715 TEV 2.1014 Tablet / comprime

pms-Alendronate FC 02284006 PMS 2.1014 Tablet / comprime

Alendronic Acid and Colecalciferol / Acide Alendronique et

Colecalciferol

Tab/Co. Orl 70 mg / 5 600 IU Fosavance 02314940 FRS 1.2174 Tablet / comprime

Apo-Alendronate/Vitamin D3 02454475 APX 1.2174 Tablet / comprime

Sandoz Alendronate/Cholecalciferol 02429160 SDZ 1.2174 Tablet / comprime

Teva-Alendronate/Cholecalciferol 02403641 TEV 1.2174 Tablet / comprime

Allopurinol / Allopurinol Tab/Co. Orl 100 mg Zyloprim 00402818 AAP 0.0780 Tablet / comprime

Apo-Allopurinol 02402769 APX 0.0780 Tablet / comprime

Mar-Allopurinol 02396327 MAR 0.0780 Tablet / comprime

Tab/Co. Orl 200 mg Zyloprim 00479799 AAP 0.1300 Tablet / comprime

Apo-Allopurinol 02402777 APX 0.1300 Tablet / comprime

Mar-Allopurinol 02396335 MAR 0.1300 Tablet / comprime

Tab/Co. Orl 300 mg Zyloprim 00402796 AAP 0.2125 Tablet / comprime

Apo-Allopurinol 02402785 APX 0.2125 Tablet / comprime

Mar-Allopurinol 02396343 MAR 0.2125 Tablet / comprime

Almotriptan / Almotriptan Tab/Co. Orl 12.5 mg Almotriptan 02466821 SAS 2.3478 Tablet / comprime

Mylan-Almotriptan 02398443 MYL 2.3478 Tablet / comprime

Sandoz Almotriptan 02405334 SDZ 2.3478 Tablet / comprime

Teva-Almotriptan 02434849 TEV 2.3478 Tablet / comprime

Alprazolam / Alprazolam Tab/Co. Orl 0.25 mg Xanax 00548359 UJC 0.0609 Tablet / comprime

Alprazolam 02349191 SAS 0.0609 Tablet / comprime

Apo-Alpraz 00865397 APX 0.0609 Tablet / comprime

Jamp-Alprazolam 02400111 JPC 0.0609 Tablet / comprime

Teva-Alprazolam 01913484 TEV 0.0609 Tablet / comprime

Tab/Co. Orl 0.5 mg Xanax 00548367 UJC 0.0728 Tablet / comprime

Alprazolam 02349205 SAS 0.0728 Tablet / comprime

Apo-Alpraz 00865400 APX 0.0728 Tablet / comprime

Jamp-Alprazolam 02400138 JPC 0.0728 Tablet / comprime

Teva-Alprazolam 01913492 TEV 0.0728 Tablet / comprime

Amantadine / Amantadine Cap/Caps Orl 100 mg pdp-Amantadine Hydrochloride 01990403 PDP 0.5252 Capsule / capsule

Syr/Sir. Orl 10 mg/mL pdp-Amantadine 02022826 PDP 0.1098 Millilitre / millilitre

Ambrisentan / Ambrisentan Tab/Co. Orl 5 mg Volibris 02307065 GSK 106.3288 Tablet / comprime P

Apo-Ambrisentan 02475375 APX 106.3288 Tablet / comprime P

Tab/Co. Orl 10 mg Volibris 02307073 GSK 106.3288 Tablet / comprime P

Apo-Ambrisentan 02475383 APX 106.3288 Tablet / comprime P

Amcinonide / Amcinonide Crm/Cr. Top 0.1% Taro-Amcinonide 02246714 TAR 0.1955 Gram / gramme

Amikacin / Amikacine Liq/Liq Inj 250 mg/mL Amikacin 02242971 SDZ 44.5720 Millilitre / millilitre

Amiloride / Amiloride Tab/Co. Orl 5 mg Midamor 02249510 AAP 0.2771 Tablet / comprime

Amiodarone / Amiodarone Tab/Co. Orl 100 mg pms-Amiodarone 02292173 PMS 0.8593 Tablet / comprime

Tab/Co. Orl 200 mg Amiodarone 02364336 SAS 0.3706 Tablet / comprime

Amiodarone 02385465 SIV 0.3706 Tablet / comprime

Apo-Amiodarone 02246194 APX 0.3706 Tablet / comprime

Sandoz Amiodarone 02243836 SDZ 0.3706 Tablet / comprime

Teva-Amiodarone 02239835 TEV 0.3706 Tablet / comprime

pms-Amiodarone 02242472 PMS 0.3706 Tablet / comprime

Amitriptyline / Amitriptyline Tab/Co. Orl 10 mg Elavil 00335053 AAP 0.0435 Tablet / comprime

Amitriptyline 00370991 PDL 0.0435 Tablet / comprime

Apo-Amitriptyline 02403137 APX 0.0435 Tablet / comprime

Tab/Co. Orl 25 mg Elavil 00335061 AAP 0.0829 Tablet / comprime

Amitriptyline 00371009 PDL 0.0829 Tablet / comprime

Apo-Amitriptyline 02403145 APX 0.0829 Tablet / comprime

Tab/Co. Orl 50 mg Elavil 00335088 AAP 0.1540 Tablet / comprime

Apo-Amitriptyline 02403153 APX 0.1540 Tablet / comprime

Tab/Co. Orl 75 mg Elavil 00754129 AAP 0.3634 Tablet / comprime

Apo-Amitriptyline 02403161 APX 0.3634 Tablet / comprime

Amlodipine / Amlodipine Tab/Co. Orl 2.5 mg Amlodipine 02385783 SIV 0.0767 Tablet / comprime

Amlodipine 02326795 PDL 0.0767 Tablet / comprime

Amlodipine Besylate 02419556 AHI 0.0767 Tablet / comprime

Mar-Amlodipine 02371707 MAR 0.0767 Tablet / comprime

NRA-Amlodipine 02476452 NRA 0.0767 Tablet / comprime

Sandoz Amlodipine 02330474 SDZ 0.0767 Tablet / comprime

September / septembre 2020 Page 2

Page 3: Maximum Allowable Price (MAP) list for NB Drug Plans Liste ... · Maximum Allowable Price (MAP) list for NB Drug Plans Liste des prix admissibles maximums (PAM) pour régimes médicaments

Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

pharma-Amlodipine 02469022 PMS 0.0767 Tablet / comprime

pms-Amlodipine 02295148 PMS 0.0767 Tablet / comprime

Tab/Co. Orl 5 mg Norvasc 00878928 UJC 0.1343 Tablet / comprime

Act Amlodipine 02297485 ATV 0.1343 Tablet / comprime

Amlodipine 02385791 SIV 0.1343 Tablet / comprime

Amlodipine 02331284 SAS 0.1343 Tablet / comprime

Amlodipine 02429217 JPC 0.1343 Tablet / comprime

Amlodipine 02326809 PDL 0.1343 Tablet / comprime

Amlodipine Besylate 02419564 AHI 0.1343 Tablet / comprime

Apo-Amlodipine 02273373 APX 0.1343 Tablet / comprime

Auro-Amlodipine 02397072 ARO 0.1343 Tablet / comprime

Mar-Amlodipine 02371715 MAR 0.1343 Tablet / comprime

Mint-Amlodipine 02362651 MNT 0.1343 Tablet / comprime

Mylan-Amlodipine 02272113 MYL 0.1343 Tablet / comprime

NRA-Amlodipine 02476460 NRA 0.1343 Tablet / comprime

Ran-Amlodipine 02321858 RAN 0.1343 Tablet / comprime

Sandoz Amlodipine 02284383 SDZ 0.1343 Tablet / comprime

Septa-Amlodipine 02357712 SPT 0.1343 Tablet / comprime

Teva-Amlodipine 02250497 TEV 0.1343 Tablet / comprime

pharma-Amlodipine 02469030 PMS 0.1343 Tablet / comprime

Tab/Co. Orl 10 mg Norvasc 00878936 UJC 0.1993 Tablet / comprime

Act Amlodipine 02297493 ATV 0.1993 Tablet / comprime

Amlodipine 02331292 SAS 0.1993 Tablet / comprime

Amlodipine 02429225 JPC 0.1993 Tablet / comprime

Amlodipine 02326817 PDL 0.1993 Tablet / comprime

Amlodipine 02385805 SIV 0.1993 Tablet / comprime

Amlodipine Besylate 02419572 AHI 0.1993 Tablet / comprime

Apo-Amlodipine 02273381 APX 0.1993 Tablet / comprime

Auro-Amlodipine 02397080 ARO 0.1993 Tablet / comprime

Mar-Amlodipine 02371723 MAR 0.1993 Tablet / comprime

Mint-Amlodipine 02362678 MNT 0.1993 Tablet / comprime

Mylan-Amlodipine 02272121 MYL 0.1993 Tablet / comprime

NRA-Amlodipine 02476479 NRA 0.1993 Tablet / comprime

Ran-Amlodipine 02321866 RAN 0.1993 Tablet / comprime

Sandoz Amlodipine 02284391 SDZ 0.1993 Tablet / comprime

Septa-Amlodipine 02357720 SPT 0.1993 Tablet / comprime

Teva-Amlodipine 02250500 TEV 0.1993 Tablet / comprime

pharma-Amlodipine 02469049 PMS 0.1993 Tablet / comprime

Amoxicillin / Amoxicilline Cap/Caps Orl 250 mg Amoxicillin 02352710 SAS 0.0672 Capsule / capsule

Apo-Amoxi 00628115 APX 0.0672 Capsule / capsule

Auro-Amoxicillin 02388073 ARO 0.0672 Capsule / capsule

Jamp-Amoxicillin 02433060 JPC 0.0672 Capsule / capsule

Novamoxin 00406724 TEV 0.0672 Capsule / capsule

Cap/Caps Orl 500 mg Amoxicillin 02352729 SAS 0.1308 Capsule / capsule

Amoxicillin 02401509 SIV 0.1308 Capsule / capsule

Apo-Amoxi 00628123 APX 0.1308 Capsule / capsule

Auro-Amoxicillin 02388081 ARO 0.1308 Capsule / capsule

Jamp-Amoxicillin 02433079 JPC 0.1308 Capsule / capsule

Novamoxin 00406716 TEV 0.1308 Capsule / capsule

Pws/Pds. Orl 25 mg Apo-Amoxi 00628131 APX 0.0353 Millilitre / millilitre

Novamoxin 00452149 TEV 0.0353 Millilitre / millilitre

Novamoxin 125 (sugar-reduced) 01934171 TEV 0.0353 Millilitre / millilitre

Pws/Pds. Orl 50 mg Amoxicillin 02352753 SAS 0.0540 Millilitre / millilitre

Amoxicillin 02401541 SIV 0.0540 Millilitre / millilitre

Amoxicillin (sugar-reduced) 02352788 SAS 0.0540 Millilitre / millilitre

Apo-Amoxi 00628158 APX 0.0540 Millilitre / millilitre

Apo-Amoxi (Sugar-Free) 02230880 APX 0.0540 Millilitre / millilitre

Novamoxin 00452130 TEV 0.0540 Millilitre / millilitre

Novamoxin 125 (sugar-reduced) 01934163 TEV 0.0540 Millilitre / millilitre

TabC/Co.C. Orl 125 mg Novamoxin chew 02036347 TEV 0.4584 Tablet / comprime

TabC/Co.C. Orl 250 mg Novamoxin chew 02036355 TEV 0.7512 Tablet / comprime

Amoxicillin / Clavulanic Acid / Amoxicilline / Acide Clavulanique Tab/Co. Orl 250 mg / 125 mg Apo-Amoxi Clav 02243350 APX 0.9375 Tablet / comprime

Tab/Co. Orl 500 mg / 125 mg Clavulin-500 F 01916858 GSK 0.7555 Tablet / comprime

Apo-Amoxi Clav 02243351 APX 0.7555 Tablet / comprime

Sandoz Amoxi-Clav 02482576 SDZ 0.7555 Tablet / comprime

Tab/Co. Orl 875 mg / 125 mg Clavulin 02238829 GSK 0.5551 Tablet / comprime

Apo-Amoxi Clav 02245623 APX 0.5551 Tablet / comprime

Sandoz Amoxi-Clav 02482584 SDZ 0.5551 Tablet / comprime

Ampicillin / Ampicilline Cap/Caps Orl 250 mg Teva-Ampicillin 00020877 TEV 0.3796 Capsule / capsule

Cap/Caps Orl 500 mg Teva-Ampicillin 00020885 TEV 0.7197 Capsule / capsule

Pws/Pds. Inj 500 mg Ampicillin Sodium 00872652 TEV 2.1500 Vial / fiole

Pws/Pds. Inj 1 g Ampicillin Sodium 01933345 TEV 3.6000 Vial / fiole

Pws/Pds. Inj 2 g Ampicillin Sodium 01933353 TEV 7.2000 Vial / fiole

September / septembre 2020 Page 3

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Anagrelide / Anagrelide Cap/Caps Orl 0.5 mg Agrylin 02236859 SHI 6.2662 Capsule / capsule

Sandoz Anagrelide 02260107 SDZ 2.6361 Capsule / capsule

pms-Anagrelide 02274949 PMS 2.6361 Capsule / capsule

Anastrozole / Anastrozole Tab/Co. Orl 1 mg Arimidex 02224135 AZE 0.9522 Tablet / comprime

Act Anastrozole 02394898 TEV 0.9522 Tablet / comprime

Anastrozole 02351218 AHI 0.9522 Tablet / comprime

Anastrozole 02442736 SAS 0.9522 Tablet / comprime

Apo-Anastrozole 02374420 APX 0.9522 Tablet / comprime

CCP-Anastrozole 02458799 CCM 0.9522 Tablet / comprime

Jamp-Anastrozole 02339080 JPC 0.9522 Tablet / comprime

Mar-Anastrozole 02379562 MAR 0.9522 Tablet / comprime

Mint-Anastrozole 02393573 MNT 0.9522 Tablet / comprime

Nat-Anastrozole 02417855 NAT 0.9522 Tablet / comprime

Sandoz Anastrozole 02338467 SDZ 0.9522 Tablet / comprime

Taro-Anastrozole 02365650 TAR 0.9522 Tablet / comprime

pms-Anastrozole 02320738 PMS 0.9522 Tablet / comprime

Aripiprazole / Aripiprazole Tab/Co. Orl 2 mg Abilify 02322374 OTS 0.8092 Tablet / comprime

Apo-Aripiprazole 02471086 APX 0.8092 Tablet / comprime

Auro-Aripiprazole 02460025 ARO 0.8092 Tablet / comprime

Mint-Aripiprazole 02483556 MNT 0.8092 Tablet / comprime

Sandoz Aripiprazole 02473658 SDZ 0.8092 Tablet / comprime

Teva-Aripiprazole 02464144 TEV 0.8092 Tablet / comprime

pms-Aripiprazole 02466635 PMS 0.8092 Tablet / comprime

Tab/Co. Orl 5 mg Abilify 02322382 OTS 0.9046 Tablet / comprime

Apo-Aripiprazole 02471094 APX 0.9046 Tablet / comprime

Auro-Aripiprazole 02460033 ARO 0.9046 Tablet / comprime

Mint-Aripiprazole 02483564 MNT 0.9046 Tablet / comprime

Sandoz Aripiprazole 02473666 SDZ 0.9046 Tablet / comprime

Teva-Aripiprazole 02464152 TEV 0.9046 Tablet / comprime

pms-Aripiprazole 02466643 PMS 0.9046 Tablet / comprime

Tab/Co. Orl 10 mg Abilify 02322390 OTS 1.0754 Tablet / comprime

Apo-Aripiprazole 02471108 APX 1.0754 Tablet / comprime

Auro-Aripiprazole 02460041 ARO 1.0754 Tablet / comprime

Mint-Aripiprazole 02483572 MNT 1.0754 Tablet / comprime

Sandoz Aripiprazole 02473674 SDZ 1.0754 Tablet / comprime

Teva-Aripiprazole 02464160 TEV 1.0754 Tablet / comprime

pms-Aripiprazole 02466651 PMS 1.0754 Tablet / comprime

Tab/Co. Orl 15 mg Abilify 02322404 OTS 1.2692 Tablet / comprime

Apo-Aripiprazole 02471116 APX 1.2692 Tablet / comprime

Auro-Aripiprazole 02460068 ARO 1.2692 Tablet / comprime

Mint-Aripiprazole 02483580 MNT 1.2692 Tablet / comprime

Sandoz Aripiprazole 02473682 SDZ 1.2692 Tablet / comprime

Teva-Aripiprazole 02464179 TEV 1.2692 Tablet / comprime

pms-Aripiprazole 02466678 PMS 1.2692 Tablet / comprime

Tab/Co. Orl 20 mg Abilify 02322412 OTS 1.0017 Tablet / comprime

Apo-Aripiprazole 02471124 APX 1.0017 Tablet / comprime

Auro-Aripiprazole 02460076 ARO 1.0017 Tablet / comprime

Mint-Aripiprazole 02483599 MNT 1.0017 Tablet / comprime

Sandoz Aripiprazole 02473690 SDZ 1.0017 Tablet / comprime

Teva-Aripiprazole 02464187 TEV 1.0017 Tablet / comprime

pms-Aripiprazole 02466686 PMS 1.0017 Tablet / comprime

Tab/Co. Orl 30 mg Abilify 02322455 OTS 1.0017 Tablet / comprime

Apo-Aripiprazole 02471132 APX 1.0017 Tablet / comprime

Auro-Aripiprazole 02460084 ARO 1.0017 Tablet / comprime

Mint-Aripiprazole 02483602 MNT 1.0017 Tablet / comprime

Sandoz Aripiprazole 02473704 SDZ 1.0017 Tablet / comprime

Teva-Aripiprazole 02464195 TEV 1.0017 Tablet / comprime

pms-Aripiprazole 02466694 PMS 1.0017 Tablet / comprime

Atazanavir / Atazanavir Cap/Caps Orl 150 mg Reyataz 02248610 BRI 5.6771 Capsule / capsule

Mylan-Atazanavir 02456877 MYL 5.6771 Capsule / capsule

Teva-Atazanavir 02443791 TEV 5.6771 Capsule / capsule

Cap/Caps Orl 200 mg Reyataz 02248611 BRI 5.7104 Capsule / capsule

Mylan-Atazanavir 02456885 MYL 5.7104 Capsule / capsule

Teva-Atazanavir 02443813 TEV 5.7104 Capsule / capsule

Cap/Caps Orl 300 mg Reyataz 02294176 BRI 11.2165 Capsule / capsule

Mylan-Atazanavir 02456893 MYL 11.2165 Capsule / capsule

Teva-Atazanavir 02443821 TEV 11.2165 Capsule / capsule

Atenolol / Atenolol Tab/Co. Orl 25 mg Jamp-Atenolol 02367556 JPC 0.0521 Tablet / comprime

Mar-Atenolol 02371979 MAR 0.0521 Tablet / comprime

Mint-Atenolol 02368013 MNT 0.0521 Tablet / comprime

Taro-Atenolol 02373963 SUN 0.0521 Tablet / comprime

Teva-Atenolol 02266660 TEV 0.0521 Tablet / comprime

pms-Atenolol 02246581 PMS 0.0521 Tablet / comprime

Tab/Co. Orl 50 mg Tenormin 02039532 AZE 0.1107 Tablet / comprime

September / septembre 2020 Page 4

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Act Atenolol 02255545 ATV 0.1107 Tablet / comprime

Apo-Atenol 00773689 APX 0.1107 Tablet / comprime

Atenolol 02466465 SAS 0.1107 Tablet / comprime

Atenolol 02238316 SIV 0.1107 Tablet / comprime

Jamp-Atenolol 02367564 JPC 0.1107 Tablet / comprime

Mar-Atenolol 02371987 MAR 0.1107 Tablet / comprime

Mint-Atenolol 02368021 MNT 0.1107 Tablet / comprime

Taro-Atenolol 02267985 SUN 0.1107 Tablet / comprime

Teva-Atenolol 02171791 TEV 0.1107 Tablet / comprime

pms-Atenolol 02237600 PMS 0.1107 Tablet / comprime

Tab/Co. Orl 100 mg Tenormin 02039540 AZE 0.1821 Tablet / comprime

Act Atenolol 02255553 ATV 0.1821 Tablet / comprime

Apo-Atenol 00773697 APX 0.1821 Tablet / comprime

Atenolol 02238318 SIV 0.1821 Tablet / comprime

Atenolol 02466473 SAS 0.1821 Tablet / comprime

Jamp-Atenolol 02367572 JPC 0.1821 Tablet / comprime

Mar-Atenolol 02371995 MAR 0.1821 Tablet / comprime

Mint-Atenolol 02368048 MNT 0.1821 Tablet / comprime

Taro-Atenolol 02267993 SUN 0.1821 Tablet / comprime

Teva-Atenolol 02171805 TEV 0.1821 Tablet / comprime

pms-Atenolol 02237601 PMS 0.1821 Tablet / comprime

Atenolol / Chlorthalidone / Atenolol / Chlorthalidone Tab/Co. Orl 50 mg / 25 mg Tenoretic 02049961 AZE 0.3195 Tablet / comprime

AA-Atenidone 02248763 AAP 0.3195 Tablet / comprime

Tab/Co. Orl 100 mg / 25 mg Tenoretic 02049988 AZE 0.5236 Tablet / comprime

AA-Atenidone 02248764 AAP 0.5236 Tablet / comprime

Atomoxetine / Atomoxetine Cap/Caps Orl 10 mg Strattera 02262800 LIL 0.5106 Capsule / capsule

Apo-Atomoxetine 02318024 APX 0.5106 Capsule / capsule

Atomoxetine 02467747 SAS 0.5106 Capsule / capsule

Atomoxetine 02445883 SIV 0.5106 Capsule / capsule

Auro-Atomoxetine 02471485 ARO 0.5106 Capsule / capsule

Sandoz Atomoxetine 02386410 SDZ 0.5106 Capsule / capsule

Teva-Atomoxetine 02314541 TEV 0.5106 Capsule / capsule

pms-Atomoxetine 02381028 PMS 0.5106 Capsule / capsule

Cap/Caps Orl 18 mg Strattera 02262819 LIL 0.5748 Capsule / capsule

Apo-Atomoxetine 02318032 APX 0.5748 Capsule / capsule

Atomoxetine 02445905 SIV 0.5748 Capsule / capsule

Atomoxetine 02467755 SAS 0.5748 Capsule / capsule

Auro-Atomoxetine 02471493 ARO 0.5748 Capsule / capsule

Sandoz Atomoxetine 02386429 SDZ 0.5748 Capsule / capsule

Teva-Atomoxetine 02314568 TEV 0.5748 Capsule / capsule

pms-Atomoxetine 02381036 PMS 0.5748 Capsule / capsule

Cap/Caps Orl 25 mg Strattera 02262827 LIL 0.6420 Capsule / capsule

Apo-Atomoxetine 02318040 APX 0.6420 Capsule / capsule

Atomoxetine 02445913 SIV 0.6420 Capsule / capsule

Atomoxetine 02467763 SAS 0.6420 Capsule / capsule

Auro-Atomoxetine 02471507 ARO 0.6420 Capsule / capsule

Sandoz Atomoxetine 02386437 SDZ 0.6420 Capsule / capsule

Teva-Atomoxetine 02314576 TEV 0.6420 Capsule / capsule

pms-Atomoxetine 02381044 PMS 0.6420 Capsule / capsule

Cap/Caps Orl 40 mg Strattera 02262835 LIL 0.7369 Capsule / capsule

Apo-Atomoxetine 02318059 APX 0.7369 Capsule / capsule

Atomoxetine 02445948 SIV 0.7369 Capsule / capsule

Atomoxetine 02467771 SAS 0.7369 Capsule / capsule

Auro-Atomoxetine 02471515 ARO 0.7369 Capsule / capsule

Sandoz Atomoxetine 02386445 SDZ 0.7369 Capsule / capsule

Teva-Atomoxetine 02314584 TEV 0.7369 Capsule / capsule

pms-Atomoxetine 02381052 PMS 0.7369 Capsule / capsule

Cap/Caps Orl 60 mg Strattera 02262843 LIL 0.8092 Capsule / capsule

Apo-Atomoxetine 02318067 APX 0.8092 Capsule / capsule

Atomoxetine 02467798 SAS 0.8092 Capsule / capsule

Atomoxetine 02445956 SIV 0.8092 Capsule / capsule

Auro-Atomoxetine 02471523 ARO 0.8092 Capsule / capsule

Sandoz Atomoxetine 02386453 SDZ 0.8092 Capsule / capsule

Teva-Atomoxetine 02314592 TEV 0.8092 Capsule / capsule

pms-Atomoxetine 02381060 PMS 0.8092 Capsule / capsule

Cap/Caps Orl 80 mg Strattera 02279347 LIL 1.2193 Capsule / capsule

Apo-Atomoxetine 02318075 APX 1.2193 Capsule / capsule

Atomoxetine 02467801 SAS 1.2193 Capsule / capsule

Auro-Atomoxetine 02471531 ARO 1.2193 Capsule / capsule

Sandoz Atomoxetine 02386461 SDZ 1.2193 Capsule / capsule

Teva-Atomoxetine 02362511 TEV 1.2193 Capsule / capsule

Cap/Caps Orl 100 mg Strattera 02279355 LIL 1.3382 Capsule / capsule

Apo-Atomoxetine 02318083 APX 1.3382 Capsule / capsule

Atomoxetine 02467828 SAS 1.3382 Capsule / capsule

September / septembre 2020 Page 5

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Auro-Atomoxetine 02471558 ARO 1.3382 Capsule / capsule

Sandoz Atomoxetine 02386488 SDZ 1.3382 Capsule / capsule

Atorvastatin / Atorvastatine Tab/Co. Orl 10 mg Lipitor 02230711 UJC 0.1743 Tablet / comprime

ACH-Atorvastatin Calcium 02457741 AHI 0.1743 Tablet / comprime

Apo-Atorvastatin 02295261 APX 0.1743 Tablet / comprime

Atorvastatin 02346486 PDL 0.1743 Tablet / comprime

Atorvastatin 02411350 SIV 0.1743 Tablet / comprime

Auro-Atorvastatin 02407256 ARO 0.1743 Tablet / comprime

Jamp-Atorvastatin 02391058 JPC 0.1743 Tablet / comprime

Mar-Atorvastatin 02454017 MAR 0.1743 Tablet / comprime

Mint-Atorvastatin 02479508 MNT 0.1743 Tablet / comprime

Mylan-Atorvastatin 02392933 MYL 0.1743 Tablet / comprime

NRA-Atorvastatin 02476517 NRA 0.1743 Tablet / comprime

Reddy-Atorvastatin 02417936 RCH 0.1743 Tablet / comprime

Sandoz Atorvastatin 02324946 SDZ 0.1743 Tablet / comprime

Taro-Atorvastatin 02313707 SUN 0.1743 Tablet / comprime

Teva-Atorvastatin 02310899 TEV 0.1743 Tablet / comprime

pms-Atorvastatin 02477149 PMS 0.1743 Tablet / comprime

pms-Atorvastatin 02399377 PMS 0.1743 Tablet / comprime

Tab/Co. Orl 20 mg Lipitor 02230713 UJC 0.2179 Tablet / comprime

ACH-Atorvastatin Calcium 02457768 AHI 0.2179 Tablet / comprime

Apo-Atorvastatin 02295288 APX 0.2179 Tablet / comprime

Atorvastatin 02411369 SIV 0.2179 Tablet / comprime

Atorvastatin 02346494 PDL 0.2179 Tablet / comprime

Auro-Atorvastatin 02407264 ARO 0.2179 Tablet / comprime

Jamp-Atorvastatin 02391066 JPC 0.2179 Tablet / comprime

Mar-Atorvastatin 02454025 MAR 0.2179 Tablet / comprime

Mint-Atorvastatin 02479516 MNT 0.2179 Tablet / comprime

Mylan-Atorvastatin 02392941 MYL 0.2179 Tablet / comprime

NRA-Atorvastatin 02476525 NRA 0.2179 Tablet / comprime

Reddy-Atorvastatin 02417944 RCH 0.2179 Tablet / comprime

Sandoz Atorvastatin 02324954 SDZ 0.2179 Tablet / comprime

Taro-Atorvastatin 02313715 SUN 0.2179 Tablet / comprime

Teva-Atorvastatin 02310902 TEV 0.2179 Tablet / comprime

pms-Atorvastatin 02477157 PMS 0.2179 Tablet / comprime

pms-Atorvastatin 02399385 PMS 0.2179 Tablet / comprime

Tab/Co. Orl 40 mg Lipitor 02230714 UJC 0.2342 Tablet / comprime

ACH-Atorvastatin Calcium 02457776 AHI 0.2342 Tablet / comprime

Apo-Atorvastatin 02295296 APX 0.2342 Tablet / comprime

Atorvastatin 02411377 SIV 0.2342 Tablet / comprime

Atorvastatin 02346508 PDL 0.2342 Tablet / comprime

Auro-Atorvastatin 02407272 ARO 0.2342 Tablet / comprime

Jamp-Atorvastatin 02391074 JPC 0.2342 Tablet / comprime

Mar-Atorvastatin 02454033 MAR 0.2342 Tablet / comprime

Mint-Atorvastatin 02479524 MNT 0.2342 Tablet / comprime

Mylan-Atorvastatin 02392968 MYL 0.2342 Tablet / comprime

NRA-Atorvastatin 02476533 NRA 0.2342 Tablet / comprime

Reddy-Atorvastatin 02417952 RCH 0.2342 Tablet / comprime

Sandoz Atorvastatin 02324962 SDZ 0.2342 Tablet / comprime

Taro-Atorvastatin 02313723 SUN 0.2342 Tablet / comprime

Teva-Atorvastatin 02310910 TEV 0.2342 Tablet / comprime

pms-Atorvastatin 02399393 PMS 0.2342 Tablet / comprime

pms-Atorvastatin 02477165 PMS 0.2342 Tablet / comprime

Tab/Co. Orl 80 mg Lipitor 02243097 UJC 0.2342 Tablet / comprime

ACH-Atorvastatin Calcium 02457784 AHI 0.2342 Tablet / comprime

Apo-Atorvastatin 02295318 APX 0.2342 Tablet / comprime

Atorvastatin 02411385 SIV 0.2342 Tablet / comprime

Atorvastatin 02346516 PDL 0.2342 Tablet / comprime

Auro-Atorvastatin 02407280 ARO 0.2342 Tablet / comprime

Jamp-Atorvastatin 02391082 JPC 0.2342 Tablet / comprime

Mar-Atorvastatin 02454041 MAR 0.2342 Tablet / comprime

Mylan-Atorvastatin 02392976 MYL 0.2342 Tablet / comprime

NRA-Atorvastatin 02476541 NRA 0.2342 Tablet / comprime

Reddy-Atorvastatin 02417960 RCH 0.2342 Tablet / comprime

Sandoz Atorvastatin 02324970 SDZ 0.2342 Tablet / comprime

Taro-Atorvastatin 02313758 SUN 0.2342 Tablet / comprime

Teva-Atorvastatin 02310929 TEV 0.2342 Tablet / comprime

pms-Atorvastatin 02477173 PMS 0.2342 Tablet / comprime

pms-Atorvastatin 02399407 PMS 0.2342 Tablet / comprime

Atorvastatin and Amlodipine / Atorvastatine et Amlodipine Tab/Co. Orl 10 mg / 5 mg Caduet 02273233 UJC 0.5802 Tablet / comprime

Apo-Amlodipine-Atorvastatin 02411253 APX 0.5802 Tablet / comprime

GD-Amlodipine/Atorvastatin 02362759 UJC 0.5802 Tablet / comprime

pms-Amlodipine/Atorvastatin 02404222 PMS 0.5802 Tablet / comprime

Tab/Co. Orl 10 mg / 10 mg Caduet 02273284 UJC 0.6125 Tablet / comprime

September / septembre 2020 Page 6

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Apo-Amlodipine-Atorvastatin 02411318 APX 0.6125 Tablet / comprime

GD-Amlodipine/Atorvastatin 02362791 UJC 0.6125 Tablet / comprime

pms-Amlodipine/Atorvastatin 02404249 PMS 0.6125 Tablet / comprime

Tab/Co. Orl 20 mg / 5 mg Caduet 02273241 UJC 0.6842 Tablet / comprime

Apo-Amlodipine-Atorvastatin 02411261 APX 0.6842 Tablet / comprime

GD-Amlodipine/Atorvastatin 02362767 UJC 0.6842 Tablet / comprime

pms-Amlodipine/Atorvastatin 02404230 PMS 0.6842 Tablet / comprime

Tab/Co. Orl 20 mg / 10 mg Caduet 02273292 UJC 0.7636 Tablet / comprime

Apo-Amlodipine-Atorvastatin 02411326 APX 0.7636 Tablet / comprime

GD-Amlodipine/Atorvastatin 02362805 UJC 0.7636 Tablet / comprime

pms-Amlodipine/Atorvastatin 02404257 PMS 0.7636 Tablet / comprime

Tab/Co. Orl 40 mg / 5 mg Caduet 02273268 UJC 0.7232 Tablet / comprime

Apo-Amlodipine-Atorvastatin 02411288 APX 0.7232 Tablet / comprime

GD-Amlodipine/Atorvastatin 02362775 UJC 0.7232 Tablet / comprime

Tab/Co. Orl 40 mg / 10 mg Caduet 02273306 UJC 0.8000 Tablet / comprime

Apo-Amlodipine-Atorvastatin 02411334 APX 0.8000 Tablet / comprime

GD-Amlodipine/Atorvastatin 02362813 UJC 0.8000 Tablet / comprime

Tab/Co. Orl 80 mg / 5 mg Caduet 02273276 UJC 0.7232 Tablet / comprime

Apo-Amlodipine-Atorvastatin 02411296 APX 0.7232 Tablet / comprime

GD-Amlodipine/Atorvastatin 02362783 UJC 0.7232 Tablet / comprime

Tab/Co. Orl 80 mg / 10 mg Caduet 02273314 UJC 0.8000 Tablet / comprime

Apo-Amlodipine-Atorvastatin 02411342 APX 0.8000 Tablet / comprime

GD-Amlodipine/Atorvastatin 02362821 UJC 0.8000 Tablet / comprime

Atropine / Atropine Dps/Gttes Oph 1% Isopto Atropine 00035017 ALC 0.5490 Millilitre / millilitre

Atropine 02023695 PST 0.5490 Millilitre / millilitre

Azathioprine / Azathioprine Tab/Co. Orl 50 mg Imuran 00004596 APN 0.2405 Tablet / comprime

Apo-Azathioprine 02242907 APX 0.2405 Tablet / comprime

Teva-Azathioprine 02236819 TEV 0.2405 Tablet / comprime

Azithromycin / Azithromycine Pws/Pds. Orl 100 mg/5 mL Zithromax 02223716 PFI 0.3726 Millilitre / millilitre

Auro-Azithromycin 02482363 ARO 0.3726 Millilitre / millilitre

Azithromycin 02274388 PMS 0.3726 Millilitre / millilitre

Sandoz Azithromycin 02332388 SDZ 0.3726 Millilitre / millilitre

Pws/Pds. Orl 200 mg/5 mL Zithromax 02223724 PFI 0.5280 Millilitre / millilitre

Auro-Azithromycin 02482371 ARO 0.5280 Millilitre / millilitre

Azithromycin 02274396 PMS 0.5280 Millilitre / millilitre

GD-Azithromycin 02274574 GMD 0.5280 Millilitre / millilitre

Sandoz Azithromycin 02332396 SDZ 0.5280 Millilitre / millilitre

pms-Azithromycin 02418460 PMS 0.5280 Millilitre / millilitre

Pws/Pds. Inj 500 mg Zithromax 02239952 PFI 22.7130 Vial / fiole

Tab/Co. Orl 250 mg Zithromax 02212021 PFI 0.9410 Tablet / comprime

Apo-Azithromycin Z 02415542 APX 0.9410 Tablet / comprime

Azithromycin 02442434 SIV 0.9410 Tablet / comprime

Azithromycin 02330881 SAS 0.9410 Tablet / comprime

Jamp-Azithromycin 02452308 JPC 0.9410 Tablet / comprime

Mar-Azithromycin 02452324 MAR 0.9410 Tablet / comprime

NRA-Azithromycin 02479680 NRA 0.9410 Tablet / comprime

Sandoz Azithromycin 02265826 SDZ 0.9410 Tablet / comprime

Teva-Azithromycin 02267845 TEV 0.9410 Tablet / comprime

pms-Azithromycin 02261634 PMS 0.9410 Tablet / comprime

Tab/Co. Orl 600 mg pms-Azithromycin 02261642 PMS 10.6652 Tablet / comprime

Baclofen / Baclofene Liq/Liq Int 0.05 mg/mL Lioresal 02131048 NVR 7.5160 Millilitre / millilitre

Baclofen 02457059 TLG 7.5160 Millilitre / millilitre

Liq/Liq Int 0.5 mg/mL Lioresal 02131056 NVR 5.6328 Millilitre / millilitre

Baclofen 02457067 TLG 5.6328 Millilitre / millilitre

Liq/Liq Int 2 mg/mL Lioresal 02131064 NVR 22.5334 Millilitre / millilitre

Baclofen 02457075 TLG 22.5334 Millilitre / millilitre

Tab/Co. Orl 10 mg Lioresal 00455881 NVR 0.1595 Tablet / comprime

Apo-Baclofen 02139332 APX 0.1595 Tablet / comprime

Baclofen 02287021 SAS 0.1595 Tablet / comprime

Mylan-Baclofen 02088398 MYL 0.1595 Tablet / comprime

pms-Baclofen 02063735 PMS 0.1595 Tablet / comprime

Tab/Co. Orl 20 mg Apo-Baclofen 02139391 APX 0.3104 Tablet / comprime

Baclofen 02287048 SAS 0.3104 Tablet / comprime

Mylan-Baclofen 02088401 MYL 0.3104 Tablet / comprime

pms-Baclofen 02063743 PMS 0.3104 Tablet / comprime

Beclomethasone / Beclomethasone Aem/Aem. Nas 50 mcg Apo-Beclomethasone AQ 02238796 APX 0.0613 Dose / dose

Mylan-Beclo AQ 02172712 MYL 0.0613 Dose / dose

Benazepril / Benazepril Tab/Co. Orl 5 mg Benazepril 02290332 AAP 0.8333 Tablet / comprime

Tab/Co. Orl 10 mg Benazepril 02290340 AAP 0.9870 Tablet / comprime

Tab/Co. Orl 20 mg Benazepril 02273918 AAP 1.1311 Tablet / comprime

Benzatropine / Benzytropine Tab/Co. Orl 1 mg pdp-Benztropine 00706531 PDP 0.0522 Tablet / comprime

Tab/Co. Orl 2 mg pdp-Benztropine 00426857 PDP 0.0464 Tablet / comprime

Benzydamine / Benzydamine Liq/Liq Buc 0.15% pms-Benzydamine 02239537 PMS 0.0325 Millilitre / millilitre

Betahistine / Betahistine Tab/Co. Orl 8 mg Auro-Betahistine 02449145 ARO 0.1232 Tablet / comprime

September / septembre 2020 Page 7

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Teva-Betahistine 02280183 TEV 0.1232 Tablet / comprime

Tab/Co. Orl 16 mg Serc 02243878 BGP 0.1106 Tablet / comprime

Auro-Betahistine 02449153 ARO 0.1106 Tablet / comprime

Betahistine 02466449 SAS 0.1106 Tablet / comprime

Teva-Betahistine 02280191 TEV 0.1106 Tablet / comprime

pms-Betahistine 02330210 PMS 0.1106 Tablet / comprime

Tab/Co. Orl 24 mg Serc 02247998 BGP 0.1659 Tablet / comprime

Auro-Betahistine 02449161 ARO 0.1659 Tablet / comprime

Betahistine 02466457 SAS 0.1659 Tablet / comprime

Teva-Betahistine 02280205 TEV 0.1659 Tablet / comprime

pms-Betahistine 02330237 PMS 0.1659 Tablet / comprime

Betamethasone / Salicylic Acid / Betamethasone / Acide

Salicylique

Lot/Lot Top 0.5 mg / 20 mg Diprosalic 00578428 FRS 0.4512 Gram / gramme

ratio-Topisalic 02245688 TEV 0.4512 Gram / gramme

Betamethasone Dipropionate / Dipropionate De Betamethasone Crm/Cr. Top 0.05% Diprosone 00323071 FRS 0.2046 Gram / gramme

Teva-Topisone 00804991 TEV 0.2046 Gram / gramme

Crm/Cr. Top 0.05% Teva-Topilene 00849650 TEV 0.5186 Gram / gramme

Lot/Lot Top 0.05% Diprosone 00417246 FRS 0.1980 Gram / gramme

Teva-Topisone 00809187 TEV 0.1980 Gram / gramme

Lot/Lot Top 0.05% Teva-Topilene 01927914 TEV 0.2696 Gram / gramme

Ont/Ont Top 0.05% Diprosone 00344923 FRS 0.2152 Gram / gramme

Teva-Topisone 00805009 TEV 0.2152 Gram / gramme

Ont/Ont Top 0.05% Diprolene Glycol 00629367 FRS 0.5187 Gram / gramme

Teva-Topilene Glycol 00849669 TEV 0.5187 Gram / gramme

Betamethasone Valerate / Valerate De Betamethasone Crm/Cr. Top 0.05% Celestoderm V/2 02357860 VLN 0.0596 Gram / gramme

Betaderm 00716618 TAR 0.0596 Gram / gramme

Teva-Ectosone Mild 00535427 TEV 0.0596 Gram / gramme

Crm/Cr. Top 0.1% Betaderm 00716626 TAR 0.0889 Gram / gramme

Celestoderm V 02357844 PMS 0.0889 Gram / gramme

Teva-Ectosone 00535435 TEV 0.0889 Gram / gramme

Lot/Lot Top 0.05% Teva-Ectosone Mild 00653209 TEV 0.2375 Gram / gramme

Lot/Lot Top 0.1% Betaderm 00716634 TAR 0.0852 Gram / gramme

Teva-Ectosone Scalp 00653217 TEV 0.0852 Gram / gramme

Lot/Lot Top 0.1% Teva-Ectosone 00750050 TEV 0.3125 Gram / gramme

Ont/Ont Top 0.05% Celestoderm V/2 02357879 VLN 0.0596 Gram / gramme

Betaderm 00716642 TAR 0.0596 Gram / gramme

Ont/Ont Top 0.1% Celestoderm V 02357852 VLN 0.0889 Gram / gramme

Betaderm 00716650 TAR 0.0889 Gram / gramme

Bicalutamide / Bicalutamide Tab/Co. Orl 50 mg Casodex 02184478 AZE 1.2690 Tablet / comprime

Apo-Bicalutamide 02296063 APX 1.2690 Tablet / comprime

Bicalutamide 02382423 SIV 1.2690 Tablet / comprime

Bicalutamide 02325985 AHI 1.2690 Tablet / comprime

Jamp-Bicalutamide 02357216 JPC 1.2690 Tablet / comprime

Teva-Bicalutamide 02270226 TEV 1.2690 Tablet / comprime

pms-Bicalutamide 02275589 PMS 1.2690 Tablet / comprime

Bimatoprost / Bimatoprost Liq/Liq Oph 0.03% Vistitan 02429063 SDZ 9.1936 Millilitre / millilitre

Bisoprolol / Bisoprolol Tab/Co. Orl 5 mg Apo-Bisoprolol 02256134 APX 0.0715 Tablet / comprime

Bisoprolol 02495562 SIV 0.0715 Tablet / comprime

Bisoprolol 02383055 SIV 0.0715 Tablet / comprime

Bisoprolol 02391589 SAS 0.0715 Tablet / comprime

Mint-Bisoprolol 02465612 MNT 0.0715 Tablet / comprime

Sandoz Bisoprolol 02494035 SDZ 0.0715 Tablet / comprime

Sandoz Bisoprolol 02247439 SDZ 0.0715 Tablet / comprime

Teva-Bisoprolol 02267470 TEV 0.0715 Tablet / comprime

Tab/Co. Orl 10 mg Apo-Bisoprolol 02256177 APX 0.1044 Tablet / comprime

Bisoprolol 02495570 SIV 0.1044 Tablet / comprime

Bisoprolol 02391597 SAS 0.1044 Tablet / comprime

Bisoprolol 02383063 SIV 0.1044 Tablet / comprime

Mint-Bisoprolol 02465620 MNT 0.1044 Tablet / comprime

Sandoz Bisoprolol 02247440 SDZ 0.1044 Tablet / comprime

Sandoz Bisoprolol 02494043 SDZ 0.1044 Tablet / comprime

Teva-Bisoprolol 02267489 TEV 0.1044 Tablet / comprime

Bosentan / Bosentan Tab/Co. Orl 62.5 mg Tracleer 02244981 JAN 16.0447 Tablet / comprime P

Nat-Bosentan 02467984 NAT 16.0447 Tablet / comprime P

Sandoz Bosentan 02386275 SDZ 16.0447 Tablet / comprime P

Taro-Bosentan 02483130 TAR 16.0447 Tablet / comprime P

pms-Bosentan 02383012 PMS 16.0447 Tablet / comprime P

Tab/Co. Orl 125 mg Tracleer 02244982 JAN 16.0447 Tablet / comprime P

Nat-Bosentan 02467992 NAT 16.0447 Tablet / comprime P

Sandoz Bosentan 02386283 SDZ 16.0447 Tablet / comprime P

Taro-Bosentan 02483149 TAR 16.0447 Tablet / comprime P

pms-Bosentan 02383020 PMS 16.0447 Tablet / comprime P

Brimonidine / Brimonidine Liq/Liq Oph 0.15% Alphagan P 02248151 ALL 3.7165 Millilitre / millilitre

Brimonidine P 02301334 AAP 1.9320 Millilitre / millilitre

September / septembre 2020 Page 8

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Liq/Liq Oph 0.2% Alphagan 02236876 ALL 1.1550 Millilitre / millilitre

Apo-Brimonidine 02260077 APX 1.1550 Millilitre / millilitre

Sandoz Brimonidine 02305429 SDZ 1.1550 Millilitre / millilitre

pms-Brimonidine 02246284 PMS 1.1550 Millilitre / millilitre

Bromazepam / Bromazepam Tab/Co. Orl 3 mg Teva-Bromazepam 02230584 TEV 0.0375 Tablet / comprime

Tab/Co. Orl 6 mg Teva-Bromazepam 02230585 TEV 0.0548 Tablet / comprime

Bromocriptine / Bromocriptine Cap/Caps Orl 5 mg Bromocriptine 02230454 AAP 1.5251 Capsule / capsule

Tab/Co. Orl 2.5 mg Bromocriptine 02087324 AAP 1.0188 Tablet / comprime

Budesonide / Budesonide Aem/Aem. Nas 64 mcg Rhinocort Aqua 02231923 JNJ 0.0843 Dose / dose

Mylan-Budesonide AQ 02241003 MYL 0.0843 Dose / dose

Aem/Aem. Nas 100 mcg Mylan-Budesonide AQ 02230648 MYL 0.0772 Dose / dose

Sus/Susp Inh 0.5 mg/mL Pulmicort Nebuamp 01978926 AZE 0.9558 Millilitre / millilitre

Teva-Budesonide 02465957 TEV 0.6839 Millilitre / millilitre

Buprenorphine / Naloxone / Buprenorphine / Naloxone Slt/Co.S.L. Orl 2 mg / 0.5 mg Suboxone 02295695 IUK 1.3350 Tablet / comprime

Act Buprenorphine/Naloxone 02453908 TEV 1.3350 Tablet / comprime

pms-Buprenorphine/Naloxone 02424851 PMS 1.3350 Tablet / comprime

Slt/Co.S.L. Orl 8 mg / 2 mg Suboxone 02295709 IUK 2.3650 Tablet / comprime

Act Buprenorphine/Naloxone 02453916 TEV 2.3650 Tablet / comprime

pms-Buprenorphine/Naloxone 02424878 PMS 2.3650 Tablet / comprime

Bupropion / Bupropion ERT/Co.L.P. Orl 150 mg Wellbutrin XL 02275090 VLN 0.1463 Tablet / comprime

Mylan-Bupropion XL 02382075 MYL 0.1463 Tablet / comprime

Taro-Bupropion XL 02475804 SUN 0.1463 Tablet / comprime

Teva-Bupropion XL 02439654 TEV 0.1463 Tablet / comprime

ERT/Co.L.P. Orl 300 mg Wellbutrin XL 02275104 VLN 0.2927 Tablet / comprime

Mylan-Bupropion XL 02382083 MYL 0.2927 Tablet / comprime

Taro-Bupropion XL 02475812 SUN 0.2927 Tablet / comprime

Teva-Bupropion XL 02439662 TEV 0.2927 Tablet / comprime

SRT/Co.L.L. Orl 100 mg Bupropion SR 02391562 SAS 0.1547 Tablet / comprime

Sandoz Bupropion SR 02275074 SDZ 0.1547 Tablet / comprime

SRT/Co.L.L. Orl 150 mg Wellbutrin SR 02237825 VLN 0.2298 Tablet / comprime

Bupropion SR 02391570 SAS 0.2298 Tablet / comprime

Sandoz Bupropion SR 02275082 SDZ 0.2298 Tablet / comprime

Buspirone / Buspirone Tab/Co. Orl 10 mg Apo-Buspirone 02211076 APX 0.3517 Tablet / comprime

Teva-Buspirone 02231492 TEV 0.3517 Tablet / comprime

pms-Buspirone 02230942 PMS 0.3517 Tablet / comprime

Cabergoline / Cabergoline Tab/Co. Orl 0.5 mg Dostinex 02242471 PAL 18.8175 Tablet / comprime

Apo-Cabergoline 02455897 APX 12.3941 Tablet / comprime

Calcitriol / Calcitriol Cap/Caps Orl 0.25 mcg Rocaltrol 00481823 HLR 0.3536 Capsule / capsule

Calcitriol-Odan 02431637 ODN 0.3536 Capsule / capsule

Taro-Calcitriol 02485710 TAR 0.3536 Capsule / capsule

Cap/Caps Orl 0.5 mcg Rocaltrol 00481815 HLR 0.5623 Capsule / capsule

Calcitriol-Odan 02431645 ODN 0.5623 Capsule / capsule

Taro-Calcitriol 02485729 TAR 0.5623 Capsule / capsule

Candesartan / Candesartan Tab/Co. Orl 4 mg Atacand 02239090 AZE 0.8443 Tablet / comprime

Apo-Candesartan 02365340 APX 0.1700 Tablet / comprime

Auro-Candesartan 02445786 ARO 0.1700 Tablet / comprime

Candesartan 02388901 SAS 0.1700 Tablet / comprime

Candesartan Cilexetil 02379260 AHI 0.1700 Tablet / comprime

Jamp-Candesartan 02386496 JPC 0.1700 Tablet / comprime

Sandoz Candesartan 02326957 SDZ 0.1700 Tablet / comprime

Taro-Candesartan 02380684 SUN 0.1700 Tablet / comprime

pms-Candesartan 02391171 PMS 0.1700 Tablet / comprime

Tab/Co. Orl 8 mg Atacand 02239091 AZE 0.2281 Tablet / comprime

Apo-Candesartan 02365359 APX 0.2281 Tablet / comprime

Auro-Candesartan 02445794 ARO 0.2281 Tablet / comprime

Candesartan 02388707 SIV 0.2281 Tablet / comprime

Candesartan 02388928 SAS 0.2281 Tablet / comprime

Candesartan Cilexetil 02379279 AHI 0.2281 Tablet / comprime

Jamp-Candesartan 02386518 JPC 0.2281 Tablet / comprime

Mint-Candesartan 02476916 MNT 0.2281 Tablet / comprime

Sandoz Candesartan 02326965 SDZ 0.2281 Tablet / comprime

Taro-Candesartan 02380692 SUN 0.2281 Tablet / comprime

Teva-Candesartan 02366312 TEV 0.2281 Tablet / comprime

pms-Candesartan 02391198 PMS 0.2281 Tablet / comprime

Tab/Co. Orl 16 mg Atacand 02239092 AZE 0.2281 Tablet / comprime

Apo-Candesartan 02365367 APX 0.2281 Tablet / comprime

Auro-Candesartan 02445808 ARO 0.2281 Tablet / comprime

Candesartan 02388715 SIV 0.2281 Tablet / comprime

Candesartan 02388936 SAS 0.2281 Tablet / comprime

Candesartan Cilexetil 02379287 AHI 0.2281 Tablet / comprime

Jamp-Candesartan 02386526 JPC 0.2281 Tablet / comprime

Mint-Candesartan 02476924 MNT 0.2281 Tablet / comprime

Sandoz Candesartan 02326973 SDZ 0.2281 Tablet / comprime

Taro-Candesartan 02380706 SUN 0.2281 Tablet / comprime

September / septembre 2020 Page 9

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Teva-Candesartan 02366320 TEV 0.2281 Tablet / comprime

pms-Candesartan 02391201 PMS 0.2281 Tablet / comprime

Tab/Co. Orl 32 mg Atacand 02311658 AZE 1.4043 Tablet / comprime

Apo-Candesartan 02399105 APX 0.2281 Tablet / comprime

Auro-Candesartan 02445816 ARO 0.2281 Tablet / comprime

Candesartan 02435845 SAS 0.2281 Tablet / comprime

Candesartan Cilexetil 02379295 AHI 0.2281 Tablet / comprime

Jamp-Candesartan 02386534 JPC 0.2281 Tablet / comprime

Sandoz Candesartan 02417340 SDZ 0.2281 Tablet / comprime

Taro-Candesartan 02380714 SUN 0.2281 Tablet / comprime

Teva-Candesartan 02366339 TEV 0.2281 Tablet / comprime

pms-Candesartan 02391228 PMS 0.2281 Tablet / comprime

Candesartan / Hydrochlorothiazide / Candesartan /

Hydrochlorothiazide

Tab/Co. Orl 16 mg / 12.5 mg Atacand Plus 02244021 AZE 0.2156 Tablet / comprime

Auro-Candesartan HCT 02421038 ARO 0.2156 Tablet / comprime

Candesartan HCT 02394812 SIV 0.2156 Tablet / comprime

Candesartan/HCTZ 02394804 SAS 0.2156 Tablet / comprime

Jamp-Candesartan HCT 02473240 JPC 0.2156 Tablet / comprime

Sandoz Candesartan Plus 02327902 SDZ 0.2156 Tablet / comprime

Teva-Candesartan/HCTZ 02395541 TEV 0.2156 Tablet / comprime

pms-Candesartan-HCTZ 02391295 PMS 0.2156 Tablet / comprime

Tab/Co. Orl 32 mg / 12.5 mg Atacand Plus 02332922 AZE 0.2156 Tablet / comprime

Auro-Candesartan HCT 02421046 ARO 0.2156 Tablet / comprime

Jamp-Candesartan HCT 02473259 JPC 0.2156 Tablet / comprime

Sandoz Candesartan Plus 02420732 SDZ 0.2156 Tablet / comprime

Teva-Candesartan/HCTZ 02395568 TEV 0.2156 Tablet / comprime

Tab/Co. Orl 32 mg / 25 mg Atacand Plus 02332957 AZE 1.4043 Tablet / comprime

Auro-Candesartan HCT 02421054 ARO 0.3008 Tablet / comprime

Jamp-Candesartan HCT 02473267 JPC 0.3008 Tablet / comprime

Sandoz Candesartan Plus 02420740 SDZ 0.3008 Tablet / comprime

Capecitabine / Capecitabine Tab/Co. Orl 150 mg Xeloda 02238453 HLR 0.4575 Tablet / comprime

Ach-Capecitabine 02426757 AHI 0.4575 Tablet / comprime

Sandoz Capecitabine 02421917 SDZ 0.4575 Tablet / comprime

Taro-Capecitabine 02457490 TAR 0.4575 Tablet / comprime

Teva-Capecitabine 02400022 TEV 0.4575 Tablet / comprime

Tab/Co. Orl 500 mg Xeloda 02238454 HLR 1.5250 Tablet / comprime

Ach-Capecitabine 02426765 AHI 1.5250 Tablet / comprime

Sandoz Capecitabine 02421925 SDZ 1.5250 Tablet / comprime

Taro-Capecitabine 02457504 TAR 1.5250 Tablet / comprime

Teva-Capecitabine 02400030 TEV 1.5250 Tablet / comprime

Captopril / Captopril Tab/Co. Orl 12.5 mg Teva-Captopril 01942964 TEV 0.1060 Tablet / comprime

Tab/Co. Orl 25 mg Teva-Captopril 01942972 TEV 0.1500 Tablet / comprime

Tab/Co. Orl 50 mg Teva-Captopril 01942980 TEV 0.2795 Tablet / comprime

Tab/Co. Orl 100 mg Teva-Captopril 01942999 TEV 0.5198 Tablet / comprime

Carbamazepine / Carbamazepine SRT/Co.L.L. Orl 200 mg Tegretol CR 00773611 NVR 0.0930 Tablet / comprime

Sandoz Carbamazepine CR 02261839 SDZ 0.0930 Tablet / comprime

pms-Carbamazepine 02231543 PMS 0.0930 Tablet / comprime

SRT/Co.L.L. Orl 400 mg Tegretol CR 00755583 NVR 0.1859 Tablet / comprime

Sandoz Carbamazepine CR 02261847 SDZ 0.1859 Tablet / comprime

pms-Carbamazepine 02231544 PMS 0.1859 Tablet / comprime

Sus/Susp Orl 100 mg/5 mL Tegretol 02194333 NVR 0.0582 Millilitre / millilitre

Taro-Carbamazepine 02367394 TAR 0.0582 Millilitre / millilitre

Tab/Co. Orl 200 mg Tegretol 00010405 NVR 0.1467 Tablet / comprime

Taro-Carbamazepine 02407515 TAR 0.1467 Tablet / comprime

Teva-Carbamazepine 00782718 TEV 0.1467 Tablet / comprime

Carvedilol / Carvedilol Tab/Co. Orl 3.125 mg Apo-Carvedilol 02247933 APX 0.2431 Tablet / comprime

Auro-Carvedilol 02418495 ARO 0.2431 Tablet / comprime

Carvedilol 02364913 SAS 0.2431 Tablet / comprime

Carvedilol 02248752 SIV 0.2431 Tablet / comprime

Jamp-Carvedilol 02368897 JPC 0.2431 Tablet / comprime

pms-Carvedilol 02245914 PMS 0.2431 Tablet / comprime

ratio-Carvedilol 02252309 TEV 0.2431 Tablet / comprime

Tab/Co. Orl 6.25 mg Apo-Carvedilol 02247934 APX 0.2431 Tablet / comprime

Auro-Carvedilol 02418509 ARO 0.2431 Tablet / comprime

Carvedilol 02364921 SAS 0.2431 Tablet / comprime

Carvedilol 02248753 SIV 0.2431 Tablet / comprime

Jamp-Carvedilol 02368900 JPC 0.2431 Tablet / comprime

pms-Carvedilol 02245915 PMS 0.2431 Tablet / comprime

ratio-Carvedilol 02252317 TEV 0.2431 Tablet / comprime

Tab/Co. Orl 12.5 mg Apo-Carvedilol 02247935 APX 0.2431 Tablet / comprime

Auro-Carvedilol 02418517 ARO 0.2431 Tablet / comprime

Carvedilol 02364948 SAS 0.2431 Tablet / comprime

Carvedilol 02248754 SIV 0.2431 Tablet / comprime

Jamp-Carvedilol 02368919 JPC 0.2431 Tablet / comprime

September / septembre 2020 Page 10

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

pms-Carvedilol 02245916 PMS 0.2431 Tablet / comprime

ratio-Carvedilol 02252325 TEV 0.2431 Tablet / comprime

Tab/Co. Orl 25 mg Apo-Carvedilol 02247936 APX 0.2431 Tablet / comprime

Auro-Carvedilol 02418525 ARO 0.2431 Tablet / comprime

Carvedilol 02364956 SAS 0.2431 Tablet / comprime

Carvedilol 02248755 SIV 0.2431 Tablet / comprime

Jamp-Carvedilol 02368927 JPC 0.2431 Tablet / comprime

pms-Carvedilol 02245917 PMS 0.2431 Tablet / comprime

ratio-Carvedilol 02252333 TEV 0.2431 Tablet / comprime

Caspofungin / Caspofungin Pwd/Pws. Inj 50 mg Cancidas IV 02244265 FRS 188.7000 Vial / fiole

Caspofungin for Injection 02460947 MDN 188.7000 Vial / fiole

Pwd/Pws. Inj 70 mg Cancidas IV 02244266 FRS 188.7000 Vial / fiole

Caspofungin for Injection 02460955 MDN 188.7000 Vial / fiole

Cefadroxil / Cefadroxil Cap/Caps Orl 500 mg Apo-Cefadroxil 02240774 APX 0.8421 Capsule / capsule

Teva-Cefadroxil 02235134 TEV 0.8421 Capsule / capsule

Cefazolin / Cefazoline Pws/Pds. Inj 500 mg Cefazolin Sodium 02308932 SDZ 2.5000 Vial / fiole

Cefazolin Sodium 02108119 TEV 2.5000 Vial / fiole

Pws/Pds. Inj 1 g Cefazolin Sodium 02108127 TEV 3.2308 Vial / fiole

Cefazolin Sodium 02308959 SDZ 3.2308 Vial / fiole

Cefepime / Cefepime Pws/Pds. Inj 1 g Apo-Cefepime 02467496 APX 15.1003 Vial / fiole

Pws/Pds. Inj 2 g Apo-Cefepime 02467518 APX 30.1962 Vial / fiole

Cefixime / Cefixime Pws/Pds. Orl 20 mg Suprax 00868965 ODN 0.3899 Millilitre / millilitre

Auro-Cefixime 02468689 ARO 0.3899 Millilitre / millilitre

Tab/Co. Orl 400 mg Suprax 00868981 ODN 2.7172 Tablet / comprime

Auro-Cefixime 02432773 ARO 2.7172 Tablet / comprime

Cefotaxime / Cefotaxime Pws/Pds. Inj 1 g Cefotaxime Sodium 02434091 STR 8.3300 Vial / fiole

Pws/Pds. Inj 2 g Cefotaxime Sodium 02434105 STR 16.6855 Vial / fiole

Cefoxitin / Cefoxitine Pws/Pds. Inj 1 g Cefoxitin Sodium 02128187 TEV 10.6000 Vial / fiole

Pws/Pds. Inj 2 g Cefoxitin Sodium 02128195 TEV 21.2500 Vial / fiole

Cefprozil / Cefprozil Pws/Pds. Orl 25 mg Taro-Cefprozil 02329204 SUN 0.1649 Millilitre / millilitre

Pws/Pds. Orl 50 mg Taro-Cefprozil 02293579 SUN 0.3294 Millilitre / millilitre

Tab/Co. Orl 250 mg Auro-Cefprozil 02347245 ARO 0.4332 Tablet / comprime

Sandoz Cefprozil 02302179 SDZ 0.4332 Tablet / comprime

Taro-Cefprozil 02293528 SUN 0.4332 Tablet / comprime

Tab/Co. Orl 500 mg Auro-Cefprozil 02347253 ARO 0.8494 Tablet / comprime

Sandoz Cefprozil 02302187 SDZ 0.8494 Tablet / comprime

Taro-Cefprozil 02293536 SUN 0.8494 Tablet / comprime

Ceftazidime / Ceftazidime Pws/Pds. Inj 1 g Fortaz 02212218 GSK 18.8500 Vial / fiole

Ceftazidime 00886971 FKB 18.8500 Vial / fiole

Pws/Pds. Inj 2 g Fortaz 02212226 GSK 37.1000 Vial / fiole

Ceftazidime 00886955 FKB 37.1000 Vial / fiole

Ceftriaxone / Ceftriaxone Pws/Pds. Inj 250 mg Ceftriaxone Sodium 02325594 STR 3.9501 Vial / fiole

Pws/Pds. Inj 1 g Ceftriaxone 02292270 SDZ 12.4950 Vial / fiole

Ceftriaxone Sodium 02287633 TEV 12.4950 Vial / fiole

Ceftriaxone Sodium 02325616 STR 12.4950 Vial / fiole

Pws/Pds. Inj 2 g Ceftriaxone 02292289 SDZ 24.1300 Vial / fiole

Ceftriaxone Sodium 02325624 STR 24.1300 Vial / fiole

Cefuroxime / Cefuroxime Pws/Pds. Inj 750 mg Cefuroxime 02241638 FKB 19.8900 Vial / fiole

Pws/Pds. Inj 1.5 g Cefuroxime 02241639 FKB 28.0400 Vial / fiole

Tab/Co. Orl 250 mg Ceftin 02212277 GSK 0.7237 Tablet / comprime

Apo-Cefuroxime 02244393 APX 0.7237 Tablet / comprime

Auro-Cefuroxime 02344823 ARO 0.7237 Tablet / comprime

Tab/Co. Orl 500 mg Ceftin 02212285 GSK 1.4337 Tablet / comprime

Apo-Cefuroxime 02244394 APX 1.4337 Tablet / comprime

Auro-Cefuroxime 02344831 ARO 1.4337 Tablet / comprime

Celecoxib / Celecoxib Cap/Caps Orl 100 mg Celebrex 02239941 UJC 0.1279 Capsule / capsule

Act-Celecoxib 02420155 ATV 0.1279 Capsule / capsule

Apo-Celecoxib 02418932 APX 0.1279 Capsule / capsule

Auro-Celecoxib 02445670 ARO 0.1279 Capsule / capsule

Celecoxib 02429675 SIV 0.1279 Capsule / capsule

Jamp-Celecoxib 02424533 JPC 0.1279 Capsule / capsule

Mar-Celecoxib 02420058 MAR 0.1279 Capsule / capsule

Mint-Celecoxib 02412497 MNT 0.1279 Capsule / capsule

NRA-Celecoxib 02479737 NRA 0.1279 Capsule / capsule

Ran-Celecoxib 02412373 RAN 0.1279 Capsule / capsule

SDZ Celecoxib 02442639 SDZ 0.1279 Capsule / capsule

pms-Celecoxib 02355442 PMS 0.1279 Capsule / capsule

Cap/Caps Orl 200 mg Celebrex 02239942 UJC 0.2558 Capsule / capsule

Act-Celecoxib 02420163 ATV 0.2558 Capsule / capsule

Apo-Celecoxib 02418940 APX 0.2558 Capsule / capsule

Auro-Celecoxib 02445689 ARO 0.2558 Capsule / capsule

Celecoxib 02429683 SIV 0.2558 Capsule / capsule

Jamp-Celecoxib 02424541 JPC 0.2558 Capsule / capsule

Mar-Celecoxib 02420066 MAR 0.2558 Capsule / capsule

September / septembre 2020 Page 11

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Mint-Celecoxib 02412500 MNT 0.2558 Capsule / capsule

NRA-Celecoxib 02479745 NRA 0.2558 Capsule / capsule

Ran-Celecoxib 02412381 RAN 0.2558 Capsule / capsule

SDZ Celecoxib 02442647 SDZ 0.2558 Capsule / capsule

pms-Celecoxib 02355450 PMS 0.2558 Capsule / capsule

Cephalexin / Cephalexine Cap/Caps Orl 250 mg Teva-Cephalexin 00342084 TEV 0.3620 Capsule / capsule

Cap/Caps Orl 500 mg Teva-Cephalexin 00342114 TEV 0.6845 Capsule / capsule

Pws/Pds. Orl 25 mg Teva-Cephalexin 00342106 TEV 0.2193 Millilitre / millilitre

Pws/Pds. Orl 50 mg Teva-Cephalexin 00342092 TEV 0.3675 Millilitre / millilitre

Tab/Co. Orl 250 mg Apo-Cephalex 00768723 APX 0.0866 Tablet / comprime

Auro-Cephalexin 02470578 ARO 0.0866 Tablet / comprime

Teva-Cephalexin 00583413 TEV 0.0866 Tablet / comprime

Tab/Co.

Orl 500 mg

Apo-Cephalex 00768715 APX 0.1731 Tablet / comprime

Tab/Co. Orl 500 mg Auro-Cephalexin 02470586 ARO 0.1731 Tablet / comprime

Teva-Cephalexin 00583421 TEV 0.1731 Tablet / comprime

Cetirizine / Cetirizine Tab/Co. Orl 10 mg Reactine 02223554 JNJ 0.4083 Tablet / comprime

Apo-Cetirizine 02231603 APX 0.4083 Tablet / comprime

Chloral Hydrate / Hydrate De Chloral Syr/Sir. Orl 100 mg/mL Chloral Hydrate Syrup Odan 02247621 ODN 0.0520 Millilitre / millilitre

Chlordiazepoxide / Chlordiazepoxide Cap/Caps Orl 5 mg Chlordiazepoxide 00522724 AAP 0.0717 Capsule / capsule

Cap/Caps Orl 10 mg Chlordiazepoxide 00522988 AAP 0.1091 Capsule / capsule

Cap/Caps Orl 25 mg Chlordiazepoxide 00522996 AAP 0.1740 Capsule / capsule

Chloroquine / Chloroquine Tab/Co. Orl 250 mg Teva-Chloroquine 00021261 TEV 0.3208 Tablet / comprime

Chlorphenamine (Chlorpheniramine) / Chlorphenamine

(Chlorpheniramine)

Tab/Co. Orl 4 mg Chlor-Tripolon 00738972 SCO 0.0645 Tablet / comprime

Novo-Pheniram 00021288 TEV 0.0645 Tablet / comprime

Chlorpromazine / Chlorpromazine Tab/Co. Orl 25 mg Teva-Chlorpromazine 00232823 TEV 0.1365 Tablet / comprime

Tab/Co. Orl 50 mg Teva-Chlorpromazine 00232807 TEV 0.1565 Tablet / comprime

Tab/Co. Orl 100 mg Teva-Chlorpromazine 00232831 TEV 0.3200 Tablet / comprime

Chlorthalidone / Chlorthalidone Tab/Co. Orl 50 mg Chlorthalidone 00360279 AAP 0.1267 Tablet / comprime

Cholestyramine / Cholestyramine Pws/Pds. Orl 4 g Packets/sachets Cholestyramine-Odan 02455609 ODN 0.0923 Gram / gramme

Jamp-Cholestyramine 02478595 JPC 0.0923 Gram / gramme

Olestyr 02210320 PMS 0.0923 Gram / gramme

Olestyr 00890960 PMS 0.0923 Gram / gramme

Cilazapril / Cilazapril Tab/Co. Orl 1 mg Apo-Cilazapril 02291134 APX 0.3115 Tablet / comprime

Mylan-Cilazapril 02283778 MYL 0.3115 Tablet / comprime

Tab/Co. Orl 2.5 mg Inhibace 01911473 MSD 0.4295 Tablet / comprime

Apo-Cilazapril 02291142 APX 0.4295 Tablet / comprime

Mylan-Cilazapril 02283786 MYL 0.4295 Tablet / comprime

Tab/Co. Orl 5 mg Inhibace 01911481 MSD 0.4989 Tablet / comprime

Apo-Cilazapril 02291150 APX 0.4989 Tablet / comprime

Mylan-Cilazapril 02283794 MYL 0.4989 Tablet / comprime

Cilazapril / Hydrochlorothiazide / Cilazapril /

Hydrochlorothiazide

Tab/Co. Orl 5 mg / 12.5 mg Inhibace Plus 02181479 HLR 0.4170 Tablet / comprime

Apo-Cilazapril/HCTZ 02284987 APX 0.4170 Tablet / comprime

Teva-Cilazapril/HCTZ 02313731 TEV 0.4170 Tablet / comprime

Cimetidine / Cimetidine Tab/Co. Orl 200 mg Cimetidine 00584215 AAP 0.3284 Tablet / comprime

Tab/Co. Orl 300 mg Cimetidine 00487872 AAP 0.3423 Tablet / comprime

Cinacalcet / Cinacalcet Tab/Co. Orl 30 mg Sensipar 02257130 AGA 2.7418 Tablet / comprime

Apo-Cinacalcet 02452693 APX 2.7418 Tablet / comprime

Auro-Cinacalcet 02478900 ARO 2.7418 Tablet / comprime

Mar-Cinacalcet 02480298 MAR 2.7418 Tablet / comprime

Teva-Cinacalcet 02441624 TEV 2.7418 Tablet / comprime

Tab/Co. Orl 60 mg Sensipar 02257149 AGA 4.9995 Tablet / comprime

Apo-Cinacalcet 02452707 APX 4.9995 Tablet / comprime

Auro-Cinacalcet 02478919 ARO 4.9995 Tablet / comprime

Mar-Cinacalcet 02480301 MAR 4.9995 Tablet / comprime

Teva-Cinacalcet 02441632 TEV 4.9995 Tablet / comprime

Tab/Co. Orl 90 mg Sensipar 02257157 AGA 7.2752 Tablet / comprime

Apo-Cinacalcet 02452715 APX 7.2752 Tablet / comprime

Auro-Cinacalcet 02478943 ARO 7.2752 Tablet / comprime

Mar-Cinacalcet 02480328 MAR 7.2752 Tablet / comprime

Teva-Cinacalcet 02441640 TEV 7.2752 Tablet / comprime

Ciprofloxacin / Ciprofloxacine Liq/Liq Oph 0.3% Ciloxan 01945270 NVR 1.7600 Millilitre / millilitre

Sandoz Ciprofloxacin 02387131 SDZ 1.7600 Millilitre / millilitre

Liq/Liq IV 2 mg/mL Ciprofloxacin Intravenous Infusion BP 02304759 SDZ 0.1540 Millilitre / millilitre

Tab/Co. Orl 250 mg Act Ciprofloxacin 02247339 TEV 0.4454 Tablet / comprime

Auro-Ciprofloxacin 02381907 ARO 0.4454 Tablet / comprime

Ciprofloxacin 02353318 SAS 0.4454 Tablet / comprime

Ciprofloxacin 02386119 SIV 0.4454 Tablet / comprime

Jamp-Ciprofloxacin 02380358 JPC 0.4454 Tablet / comprime

Mar-Ciprofloxacin 02379686 MAR 0.4454 Tablet / comprime

Mint-Ciproflox 02423553 MNT 0.4454 Tablet / comprime

Sandoz Ciprofloxacin 02248756 SDZ 0.4454 Tablet / comprime

Taro-Ciproflox 02303728 SUN 0.4454 Tablet / comprime

September / septembre 2020 Page 12

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

pms-Ciprofloxacin 02248437 PMS 0.4454 Tablet / comprime

Tab/Co. Orl 500 mg Cipro 02155966 BAY 0.5025 Tablet / comprime

Act Ciprofloxacin 02247340 TEV 0.5025 Tablet / comprime

Auro-Ciprofloxacin 02381923 ARO 0.5025 Tablet / comprime

Ciprofloxacin 02386127 SIV 0.5025 Tablet / comprime

Ciprofloxacin 02353326 SAS 0.5025 Tablet / comprime

Jamp-Ciprofloxacin 02380366 JPC 0.5025 Tablet / comprime

Mar-Ciprofloxacin 02379694 MAR 0.5025 Tablet / comprime

Sandoz Ciprofloxacin 02248757 SDZ 0.5025 Tablet / comprime

Taro-Ciproflox 02303736 SUN 0.5025 Tablet / comprime

pms-Ciprofloxacin 02248438 PMS 0.5025 Tablet / comprime

Tab/Co. Orl 750 mg Act Ciprofloxacin 02247341 TEV 0.9201 Tablet / comprime

Jamp-Ciprofloxacin 02380374 JPC 0.9201 Tablet / comprime

Mar-Ciprofloxacin 02379708 MAR 0.9201 Tablet / comprime

Mint-Ciproflox 02423588 MNT 0.9201 Tablet / comprime

Sandoz Ciprofloxacin 02248758 SDZ 0.9201 Tablet / comprime

Taro-Ciproflox 02303744 SUN 0.9201 Tablet / comprime

pms-Ciprofloxacin 02248439 PMS 0.9201 Tablet / comprime

Citalopram / Citalopram Tab/Co. Orl 10 mg Citalopram 02430517 JPC 0.0796 Tablet / comprime

Citalopram 02445719 SAS 0.0796 Tablet / comprime

Citalopram 02387948 SIV 0.0796 Tablet / comprime

Citalopram-10 02325047 PDL 0.0796 Tablet / comprime

Mar-Citalopram 02371871 MAR 0.0796 Tablet / comprime

Mint-Citalopram 02429691 MNT 0.0796 Tablet / comprime

Nat-Citalopram 02409003 NAT 0.0796 Tablet / comprime

Teva-Citalopram 02312336 TEV 0.0796 Tablet / comprime

pms-Citalopram 02270609 PMS 0.0796 Tablet / comprime

Tab/Co. Orl 20 mg Celexa 02239607 VLH 0.1332 Tablet / comprime

Apo-Citalopram 02246056 APX 0.1332 Tablet / comprime

Auro-Citalopram 02275562 ARO 0.1332 Tablet / comprime

CCP-Citalopram 02459914 CCM 0.1332 Tablet / comprime

Citalopram 02430541 JPC 0.1332 Tablet / comprime

Citalopram 02387956 SIV 0.1332 Tablet / comprime

Citalopram 02353660 SAS 0.1332 Tablet / comprime

Citalopram-20 02257513 PDL 0.1332 Tablet / comprime

Mar-Citalopram 02371898 MAR 0.1332 Tablet / comprime

Mint-Citalopram 02429705 MNT 0.1332 Tablet / comprime

Nat-Citalopram 02409011 NAT 0.1332 Tablet / comprime

Ran-Citalo 02285622 RAN 0.1332 Tablet / comprime

Sandoz Citalopram 02248170 SDZ 0.1332 Tablet / comprime

Septa-Citalopram 02355272 SPT 0.1332 Tablet / comprime

Teva-Citalopram 02293218 TEV 0.1332 Tablet / comprime

pms-Citalopram 02248010 PMS 0.1332 Tablet / comprime

Tab/Co. Orl 40 mg Celexa 02239608 VLH 0.1332 Tablet / comprime

Apo-Citalopram 02246057 APX 0.1332 Tablet / comprime

Auro-Citalopram 02275570 ARO 0.1332 Tablet / comprime

CCP-Citalopram 02459922 CCM 0.1332 Tablet / comprime

Citalopram 02387964 SIV 0.1332 Tablet / comprime

Citalopram 02430568 JPC 0.1332 Tablet / comprime

Citalopram 02353679 SAS 0.1332 Tablet / comprime

Citalopram-40 02257521 PDL 0.1332 Tablet / comprime

Mar-Citalopram 02371901 MAR 0.1332 Tablet / comprime

Mint-Citalopram 02429713 MNT 0.1332 Tablet / comprime

Nat-Citalopram 02409038 NAT 0.1332 Tablet / comprime

Sandoz Citalopram 02248171 SDZ 0.1332 Tablet / comprime

Septa-Citalopram 02355280 SPT 0.1332 Tablet / comprime

Teva-Citalopram 02293226 TEV 0.1332 Tablet / comprime

pms-Citalopram 02248011 PMS 0.1332 Tablet / comprime

Clarithromycin / Clarithromycine ERT/Co.L.P. Orl 500 mg Biaxin XL 02244756 ABB 1.2572 Tablet / comprime

Act Clarithromycin XL 02403196 TEV 1.2572 Tablet / comprime

Apo-Clarithromycin XL 02413345 APX 1.2572 Tablet / comprime

Pws/Pds. Orl 125 mg/5 mL Biaxin 02146908 ABB 0.2047 Millilitre / millilitre

Clarithromycin 02408988 SAS 0.2047 Millilitre / millilitre

Taro-Clarithromycin 02390442 TAR 0.2047 Millilitre / millilitre

Pws/Pds. Orl 250 mg/5 mL Biaxin 02244641 ABB 0.3998 Millilitre / millilitre

Clarithromycin 02408996 SAS 0.3998 Millilitre / millilitre

Taro-Clarithromycin 02390450 TAR 0.3998 Millilitre / millilitre

Tab/Co. Orl 250 mg Biaxin BID 01984853 ABB 0.4122 Tablet / comprime

Apo-Clarithromycin 02274744 APX 0.4122 Tablet / comprime

Clarithromycin 02466120 SAS 0.4122 Tablet / comprime

Clarithromycin 02442469 SIV 0.4122 Tablet / comprime

Ran-Clarithromycin 02361426 RAN 0.4122 Tablet / comprime

Sandoz Clarithromycin 02266539 SDZ 0.4122 Tablet / comprime

Teva-Clarithromycin 02248804 TEV 0.4122 Tablet / comprime

September / septembre 2020 Page 13

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

pms-Clarithromycin 02247573 PMS 0.4122 Tablet / comprime

Tab/Co. Orl 500 mg Biaxin BID 02126710 ABB 0.8318 Tablet / comprime

Apo-Clarithromycin 02274752 APX 0.8318 Tablet / comprime

Clarithromycin 02442485 SIV 0.8318 Tablet / comprime

Ran-Clarithromycin 02361434 RAN 0.8318 Tablet / comprime

Sandoz Clarithromycin 02266547 SDZ 0.8318 Tablet / comprime

Teva-Clarithromycin 02248805 TEV 0.8318 Tablet / comprime

pms-Clarithromycin 02247574 PMS 0.8318 Tablet / comprime

Clidinium / Chlordiazepoxide / Clidinium / Chlordiazepoxide Cap/Caps Orl 5 mg / 2.5 mg Librax 00115630 BSL 0.2451 Capsule / capsule

Chlorax 00618454 AAP 0.2451 Capsule / capsule

Clindamycin / Clindamycine Cap/Caps Orl 150 mg Dalacin C 00030570 PFI 0.2217 Capsule / capsule

Auro-Clindamycin 02436906 ARO 0.2217 Capsule / capsule

Jamp-Clindamycin 02483734 JPC 0.2217 Capsule / capsule

Teva-Clindamycin 02241709 TEV 0.2217 Capsule / capsule

Cap/Caps Orl 300 mg Dalacin C 02182866 PFI 0.4434 Capsule / capsule

Auro-Clindamycin 02436914 ARO 0.4434 Capsule / capsule

Jamp-Clindamycin 02483742 JPC 0.4434 Capsule / capsule

Teva-Clindamycin 02241710 TEV 0.4434 Capsule / capsule

Liq/Liq Top 1% Dalacin T 00582301 PFI 0.2310 Millilitre / millilitre

Clindamycin Phosphate Topical Solution 02483769 TLG 0.2310 Millilitre / millilitre

Taro-Clindamycin 02266938 TAR 0.2310 Millilitre / millilitre

Liq/Liq Inj 150 mg/mL Dalacin C Phosphate 00260436 PFI 3.6550 Millilitre / millilitre

Clindamycin (2mL, 4mL, 6mL vials) 02230540 SDZ 3.6550 Millilitre / millilitre

Clindamycin (bulk vials) 02230535 SDZ 3.6550 Millilitre / millilitre

Clobazam / Clobazam Tab/Co. Orl 10 mg Apo-Clobazam 02244638 APX 0.2197 Tablet / comprime

Teva-Clobazam 02238334 TEV 0.2197 Tablet / comprime

Clobetasol / Clobetasol Crm/Cr. Top 0.05% Dermovate 02213265 TPH 0.2279 Gram / gramme

Mylan-Clobetasol 02024187 MYL 0.2279 Gram / gramme

Taro-Clobetasol Cream 02245523 TAR 0.2279 Gram / gramme

ratio-Clobetasol 01910272 TEV 0.2279 Gram / gramme

Lot/Lot Top 0.05% Dermovate 02213281 TPH 0.1990 Gram / gramme

Mylan-Clobetasol Propionate 02216213 MYL 0.1990 Gram / gramme

Taro-Clobetasol Topical Sol'n 02245522 TAR 0.1990 Gram / gramme

ratio-Clobetasol 01910299 TEV 0.1990 Gram / gramme

Ont/Ont Top 0.05% Dermovate 02213273 TPH 0.2279 Gram / gramme

Mylan-Clobetasol 02026767 MYL 0.2279 Gram / gramme

Taro-Clobetasol Ointment 02245524 TAR 0.2279 Gram / gramme

ratio-Clobetasol 01910280 TEV 0.2279 Gram / gramme

Clomipramine / Clomipramine Tab/Co. Orl 10 mg Anafranil 00330566 AAP 0.2949 Tablet / comprime

Tab/Co. Orl 25 mg Anafranil 00324019 AAP 0.3417 Tablet / comprime

Cap/Caps Orl 25 mg Taro-Clomipramine 02497506 TAR 0.3417 Capsule / capsule

Tab/Co. Orl 50 mg Anafranil 00402591 AAP 0.6291 Tablet / comprime

Cap/Caps Orl 50 mg Taro-Clomipramine 02497514 TAR 0.6291 Capsule / capsule

Clonazepam / Clonazepam Tab/Co. Orl 0.25 mg pms-Clonazepam 02179660 PMS 0.0850 Tablet / comprime

Tab/Co. Orl 0.5 mg Rivotril 00382825 HLR 0.0418 Tablet / comprime

Apo-Clonazepam 02177889 APX 0.0418 Tablet / comprime

pms-Clonazepam R 02207818 PMS 0.0418 Tablet / comprime

Tab/Co. Orl 1 mg pms-Clonazepam 02048728 PMS 0.1487 Tablet / comprime

Tab/Co. Orl 2 mg Rivotril 00382841 HLR 0.0721 Tablet / comprime

Apo-Clonazepam 02177897 APX 0.0721 Tablet / comprime

pms-Clonazepam 02048736 PMS 0.0721 Tablet / comprime

Clonidine / Clonidine Tab/Co. Orl 0.025 mg Teva-Clonidine 02304163 TEV 0.2713 Tablet / comprime

Tab/Co. Orl 0.1 mg Mint-Clonidine 02462192 MNT 0.0927 Tablet / comprime

Teva-Clonidine 02046121 TEV 0.0927 Tablet / comprime

Tab/Co. Orl 0.2 mg Mint-Clonidine 02462206 MNT 0.1653 Tablet / comprime

Teva-Clonidine 02046148 TEV 0.1653 Tablet / comprime

Clopidogrel / Clopidogrel Tab/Co. Orl 75 mg Plavix 02238682 SAV 0.2631 Tablet / comprime

Apo-Clopidogrel 02252767 APX 0.2631 Tablet / comprime

Auro-Clopidogrel 02416387 ARO 0.2631 Tablet / comprime

Clopidogrel 02394820 PDL 0.2631 Tablet / comprime

Clopidogrel 02385813 SIV 0.2631 Tablet / comprime

Clopidogrel 02400553 SAS 0.2631 Tablet / comprime

Jamp-Clopidogrel 02415550 JPC 0.2631 Tablet / comprime

Mar-Clopidogrel 02422255 MAR 0.2631 Tablet / comprime

NRA-Clopidogrel 02482037 NRA 0.2631 Tablet / comprime

Sandoz Clopidogrel 02359316 SDZ 0.2631 Tablet / comprime

Taro-Clopidogrel 02379813 SUN 0.2631 Tablet / comprime

Teva-Clopidogrel 02293161 TEV 0.2631 Tablet / comprime

pms-Clopidogrel 02348004 PMS 0.2631 Tablet / comprime

Clorazepate Dipotassium / Clorazepate Dipotassique Cap/Caps Orl 3.75 mg Clorazepate 00860689 AAP 0.1506 Capsule / capsule

Cap/Caps Orl 7.5 mg Clorazepate 00860700 AAP 0.1810 Capsule / capsule

Cap/Caps Orl 15 mg Clorazepate 00860697 AAP 0.3259 Capsule / capsule

Clotrimazole / Betamethasone / Clotrimazole / Betamethasone Crm/Cr. Top 1% / 0.05% Lotriderm 00611174 FRS 0.6964 Gram / gramme

September / septembre 2020 Page 14

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Taro-Clotrimazole/Betamethasone Dipropionate 02496410 TAR 0.6964 Gram / gramme

Clotrimazole / Clotrimazole Crm/Cr. Top 1% Canesten 02150867 YNO 0.2060 Gram / gramme

Clotrimaderm 00812382 TAR 0.2060 Gram / gramme

Cloxacillin / Cloxacilline Cap/Caps Orl 250 mg Teva-Cloxacillin 00337765 TEV 0.3620 Capsule / capsule

Cap/Caps Orl 500 mg Teva-Cloxacillin 00337773 TEV 0.6845 Capsule / capsule

Pws/Pds. Orl 25 mg Teva-Cloxacillin 00337757 TEV 0.0911 Millilitre / millilitre

Clozapine / Clozapine Tab/Co. Orl 25 mg Clozaril 00894737 HLS 0.6594 Tablet / comprime

AA-Clozapine 02248034 AAP 0.6594 Tablet / comprime

Gen-Clozapine 02247243 MYL 0.6594 Tablet / comprime

Tab/Co. Orl 50 mg AA-Clozapine 02458748 AAP 1.3188 Tablet / comprime

Gen-Clozapine 02305003 MYL 1.3188 Tablet / comprime

Tab/Co. Orl 100 mg Clozaril 00894745 HLS 2.6446 Tablet / comprime

AA-Clozapine 02248035 AAP 2.6446 Tablet / comprime

Gen-Clozapine 02247244 MYL 2.6446 Tablet / comprime

Tab/Co. Orl 200 mg AA-Clozapine 02458756 AAP 5.2892 Tablet / comprime

Gen-Clozapine 02305011 MYL 5.2892 Tablet / comprime

Codeine / Codeine Liq/Liq Inj 30 mg/mL Codeine Phosphate 00544884 SDZ 4.1828 Millilitre / millilitre

Tab/Co. Orl 15 mg Teva-Codeine 00593435 TEV 0.0542 Tablet / comprime

Tab/Co. Orl 30 mg Teva-Codeine 00593451 TEV 0.0966 Tablet / comprime

Colchicine / Colchicine Tab/Co. Orl 0.6 mg Colchicine 00572349 ODN 0.2565 Tablet / comprime

Jamp-Colchicine 02373823 JPC 0.2565 Tablet / comprime

Sandoz Colchicine 00287873 SDZ 0.2565 Tablet / comprime

pms-Colchicine 02402181 PMS 0.2565 Tablet / comprime

Cortisone / Cortisone Tab/Co. Orl 25 mg Cortisone 00280437 VLN 0.3611 Tablet / comprime

Cromoglicic Acid / Acide Cromoglicique Liq/Liq Inh 1% pms-Sodium Cromoglycate 02046113 PMS 0.8165 Millilitre / millilitre

Liq/Liq Oph 2% Opticrom 02230621 ALL 0.9500 Millilitre / millilitre

Cromolyn Ophthalmic Solution 02009277 PDP 0.9500 Millilitre / millilitre

Cyanocobalamin / Cyanocobalamine Liq/Liq Inj 1 000 mcg/mL Cyanocobalamin 01987003 STR 0.3063 Millilitre / millilitre

Cyanocobalamin Injection USP 00626112 OMG 0.3063 Millilitre / millilitre

Jamp-Cyanocobalamin 02420147 JPC 0.3063 Millilitre / millilitre

Vitamin B12* (10mL) 00521515 SDZ 0.3063 Millilitre / millilitre

Cyclobenzaprine / Cyclobenzaprine Tab/Co. Orl 10 mg Apo-Cycloprine 02177145 APX 0.1022 Tablet / comprime

Auro-Cyclobenzaprine 02348853 ARO 0.1022 Tablet / comprime

Cyclobenzaprine 02424584 SIV 0.1022 Tablet / comprime

Cyclobenzaprine 02287064 SAS 0.1022 Tablet / comprime

Flexeril 02495422 ORI 0.1022 Tablet / comprime

Jamp-Cyclobenzaprine 02357127 JPC 0.1022 Tablet / comprime

Novo-Cycloprine 02080052 TEV 0.1022 Tablet / comprime

pms-Cyclobenzaprine 02212048 PMS 0.1022 Tablet / comprime

Cyclosporine / Cyclosporine Cap/Caps Orl 25 mg Neoral 02150689 NVR 1.5150 Capsule / capsule

Sandoz Cyclosporine 02247073 SDZ 0.9952 Capsule / capsule

Cap/Caps Orl 50 mg Neoral 02150662 NVR 2.9550 Capsule / capsule

Sandoz Cyclosporine 02247074 SDZ 1.9400 Capsule / capsule

Cap/Caps Orl 100 mg Neoral 02150670 NVR 5.9120 Capsule / capsule

Sandoz Cyclosporine 02242821 SDZ 3.8815 Capsule / capsule

Cyproterone / Cyproterone Tab/Co. Orl 50 mg Androcur 00704431 PMS 1.4000 Tablet / comprime

Med-Cyproterone 02390760 GMP 1.4000 Tablet / comprime

Dabigatran Etexilate / Dabigatran Etexilate Cap/Caps Orl 110 mg Pradaxa 02312441 BOE 1.6720 Capsule / capsule

Apo-Dabigatran 02468905 APX 1.2540 Capsule / capsule

Cap/Caps Orl 150 mg Pradaxa 02358808 BOE 1.6720 Capsule / capsule

Apo-Dabigatran 02468913 APX 1.2540 Capsule / capsule

Dapsone / Dapsone Tab/Co. Orl 100 mg Dapsone 02041510 JCB 0.7031 Tablet / comprime

Mar-Dapsone 02481227 MAR 0.7031 Tablet / comprime

Riva-Dapsone 02489058 RIV 0.7031 Tablet / comprime

Darunavir / Darunavir Tab/Co. Orl 600 mg Prezista 02324024 JAN 8.5940 Tablet / comprime

Apo-Darunavir 02487241 APX 8.5940 Tablet / comprime

Auro-Darunavir 02486121 ARO 8.5940 Tablet / comprime

Tab/Co. Orl 800 mg Prezista 02393050 JAN 11.6590 Tablet / comprime

Apo-Darunavir 02487268 APX 11.6590 Tablet / comprime

Auro-Darunavir 02486148 ARO 11.6590 Tablet / comprime

Dasatinib / Dasatinib Tab/Co. Orl 20 mg Sprycel 02293129 BRI 29.0138 Tablet / comprime P

Apo-Dasatinib 02470705 APX 29.0138 Tablet / comprime P

Tab/Co. Orl 50 mg Sprycel 02293137 BRI 58.3925 Tablet / comprime P

Apo-Dasatinib 02470713 APX 58.3925 Tablet / comprime P

Tab/Co. Orl 70 mg Sprycel 02293145 BRI 64.3532 Tablet / comprime P

Apo-Dasatinib 02481499 APX 64.3532 Tablet / comprime P

Tab/Co. Orl 80 mg Sprycel 02360810 BRI 117.3255 Tablet / comprime P

Apo-Dasatinib 02481502 APX 117.3255 Tablet / comprime P

Tab/Co. Orl 100 mg Sprycel 02320193 BRI 116.7062 Tablet / comprime P

Apo-Dasatinib 02470721 APX 116.7062 Tablet / comprime P

Deferasirox / Deferasirox Tab/Co. Orl 90 mg Jadenu 02452219 NVR 7.8909 Tablet / comprime P

Apo-Deferasirox (Type J) 02485265 APX 7.8909 Tablet / comprime P

Tab/Co. Orl 125 mg Exjade 02287420 NVR 2.6204 Tablet / comprime P

September / septembre 2020 Page 15

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Apo-Deferasirox 02461544 APX 2.6204 Tablet / comprime P

Sandoz Deferasirox 02464454 SDZ 2.6204 Tablet / comprime P

Taro-Deferasirox 02463520 TAR 2.6204 Tablet / comprime P

Teva-Deferasirox 02407957 TEV 2.6204 Tablet / comprime P

Tab/Co. Orl 180 mg Jadenu 02452227 NVR 15.7830 Tablet / comprime P

Apo-Deferasirox (Type J) 02485273 APX 15.7830 Tablet / comprime P

Tab/Co. Orl 250 mg Exjade 02287439 NVR 5.2410 Tablet / comprime P

Apo-Deferasirox 02461552 APX 5.2410 Tablet / comprime P

Sandoz Deferasirox 02464462 SDZ 5.2410 Tablet / comprime P

Taro-Deferasirox 02463539 TAR 5.2410 Tablet / comprime P

Teva-Deferasirox 02407965 TEV 5.2410 Tablet / comprime P

Tab/Co. Orl 360 mg Jadenu 02452235 NVR 31.5683 Tablet / comprime P

Apo-Deferasirox (Type J) 02485281 APX 31.5683 Tablet / comprime P

Tab/Co. Orl 500 mg Exjade 02287447 NVR 10.4824 Tablet / comprime P

Apo-Deferasirox 02461560 APX 10.4824 Tablet / comprime P

Sandoz Deferasirox 02464470 SDZ 10.4824 Tablet / comprime P

Taro-Deferasirox 02463547 TAR 10.4824 Tablet / comprime P

Teva-Deferasirox 02407973 TEV 10.4824 Tablet / comprime P

Deferoxamine / Deferoxamine Pws/Pds. Inj 500 mg Desferal 01981242 NVR 13.3800 Vial / fiole

Deferoxamine Mesilate 02241600 PFI 13.3800 Vial / fiole

Pws/Pds. Inj 2 g Deferoxamine Mesilate 02247022 PFI 53.7400 Vial / fiole

Desipramine / Desipramine Tab/Co. Orl 10 mg Desipramine 02216248 AAP 0.4056 Tablet / comprime

Tab/Co. Orl 25 mg Desipramine 02216256 AAP 0.3880 Tablet / comprime

Tab/Co. Orl 50 mg Desipramine 02216264 AAP 0.6838 Tablet / comprime

Tab/Co. Orl 75 mg Desipramine 02216272 AAP 0.9093 Tablet / comprime

Tab/Co. Orl 100 mg Desipramine 02216280 AAP 0.9507 Tablet / comprime

Desmopressin / Desmopressine Aem/Aem. Nas 10 mcg DDAVP Spray 00836362 FEI 1.4444 Dose / dose

Desmopressin Spray 02242465 AAP 1.4444 Dose / dose

Tab/Co. Orl 0.1 mg DDAVP 00824305 FEI 0.6609 Tablet / comprime

Desmopressin 02284030 AAP 0.6609 Tablet / comprime

Tab/Co. Orl 0.2 mg DDAVP 00824143 FEI 1.3216 Tablet / comprime

Desmopressin 02284049 AAP 1.3216 Tablet / comprime

Desogestrel and Ethinyl Estradiol / Desogestrel et

Ethinyloestradiol

Tab/Co. Orl 0.15 mg / 0.03 mg Marvelon (21) 02042487 FRS 0.3700 Tablet / comprime

Apri (21) 02317192 TEV 0.3700 Tablet / comprime

Freya (21) 02396491 MYL 0.3700 Tablet / comprime

Mirvala (21) 02410249 APX 0.3700 Tablet / comprime

Tab/Co. Orl 0.15 mg / 0.03 mg Marvelon (28) 02042479 FRS 0.2775 Tablet / comprime

Apri (28) 02317206 TEV 0.2775 Tablet / comprime

Freya (28) 02396610 MYL 0.2775 Tablet / comprime

Mirvala (28) 02410257 APX 0.2775 Tablet / comprime

Desonide / Desonide Crm/Cr. Top 0.05% pdp-Desonide 02229315 PDP 0.3275 Gram / gramme

Ont/Ont Top 0.05% pdp-Desonide 02229323 PDP 0.3107 Gram / gramme

Desoximetasone / Desoximetasone Crm/Cr. Top 0.05% Topicort Mild 02221918 BSL 0.4792 Gram / gramme

Crm/Cr. Top 0.25% Topicort 02221896 BSL 0.7181 Gram / gramme

Gel/Gel Top 0.05% Topicort 02221926 BSL 0.5540 Gram / gramme

Dexamethasone / Dexamethasone Liq/Liq Inj 4 mg/mL Dexamethasone sodium phosphate 00664227 SDZ 1.6060 Millilitre / millilitre

Dexamethasone sodium phosphate 01977547 STR 1.6060 Millilitre / millilitre

Dexamethasone-Omega 02204266 OMG 1.6060 Millilitre / millilitre

Tab/Co. Orl 0.5 mg Apo-Dexamethasone 02261081 APX 0.1564 Tablet / comprime

pms-Dexamethasone 01964976 PMS 0.1564 Tablet / comprime

Tab/Co. Orl 2 mg pms-Dexamethasone 02279363 PMS 0.5267 Tablet / comprime

Tab/Co. Orl 4 mg Apo-Dexamethasone 02250055 APX 0.3046 Tablet / comprime

pms-Dexamethasone 01964070 PMS 0.3046 Tablet / comprime

Dexamphetamine / Dexamphetamine SRC/Caps.L.L. Orl 10 mg Dexedrine 01924559 PAL 0.8096 Capsule / capsule

Act-Dextroamphetamine SR 02448319 TEV 0.8096 Capsule / capsule

SRC/Caps.L.L. Orl 15 mg Dexedrine 01924567 PAL 1.4067 Capsule / capsule

Act-Dextroamphetamine SR 02448327 TEV 0.9898 Capsule / capsule

Tab/Co. Orl 5 mg Dexedrine 01924516 PAL 0.5081 Tablet / comprime

Dextroamphetamine 02443236 AAP 0.5081 Tablet / comprime

Diazepam / Diazepam Liq/Liq Inj 5 mg/mL Diazepam 00399728 SDZ 1.6415 Millilitre / millilitre

Tab/Co. Orl 2 mg Diazepam 00405329 AAP 0.0532 Tablet / comprime

Tab/Co. Orl 5 mg Valium 00013285 HLR 0.0650 Tablet / comprime

Diazepam 00362158 AAP 0.0650 Tablet / comprime

pms-Diazepam 02247491 PMS 0.0650 Tablet / comprime

Tab/Co. Orl 10 mg Diazepam 00405337 AAP 0.0867 Tablet / comprime

pms-Diazepam 02247492 PMS 0.0867 Tablet / comprime

Diclofenac / Diclofenac ECT/Co.Ent Orl 25 mg Apo-Diclo 00839175 APX 0.0781 Tablet / comprime

Teva-Difenac 00808539 TEV 0.0781 Tablet / comprime

pms-Diclofenac 02302616 PMS 0.0781 Tablet / comprime

ECT/Co.Ent Orl 50 mg Voltaren 00514012 NVR 0.2024 Tablet / comprime

Apo-Diclo 00839183 APX 0.2024 Tablet / comprime

Diclofenac EC 02352397 SAS 0.2024 Tablet / comprime

Sandoz Diclofenac 02261960 SDZ 0.2024 Tablet / comprime

September / septembre 2020 Page 16

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Teva-Difenac 00808547 TEV 0.2024 Tablet / comprime

pms-Diclofenac 02302624 PMS 0.2024 Tablet / comprime

Liq/Liq Oph 0.1% Voltaren 01940414 NVR 1.2397 Millilitre / millilitre

Apo-Diclofenac 02441020 APX 1.2397 Millilitre / millilitre

Diclofenac 02475065 PST 1.2397 Millilitre / millilitre

Sandoz Diclofenac Ophtha 02454807 SDZ 1.2397 Millilitre / millilitre

SRT/Co.L.L. Orl 75 mg Voltaren SR 00782459 NVR 0.2320 Tablet / comprime

Apo-Diclo SR 02162814 APX 0.2320 Tablet / comprime

Sandoz Diclofenac SR 02261901 SDZ 0.2320 Tablet / comprime

Teva-Difenac SR 02158582 TEV 0.2320 Tablet / comprime

pms-Diclofenac SR 02231504 PMS 0.2320 Tablet / comprime

SRT/Co.L.L. Orl 100 mg Voltaren SR 00590827 NVR 0.4048 Tablet / comprime

Apo-Diclo SR 02091194 APX 0.4048 Tablet / comprime

Sandoz Diclofenac SR 02261944 SDZ 0.4048 Tablet / comprime

Teva-Difenac SR 02048698 TEV 0.4048 Tablet / comprime

pms-Diclofenac SR 02231505 PMS 0.4048 Tablet / comprime

Sup/Supp. Rt 50 mg Voltaren 00632724 NVR 0.4339 Suppository / suppositoire

Sandoz Diclofenac 02261928 SDZ 0.4339 Suppository / suppositoire

pms-Difenac 02231506 PMS 0.4339 Suppository / suppositoire

Sup/Supp. Rt 100 mg Sandoz Diclofenac 02261936 SDZ 0.5840 Suppository / suppositoire

pms-Difenac 02231508 PMS 0.5840 Suppository / suppositoire

Diclofenac / Misoprostol / Diclofenac / Misoprostol Tab/Co. Orl 50 mg / 200 mcg Arthrotec 01917056 PFI 0.3027 Tablet / comprime

GD-Diclofenac/Misoprostol 02341689 GMD 0.3027 Tablet / comprime

pms-Diclofenac/Misoprostol 02413469 PMS 0.3027 Tablet / comprime

Tab/Co. Orl 75 mg / 200 mcg Arthrotec 02229837 PFI 0.4120 Tablet / comprime

GD-Diclofenac/Misoprostol 02341697 GMD 0.4120 Tablet / comprime

pms-Diclofenac/Misoprostol 02413477 PMS 0.4120 Tablet / comprime

Dicycloverine (Dicyclomine) / Dicycloverine (Dicyclomine) Cap/Caps Orl 10 mg Protylol 00287709 PDL 0.0609 Capsule / capsule

Tab/Co. Orl 20 mg Jamp-Dicyclomine 02366088 JPC 0.6990 Tablet / comprime

Dienogest / Dienogest Tab/Co. Orl 2 mg Visanne 02374900 BAY 1.5346 Tablet / comprime

Aspen-Dienogest 02493055 APN 1.5346 Tablet / comprime

Diflunisal / Diflunisal Tab/Co. Orl 250 mg Diflunisal 02039486 AAP 0.6110 Tablet / comprime

Tab/Co. Orl 500 mg Diflunisal 02039494 AAP 0.7737 Tablet / comprime

Digoxin / Digoxine Liq/Liq Orl 0.05 mg/mL Toloxin 02242320 PDP 1.2487 Millilitre / millilitre

Tab/Co. Orl 0.0625 mg Toloxin 02335700 PDP 0.2617 Tablet / comprime

Tab/Co. Orl 0.125 mg Toloxin 02335719 PDP 0.2617 Tablet / comprime

Dihydroergotamine / Dihydroergotamine Liq/Liq Nas 4 mg/mL Migranal 02228947 STR 13.8833 Millilitre / millilitre

Diltiazem / Diltiazem CDC/Caps.L.C. Orl 120 mg Cardizem CD 02097249 VLN 0.3529 Capsule / capsule

Act Diltiazem CD 02370611 TEV 0.3529 Capsule / capsule

Apo-Diltiaz CD 02230997 APX 0.3529 Capsule / capsule

Diltiazem CD 02445999 SIV 0.3529 Capsule / capsule

Diltiazem CD 02400421 SAS 0.3529 Capsule / capsule

Diltiazem-CD 02231472 PDL 0.3529 Capsule / capsule

Mar-Diltiazem CD 02484064 MAR 0.3529 Capsule / capsule

Sandoz Diltiazem CD 02243338 SDZ 0.3529 Capsule / capsule

Teva-Diltazem CD 02242538 TEV 0.3529 Capsule / capsule

CDC/Caps.L.C. Orl 180 mg Cardizem CD 02097257 VLN 0.4684 Capsule / capsule

Apo-Diltiaz CD 02230998 APX 0.4684 Capsule / capsule

Diltiazem CD 02446006 SIV 0.4684 Capsule / capsule

Diltiazem CD 02400448 SAS 0.4684 Capsule / capsule

Diltiazem-CD 02231474 PDL 0.4684 Capsule / capsule

Mar-Diltiazem CD 02484072 MAR 0.4684 Capsule / capsule

Sandoz Diltiazem CD 02243339 SDZ 0.4684 Capsule / capsule

Teva-Diltazem CD 02242539 TEV 0.4684 Capsule / capsule

CDC/Caps.L.C. Orl 240 mg Cardizem CD 02097265 VLN 0.6213 Capsule / capsule

Apo-Diltiaz CD 02230999 APX 0.6213 Capsule / capsule

Diltiazem CD 02400456 SAS 0.6213 Capsule / capsule

Diltiazem CD 02446014 SIV 0.6213 Capsule / capsule

Diltiazem-CD 02231475 PDL 0.6213 Capsule / capsule

Mar-Diltiazem CD 02484080 MAR 0.6213 Capsule / capsule

Sandoz Diltiazem CD 02243340 SDZ 0.6213 Capsule / capsule

Teva-Diltazem CD 02242540 TEV 0.6213 Capsule / capsule

CDC/Caps.L.C. Orl 300 mg Cardizem CD 02097273 VLN 0.7766 Capsule / capsule

Act Diltiazem CD 02370654 TEV 0.7766 Capsule / capsule

Apo-Diltiaz CD 02229526 APX 0.7766 Capsule / capsule

Diltiazem CD 02446022 SIV 0.7766 Capsule / capsule

Diltiazem CD 02400464 SAS 0.7766 Capsule / capsule

Diltiazem-CD 02231057 PDL 0.7766 Capsule / capsule

Mar-Diltiazem CD 02484099 MAR 0.7766 Capsule / capsule

Sandoz Diltiazem CD 02243341 SDZ 0.7766 Capsule / capsule

Teva-Diltazem CD 02242541 TEV 0.7766 Capsule / capsule

ERC/Caps.L.P. Orl 120 mg Tiazac 02231150 VLN 0.2133 Capsule / capsule

Act Diltiazem T 02370441 TEV 0.2133 Capsule / capsule

Diltiazem TZ 02325306 PDL 0.2133 Capsule / capsule

September / septembre 2020 Page 17

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Jamp-Diltiazem T 02495376 JPC 0.2133 Capsule / capsule

Mar-Diltiazem T 02465353 MAR 0.2133 Capsule / capsule

Sandoz Diltiazem T 02245918 SDZ 0.2133 Capsule / capsule

Teva-Diltiazem ER 02271605 TEV 0.2133 Capsule / capsule

ERC/Caps.L.P. Orl 180 mg Tiazac 02231151 VLN 0.2889 Capsule / capsule

Act Diltiazem T 02370492 TEV 0.2889 Capsule / capsule

Diltiazem TZ 02325314 PDL 0.2889 Capsule / capsule

Jamp-Diltiazem T 02495384 JPC 0.2889 Capsule / capsule

Mar-Diltiazem T 02465361 MAR 0.2889 Capsule / capsule

Sandoz Diltiazem T 02245919 SDZ 0.2889 Capsule / capsule

Teva-Diltiazem ER 02271613 TEV 0.2889 Capsule / capsule

ERC/Caps.L.P. Orl 240 mg Tiazac 02231152 VLN 0.3832 Capsule / capsule

Act Diltiazem T 02370506 TEV 0.3832 Capsule / capsule

Diltiazem TZ 02325322 PDL 0.3832 Capsule / capsule

Jamp-Diltiazem T 02495392 JPC 0.3832 Capsule / capsule

Mar-Diltiazem T 02465388 MAR 0.3832 Capsule / capsule

Sandoz Diltiazem T 02245920 SDZ 0.3832 Capsule / capsule

Teva-Diltiazem ER 02271621 TEV 0.3832 Capsule / capsule

ERC/Caps.L.P. Orl 300 mg Tiazac 02231154 VLN 0.4720 Capsule / capsule

Act Diltiazem T 02370514 TEV 0.4720 Capsule / capsule

Diltiazem TZ 02325330 PDL 0.4720 Capsule / capsule

Jamp-Diltiazem T 02495406 JPC 0.4720 Capsule / capsule

Mar-Diltiazem T 02465396 MAR 0.4720 Capsule / capsule

Sandoz Diltiazem T 02245921 SDZ 0.4720 Capsule / capsule

Teva-Diltiazem ER 02271648 TEV 0.4720 Capsule / capsule

ERC/Caps.L.P. Orl 360 mg Tiazac 02231155 VLN 0.5778 Capsule / capsule

Act Diltiazem T 02370522 TEV 0.5778 Capsule / capsule

Diltiazem TZ 02325349 PDL 0.5778 Capsule / capsule

Jamp-Diltiazem T 02495414 JPC 0.5778 Capsule / capsule

Mar-Diltiazem T 02465418 MAR 0.5778 Capsule / capsule

Sandoz Diltiazem T 02245922 SDZ 0.5778 Capsule / capsule

Teva-Diltiazem ER 02271656 TEV 0.5778 Capsule / capsule

Tab/Co. Orl 30 mg AA-Diltiaz 00771376 AAP 0.1866 Tablet / comprime

Teva-Diltiazem 00862924 TEV 0.1866 Tablet / comprime

Tab/Co. Orl 60 mg AA-Diltiaz 00771384 AAP 0.3273 Tablet / comprime

Teva-Diltiazem 00862932 TEV 0.3273 Tablet / comprime

Dimethyl Sulfoxide / Sulfoxyde De Dimethyle Liq/Liq ITV 500 mg/g Rimso-50 00493392 MYL 1.7000 Millilitre / millilitre

Diphenhydramine / Diphenhydramine Elx/Elx Orl 12.5 mg/5 mL Benadryl 02019736 JNJ 0.0234 Millilitre / millilitre

Diphenhydramine HCl Elixir USP 02298503 JPC 0.0234 Millilitre / millilitre

Liq/Liq Inj 50 mg Diphenist 02219336 OMG 4.0400 Millilitre / millilitre

Diphenhydramine HCl 00596612 SDZ 4.0400 Millilitre / millilitre

Tab/Co. Orl 25 mg Benadryl 02017849 JNJ 0.0975 Tablet / comprime

Diphenhydramine 02257548 JPC 0.0975 Tablet / comprime

Tab/Co. Orl 50 mg Diphenhydramine 02257556 JPC 0.1297 Tablet / comprime

Dipyridamole / Acetylsalicylic Acid / Dipyridamole / Acide

Acetylsalicylique

Cap/Caps Orl 200 mg / 25 mg Aggrenox 02242119 BOE 0.9087 Capsule / capsule

Taro-Dipyridamole/ASA 02471051 TAR 0.6656 Capsule / capsule

Dipyridamole / Dipyridamole Tab/Co. Orl 25 mg Apo-Dipyridamole FC/FE 00895644 APX 0.2633 Tablet / comprime

Tab/Co. Orl 50 mg Apo-Dipyridamole FC/FE 00895652 APX 0.3685 Tablet / comprime

Tab/Co. Orl 75 mg Apo-Dipyridamole FC/FE 00895660 APX 0.4963 Tablet / comprime

Domperidone / Domperidone Tab/Co. Orl 10 mg Apo-Domperidone 02103613 APX 0.0428 Tablet / comprime

Domperidone 02350440 SAS 0.0428 Tablet / comprime

Domperidone 02238341 SIV 0.0428 Tablet / comprime

Jamp-Domperidone 02369206 JPC 0.0428 Tablet / comprime

Mar-Domperidone 02403870 MAR 0.0428 Tablet / comprime

Ran-Domperidone 02268078 RAN 0.0428 Tablet / comprime

Teva-Domperidone 01912070 TEV 0.0428 Tablet / comprime

pms-Domperidone 02236466 PMS 0.0428 Tablet / comprime

Donepezil / Donepezil Tab/Co. Orl 5 mg Aricept 02232043 PFI 0.4586 Tablet / comprime

Apo-Donepezil 02362260 APX 0.4586 Tablet / comprime

Auro-Donepezil 02400561 ARO 0.4586 Tablet / comprime

Donepezil 02402645 AHI 0.4586 Tablet / comprime

Donepezil 02426846 SAS 0.4586 Tablet / comprime

Donepezil 02420597 SIV 0.4586 Tablet / comprime

Jamp-Donepezil 02416948 JPC 0.4586 Tablet / comprime

Mar-Donepezil 02402092 MAR 0.4586 Tablet / comprime

Mint-Donepezil 02408600 MNT 0.4586 Tablet / comprime

Nat-Donepezil 02439557 NAT 0.4586 Tablet / comprime

Sandoz Donepezil 02328666 SDZ 0.4586 Tablet / comprime

Septa-Donepezil 02428482 SPT 0.4586 Tablet / comprime

Taro-Donepezil 02381508 SUN 0.4586 Tablet / comprime

Teva-Donepezil 02340607 TEV 0.4586 Tablet / comprime

pms-Donepezil 02322331 PMS 0.4586 Tablet / comprime

Tab/Co. Orl 10 mg Aricept 02232044 PFI 0.4586 Tablet / comprime

September / septembre 2020 Page 18

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Apo-Donepezil 02362279 APX 0.4586 Tablet / comprime

Auro-Donepezil 02400588 ARO 0.4586 Tablet / comprime

Donepezil 02402653 AHI 0.4586 Tablet / comprime

Donepezil 02426854 SAS 0.4586 Tablet / comprime

Donepezil 02420600 SIV 0.4586 Tablet / comprime

Jamp-Donepezil 02416956 JPC 0.4586 Tablet / comprime

Mar-Donepezil 02402106 MAR 0.4586 Tablet / comprime

Mint-Donepezil 02408619 MNT 0.4586 Tablet / comprime

Nat-Donepezil 02439565 NAT 0.4586 Tablet / comprime

Sandoz Donepezil 02328682 SDZ 0.4586 Tablet / comprime

Septa-Donepezil 02428490 SPT 0.4586 Tablet / comprime

Taro-Donepezil 02381516 SUN 0.4586 Tablet / comprime

Teva-Donepezil 02340615 TEV 0.4586 Tablet / comprime

pms-Donepezil 02322358 PMS 0.4586 Tablet / comprime

Dorzolamide / Dorzolamide Liq/Liq Oph 2% Trusopt 02216205 ELV 2.1081 Millilitre / millilitre

Jamp-Dorzolamide 02453347 JPC 2.1081 Millilitre / millilitre

Sandoz Dorzolamide 02316307 SDZ 2.1081 Millilitre / millilitre

Doxazosin / Doxazosine Tab/Co. Orl 1 mg Apo-Doxazosin 02240588 APX 0.1719 Tablet / comprime

Jamp-Doxazosin 02489937 JPC 0.1719 Tablet / comprime

Teva-Doxazosin 02242728 TEV 0.1719 Tablet / comprime

Tab/Co. Orl 2 mg Apo-Doxazosin 02240589 APX 0.2062 Tablet / comprime

Jamp-Doxazosin 02489945 JPC 0.2062 Tablet / comprime

Teva-Doxazosin 02242729 TEV 0.2062 Tablet / comprime

Tab/Co. Orl 4 mg Apo-Doxazosin 02240590 APX 0.2681 Tablet / comprime

Jamp-Doxazosin 02489953 JPC 0.2681 Tablet / comprime

Teva-Doxazosin 02242730 TEV 0.2681 Tablet / comprime

Doxepin / Doxepine Cap/Caps Orl 10 mg Sinequan 00024325 AAP 0.3496 Capsule / capsule

Cap/Caps Orl 25 mg Sinequan 00024333 AAP 0.4289 Capsule / capsule

Cap/Caps Orl 50 mg Sinequan 00024341 AAP 0.7957 Capsule / capsule

Doxycycline / Doxycycline Cap/Caps Orl 100 mg Apo-Doxy 00740713 APX 0.5860 Capsule / capsule

Doxycycline 02351234 SAS 0.5860 Capsule / capsule

Teva-Doxycycline 00725250 TEV 0.5860 Capsule / capsule

Tab/Co. Orl 100 mg Doxycin 00860751 RIV 0.5860 Tablet / comprime

Apo-Doxy 00874256 APX 0.5860 Tablet / comprime

Doxycycline 02351242 SAS 0.5860 Tablet / comprime

Teva-Doxycycline 02158574 TEV 0.5860 Tablet / comprime

Doxylamine / Pyridoxine / Doxylamine / Pyridoxine SRT/Co.L.L. Orl 10 mg / 10 mg Diclectin 00609129 DUI 0.6402 Tablet / comprime

Apo-Doxylamine/B6 02413248 APX 0.6402 Tablet / comprime

pms-Doxylamine-Pyridoxine 02406187 PMS 0.6402 Tablet / comprime

Duloxetine / Duloxetine CDR/Caps.L.R. Orl 30 mg Cymbalta 02301482 LIL 0.4814 Capsule / capsule

Apo-Duloxetine 02440423 APX 0.4814 Capsule / capsule

Auro-Duloxetine 02436647 ARO 0.4814 Capsule / capsule

Duloxetine 02490889 SAS 0.4814 Capsule / capsule

Duloxetine 02453630 SIV 0.4814 Capsule / capsule

Duloxetine DR 02437082 TEV 0.4814 Capsule / capsule

Jamp-Duloxetine 02451913 JPC 0.4814 Capsule / capsule

Mar-Duloxetine 02446081 MAR 0.4814 Capsule / capsule

Mint-Duloxetine 02438984 MNT 0.4814 Capsule / capsule

NRA-Duloxetine 02482126 NRA 0.4814 Capsule / capsule

Ran-Duloxetine 02438259 RAN 0.4814 Capsule / capsule

Sandoz Duloxetine 02439948 SDZ 0.4814 Capsule / capsule

Teva-Duloxetine 02456753 TEV 0.4814 Capsule / capsule

pms-Duloxetine 02429446 PMS 0.4814 Capsule / capsule

CDR/Caps.L.R. Orl 60 mg Cymbalta 02301490 LIL 0.9769 Capsule / capsule

Apo-Duloxetine 02440431 APX 0.9769 Capsule / capsule

Auro-Duloxetine 02436655 ARO 0.9769 Capsule / capsule

Duloxetine 02490897 SAS 0.9769 Capsule / capsule

Duloxetine 02453649 SIV 0.9769 Capsule / capsule

Duloxetine DR 02437090 TEV 0.9769 Capsule / capsule

Jamp-Duloxetine 02451921 JPC 0.9769 Capsule / capsule

Mar-Duloxetine 02446103 MAR 0.9769 Capsule / capsule

Mint-Duloxetine 02438992 MNT 0.9769 Capsule / capsule

NRA-Duloxetine 02482134 NRA 0.9769 Capsule / capsule

Ran-Duloxetine 02438267 RAN 0.9769 Capsule / capsule

Sandoz Duloxetine 02439956 SDZ 0.9769 Capsule / capsule

Teva-Duloxetine 02456761 TEV 0.9769 Capsule / capsule

pms-Duloxetine 02429454 PMS 0.9769 Capsule / capsule

Dutasteride / Dutasteride Cap/Caps Orl 0.5 mg Avodart 02247813 GSK 0.3027 Capsule / capsule

Apo-Dutasteride 02404206 APX 0.3027 Capsule / capsule

Auro-Dutasteride 02469308 ARO 0.3027 Capsule / capsule

Dutasteride 02429012 SIV 0.3027 Capsule / capsule

Dutasteride 02443058 SAS 0.3027 Capsule / capsule

Jamp-Dutasteride 02484870 JPC 0.3027 Capsule / capsule

Med-Dutasteride 02416298 GMP 0.3027 Capsule / capsule

September / septembre 2020 Page 19

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Mint-Dutasteride 02428873 MNT 0.3027 Capsule / capsule

Sandoz Dutasteride 02424444 SDZ 0.3027 Capsule / capsule

Teva-Dutasteride 02408287 TEV 0.3027 Capsule / capsule

pms-Dutasteride 02393220 PMS 0.3027 Capsule / capsule

Efavirenz / Efavirenz Tab/Co. Orl 600 mg Sustiva 02246045 BRI 3.8030 Tablet / comprime

Auro-Efavirenz 02418428 ARO 3.8030 Tablet / comprime

Jamp-Efavirenz 02458233 JPC 3.8030 Tablet / comprime

Mylan-Efavirenz 02381524 MYL 3.8030 Tablet / comprime

Teva-Efavirenz 02389762 TEV 3.8030 Tablet / comprime

Eletriptan / Eletriptan Tab/Co. Orl 20 mg Relpax 02256290 UJC 2.6172 Tablet / comprime

Apo-Eletriptan 02386054 APX 2.6172 Tablet / comprime

Auro-Eletriptan 02479451 ARO 2.6172 Tablet / comprime

Teva-Eletriptan 02382091 TEV 2.6172 Tablet / comprime

Tab/Co. Orl 40 mg Relpax 02256304 UJC 2.6172 Tablet / comprime

Apo-Eletriptan 02386062 APX 2.6172 Tablet / comprime

Auro-Eletriptan 02479478 ARO 2.6172 Tablet / comprime

Teva-Eletriptan 02382105 TEV 2.6172 Tablet / comprime

Emtricitabine, Tenofovir Disoproxil and Efavirenz / Emtricitabine,

Tenofovir Disoproxil et Efavirenz

Tab/Co. Orl 200 mg / 300 mg /

600 mg

Atripla 02300699 GIL 11.3300 Tablet / comprime

Apo-Efavirenz/Emtricitabine/Tenofovir 02468247 APX 11.3300 Tablet / comprime

Auro-Efavirenz-Emtricitabine-Tenofovir 02478404 ARO 11.3300 Tablet / comprime

Mylan-

Efavirenz/Emtricitabine/TenofovirDisoproxilFum

arate

02461412 MYL 11.3300 Tablet / comprime

Sandoz Efavirenz/Emtricitabine/Tenofovir 02484676 SDZ 11.3300 Tablet / comprime

Teva-Efavirenz/Emtricitabine/Tenofovir 02393549 TEV 11.3300 Tablet / comprime

pms-Efavirenz-Emtricitabine-Tenofovir 02487284 PMS 11.3300 Tablet / comprime

Enalapril / Hydrochlorothiazide / Enalapril / Hydrochlorothiazide Tab/Co. Orl 5 mg / 12.5 mg Enalapril/HCTZ 02352923 AAP 0.7493 Tablet / comprime

Tab/Co. Orl 10 mg / 25 mg Vaseretic 00657298 FRS 1.0741 Tablet / comprime

Enalapril/HCTZ 02352931 AAP 1.0741 Tablet / comprime

Enalapril / Enalapril Tab/Co. Orl 2.5 mg Act Enalapril 02291878 TEV 0.1863 Tablet / comprime

Apo-Enalapril 02020025 APX 0.1863 Tablet / comprime

Enalapril 02400650 SAS 0.1863 Tablet / comprime

Enalapril 02442957 SIV 0.1863 Tablet / comprime

Jamp-Enalapril 02474786 JPC 0.1863 Tablet / comprime

Mar-Enalapril 02459450 MAR 0.1863 Tablet / comprime

Ran-Enalapril 02352230 RAN 0.1863 Tablet / comprime

Sandoz Enalapril 02299933 SDZ 0.1863 Tablet / comprime

Tab/Co. Orl 5 mg Vasotec 00708879 FRS 0.2203 Tablet / comprime

Act Enalapril 02291886 TEV 0.2203 Tablet / comprime

Apo-Enalapril 02019884 APX 0.2203 Tablet / comprime

Enalapril 02400669 SAS 0.2203 Tablet / comprime

Enalapril 02442965 SIV 0.2203 Tablet / comprime

Jamp-Enalapril 02474794 JPC 0.2203 Tablet / comprime

Mar-Enalapril 02459469 MAR 0.2203 Tablet / comprime

Ran-Enalapril 02352249 RAN 0.2203 Tablet / comprime

Sandoz Enalapril 02299941 SDZ 0.2203 Tablet / comprime

Tab/Co. Orl 10 mg Vasotec 00670901 FRS 0.2647 Tablet / comprime

Act Enalapril 02291894 TEV 0.2647 Tablet / comprime

Apo-Enalapril 02019892 APX 0.2647 Tablet / comprime

Enalapril 02400677 SAS 0.2647 Tablet / comprime

Enalapril 02442973 SIV 0.2647 Tablet / comprime

Jamp-Enalapril 02474808 JPC 0.2647 Tablet / comprime

Mar-Enalapril 02444771 MAR 0.2647 Tablet / comprime

Ran-Enalapril 02352257 RAN 0.2647 Tablet / comprime

Sandoz Enalapril 02299968 SDZ 0.2647 Tablet / comprime

Tab/Co. Orl 20 mg Vasotec 00670928 FRS 0.3195 Tablet / comprime

Act Enalapril 02291908 TEV 0.3195 Tablet / comprime

Apo-Enalapril 02019906 APX 0.3195 Tablet / comprime

Enalapril 02442981 SIV 0.3195 Tablet / comprime

Enalapril 02400685 SAS 0.3195 Tablet / comprime

Jamp-Enalapril 02474816 JPC 0.3195 Tablet / comprime

Mar-Enalapril 02444798 MAR 0.3195 Tablet / comprime

Ran-Enalapril 02352265 RAN 0.3195 Tablet / comprime

Sandoz Enalapril 02299976 SDZ 0.3195 Tablet / comprime

Entacapone / Entacapone Tab/Co. Orl 200 mg Comtan 02243763 SDZ 0.4010 Tablet / comprime

Sandoz Entacapone 02380005 SDZ 0.4010 Tablet / comprime

Teva-Entacapone 02375559 TEV 0.4010 Tablet / comprime

Entecavir / Entecavir Tab/Co. Orl 0.5 mg Baraclude 02282224 BRI 5.5000 Tablet / comprime

Apo-Entecavir 02396955 APX 5.5000 Tablet / comprime

Auro-Entecavir 02448777 ARO 5.5000 Tablet / comprime

Jamp-Entecavir 02467232 JPC 5.5000 Tablet / comprime

Mint-Entecavir 02485907 MNT 5.5000 Tablet / comprime

pms-Entecavir 02430576 PMS 5.5000 Tablet / comprime

September / septembre 2020 Page 20

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Eplerenone / Eplerenone Tab/Co. Orl 25 mg Inspra 02323052 UJC 2.0595 Tablet / comprime

Mint-Eplerenone 02471442 MNT 2.0595 Tablet / comprime

Tab/Co. Orl 50 mg Inspra 02323060 UJC 2.0595 Tablet / comprime

Mint-Eplerenone 02471450 MNT 2.0595 Tablet / comprime

Ergocalciferol / Ergocalciferol Cap/Caps Orl 50 000 IU D-Forte 02237450 EUR 0.1986 Capsule / capsule

Dps/Gttes Orl 8 288 IU Erdol (Drisodan) 80003615 ODN 0.2189 Millilitre / millilitre

Erlotinib / Erlotinib Tab/Co. Orl 25 mg Tarceva 02269007 HLR 3.4615 Tablet / comprime

Apo-Erlotinib 02461862 APX 3.4615 Tablet / comprime

Nat-Erlotinib 02483912 NAT 3.4615 Tablet / comprime

Teva-Erlotinib 02377691 TEV 3.4615 Tablet / comprime

Tab/Co. Orl 100 mg Tarceva 02269015 HLR 13.2000 Tablet / comprime

Apo-Erlotinib 02461870 APX 13.2000 Tablet / comprime

Nat-Erlotinib 02483920 NAT 13.2000 Tablet / comprime

Teva-Erlotinib 02377705 TEV 13.2000 Tablet / comprime

pms-Erlotinib 02454386 PMS 13.2000 Tablet / comprime

Tab/Co. Orl 150 mg Tarceva 02269023 HLR 19.8000 Tablet / comprime

Apo-Erlotinib 02461889 APX 19.8000 Tablet / comprime

Nat-Erlotinib 02483939 NAT 19.8000 Tablet / comprime

Teva-Erlotinib 02377713 TEV 19.8000 Tablet / comprime

pms-Erlotinib 02454394 PMS 19.8000 Tablet / comprime

Erythromycin / Erythromycine Ont/Ont Oph 0.5% Erythromycin 02326663 SGQ 2.7286 Gram / gramme

pdp-Erythromycin 01912755 PDP 2.7286 Gram / gramme

Tab/Co. Orl 250 mg Erythro 00682020 AAP 0.1865 Tablet / comprime

Escitalopram / Escitalopram Tab/Co. Orl 10 mg Cipralex 02263238 VLH 0.3109 Tablet / comprime

Ach-Escitalopram 02434652 AHI 0.3109 Tablet / comprime

Apo-Escitalopram 02295016 APX 0.3109 Tablet / comprime

Auro-Escitalopram 02397358 ARO 0.3109 Tablet / comprime

Escitalopram 02429039 SIV 0.3109 Tablet / comprime

Escitalopram 02430118 SAS 0.3109 Tablet / comprime

Jamp-Escitalopram 02429780 JPC 0.3109 Tablet / comprime

Mar-Escitalopram 02423480 MAR 0.3109 Tablet / comprime

Mint-Escitalopram 02407418 MNT 0.3109 Tablet / comprime

Mylan-Escitalopram 02309467 MYL 0.3109 Tablet / comprime

NRA-Escitalopram 02476851 NRA 0.3109 Tablet / comprime

Nat-Escitalopram 02440296 NAT 0.3109 Tablet / comprime

Ran-Escitalopram 02385481 RAN 0.3109 Tablet / comprime

Sandoz Escitalopram 02364077 SDZ 0.3109 Tablet / comprime

Teva-Escitalopram 02318180 TEV 0.3109 Tablet / comprime

pharma-Escitalopram 02469243 PMS 0.3109 Tablet / comprime

Tab/Co. Orl 20 mg Cipralex 02263254 VLH 0.3310 Tablet / comprime

Ach-Escitalopram 02434660 AHI 0.3310 Tablet / comprime

Apo-Escitalopram 02295024 APX 0.3310 Tablet / comprime

Auro-Escitalopram 02397374 ARO 0.3310 Tablet / comprime

Escitalopram 02430126 SAS 0.3310 Tablet / comprime

Escitalopram 02429047 SIV 0.3310 Tablet / comprime

Jamp-Escitalopram 02429799 JPC 0.3310 Tablet / comprime

Mar-Escitalopram 02423502 MAR 0.3310 Tablet / comprime

Mint-Escitalopram 02407434 MNT 0.3310 Tablet / comprime

Mylan-Escitalopram 02309475 MYL 0.3310 Tablet / comprime

NRA-Escitalopram 02476878 NRA 0.3310 Tablet / comprime

Nat-Escitalopram 02440318 NAT 0.3310 Tablet / comprime

Ran-Escitalopram 02385503 RAN 0.3310 Tablet / comprime

Sandoz Escitalopram 02364085 SDZ 0.3310 Tablet / comprime

Teva-Escitalopram 02318202 TEV 0.3310 Tablet / comprime

pharma-Escitalopram 02469251 PMS 0.3310 Tablet / comprime

Estradiol / Estradiol Pth/Pth Trd 50 mcg Estradot 02244000 NVR 2.5331 Patch / timbre cutane

Sandoz Estradiol Derm Srd 02246967 SDZ 2.5331 Patch / timbre cutane

Pth/Pth Trd 75 mcg Estradot 02244001 NVR 2.7169 Patch / timbre cutane

Sandoz Estradiol Derm Srd 02246968 SDZ 2.7169 Patch / timbre cutane

Pth/Pth Trd 100 mcg Estradot 02244002 NVR 2.8744 Patch / timbre cutane

Sandoz Estradiol Derm Srd 02246969 SDZ 2.8744 Patch / timbre cutane

Tab/Co. Orl 0.5 mg Estrace 02225190 TML 0.1199 Tablet / comprime

Lupin-Estradiol 02449048 LUP 0.1199 Tablet / comprime

Tab/Co. Orl 1 mg Estrace 02148587 TML 0.2313 Tablet / comprime

Lupin-Estradiol 02449056 LUP 0.2313 Tablet / comprime

Tab/Co. Orl 2 mg Estrace 02148595 TML 0.4083 Tablet / comprime

Lupin-Estradiol 02449064 LUP 0.4083 Tablet / comprime

Ethambutol / Ethambutol Tab/Co. Orl 100 mg Etibi 00247960 BSL 0.2250 Tablet / comprime

Tab/Co. Orl 400 mg Etibi 00247979 BSL 0.6749 Tablet / comprime

Etidronic Acid / Acide Etidronique Tab/Co. Orl 200 mg Act Etidronate 02248686 TEV 0.3569 Tablet / comprime

Everolimus / Everolimus Tab/Co. Orl 2.5 mg Afinitor 02369257 NVR 151.9905 Tablet / comprime P

Teva-Everolimus 02463229 TEV 151.9905 Tablet / comprime P

Tab/Co. Orl 5 mg Afinitor 02339501 NVR 151.9905 Tablet / comprime P

Teva-Everolimus 02463237 TEV 151.9905 Tablet / comprime P

September / septembre 2020 Page 21

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Tab/Co. Orl 10 mg Afinitor 02339528 NVR 151.9905 Tablet / comprime P

Teva-Everolimus 02463253 TEV 151.9905 Tablet / comprime P

Exemestane / Exemestane Tab/Co. Orl 25 mg Aromasin 02242705 PFI 1.3263 Tablet / comprime

Act Exemestane 02390183 TEV 1.3263 Tablet / comprime

Med-Exemestane 02407841 GMP 1.3263 Tablet / comprime

Teva-Exemestane 02408473 TEV 1.3263 Tablet / comprime

Ezetimibe / Ezetimibe Tab/Co. Orl 10 mg Ezetrol 02247521 FRS 0.1811 Tablet / comprime

ACH-Ezetimibe 02425610 AHI 0.1811 Tablet / comprime

Apo-Ezetimibe 02427826 APX 0.1811 Tablet / comprime

Auro-Ezetimibe 02469286 ARO 0.1811 Tablet / comprime

Ezetimibe 02422549 PDL 0.1811 Tablet / comprime

Ezetimibe 02429659 SIV 0.1811 Tablet / comprime

Ezetimibe 02431300 SAS 0.1811 Tablet / comprime

Jamp-Ezetimibe 02423235 JPC 0.1811 Tablet / comprime

Mar-Ezetimibe 02422662 MAR 0.1811 Tablet / comprime

Mint-Ezetimibe 02423243 MNT 0.1811 Tablet / comprime

NRA-Ezetimibe 02481669 NRA 0.1811 Tablet / comprime

Ran-Ezetimibe 02419548 RAN 0.1811 Tablet / comprime

Sandoz Ezetimibe 02416778 SDZ 0.1811 Tablet / comprime

Teva-Ezetimibe 02354101 TEV 0.1811 Tablet / comprime

pms-Ezetimibe 02416409 PMS 0.1811 Tablet / comprime

Famciclovir / Famciclovir Tab/Co. Orl 125 mg Famvir 02229110 NVR 0.5564 Tablet / comprime

Act Famciclovir 02305682 TEV 0.5564 Tablet / comprime

Apo-Famciclovir 02292025 APX 0.5564 Tablet / comprime

Sandoz Famciclovir 02278634 SDZ 0.5564 Tablet / comprime

pms-Famciclovir 02278081 PMS 0.5564 Tablet / comprime

Tab/Co. Orl 250 mg Famvir 02229129 NVR 0.7541 Tablet / comprime

Act Famciclovir 02305690 TEV 0.7541 Tablet / comprime

Apo-Famciclovir 02292041 APX 0.7541 Tablet / comprime

Sandoz Famciclovir 02278642 SDZ 0.7541 Tablet / comprime

pms-Famciclovir 02278103 PMS 0.7541 Tablet / comprime

Tab/Co. Orl 500 mg Famvir 02177102 NVR 1.3436 Tablet / comprime

Act Famciclovir 02305704 TEV 1.3436 Tablet / comprime

Apo-Famciclovir 02292068 APX 1.3436 Tablet / comprime

Sandoz Famciclovir 02278650 SDZ 1.3436 Tablet / comprime

pms-Famciclovir 02278111 PMS 1.3436 Tablet / comprime

Famotidine / Famotidine Tab/Co. Orl 20 mg Famotidine 02351102 SAS 0.2657 Tablet / comprime

Teva-Famotidine 02022133 TEV 0.2657 Tablet / comprime

Tab/Co. Orl 40 mg Famotidine 02351110 SAS 0.4833 Tablet / comprime

Teva-Famotidine 02022141 TEV 0.4833 Tablet / comprime

Febuxostat / Febuxostat Tab/Co. Orl 80 mg Uloric 02357380 TAK 0.7950 Tablet / comprime

Jamp-Febuxostat 02490870 JPC 0.7950 Tablet / comprime

Mar-Febuxostat 02473607 MAR 0.7950 Tablet / comprime

Felodipine / Felodipine ERT/Co.L.P. Orl 2.5 mg Plendil 02057778 AZE 0.3815 Tablet / comprime

Apo-Felodipine 02452367 APX 0.3815 Tablet / comprime

ERT/Co.L.P. Orl 5 mg Plendil 00851779 AZE 0.3398 Tablet / comprime

Apo-Felodipine 02452375 APX 0.3398 Tablet / comprime

Sandoz Felodipine 02280264 SDZ 0.3398 Tablet / comprime

ERT/Co.L.P. Orl 10 mg Plendil 00851787 AZE 0.5098 Tablet / comprime

Apo-Felodipine 02452383 APX 0.5098 Tablet / comprime

Sandoz Felodipine 02280272 SDZ 0.5098 Tablet / comprime

Fenofibrate / Fenofibrate Cap/Caps Orl 67 mg AA-Feno Micro 02243180 AAP 0.5479 Capsule / capsule

Cap/Caps Orl 200 mg AA-Feno-Micro 02239864 AAP 0.2723 Capsule / capsule

ratio-Fenofibrate MC 02250039 TEV 0.2723 Capsule / capsule

Tab/Co. Orl 100 mg Apo-Feno-Super 02246859 APX 0.5406 Tablet / comprime

Sandoz Fenofibrate S 02288044 SDZ 0.5406 Tablet / comprime

Tab/Co. Orl 160 mg Lipidil Supra 02241602 BGP 0.2723 Tablet / comprime

Apo-Feno-Super 02246860 APX 0.2723 Tablet / comprime

Sandoz Fenofibrate S 02288052 SDZ 0.2723 Tablet / comprime

Fentanyl / Fentanyl Pth/Pth Trd 12 mcg/hr Sandoz Fentanyl patch 02327112 SDZ 2.2280 Patch / timbre cutane

Teva-Fentanyl 02311925 TEV 2.2280 Patch / timbre cutane

pms-Fentanyl MTX 02341379 PMS 2.2280 Patch / timbre cutane

Pth/Pth Trd 25 mcg/hr Sandoz Fentanyl 02327120 SDZ 3.6560 Patch / timbre cutane

Teva-Fentanyl 02282941 TEV 3.6560 Patch / timbre cutane

pms-Fentanyl MTX 02341387 PMS 3.6560 Patch / timbre cutane

Pth/Pth Trd 37 mcg/hr Sandoz Fentanyl 02327139 SDZ 8.5000 Patch / timbre cutane

Pth/Pth Trd 50 mcg/hr Sandoz Fentanyl 02327147 SDZ 6.8820 Patch / timbre cutane

Teva-Fentanyl 02282968 TEV 6.8820 Patch / timbre cutane

pms-Fentanyl MTX 02341395 PMS 6.8820 Patch / timbre cutane

Pth/Pth Trd 75 mcg/hr Sandoz Fentanyl 02327155 SDZ 9.6800 Patch / timbre cutane

Teva-Fentanyl 02282976 TEV 9.6800 Patch / timbre cutane

pms-Fentanyl MTX 02341409 PMS 9.6800 Patch / timbre cutane

Pth/Pth Trd 100 mcg/hr Sandoz Fentanyl 02327163 SDZ 12.0500 Patch / timbre cutane

Teva-Fentanyl 02282984 TEV 12.0500 Patch / timbre cutane

September / septembre 2020 Page 22

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

pms-Fentanyl MTX 02341417 PMS 12.0500 Patch / timbre cutane

Ferrous Fumarate / Fumarate Ferreux Cap/Caps Orl 300 mg Palafer 01923420 BSL 0.1050 Capsule / capsule

Jamp-Fer 80024232 JPC 0.1050 Capsule / capsule

Sandoz-Fer 02237556 SDZ 0.1050 Capsule / capsule

Ferrous Sulphate / Sulfate Ferreux Dps/Gttes Orl 125 mg/mL pms-Ferrous Sulfate 00816035 PMS 0.2966 Millilitre / millilitre

Liq/Liq Orl 15 mg Fer-In-Sol 00762954 MJO 0.1432 Millilitre / millilitre

Ferodan 02237385 ODN 0.1432 Millilitre / millilitre

Jamp Ferrous Sulfate 80008309 JPC 0.1432 Millilitre / millilitre

Syr/Sir. Orl 150 mg/5 mL Fer-In-Sol 00017884 MJO 0.0272 Millilitre / millilitre

Ferodan 00758469 ODN 0.0272 Millilitre / millilitre

Finasteride / Finasteride Tab/Co. Orl 5 mg Proscar 02010909 FRS 0.4138 Tablet / comprime

Apo-Finasteride 02365383 APX 0.4138 Tablet / comprime

Auro-Finasteride 02405814 ARO 0.4138 Tablet / comprime

Finasteride 02355043 AHI 0.4138 Tablet / comprime

Finasteride 02445077 SAS 0.4138 Tablet / comprime

Finasteride 02447541 SIV 0.4138 Tablet / comprime

Jamp-Finasteride 02357224 JPC 0.4138 Tablet / comprime

Mint-Finasteride 02389878 MNT 0.4138 Tablet / comprime

Sandoz Finasteride 02322579 SDZ 0.4138 Tablet / comprime

Teva-Finasteride 02348500 TEV 0.4138 Tablet / comprime

pms-Finasteride 02310112 PMS 0.4138 Tablet / comprime

Fingolimod / Fingolimod Cap/Caps Orl 0.5 mg Gilenya 02365480 NVR 21.7381 Capsule / capsule

Apo-Fingolimod 02469936 APX 21.7381 Capsule / capsule

Jamp-Fingolimod 02487772 JPC 21.7381 Capsule / capsule

Mar-Fingolimod 02474743 MAR 21.7381 Capsule / capsule

Mylan-Fingolimod 02469715 MYL 21.7381 Capsule / capsule

Sandoz Fingolimod 02482606 SDZ 21.7381 Capsule / capsule

Taro-Fingolimod 02469618 TAR 21.7381 Capsule / capsule

Teva-Fingolimod 02469561 TEV 21.7381 Capsule / capsule

pms-Fingolimod 02469782 PMS 21.7381 Capsule / capsule

Flecainide / Flecainide Tab/Co. Orl 50 mg Apo-Flecainide 02275538 APX 0.2778 Tablet / comprime

Auro-Flecainide 02459957 ARO 0.2778 Tablet / comprime

Tab/Co. Orl 100 mg Apo-Flecainide 02275546 APX 0.5558 Tablet / comprime

Auro-Flecainide 02459965 ARO 0.5558 Tablet / comprime

Floctafenine / Floctafenine Tab/Co. Orl 400 mg Floctafenine 02244681 AAP 0.8285 Tablet / comprime

Fluconazole / Fluconazole Cap/Caps Orl 150 mg Diflucan 02141442 CHC 3.6392 Capsule / capsule

Apo-Fluconazole 02241895 APX 3.6392 Capsule / capsule

Mar-Fluconazole-150 02428792 MAR 3.6392 Capsule / capsule

Liq/Liq Inj 2 mg/mL Diflucan 00891835 PFI 0.4085 Millilitre / millilitre

Tab/Co. Orl 50 mg Act Fluconazole 02281260 TEV 1.2904 Tablet / comprime

Apo-Fluconazole 02237370 APX 1.2904 Tablet / comprime

Mylan-Fluconazole 02245292 MYL 1.2904 Tablet / comprime

Novo-Fluconazole 02236978 TEV 1.2904 Tablet / comprime

pms-Fluconazole 02245643 PMS 1.2904 Tablet / comprime

Tab/Co. Orl 100 mg Act Fluconazole 02281279 TEV 2.2891 Tablet / comprime

Apo-Fluconazole 02237371 APX 2.2891 Tablet / comprime

Mylan-Fluconazole 02245293 MYL 2.2891 Tablet / comprime

Novo-Fluconazole 02236979 TEV 2.2891 Tablet / comprime

pms-Fluconazole 02245644 PMS 2.2891 Tablet / comprime

Flunarizine / Flunarizine Cap/Caps Orl 5 mg Flunarizine 02246082 AAP 0.7348 Capsule / capsule

Fluocinonide / Fluocinonide Crm/Cr. Top 0.05% Lidex 02161923 VLN 0.2444 Gram / gramme

Lyderm 00716863 TPH 0.2444 Gram / gramme

Gel/Gel Top 0.05% Lidex Gel 02161974 VLN 0.3321 Gram / gramme

Lyderm 02236997 TPH 0.3321 Gram / gramme

Ont/Ont Top 0.05% Lidex 02161966 VLN 0.3278 Gram / gramme

Lyderm 02236996 TPH 0.3278 Gram / gramme

Fluorometholone / Fluorometholone Dps/Gttes Oph 0.1% Sandoz Fluorometholone 00432814 SDZ 1.7880 Millilitre / millilitre

Fluoxetine / Fluoxetine Cap/Caps Orl 10 mg Prozac 02018985 LIL 0.3404 Capsule / capsule

Apo-Fluoxetine 02216353 APX 0.3404 Capsule / capsule

Auro-Fluoxetine 02385627 ARO 0.3404 Capsule / capsule

Fluoxetine 02393441 AHI 0.3404 Capsule / capsule

Fluoxetine 02286068 SAS 0.3404 Capsule / capsule

Fluoxetine 02374447 SIV 0.3404 Capsule / capsule

Jamp-Fluoxetine 02401894 JPC 0.3404 Capsule / capsule

Sandoz Fluoxetine 02479486 SDZ 0.3404 Capsule / capsule

Teva-Fluoxetine 02216582 TEV 0.3404 Capsule / capsule

pms-Fluoxetine 02177579 PMS 0.3404 Capsule / capsule

Cap/Caps Orl 20 mg Prozac 00636622 LIL 0.3311 Capsule / capsule

Apo-Fluoxetine 02216361 APX 0.3311 Capsule / capsule

Auro-Fluoxetine 02385635 ARO 0.3311 Capsule / capsule

Fluoxetine 02383241 AHI 0.3311 Capsule / capsule

Fluoxetine 02286076 SAS 0.3311 Capsule / capsule

Fluoxetine 02374455 SIV 0.3311 Capsule / capsule

Jamp-Fluoxetine 02386402 JPC 0.3311 Capsule / capsule

September / septembre 2020 Page 23

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Sandoz Fluoxetine 02479494 SDZ 0.3311 Capsule / capsule

Teva-Fluoxetine 02216590 TEV 0.3311 Capsule / capsule

pms-Fluoxetine 02177587 PMS 0.3311 Capsule / capsule

Cap/Caps Orl 40 mg pms-Fluoxetine 02464640 PMS 0.6622 Capsule / capsule

Cap/Caps Orl 60 mg pms-Fluoxetine 02464659 PMS 0.9933 Capsule / capsule

Liq/Liq Orl 20 mg/5 mL Apo-Fluoxetine 02231328 APX 0.3083 Millilitre / millilitre

Odan-Fluoxetine 02459361 ODN 0.3083 Millilitre / millilitre

Fluphenazine / Fluphenazine Tab/Co. Orl 1 mg Fluphenazine 00405345 AAP 0.1739 Tablet / comprime

Tab/Co. Orl 2 mg Fluphenazine 00410632 AAP 0.2252 Tablet / comprime

Tab/Co. Orl 5 mg Fluphenazine 00405361 AAP 0.1720 Tablet / comprime

Flurazepam / Flurazepam Cap/Caps Orl 15 mg Flurazepam 00521698 AAP 0.1166 Capsule / capsule

Cap/Caps Orl 30 mg Flurazepam 00521701 AAP 0.1364 Capsule / capsule

Flurbiprofen / Flurbiprofene Tab/Co. Orl 50 mg Flurbiprofen 01912046 AAP 0.4530 Tablet / comprime

Tab/Co. Orl 100 mg Flurbiprofen 01912038 AAP 0.3039 Tablet / comprime

Teva-Flurbiprofen 02100517 TEV 0.3039 Tablet / comprime

Flutamide / Flutamide Tab/Co. Orl 250 mg Flutamide 02238560 AAP 1.8255 Tablet / comprime

Fluticasone / Fluticasone Aem/Aem. Nas 50 mcg Apo-Fluticasone 02294745 APX 0.1831 Dose / dose

ratio-Fluticasone 02296071 TEV 0.1831 Dose / dose

Fluvastatin / Fluvastatine Cap/Caps Orl 20 mg Teva-Fluvastatin 02299224 TEV 0.2202 Capsule / capsule

Cap/Caps Orl 40 mg Teva-Fluvastatin 02299232 TEV 0.3092 Capsule / capsule

Fluvoxamine / Fluvoxamine Tab/Co. Orl 50 mg Luvox 01919342 BGP 0.2105 Tablet / comprime

Act Fluvoxamine 02255529 TEV 0.2105 Tablet / comprime

Apo-Fluvoxamine 02231329 APX 0.2105 Tablet / comprime

Tab/Co. Orl 100 mg Luvox 01919369 BGP 0.3783 Tablet / comprime

Act Fluvoxamine 02255537 TEV 0.3783 Tablet / comprime

Apo-Fluvoxamine 02231330 APX 0.3783 Tablet / comprime

Folic Acid / Acide Folique Tab/Co. Orl 5 mg Jamp-Folic 02366061 JPC 0.0198 Tablet / comprime

Sandoz-Folic 02285673 SDZ 0.0198 Tablet / comprime

Fosfomycin / Fosfomycine Pws/Pds. Orl 3 g Monurol 02240335 PAL 4.6750 Gram / gramme

Jamp-Fosfomycin 02473801 JPC 4.6750 Gram / gramme

Fosinopril / Fosinopril Tab/Co. Orl 10 mg Apo-Fosinopril 02266008 APX 0.2177 Tablet / comprime

Fosinopril 02459388 SAS 0.2177 Tablet / comprime

Jamp-Fosinopril 02331004 JPC 0.2177 Tablet / comprime

Ran-Fosinopril 02294524 RAN 0.2177 Tablet / comprime

Teva-Fosinopril 02247802 TEV 0.2177 Tablet / comprime

Tab/Co. Orl 20 mg Apo-Fosinopril 02266016 APX 0.2619 Tablet / comprime

Fosinopril 02459396 SAS 0.2619 Tablet / comprime

Jamp-Fosinopril 02331012 JPC 0.2619 Tablet / comprime

Ran-Fosinopril 02294532 RAN 0.2619 Tablet / comprime

Teva-Fosinopril 02247803 TEV 0.2619 Tablet / comprime

Fulvestrant / Fulvestrant Liq/Liq IM 50 mg/mL Fulvestrant Injection 02483610 SDZ 58.2895 Millilitre / millilitre

Teva-Fulvestrant 02460130 TEV 58.2895 Millilitre / millilitre

Furosemide / Furosemide Liq/Liq Inj 10 mg/mL Furosemide 02382539 SDZ 0.8650 Millilitre / millilitre

Furosemide 00527033 SDZ 0.8650 Millilitre / millilitre

Tab/Co. Orl 20 mg Apo-Furosemide 00396788 APX 0.0218 Tablet / comprime

Mint-Furosemide 02466759 MNT 0.0218 Tablet / comprime

Teva-Furosemide 00337730 TEV 0.0218 Tablet / comprime

Tab/Co. Orl 40 mg Apo-Furosemide 00362166 APX 0.0327 Tablet / comprime

Mint-Furosemide 02466767 MNT 0.0327 Tablet / comprime

Teva-Furosemide 00337749 TEV 0.0327 Tablet / comprime

Tab/Co. Orl 80 mg Apo-Furosemide 00707570 APX 0.0703 Tablet / comprime

Furosemide 02351447 SAS 0.0703 Tablet / comprime

Mint-Furosemide 02466775 MNT 0.0703 Tablet / comprime

Teva-Furosemide 00765953 TEV 0.0703 Tablet / comprime

Gabapentin / Gabapentine Cap/Caps Orl 100 mg Neurontin 02084260 UJC 0.0416 Capsule / capsule

Apo-Gabapentin 02244304 APX 0.0416 Capsule / capsule

Auro-Gabapentin 02321203 ARO 0.0416 Capsule / capsule

Gabapentin 02353245 SAS 0.0416 Capsule / capsule

Gabapentin 02246314 SIV 0.0416 Capsule / capsule

Gabapentin 02416840 AHI 0.0416 Capsule / capsule

Jamp-Gabapentin 02361469 JPC 0.0416 Capsule / capsule

Mar-Gabapentin 02391473 MAR 0.0416 Capsule / capsule

Teva-Gabapentin 02244513 TEV 0.0416 Capsule / capsule

pms-Gabapentin 02243446 PMS 0.0416 Capsule / capsule

Cap/Caps Orl 300 mg Neurontin 02084279 UJC 0.1012 Capsule / capsule

Apo-Gabapentin 02244305 APX 0.1012 Capsule / capsule

Auro-Gabapentin 02321211 ARO 0.1012 Capsule / capsule

Gabapentin 02416859 AHI 0.1012 Capsule / capsule

Gabapentin 02246315 SIV 0.1012 Capsule / capsule

Gabapentin 02353253 SAS 0.1012 Capsule / capsule

Jamp-Gabapentin 02361485 JPC 0.1012 Capsule / capsule

Mar-Gabapentin 02391481 MAR 0.1012 Capsule / capsule

Ran-Gabapentin 02319063 RAN 0.1012 Capsule / capsule

Teva-Gabapentin 02244514 TEV 0.1012 Capsule / capsule

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

pms-Gabapentin 02243447 PMS 0.1012 Capsule / capsule

Cap/Caps Orl 400 mg Neurontin 02084287 UJC 0.1206 Capsule / capsule

Apo-Gabapentin 02244306 APX 0.1206 Capsule / capsule

Auro-Gabapentin 02321238 ARO 0.1206 Capsule / capsule

Gabapentin 02246316 SIV 0.1206 Capsule / capsule

Gabapentin 02416867 AHI 0.1206 Capsule / capsule

Gabapentin 02353261 SAS 0.1206 Capsule / capsule

Jamp-Gabapentin 02361493 JPC 0.1206 Capsule / capsule

Mar-Gabapentin 02391503 MAR 0.1206 Capsule / capsule

Teva-Gabapentin 02244515 TEV 0.1206 Capsule / capsule

pms-Gabapentin 02243448 PMS 0.1206 Capsule / capsule

Tab/Co. Orl 600 mg Neurontin 02239717 UJC 0.1809 Tablet / comprime

Apo-Gabapentin 02293358 APX 0.1809 Tablet / comprime

Auro-Gabapentin 02428334 ARO 0.1809 Tablet / comprime

Gabapentin 02431289 SAS 0.1809 Tablet / comprime

Gabapentin 02392526 AHI 0.1809 Tablet / comprime

Gabapentin 02410990 GLM 0.1809 Tablet / comprime

Gabapentin 02388200 SIV 0.1809 Tablet / comprime

Jamp-Gabapentin 02402289 JPC 0.1809 Tablet / comprime

Teva-Gabapentin 02248457 TEV 0.1809 Tablet / comprime

Tab/Co. Orl 800 mg Neurontin 02239718 UJC 0.2412 Tablet / comprime

Apo-Gabapentin 02293366 APX 0.2412 Tablet / comprime

Auro-Gabapentin 02428342 ARO 0.2412 Tablet / comprime

Gabapentin 02388219 SIV 0.2412 Tablet / comprime

Gabapentin 02411008 GLM 0.2412 Tablet / comprime

Gabapentin 02431297 SAS 0.2412 Tablet / comprime

Gabapentin 02392534 AHI 0.2412 Tablet / comprime

Jamp-Gabapentin 02402297 JPC 0.2412 Tablet / comprime

Teva-Gabapentin 02247346 TEV 0.2412 Tablet / comprime

Galantamine / Galantamine ERC/Caps.L.P. Orl 8 mg Auro-Galantamine ER 02425157 ARO 1.1475 Capsule / capsule

Galantamine ER 02443015 SAS 1.1475 Capsule / capsule

Mar-Galantamine ER 02420821 MAR 1.1475 Capsule / capsule

Mylan-Galantamine ER 02339439 MYL 1.1475 Capsule / capsule

pms-Galantamine ER 02398370 PMS 1.1475 Capsule / capsule

ERC/Caps.L.P. Orl 16 mg Auro-Galantamine ER 02425165 ARO 1.1475 Capsule / capsule

Galantamine ER 02443023 SAS 1.1475 Capsule / capsule

Mar-Galantamine ER 02420848 MAR 1.1475 Capsule / capsule

Mylan-Galantamine ER 02339447 MYL 1.1475 Capsule / capsule

pms-Galantamine ER 02398389 PMS 1.1475 Capsule / capsule

ERC/Caps.L.P. Orl 24 mg Auro-Galantamine ER 02425173 ARO 1.1475 Capsule / capsule

Galantamine ER 02443031 SAS 1.1475 Capsule / capsule

Mar-Galantamine ER 02420856 MAR 1.1475 Capsule / capsule

Mylan-Galantamine ER 02339455 MYL 1.1475 Capsule / capsule

pms-Galantamine ER 02398397 PMS 1.1475 Capsule / capsule

Gemfibrozil / Gemfibrozil Cap/Caps Orl 300 mg pms-Gemfibrozil 02239951 PMS 0.1288 Capsule / capsule

Tab/Co. Orl 600 mg Teva-Gemfibrozil 02142074 TEV 0.5157 Tablet / comprime

Gentamicin / Gentamicine Liq/Liq Inj 40 mg/mL Gentamicin 02242652 SDZ 8.9447 Millilitre / millilitre

Glibenclamide (Glyburide) / Glibenclamide (Glyburide) Tab/Co. Orl 2.5 mg Diabeta 02224550 SAV 0.0321 Tablet / comprime

Apo-Glyburide 01913654 APX 0.0321 Tablet / comprime

Glyburide 02350459 SAS 0.0321 Tablet / comprime

Teva-Glyburide 01913670 TEV 0.0321 Tablet / comprime

Tab/Co. Orl 5 mg Diabeta 02224569 SAV 0.0573 Tablet / comprime

Apo-Glyburide 01913662 APX 0.0573 Tablet / comprime

Glyburide 02350467 SAS 0.0573 Tablet / comprime

Teva-Glyburide 01913689 TEV 0.0573 Tablet / comprime

Gliclazide / Gliclazide ERT/Co.L.P. Orl 30 mg Diamicron MR 02242987 SEV 0.0931 Tablet / comprime

Apo-Gliclazide MR 02297795 APX 0.0931 Tablet / comprime

Jamp-Gliclazide MR 02429764 JPC 0.0931 Tablet / comprime

Mint-Gliclazide MR 02423286 MNT 0.0931 Tablet / comprime

Mylan-Gliclazide MR 02438658 MYL 0.0931 Tablet / comprime

Sandoz Gliclazide MR 02461323 SDZ 0.0931 Tablet / comprime

Taro-Gliclazide MR 02463571 SUN 0.0931 Tablet / comprime

ERT/Co.L.P. Orl 60 mg Diamicron MR 02356422 SEV 0.0632 Tablet / comprime

Apo-Gliclazide MR 02407124 APX 0.0632 Tablet / comprime

Mint-Gliclazide MR 02423294 MNT 0.0632 Tablet / comprime

Sandoz Gliclazide MR 02461331 SDZ 0.0632 Tablet / comprime

Taro-Gliclazide MR 02439328 SUN 0.0632 Tablet / comprime

Tab/Co. Orl 80 mg Diamicron 00765996 SEV 0.0931 Tablet / comprime

Apo-Gliclazide 02245247 APX 0.0931 Tablet / comprime

Gliclazide 02287072 SAS 0.0931 Tablet / comprime

Teva-Gliclazide 02238103 TEV 0.0931 Tablet / comprime

Glimepiride / Glimepiride Tab/Co. Orl 1 mg Sandoz Glimepiride 02269589 SDZ 0.3857 Tablet / comprime

Tab/Co. Orl 2 mg Sandoz Glimepiride 02269597 SDZ 0.3857 Tablet / comprime

Tab/Co. Orl 4 mg Sandoz Glimepiride 02269619 SDZ 0.3857 Tablet / comprime

September / septembre 2020 Page 25

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Glycopyrronium Bromide (Glycopyrrolate) / Bromure De

Glycopyrronium (Glycopyrrolate)

Liq/Liq Inj 0.2 mg/mL Glycopyrrolate 02039508 SDZ 3.9750 Millilitre / millilitre

Haloperidol / Haloperidol Liq/Liq Inj 5 mg/mL Haloperidol 00808652 SDZ 4.8300 Millilitre / millilitre

Haloperidol Injection 02366010 OMG 4.8300 Millilitre / millilitre

Liq/Liq Inj 100 mg/mL Haloperidol LA 02130300 SDZ 16.9233 Millilitre / millilitre

Tab/Co. Orl 0.5 mg Teva-Haloperidol 00363685 TEV 0.1362 Tablet / comprime

Tab/Co. Orl 1 mg Teva-Haloperidol 00363677 TEV 0.2046 Tablet / comprime

Tab/Co. Orl 2 mg Teva-Haloperidol 00363669 TEV 0.3058 Tablet / comprime

Tab/Co. Orl 5 mg Teva-Haloperidol 00363650 TEV 0.4877 Tablet / comprime

Tab/Co. Orl 10 mg Teva-Haloperidol 00713449 TEV 0.7095 Tablet / comprime

Hydralazine / Hydralazine Tab/Co. Orl 10 mg Apo-Hydralazine 00441619 APX 0.0355 Tablet / comprime

Jamp-Hydralazine 02457865 JPC 0.0355 Tablet / comprime

Mint-Hydralazine 02468778 MNT 0.0355 Tablet / comprime

Tab/Co. Orl 25 mg Apo-Hydralazine 00441627 APX 0.0609 Tablet / comprime

Jamp-Hydralazine 02457873 JPC 0.0609 Tablet / comprime

Mint-Hydralazine 02468786 MNT 0.0609 Tablet / comprime

Tab/Co. Orl 50 mg Apo-Hydralazine 00441635 APX 0.0956 Tablet / comprime

Jamp-Hydralazine 02457881 JPC 0.0956 Tablet / comprime

Mint-Hydralazine 02468794 MNT 0.0956 Tablet / comprime

Hydrochlorothiazide / Amiloride / Hydrochlorothiazide /

Amiloride

Tab/Co. Orl 50 mg / 5 mg AA-Amilzide 00784400 AAP 0.0838 Tablet / comprime

Hydrochlorothiazide / Hydrochlorothiazide Tab/Co. Orl 12.5 mg Apo-Hydro 02327856 APX 0.0322 Tablet / comprime

Mint-Hydrochlorothiazide 02425947 MNT 0.0322 Tablet / comprime

pms-Hydrochlorothiazide 02274086 PMS 0.0322 Tablet / comprime

Tab/Co. Orl 25 mg Apo-Hydro 00326844 APX 0.0157 Tablet / comprime

Mint-Hydrochlorothiazide 02426196 MNT 0.0157 Tablet / comprime

Teva-Hydrochlorothiazide 00021474 TEV 0.0157 Tablet / comprime

pms-Hydrochlorothiazide 02247386 PMS 0.0157 Tablet / comprime

Tab/Co. Orl 50 mg Apo-Hydro 00312800 APX 0.0217 Tablet / comprime

Hydrochlorothiazide 02360608 SAS 0.0217 Tablet / comprime

Teva-Hydrazide 00021482 TEV 0.0217 Tablet / comprime

pms-Hydrochlorothiazide 02247387 PMS 0.0217 Tablet / comprime

Hydrochlorothiazide / Spironolactone / Hydrochlorothiazide /

Spironolactone

Tab/Co. Orl 25 mg / 25 mg Aldactazide-25 00180408 PFI 0.1076 Tablet / comprime

Teva-Spironolactone HCTZ 00613231 TEV 0.1076 Tablet / comprime

Tab/Co. Orl 50 mg / 50 mg Aldactazide-50 00594377 PFI 0.2276 Tablet / comprime

Teva-Spironolactone HCTZ 00657182 TEV 0.2276 Tablet / comprime

Hydrochlorothiazide / Triamterene / Hydrochlorothiazide /

Triamterene

Tab/Co. Orl 25 mg / 50 mg Apo-Triazide 00441775 APX 0.0608 Tablet / comprime

Teva-Triamterene/HCTZ 00532657 TEV 0.0608 Tablet / comprime

Hydrocortisone / Cinchocaine / Framycetin / Esculin /

Hydrocortisone / Cinchocaine / Framycetine / Esculine

Ont/Ont Rt 5 mg / 5 mg / 10 mg /

10 mg

Proctosedyl 02223252 AXC 0.4000 Gram / gramme

Proctol Ointment 02247322 ODN 0.4000 Gram / gramme

Sandoz Proctomyxin HC 02242527 SDZ 0.4000 Gram / gramme

Sup/Supp. Rt 5 mg / 5 mg / 10 mg /

10 mg

Proctosedyl 02223260 AXC 0.6000 Suppository / suppositoire

Proctol Suppositories 02247882 ODN 0.6000 Suppository / suppositoire

Sandoz Proctomyxin HC Supp 02242528 SDZ 0.6000 Suppository / suppositoire

Hydrocortisone / Pramoxine / Zinc / Hydrocortisone / Pramoxine

/ Zinc

Ont/Ont Rt 0.5% / 1% / 0.5% Anugesic-HC 00505781 JNJ 0.7314 Gram / gramme

Proctodan-HC Ointment 02234466 ODN 0.7314 Gram / gramme

Sup/Supp. Rt 10 mg / 20 mg /

10 mg

Anugesic-HC 00476242 JNJ 1.0875 Suppository / suppositoire

Proctodan-HC Suppositories 02240851 ODN 1.0875 Suppository / suppositoire

Sandoz Anuzinc HC Plus 02242797 SDZ 1.0875 Suppository / suppositoire

Hydrocortisone / Zinc / Hydrocortisone / Zinc Ont/Ont Rt 0.5% / 0.5% Anusol-HC 00505773 JNJ 0.3850 Gram / gramme

Anodan HC 02128446 ODN 0.3850 Gram / gramme

Jamp-Zinc-HC 02387239 JPC 0.3850 Gram / gramme

Sup/Supp. Rt 0.5% / 0.5% Anusol-HC 00476285 JNJ 0.6125 Suppository / suppositoire

Anodan HC 02236399 ODN 0.6125 Suppository / suppositoire

Sandoz Anuzinc HC 02242798 SDZ 0.6125 Suppository / suppositoire

Hydrocortisone Acetate / Acetate D'Hydrocortisone Crm/Cr. Top 0.5% Cortate 80021088 SCO 0.1267 Gram / gramme

Hydrosone 00564281 ROG 0.1267 Gram / gramme

Crm/Cr. Top 1% Prevex HC 00804533 GSK 0.0859 Gram / gramme

Hyderm 00716839 TAR 0.0859 Gram / gramme

Sandoz Hydrocortisone 02412926 SDZ 0.0859 Gram / gramme

Lot/Lot Top 1% Jamp-Hydrocortisone 80057191 JPC 0.1191 Gram / gramme

Hydrocortisone Valerate / Valerate D'Hydrocortisone Crm/Cr. Top 0.2% Hydroval 02242984 TPH 0.1375 Gram / gramme

Ont/Ont Top 0.2% Hydroval 02242985 TPH 0.1375 Gram / gramme

Hydromorphone / Hydromorphone Liq/Liq Inj 2 mg/mL Dilaudid 00627100 PFR 1.5250 Millilitre / millilitre

Hydromorphone Hydrochloride 02145901 SDZ 1.5250 Millilitre / millilitre

Liq/Liq Inj 10 mg/mL Dilaudid HP 00622133 PFR 3.3750 Millilitre / millilitre

Hydromorphone HP 10 02145928 SDZ 3.3750 Millilitre / millilitre

Liq/Liq Inj 20 mg/mL Hydromorphone HP 20 02145936 SDZ 8.9290 Millilitre / millilitre

Liq/Liq Inj 50 mg/mL Hydromorphone HP 50 02146126 SDZ 21.1271 Millilitre / millilitre

SRC/Caps.L.L. Orl 3 mg Hydromorph Contin 02125323 PFR 0.6330 Capsule / capsule

September / septembre 2020 Page 26

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Maximum Allowable Price (MAP) list for NB Drug Plans

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Apo-Hydromorphone CR 02476614 APX 0.6023 Capsule / capsule

SRC/Caps.L.L. Orl 4.5 mg Hydromorph Contin 02359502 PFR 0.7640 Capsule / capsule

Apo-Hydromorphone CR 02476622 APX 0.7275 Capsule / capsule

SRC/Caps.L.L. Orl 6 mg Hydromorph Contin 02125331 PFR 0.9480 Capsule / capsule

Apo-Hydromorphone CR 02476630 APX 0.9030 Capsule / capsule

SRC/Caps.L.L. Orl 9 mg Hydromorph Contin 02359510 PFR 1.2520 Capsule / capsule

Apo-Hydromorphone CR 02476649 APX 1.1925 Capsule / capsule

SRC/Caps.L.L. Orl 12 mg Hydromorph Contin 02125366 PFR 1.6440 Capsule / capsule

Apo-Hydromorphone CR 02476657 APX 1.5653 Capsule / capsule

SRC/Caps.L.L. Orl 18 mg Hydromorph Contin 02243562 PFR 2.3720 Capsule / capsule

Apo-Hydromorphone CR 02476665 APX 2.2590 Capsule / capsule

SRC/Caps.L.L. Orl 24 mg Hydromorph Contin 02125382 PFR 2.7450 Capsule / capsule

Apo-Hydromorphone CR 02476673 APX 2.6138 Capsule / capsule

SRC/Caps.L.L. Orl 30 mg Hydromorph Contin 02125390 PFR 3.2880 Capsule / capsule

Apo-Hydromorphone CR 02476681 APX 3.1309 Capsule / capsule

Syr/Sir. Orl 1 mg/mL pms-Hydromorphone 01916386 PMS 0.0698 Millilitre / millilitre

Tab/Co. Orl 1 mg Dilaudid 00705438 PFR 0.0950 Tablet / comprime

Apo-Hydromorphone 02364115 APX 0.0950 Tablet / comprime

Teva-Hydromorphone 02319403 TEV 0.0950 Tablet / comprime

pms-Hydromorphone 00885444 PMS 0.0950 Tablet / comprime

Tab/Co. Orl 2 mg Dilaudid 00125083 PFR 0.1416 Tablet / comprime

Apo-Hydromorphone 02364123 APX 0.1416 Tablet / comprime

pms-Hydromorphone 00885436 PMS 0.1416 Tablet / comprime

Tab/Co. Orl 4 mg Dilaudid 00125121 PFR 0.2240 Tablet / comprime

Apo-Hydromorphone 02364131 APX 0.2240 Tablet / comprime

Teva-Hydromorphone 02319438 TEV 0.2240 Tablet / comprime

pms-Hydromorphone 00885401 PMS 0.2240 Tablet / comprime

Tab/Co. Orl 8 mg Dilaudid 00786543 PFR 0.3528 Tablet / comprime

Apo-Hydromorphone 02364158 APX 0.3528 Tablet / comprime

Teva-Hydromorphone 02319446 TEV 0.3528 Tablet / comprime

pms-Hydromorphone 00885428 PMS 0.3528 Tablet / comprime

Hydroxycarbamide (Hydroxyurea) / Hydroxycarbamide

(Hydroxyuree)

Cap/Caps Orl 500 mg Hydrea 00465283 BRI 1.0203 Capsule / capsule

Apo-Hydroxyurea 02247937 APX 1.0203 Capsule / capsule

Mylan-Hydroxyurea 02242920 MYL 1.0203 Capsule / capsule

Hydroxychloroquine / Hydroxychloroquine Tab/Co. Orl 200 mg Plaquenil 02017709 SAV 0.1576 Tablet / comprime

Apo-Hydroxyquine 02246691 APX 0.1576 Tablet / comprime

Jamp-Hydroxychloroquine Sulfate 02491427 JPC 0.1576 Tablet / comprime

Mint-Hydroxychloroquine 02424991 MNT 0.1576 Tablet / comprime

Hydroxyzine / Hydroxyzine Cap/Caps Orl 10 mg Hydroxyzine 00646059 AAP 0.1143 Capsule / capsule

Novo-Hydroxyzine 00738824 TEV 0.1116 Capsule / capsule

Cap/Caps Orl 25 mg Hydroxyzine 00646024 AAP 0.1459 Capsule / capsule

Novo-Hydroxyzine 00738832 TEV 0.1425 Capsule / capsule

Cap/Caps Orl 50 mg Hydroxyzine 00646016 AAP 0.2118 Capsule / capsule

Novo-Hydroxyzine 00738840 TEV 0.2068 Capsule / capsule

Syr/Sir. Orl 2 mg/mL Atarax 00024694 ERF 0.0500 Millilitre / millilitre

Hypertonic Sodium Chloride / Chlorure De Sodium,

Hypertonique

Liq/Liq Inh 7% Hyper-Sal 80029414 KEG 0.2213 Millilitre / millilitre

Nebusal 80029758 STR 0.2213 Millilitre / millilitre

Ibuprofen / Ibuprofene Tab/Co. Orl 300 mg Apo-Ibuprofen 00441651 APX 0.1377 Tablet / comprime

Tab/Co. Orl 400 mg Motrin IB 02242658 JNJ 0.1938 Tablet / comprime

Jamp-Ibuprofen 02401290 JPC 0.0372 Tablet / comprime

Tab/Co. Orl 600 mg Apo-Ibuprofen 00585114 APX 0.1313 Tablet / comprime

Novo-Profen 00629359 TEV 0.1313 Tablet / comprime

Imatinib / Imatinib Tab/Co. Orl 100 mg Gleevec 02253275 NVR 5.2079 Tablet / comprime

Apo-Imatinib 02355337 APX 5.2079 Tablet / comprime

Mint-Imatinib 02492334 MNT 5.2079 Tablet / comprime

Nat-Imatinib 02397285 NAT 5.2079 Tablet / comprime

Teva-Imatinib 02399806 TEV 5.2079 Tablet / comprime

pms-Imatinib 02431114 PMS 5.2079 Tablet / comprime

Tab/Co. Orl 400 mg Gleevec 02253283 NVR 20.8314 Tablet / comprime

Apo-Imatinib 02355345 APX 20.8314 Tablet / comprime

Mint-Imatinib 02492342 MNT 20.8314 Tablet / comprime

Nat-Imatinib 02397293 NAT 20.8314 Tablet / comprime

Teva-Imatinib 02399814 TEV 20.8314 Tablet / comprime

pms-Imatinib 02431122 PMS 20.8314 Tablet / comprime

Imipenem / Cilastatin / Imipenem / Cilastatine Pws/Pds. Inj 250 mg / 250 mg Ran-Imipenem-Cilastatin 02351692 RAN 11.7400 Vial / fiole

Pws/Pds. Inj 500 mg / 500 mg Primaxin 00717282 FRS 37.1119 Vial / fiole

Ran-Imipenem-Cilastatin 02351706 RAN 21.9400 Vial / fiole

Imipramine / Imipramine Tab/Co. Orl 10 mg Imipramine 00360201 AAP 0.1397 Tablet / comprime

Tab/Co. Orl 25 mg Imipramine 00312797 AAP 0.2573 Tablet / comprime

Tab/Co. Orl 50 mg Imipramine 00326852 AAP 0.5021 Tablet / comprime

Tab/Co. Orl 75 mg Imipramine 00644579 AAP 0.6727 Tablet / comprime

Imiquimod / Imiquimod Crm/Cr. Top 5% Aldara P 02239505 BSL 43.4350 Gram / gramme

Taro-Imiquimod Pump 02482983 TAR 43.4350 Gram / gramme

September / septembre 2020 Page 27

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Indapamide / Indapamide Tab/Co. Orl 1.25 mg Lozide 02179709 SEV 0.0745 Tablet / comprime

Apo-Indapamide 02245246 APX 0.0745 Tablet / comprime

Jamp-Indapamide 02373904 JPC 0.0745 Tablet / comprime

Mylan-Indapamide 02240067 MYL 0.0745 Tablet / comprime

Tab/Co. Orl 2.5 mg Lozide 00564966 SEV 0.1182 Tablet / comprime

Apo-Indapamide 02223678 APX 0.1182 Tablet / comprime

Jamp-Indapamide 02373912 JPC 0.1182 Tablet / comprime

Mylan-Indapamide 02153483 MYL 0.1182 Tablet / comprime

Indomethacin / Indomethacine Cap/Caps Orl 25 mg Mint-Indomethacin 02461811 MNT 0.1519 Capsule / capsule

Teva-Indomethacin 00337420 TEV 0.1519 Capsule / capsule

Cap/Caps Orl 50 mg Mint-Indomethacin 02461536 MNT 0.2469 Capsule / capsule

Teva-Indomethacin 00337439 TEV 0.2469 Capsule / capsule

Sup/Supp. Rt 50 mg Sab-Indomethacin 02231799 SDZ 0.8840 Suppository / suppositoire

Sup/Supp. Rt 100 mg Sab-Indomethacin 02231800 SDZ 0.8920 Suppository / suppositoire

Ipratropium Bromide / Bromure D'Ipratropium Liq/Liq Inh 125 mcg/mL pms-Ipratropium 02231135 PMS 0.5753 Millilitre / millilitre

Liq/Liq Inh 250 mcg/mL Teva-Ipratropium 02216221 TEV 0.6590 Millilitre / millilitre

pms-Ipratropium (1mL nebules) 02231244 PMS 0.6590 Millilitre / millilitre

pms-Ipratropium (2mL nebules) 02231245 PMS 0.6590 Millilitre / millilitre

Liq/Liq Inh 250 mcg/mL Apo-Ipravent 02126222 APX 0.3155 Millilitre / millilitre

pms-Ipratropium 02231136 PMS 0.3155 Millilitre / millilitre

Spr/Vap Nas 0.03% pms-Ipratropium 02239627 PMS 0.0756 Dose / dose

Irbesartan / Hydrochlorothiazide / Irbesartan /

Hydrochlorothiazide

Tab/Co. Orl 150 mg / 12.5 mg Avalide 02241818 SAV 0.2281 Tablet / comprime

Auro-Irbesartan HCT 02447878 ARO 0.2281 Tablet / comprime

Irbesartan HCT 02385317 SIV 0.2281 Tablet / comprime

Irbesartan/HCTZ 02372886 SAS 0.2281 Tablet / comprime

Jamp-Irbesartan/Hydrochlorothiazide 02418223 JPC 0.2281 Tablet / comprime

Mint-Irbesartan/HCTZ 02392992 MNT 0.2281 Tablet / comprime

Sandoz Irbesartan HCT 02337428 SDZ 0.2281 Tablet / comprime

Teva-Irbesartan HCTZ 02330512 TEV 0.2281 Tablet / comprime

pms-Irbesartan HCTZ 02328518 PMS 0.2281 Tablet / comprime

Tab/Co. Orl 300 mg / 12.5 mg Avalide 02241819 SAV 0.2281 Tablet / comprime

Auro-Irbesartan HCT 02447886 ARO 0.2281 Tablet / comprime

Irbesartan HCT 02385325 SIV 0.2281 Tablet / comprime

Irbesartan/HCTZ 02372894 SAS 0.2281 Tablet / comprime

Jamp-Irbesartan/Hydrochlorothiazide 02418231 JPC 0.2281 Tablet / comprime

Mint-Irbesartan/HCTZ 02393018 MNT 0.2281 Tablet / comprime

Sandoz Irbesartan HCT 02337436 SDZ 0.2281 Tablet / comprime

Teva-Irbesartan HCTZ 02330520 TEV 0.2281 Tablet / comprime

pms-Irbesartan HCTZ 02328526 PMS 0.2281 Tablet / comprime

Tab/Co. Orl 300 mg / 25 mg Auro-Irbesartan HCT 02447894 ARO 0.2184 Tablet / comprime

Irbesartan HCT 02385333 SIV 0.2184 Tablet / comprime

Irbesartan/HCTZ 02372908 SAS 0.2184 Tablet / comprime

Jamp-Irbesartan/Hydrochlorothiazide 02418258 JPC 0.2184 Tablet / comprime

Mint-Irbesartan/HCTZ 02393026 MNT 0.2184 Tablet / comprime

Sandoz Irbesartan HCT 02337444 SDZ 0.2184 Tablet / comprime

Teva-Irbesartan HCTZ 02330539 TEV 0.2184 Tablet / comprime

pms-Irbesartan HCTZ 02328534 PMS 0.2184 Tablet / comprime

Irbesartan / Irbesartan Tab/Co. Orl 75 mg Avapro 02237923 SAV 0.2281 Tablet / comprime

Auro-Irbesartan 02406098 ARO 0.2281 Tablet / comprime

Irbesartan 02365197 PDL 0.2281 Tablet / comprime

Irbesartan 02385287 SIV 0.2281 Tablet / comprime

Irbesartan 02372347 SAS 0.2281 Tablet / comprime

Jamp-Irbesartan 02418193 JPC 0.2281 Tablet / comprime

Mint-Irbesartan 02422980 MNT 0.2281 Tablet / comprime

Sandoz Irbesartan 02328461 SDZ 0.2281 Tablet / comprime

Taro-Irbesartan 02406810 SUN 0.2281 Tablet / comprime

Teva-Irbesartan 02316390 TEV 0.2281 Tablet / comprime

pms-Irbesartan 02317060 PMS 0.2281 Tablet / comprime

Tab/Co. Orl 150 mg Avapro 02237924 SAV 0.2281 Tablet / comprime

Auro-Irbesartan 02406101 ARO 0.2281 Tablet / comprime

Irbesartan 02385295 SIV 0.2281 Tablet / comprime

Irbesartan 02372371 SAS 0.2281 Tablet / comprime

Irbesartan 02365200 PDL 0.2281 Tablet / comprime

Jamp-Irbesartan 02418207 JPC 0.2281 Tablet / comprime

Mint-Irbesartan 02422999 MNT 0.2281 Tablet / comprime

Sandoz Irbesartan 02328488 SDZ 0.2281 Tablet / comprime

Taro-Irbesartan 02406829 SUN 0.2281 Tablet / comprime

Teva-Irbesartan 02316404 TEV 0.2281 Tablet / comprime

pms-Irbesartan 02317079 PMS 0.2281 Tablet / comprime

Tab/Co. Orl 300 mg Avapro 02237925 SAV 0.2281 Tablet / comprime

Auro-Irbesartan 02406128 ARO 0.2281 Tablet / comprime

Irbesartan 02372398 SAS 0.2281 Tablet / comprime

Irbesartan 02365219 PDL 0.2281 Tablet / comprime

September / septembre 2020 Page 28

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Irbesartan 02385309 SIV 0.2281 Tablet / comprime

Jamp-Irbesartan 02418215 JPC 0.2281 Tablet / comprime

Mint-Irbesartan 02423006 MNT 0.2281 Tablet / comprime

Sandoz Irbesartan 02328496 SDZ 0.2281 Tablet / comprime

Taro-Irbesartan 02406837 SUN 0.2281 Tablet / comprime

Teva-Irbesartan 02316412 TEV 0.2281 Tablet / comprime

pms-Irbesartan 02317087 PMS 0.2281 Tablet / comprime

Isoniazid / Isoniazide Syr/Sir. Orl 10 mg/mL pdp-Isoniazid 00577812 PMS 0.2673 Millilitre / millilitre

Tab/Co. Orl 300 mg pdp-Isoniazid 00577804 PMS 0.7992 Tablet / comprime

Isosorbide Dinitrate / Dinitrate D'Isosorbide Slt/Co.S.L. Slg 5 mg ISDN S/L 00670944 AAP 0.0633 Tablet / comprime

Tab/Co. Orl 10 mg ISDN 00441686 AAP 0.0372 Tablet / comprime

Tab/Co. Orl 30 mg ISDN 00441694 AAP 0.0874 Tablet / comprime

Isosorbide Mononitrate / Mononitrate D'Isosorbide SRT/Co.L.L. Orl 60 mg Imdur 02126559 MDN 0.3523 Tablet / comprime

Apo-ISMN 02272830 APX 0.3523 Tablet / comprime

pms-ISMN 02301288 PMS 0.3523 Tablet / comprime

Isotretinoin / Isotretinoine Cap/Caps Orl 10 mg Accutane Roche 00582344 HLR 0.9313 Capsule / capsule

Clarus 02257955 MYL 0.9313 Capsule / capsule

Cap/Caps Orl 40 mg Accutane Roche 00582352 HLR 1.9003 Capsule / capsule

Clarus 02257963 MYL 1.9003 Capsule / capsule

Itraconazole / Itraconazole Cap/Caps Orl 100 mg Sporanox 02047454 JAN 3.9270 Capsule / capsule

Mint-Itraconazole 02462559 MNT 3.9270 Capsule / capsule

Liq/Liq Orl 10 mg/mL Sporanox 02231347 JAN 0.4111 Millilitre / millilitre

Jamp-Itraconazole 02484315 JPC 0.4111 Millilitre / millilitre

Odan-Itraconazole 02495988 ODN 0.4111 Millilitre / millilitre

Ketoconazole / Ketoconazole Crm/Cr. Top 2% Ketoderm 02245662 TPH 0.3595 Gram / gramme

Tab/Co. Orl 200 mg Apo-Ketoconazole 02237235 APX 0.9393 Tablet / comprime

Teva-Ketoconazole 02231061 TEV 0.9393 Tablet / comprime

Ketoprofen / Ketoprofene Cap/Caps Orl 50 mg Keto 00790427 AAP 0.3373 Capsule / capsule

ECT/Co.Ent Orl 50 mg Keto-E 00790435 AAP 0.3379 Tablet / comprime

ECT/Co.Ent Orl 100 mg Keto-E 00842664 AAP 0.6959 Tablet / comprime

SRT/Co.L.L. Orl 200 mg Keto SR 02172577 AAP 1.3925 Tablet / comprime

Ketorolac / Ketorolac Liq/Liq Oph 0.5% Acular 01968300 ALL 2.5960 Millilitre / millilitre

Ketorolac 02245821 AAP 2.5960 Millilitre / millilitre

Ketotifen / Ketotifene Tab/Co. Orl 1 mg Zaditen 00577308 TEV 1.6973 Tablet / comprime

Labetalol / Labetalol Tab/Co. Orl 100 mg Trandate 02106272 PAL 0.1983 Tablet / comprime

Apo-Labetalol 02243538 APX 0.1983 Tablet / comprime

Riva-Labetalol 02489406 RIV 0.1983 Tablet / comprime

Tab/Co. Orl 200 mg Trandate 02106280 PAL 0.3504 Tablet / comprime

Apo-Labetalol 02243539 APX 0.3504 Tablet / comprime

Riva-Labetalol 02489414 RIV 0.3504 Tablet / comprime

Lacosamide / Lacosamide Tab/Co. Orl 50 mg Vimpat 02357615 UCB 0.6313 Tablet / comprime

Auro-Lacosamide 02475332 ARO 0.6313 Tablet / comprime

Jamp-Lacosamide 02488388 JPC 0.6313 Tablet / comprime

Mar-Lacosamide 02487802 MAR 0.6313 Tablet / comprime

Mint-Lacosamide 02490544 MNT 0.6313 Tablet / comprime

Sandoz-Lacosamide 02474670 SDZ 0.6313 Tablet / comprime

Teva-Lacosamide 02472902 TEV 0.6313 Tablet / comprime

pharma-Lacosamide 02478196 PMS 0.6313 Tablet / comprime

Tab/Co. Orl 100 mg Vimpat 02357623 UCB 0.8750 Tablet / comprime

Auro-Lacosamide 02475340 ARO 0.8750 Tablet / comprime

Jamp-Lacosamide 02488396 JPC 0.8750 Tablet / comprime

Mar-Lacosamide 02487810 MAR 0.8750 Tablet / comprime

Mint-Lacosamide 02490552 MNT 0.8750 Tablet / comprime

Sandoz-Lacosamide 02474689 SDZ 0.8750 Tablet / comprime

Teva-Lacosamide 02472910 TEV 0.8750 Tablet / comprime

pharma-Lacosamide 02478218 PMS 0.8750 Tablet / comprime

Tab/Co. Orl 150 mg Vimpat 02357631 UCB 1.1763 Tablet / comprime

Auro-Lacosamide 02475359 ARO 1.1763 Tablet / comprime

Jamp-Lacosamide 02488418 JPC 1.1763 Tablet / comprime

Mar-Lacosamide 02487829 MAR 1.1763 Tablet / comprime

Mint-Lacosamide 02490560 MNT 1.1763 Tablet / comprime

Sandoz-Lacosamide 02474697 SDZ 1.1763 Tablet / comprime

Teva-Lacosamide 02472929 TEV 1.1763 Tablet / comprime

pharma-Lacosamide 02478226 PMS 1.1763 Tablet / comprime

Tab/Co. Orl 200 mg Vimpat 02357658 UCB 1.4500 Tablet / comprime

Auro-Lacosamide 02475367 ARO 1.4500 Tablet / comprime

Jamp-Lacosamide 02488426 JPC 1.4500 Tablet / comprime

Mar-Lacosamide 02487837 MAR 1.4500 Tablet / comprime

Mint-Lacosamide 02490579 MNT 1.4500 Tablet / comprime

Sandoz-Lacosamide 02474700 SDZ 1.4500 Tablet / comprime

Teva-Lacosamide 02472937 TEV 1.4500 Tablet / comprime

pharma-Lacosamide 02478234 PMS 1.4500 Tablet / comprime

Lactulose / Lactulose Syr/Sir. Orl 667 mg Jamp-Lactulose 02295881 JPC 0.0145 Millilitre / millilitre

Lactulose 02412268 SAS 0.0145 Millilitre / millilitre

September / septembre 2020 Page 29

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

pms-Lactulose 00703486 PMS 0.0145 Millilitre / millilitre

pms-Lactulose-pharma 02469391 PMS 0.0145 Millilitre / millilitre

ratio-Lactulose 00854409 RPH 0.0145 Millilitre / millilitre

Lamivudine / Lamivudine Tab/Co. Orl 100 mg Heptovir 02239193 GSK 3.5316 Tablet / comprime

Apo-Lamivudine HBV 02393239 APX 3.5316 Tablet / comprime

Tab/Co. Orl 150 mg 3TC 02192683 VIV 3.6269 Tablet / comprime

Apo-Lamivudine 02369052 APX 3.6269 Tablet / comprime

Tab/Co. Orl 300 mg 3TC 02247825 VIV 7.2538 Tablet / comprime

Apo-Lamivudine 02369060 APX 7.2538 Tablet / comprime

Lamivudine and Abacavir / Lamivudine et Abacavir Tab/Co. Orl 300 mg / 600 mg Kivexa 02269341 VIV 5.9875 Tablet / comprime

Apo-Abacavir-Lamivudine 02399539 APX 5.9875 Tablet / comprime

Auro-Abacavir/Lamivudine 02454513 ARO 5.9875 Tablet / comprime

Mylan-Abacarvir/Lamivudine 02450682 MYL 5.9875 Tablet / comprime

Teva-Abacavir/Lamivudine 02416662 TEV 5.9875 Tablet / comprime

pms-Abacavir-Lamivudine 02458381 PMS 5.9875 Tablet / comprime

Lamotrigine / Lamotrigine Tab/Co. Orl 25 mg Lamictal 02142082 GSK 0.0698 Tablet / comprime

Apo-Lamotrigine 02245208 APX 0.0698 Tablet / comprime

Auro-Lamotrigine 02381354 ARO 0.0698 Tablet / comprime

Lamotrigine 02428202 SIV 0.0698 Tablet / comprime

Lamotrigine 02343010 SAS 0.0698 Tablet / comprime

Mylan-Lamotrigine 02265494 MYL 0.0698 Tablet / comprime

pms-Lamotrigine 02246897 PMS 0.0698 Tablet / comprime

Tab/Co. Orl 100 mg Lamictal 02142104 GSK 0.2787 Tablet / comprime

Apo-Lamotrigine 02245209 APX 0.2787 Tablet / comprime

Auro-Lamotrigine 02381362 ARO 0.2787 Tablet / comprime

Lamotrigine 02428210 SIV 0.2787 Tablet / comprime

Lamotrigine 02343029 SAS 0.2787 Tablet / comprime

Mylan-Lamotrigine 02265508 MYL 0.2787 Tablet / comprime

pms-Lamotrigine 02246898 PMS 0.2787 Tablet / comprime

Tab/Co. Orl 150 mg Lamictal 02142112 GSK 0.4107 Tablet / comprime

Apo-Lamotrigine 02245210 APX 0.4107 Tablet / comprime

Auro-Lamotrigine 02381370 ARO 0.4107 Tablet / comprime

Lamotrigine 02343037 SAS 0.4107 Tablet / comprime

Lamotrigine 02428229 SIV 0.4107 Tablet / comprime

Mylan-Lamotrigine 02265516 MYL 0.4107 Tablet / comprime

pms-Lamotrigine 02246899 PMS 0.4107 Tablet / comprime

Lansoprazole / Lansoprazole SRC/Caps.L.L. Orl 15 mg Prevacid 02165503 ABB 0.5000 Capsule / capsule

Apo-Lansoprazole 02293811 APX 0.5000 Capsule / capsule

Lansoprazole 02357682 SAS 0.5000 Capsule / capsule

Lansoprazole 02433001 PMS 0.5000 Capsule / capsule

Lansoprazole 02385767 SIV 0.5000 Capsule / capsule

Mylan-Lansoprazole 02353830 MYL 0.5000 Capsule / capsule

Sandoz Lansoprazole 02385643 SDZ 0.5000 Capsule / capsule

Taro-Lansoprazole 02402610 SUN 0.5000 Capsule / capsule

Teva-Lansoprazole 02280515 TEV 0.5000 Capsule / capsule

SRC/Caps.L.L. Orl 30 mg Prevacid 02165511 ABB 0.5000 Capsule / capsule

Apo-Lansoprazole 02293838 APX 0.5000 Capsule / capsule

Lansoprazole 02433028 PMS 0.5000 Capsule / capsule

Lansoprazole 02357690 SAS 0.5000 Capsule / capsule

Lansoprazole 02410389 SIV 0.5000 Capsule / capsule

Mylan-Lansoprazole 02353849 MYL 0.5000 Capsule / capsule

Sandoz Lansoprazole 02385651 SDZ 0.5000 Capsule / capsule

Taro-Lansoprazole 02402629 SUN 0.5000 Capsule / capsule

Teva-Lansoprazole 02280523 TEV 0.5000 Capsule / capsule

Latanoprost / Latanoprost Liq/Liq Oph 0.005% Xalatan 02231493 UJC 3.6320 Millilitre / millilitre

Apo-Latanoprost 02296527 APX 3.6320 Millilitre / millilitre

GD-Latanoprost 02373041 UJC 3.6320 Millilitre / millilitre

Jamp-Latanoprost 02453355 JPC 3.6320 Millilitre / millilitre

Latanoprost Ophthalmic Solution 02489570 TLG 3.6320 Millilitre / millilitre

Med-Latanoprost 02426935 GMP 3.6320 Millilitre / millilitre

Riva-Latanopost 02341085 RIV 3.6320 Millilitre / millilitre

Sandoz Latanoprost 02367335 SDZ 3.6320 Millilitre / millilitre

Teva-Latanoprost 02254786 TEV 3.6320 Millilitre / millilitre

pms-Latanoprost 02317125 PMS 3.6320 Millilitre / millilitre

Leflunomide / Leflunomide Tab/Co. Orl 10 mg Arava 02241888 SAV 2.6433 Tablet / comprime

Apo-Leflunomide 02256495 APX 2.6433 Tablet / comprime

Leflunomide 02351668 SAS 2.6433 Tablet / comprime

Novo-Leflunomide 02261251 TEV 2.6433 Tablet / comprime

Sandoz Leflunomide 02283964 SDZ 2.6433 Tablet / comprime

pms-Leflunomide 02288265 PMS 2.6433 Tablet / comprime

Tab/Co. Orl 20 mg Arava 02241889 SAV 2.6433 Tablet / comprime

Apo-Leflunomide 02256509 APX 2.6433 Tablet / comprime

Leflunomide 02351676 SAS 2.6433 Tablet / comprime

Novo-Leflunomide 02261278 TEV 2.6433 Tablet / comprime

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Sandoz Leflunomide 02283972 SDZ 2.6433 Tablet / comprime

pms-Leflunomide 02288273 PMS 2.6433 Tablet / comprime

Letrozole / Letrozole Tab/Co. Orl 2.5 mg Femara 02231384 NVR 1.3780 Tablet / comprime

Apo-Letrozole 02358514 APX 1.3780 Tablet / comprime

CCP-Letrozole 02459884 CCM 1.3780 Tablet / comprime

Jamp-Letrozole 02373009 JPC 1.3780 Tablet / comprime

Letrozole tablets usp 02338459 AHI 1.3780 Tablet / comprime

Mar-Letrozole 02373424 MAR 1.3780 Tablet / comprime

Med-Letrozole 02322315 GMP 1.3780 Tablet / comprime

Nat-Letrozole 02421585 NAT 1.3780 Tablet / comprime

Sandoz Letrozole 02344815 SDZ 1.3780 Tablet / comprime

Teva-Letrozole 02343657 TEV 1.3780 Tablet / comprime

Zinda-Letrozole 02378213 MCK 1.3780 Tablet / comprime

pms-Letrozole 02309114 PMS 1.3780 Tablet / comprime

Levetiracetam / Levetiracetam Tab/Co. Orl 250 mg Keppra 02247027 UCB 0.3210 Tablet / comprime

Act Levetiracetam 02274183 TEV 0.3210 Tablet / comprime

Apo-Levetiracetam 02285924 APX 0.3210 Tablet / comprime

Auro-Levetiracetam 02375249 ARO 0.3210 Tablet / comprime

Jamp-Levetiracetam 02403005 JPC 0.3210 Tablet / comprime

Levetiracetam 02353342 SAS 0.3210 Tablet / comprime

Levetiracetam 02454653 PMS 0.3210 Tablet / comprime

Levetiracetam 02442531 SIV 0.3210 Tablet / comprime

Nat-Levetiracetam 02440202 NAT 0.3210 Tablet / comprime

Riva-Levetiracetam 02482274 RIV 0.3210 Tablet / comprime

Sandoz Levetiracetam 02461986 SDZ 0.3210 Tablet / comprime

Tab/Co. Orl 500 mg Keppra 02247028 UCB 0.3911 Tablet / comprime

Act Levetiracetam 02274191 TEV 0.3911 Tablet / comprime

Apo-Levetiracetam 02285932 APX 0.3911 Tablet / comprime

Auro-Levetiracetam 02375257 ARO 0.3911 Tablet / comprime

Jamp-Levetiracetam 02403021 JPC 0.3911 Tablet / comprime

Levetiracetam 02442558 SIV 0.3911 Tablet / comprime

Levetiracetam 02353350 SAS 0.3911 Tablet / comprime

Levetiracetam 02454661 PMS 0.3911 Tablet / comprime

Nat-Levetiracetam 02440210 NAT 0.3911 Tablet / comprime

Pro-Levetiracetam 02311380 PDL 0.3911 Tablet / comprime

Riva-Levetiracetam 02482282 RIV 0.3911 Tablet / comprime

Sandoz Levetiracetam 02461994 SDZ 0.3911 Tablet / comprime

Tab/Co. Orl 750 mg Keppra 02247029 UCB 0.5416 Tablet / comprime

Act Levetiracetam 02274205 TEV 0.5416 Tablet / comprime

Apo-Levetiracetam 02285940 APX 0.5416 Tablet / comprime

Auro-Levetiracetam 02375265 ARO 0.5416 Tablet / comprime

Jamp-Levetiracetam 02403048 JPC 0.5416 Tablet / comprime

Levetiracetam 02353369 SAS 0.5416 Tablet / comprime

Levetiracetam 02454688 PMS 0.5416 Tablet / comprime

Levetiracetam 02442566 SIV 0.5416 Tablet / comprime

Nat-Levetiracetam 02440229 NAT 0.5416 Tablet / comprime

Pro-Levetiracetam 02311399 PDL 0.5416 Tablet / comprime

Riva-Levetiracetam 02482290 RIV 0.5416 Tablet / comprime

Sandoz Levetiracetam 02462001 SDZ 0.5416 Tablet / comprime

Tab/Co. Orl 1000 mg Sandoz Levetiracetam 02462028 SDZ 0.7221 Tablet / comprime

Levocarnitine / Levocarnitine Liq/Liq Orl 100 mg/mL Carnitor 02144336 LBI 0.3898 Millilitre / millilitre

Odan-Levocarnitine 02492105 ODN 0.3898 Millilitre / millilitre

Levodopa / Carbidopa / Levodopa / Carbidopa SRT/Co.L.L. Orl 100 mg / 25 mg Sinemet CR 02028786 FRS 0.3857 Tablet / comprime

AA-Levocarb CR 02272873 AAP 0.3857 Tablet / comprime

SRT/Co.L.L. Orl 200 mg / 50 mg AA-Levocarb CR 02245211 AAP 0.7115 Tablet / comprime

Tab/Co. Orl 100 mg / 10 mg Apo-Levocarb 02195933 APX 0.1087 Tablet / comprime

Mint-Levocarb 02457954 MNT 0.1087 Tablet / comprime

Teva-Levocarbidopa 02244494 TEV 0.1087 Tablet / comprime

Tab/Co. Orl 100 mg / 25 mg Sinemet 00513997 FRS 0.1623 Tablet / comprime

Apo-Levocarb 02195941 APX 0.1623 Tablet / comprime

Mint-Levocarb 02457962 MNT 0.1623 Tablet / comprime

Teva-Levocarbidopa 02244495 TEV 0.1623 Tablet / comprime

Tab/Co. Orl 250 mg / 25 mg Sinemet 00328219 FRS 0.1812 Tablet / comprime

Apo-Levocarb 02195968 APX 0.1812 Tablet / comprime

Mint-Levocarb 02457970 MNT 0.1812 Tablet / comprime

Teva-Levocarbidopa 02244496 TEV 0.1812 Tablet / comprime

Levofloxacin / Levofloxacine Liq/Liq Inj 5 mg/mL Levofloxacin 02314932 PFI 0.4086 Millilitre / millilitre

Tab/Co. Orl 250 mg Act Levofloxacin 02315424 TEV 1.2038 Tablet / comprime

Apo-Levofloxacin 02284707 APX 1.2038 Tablet / comprime

Sandoz Levofloxacin 02298635 SDZ 1.2038 Tablet / comprime

Tab/Co. Orl 500 mg Act Levofloxacin 02315432 TEV 1.3718 Tablet / comprime

Apo-Levofloxacin 02284715 APX 1.3718 Tablet / comprime

Sandoz Levofloxacin 02298643 SDZ 1.3718 Tablet / comprime

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Levomepromazine (Methotrimeprazine) / Levomepromazine

(Methotrimeprazine)

Tab/Co. Orl 2 mg Methoprazine 02238403 AAP 0.0721 Tablet / comprime

Tab/Co. Orl 5 mg Methoprazine 02238404 AAP 0.1043 Tablet / comprime

Tab/Co. Orl 25 mg Methoprazine 02238405 AAP 0.2681 Tablet / comprime

Tab/Co. Orl 50 mg Methoprazine 02238406 AAP 0.4060 Tablet / comprime

Levonorgestrel / Levonorgestrel Tab/Co. Orl 1.5 mg Plan B 02293854 PAL 8.6000 Tablet / comprime

Backup Plan Onestep 02433532 APX 8.6000 Tablet / comprime

Contingency One 02425009 MYL 8.6000 Tablet / comprime

Levonorgestrel and Ethinyl Estradiol / Levonorgestrel et

Ethinyloestradiol

Tab/Co. Orl 0.1 mg / 0.02 mg Alesse (21) 02236974 PFI 0.3629 Tablet / comprime

Alysena (21) 02387875 APX 0.3629 Tablet / comprime

Aviane (21) 02298538 TEV 0.3629 Tablet / comprime

Tab/Co. Orl 0.1 mg / 0.02 mg Alesse (28) 02236975 PFI 0.2721 Tablet / comprime

Alysena (28) 02387883 APX 0.2721 Tablet / comprime

Aviane (28) 02298546 TEV 0.2721 Tablet / comprime

Tab/Co. Orl 0.15 mg / 0.03 mg Min-Ovral (21) 02042320 PFI 0.3467 Tablet / comprime

Ovima (21) 02387085 APX 0.3467 Tablet / comprime

Portia (21) 02295946 TEV 0.3467 Tablet / comprime

Tab/Co. Orl 0.15 mg / 0.03 mg Min-Ovral (28) 02042339 PFI 0.2600 Tablet / comprime

Ovima (28) 02387093 APX 0.2600 Tablet / comprime

Portia (28) 02295954 TEV 0.2600 Tablet / comprime

Lidocaine / Lidocaine Gel/Gel Top 2% Lidodan Jelly 02143879 ODN 0.3625 Gram / gramme

Linezolid / Linezolide Tab/Co. Orl 600 mg Zyvoxam 02243684 PFI 37.0500 Tablet / comprime P

Apo-Linezolid 02426552 APX 37.0500 Tablet / comprime P

Sandoz Linezolid 02422689 SDZ 37.0500 Tablet / comprime P

Lisinopril / Hydrochlorothiazide / Lisinopril / Hydrochlorothiazide Tab/Co. Orl 10 mg / 12.5 mg Zestoretic 02103729 AZE 0.2083 Tablet / comprime

Lisinopril HCTZ (Type Z) 02362945 SAS 0.2083 Tablet / comprime

Sandoz Lisinopril HCT 02302365 SDZ 0.2083 Tablet / comprime

Teva-Lisinopril HCTZ (Type Z) 02301768 TEV 0.2083 Tablet / comprime

Tab/Co. Orl 20 mg / 12.5 mg Zestoretic 02045737 AZE 0.2503 Tablet / comprime

Lisinopril HCTZ (Type Z) 02362953 SAS 0.2503 Tablet / comprime

Sandoz Lisinopril HCT 02302373 SDZ 0.2503 Tablet / comprime

Teva-Lisinopril HCTZ (Type Z) 02301776 TEV 0.2503 Tablet / comprime

Tab/Co. Orl 20 mg / 25 mg Zestoretic 02045729 AZE 0.2503 Tablet / comprime

Lisinopril HCTZ (Type Z) 02362961 SAS 0.2503 Tablet / comprime

Sandoz Lisinopril HCT 02302381 SDZ 0.2503 Tablet / comprime

Teva-Lisinopril HCTZ (Type P) 02302152 TEV 0.2503 Tablet / comprime

Teva-Lisinopril HCTZ (Type Z) 02301784 TEV 0.2503 Tablet / comprime

Lisinopril / Lisinopril Tab/Co. Orl 5 mg Zestril 02049333 AZE 0.1347 Tablet / comprime

Apo-Lisinopril 02217481 APX 0.1347 Tablet / comprime

Auro-Lisinopril 02394472 ARO 0.1347 Tablet / comprime

Lisinopril 02386232 SIV 0.1347 Tablet / comprime

Ran-Lisinopril 02294230 RAN 0.1347 Tablet / comprime

Sandoz Lisinopril 02289199 SDZ 0.1347 Tablet / comprime

Teva-Lisinopril P 02285061 TEV 0.1347 Tablet / comprime

Teva-Lisinopril Z 02285118 TEV 0.1347 Tablet / comprime

Tab/Co. Orl 10 mg Prinivil 00839396 FRS 0.1619 Tablet / comprime

Zestril 02049376 AZE 0.1619 Tablet / comprime

Apo-Lisinopril 02217503 APX 0.1619 Tablet / comprime

Auro-Lisinopril 02394480 ARO 0.1619 Tablet / comprime

Lisinopril 02386240 SIV 0.1619 Tablet / comprime

Ran-Lisinopril 02294249 RAN 0.1619 Tablet / comprime

Sandoz Lisinopril 02289202 SDZ 0.1619 Tablet / comprime

Teva-Lisinopril P 02285088 TEV 0.1619 Tablet / comprime

Teva-Lisinopril Z 02285126 TEV 0.1619 Tablet / comprime

Tab/Co. Orl 20 mg Prinivil 00839418 FRS 0.1945 Tablet / comprime

Zestril 02049384 AZE 0.1945 Tablet / comprime

Apo-Lisinopril 02217511 APX 0.1945 Tablet / comprime

Auro-Lisinopril 02394499 ARO 0.1945 Tablet / comprime

Lisinopril 02386259 SIV 0.1945 Tablet / comprime

Ran-Lisinopril 02294257 RAN 0.1945 Tablet / comprime

Sandoz Lisinopril 02289229 SDZ 0.1945 Tablet / comprime

Teva-Lisinopril P 02285096 TEV 0.1945 Tablet / comprime

Teva-Lisinopril Z 02285134 TEV 0.1945 Tablet / comprime

Lithium / Lithium Cap/Caps Orl 150 mg Carbolith 00461733 BSL 0.0667 Capsule / capsule

Lithane 02013231 ERF 0.0667 Capsule / capsule

Apo-Lithium Carbonate 02242837 APX 0.0667 Capsule / capsule

pms-Lithium Carbonate 02216132 PMS 0.0667 Capsule / capsule

Cap/Caps Orl 300 mg Carbolith 00236683 BSL 0.0657 Capsule / capsule

Lithane 00406775 ERF 0.0657 Capsule / capsule

Apo-Lithium Carbonate 02242838 APX 0.0657 Capsule / capsule

pms-Lithium Carbonate 02216140 PMS 0.0657 Capsule / capsule

SRT/Co.L.L. Orl 300 mg Lithmax SR 02266695 AAP 0.2660 Tablet / comprime

Loperamide / Loperamide Liq/Liq Orl 0.2 mg/mL pms-Loperamide Hydrochloride 02016095 PMS 0.1702 Millilitre / millilitre

September / septembre 2020 Page 32

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Tab/Co. Orl 2 mg Teva-Loperamide 02132591 TEV 0.0952 Tablet / comprime

pms-Loperamide 02228351 PMS 0.0952 Tablet / comprime

Loratadine / Loratadine Tab/Co. Orl 10 mg Claritin 00782696 SCO 0.6267 Tablet / comprime

Apo-Loratadine 02243880 APX 0.6267 Tablet / comprime

Lorazepam / Lorazepam Liq/Liq Inj 4 mg/mL Lorazepam 02243278 SDZ 21.2000 Millilitre / millilitre

Slt/Co.S.L. Orl 0.5 mg Ativan SL 02041456 PFI 0.0875 Tablet / comprime

Lorazepam Sublingual 02410745 AAP 0.0875 Tablet / comprime

Slt/Co.S.L. Orl 1 mg Ativan SL 02041464 PFI 0.1100 Tablet / comprime

Lorazepam Sublingual 02410753 AAP 0.1100 Tablet / comprime

Slt/Co.S.L. Orl 2 mg Ativan SL 02041472 PFI 0.1711 Tablet / comprime

Lorazepam Sublingual 02410761 AAP 0.1711 Tablet / comprime

Tab/Co. Orl 0.5 mg Ativan 02041413 PFI 0.0359 Tablet / comprime

Apo-Lorazepam 00655740 APX 0.0359 Tablet / comprime

Lorazepam 02351072 SAS 0.0359 Tablet / comprime

Teva-Lorazepam 00711101 TEV 0.0359 Tablet / comprime

pms-Lorazepam 00728187 PMS 0.0359 Tablet / comprime

Tab/Co. Orl 1 mg Ativan 02041421 PFI 0.0447 Tablet / comprime

Apo-Lorazepam 00655759 APX 0.0447 Tablet / comprime

Lorazepam 02351080 SAS 0.0447 Tablet / comprime

Teva-Lorazepam 00637742 TEV 0.0447 Tablet / comprime

pms-Lorazepam 00728195 PMS 0.0447 Tablet / comprime

Tab/Co. Orl 2 mg Ativan 02041448 PFI 0.0699 Tablet / comprime

Apo-Lorazepam 00655767 APX 0.0699 Tablet / comprime

Lorazepam 02351099 SAS 0.0699 Tablet / comprime

Teva-Lorazepam 00637750 TEV 0.0699 Tablet / comprime

pms-Lorazepam 00728209 PMS 0.0699 Tablet / comprime

Losartan / Hydrochlorothiazide / Losartan / Hydrochlorothiazide Tab/Co. Orl 50 mg / 12.5 mg Hyzaar 02230047 FRS 0.3147 Tablet / comprime

Auro-Losartan HCT 02423642 ARO 0.3147 Tablet / comprime

Jamp-Losartan HCTZ 02408244 JPC 0.3147 Tablet / comprime

Losartan HCT 02388960 SIV 0.3147 Tablet / comprime

Losartan/HCTZ 02427648 SAS 0.3147 Tablet / comprime

Mint-Losartan/HCTZ 02389657 MNT 0.3147 Tablet / comprime

Sandoz Losartan HCT 02313375 SDZ 0.3147 Tablet / comprime

Teva-Losartan HCTZ 02358263 TEV 0.3147 Tablet / comprime

pms-Losartan-HCTZ 02392224 PMS 0.3147 Tablet / comprime

Tab/Co. Orl 100 mg / 12.5 mg Hyzaar 02297841 FRS 0.3082 Tablet / comprime

Auro-Losartan HCT 02423650 ARO 0.3082 Tablet / comprime

Losartan HCT 02388979 SIV 0.3082 Tablet / comprime

Losartan/HCTZ 02427656 SAS 0.3082 Tablet / comprime

Mint-Losartan/HCTZ 02389665 MNT 0.3082 Tablet / comprime

Sandoz Losartan HCT 02362449 SDZ 0.3082 Tablet / comprime

Teva-Losartan HCTZ 02377144 TEV 0.3082 Tablet / comprime

pms-Losartan-HCTZ 02392232 PMS 0.3082 Tablet / comprime

Tab/Co. Orl 100 mg / 25 mg Hyzaar DS 02241007 FRS 0.3147 Tablet / comprime

Auro-Losartan HCT 02423669 ARO 0.3147 Tablet / comprime

Jamp-Losartan HCTZ 02408252 JPC 0.3147 Tablet / comprime

Losartan HCT 02388987 SIV 0.3147 Tablet / comprime

Losartan/HCTZ 02427664 SAS 0.3147 Tablet / comprime

Mint-Losartan/HCTZ DS 02389673 MNT 0.3147 Tablet / comprime

Sandoz Losartan HCT 02313383 SDZ 0.3147 Tablet / comprime

Teva-Losartan HCTZ 02377152 TEV 0.3147 Tablet / comprime

pms-Losartan-HCTZ 02392240 PMS 0.3147 Tablet / comprime

Losartan / Losartan Tab/Co. Orl 25 mg Cozaar 02182815 FRS 0.3147 Tablet / comprime

Apo-Losartan 02379058 APX 0.3147 Tablet / comprime

Auro-Losartan 02403323 ARO 0.3147 Tablet / comprime

Jamp-Losartan 02398834 JPC 0.3147 Tablet / comprime

Losartan 02388863 SAS 0.3147 Tablet / comprime

Losartan 02388790 SIV 0.3147 Tablet / comprime

Mint-Losartan 02405733 MNT 0.3147 Tablet / comprime

Sandoz Losartan 02313332 SDZ 0.3147 Tablet / comprime

Septa-Losartan 02424967 SPT 0.3147 Tablet / comprime

Teva-Losartan 02380838 TEV 0.3147 Tablet / comprime

pms-Losartan 02309750 PMS 0.3147 Tablet / comprime

Tab/Co. Orl 50 mg Cozaar 02182874 FRS 0.3147 Tablet / comprime

Apo-Losartan 02353504 APX 0.3147 Tablet / comprime

Auro-Losartan 02403331 ARO 0.3147 Tablet / comprime

Jamp-Losartan 02398842 JPC 0.3147 Tablet / comprime

Losartan 02388804 SIV 0.3147 Tablet / comprime

Losartan 02388871 SAS 0.3147 Tablet / comprime

Mint-Losartan 02405741 MNT 0.3147 Tablet / comprime

Sandoz Losartan 02313340 SDZ 0.3147 Tablet / comprime

Septa-Losartan 02424975 SPT 0.3147 Tablet / comprime

Teva-Losartan 02357968 TEV 0.3147 Tablet / comprime

September / septembre 2020 Page 33

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

pms-Losartan 02309769 PMS 0.3147 Tablet / comprime

Tab/Co. Orl 100 mg Cozaar 02182882 FRS 0.3147 Tablet / comprime

Apo-Losartan 02353512 APX 0.3147 Tablet / comprime

Auro-Losartan 02403358 ARO 0.3147 Tablet / comprime

Jamp-Losartan 02398850 JPC 0.3147 Tablet / comprime

Losartan 02388812 SIV 0.3147 Tablet / comprime

Losartan 02388898 SAS 0.3147 Tablet / comprime

Mint-Losartan 02405768 MNT 0.3147 Tablet / comprime

Sandoz Losartan 02313359 SDZ 0.3147 Tablet / comprime

Septa-Losartan 02424983 SPT 0.3147 Tablet / comprime

Teva-Losartan 02357976 TEV 0.3147 Tablet / comprime

pms-Losartan 02309777 PMS 0.3147 Tablet / comprime

Lovastatin / Lovastatine Tab/Co. Orl 20 mg Act Lovastatin 02248572 TEV 0.4919 Tablet / comprime

Apo-Lovastatin 02220172 APX 0.4919 Tablet / comprime

Lovastatin 02353229 SAS 0.4919 Tablet / comprime

Tab/Co. Orl 40 mg Act Lovastatin 02248573 TEV 0.8985 Tablet / comprime

Apo-Lovastatin 02220180 APX 0.8985 Tablet / comprime

Lovastatin 02353237 SAS 0.8985 Tablet / comprime

Loxapine / Loxapine Tab/Co. Orl 2.5 mg Xylac 02242868 PDP 0.2256 Tablet / comprime

Tab/Co. Orl 5 mg Xylac 02230837 PDP 0.1801 Tablet / comprime

Tab/Co. Orl 10 mg Xylac 02230838 PDP 0.2999 Tablet / comprime

Tab/Co. Orl 25 mg Xylac 02230839 PDP 0.4649 Tablet / comprime

Tab/Co. Orl 50 mg Xylac 02230840 PDP 0.6197 Tablet / comprime

Medroxyprogesterone / Medroxyprogesterone Sus/Susp Inj 150 mg/mL Depo-Provera 00585092 PFI 30.4800 Millilitre / millilitre

Medroxyprogesterone Acetate 02322250 SDZ 22.0000 Millilitre / millilitre

Tab/Co. Orl 2.5 mg Provera 00708917 PFI 0.0416 Tablet / comprime

Apo-Medroxy 02244726 APX 0.0416 Tablet / comprime

Teva-Medrone 02221284 TEV 0.0416 Tablet / comprime

Tab/Co. Orl 5 mg Provera 00030937 PFI 0.0823 Tablet / comprime

Apo-Medroxy 02244727 APX 0.0823 Tablet / comprime

Teva-Medrone 02221292 TEV 0.0823 Tablet / comprime

Tab/Co. Orl 10 mg Provera 00729973 PFI 0.1670 Tablet / comprime

Apo-Medroxy 02277298 APX 0.1670 Tablet / comprime

Teva-Medrone 02221306 TEV 0.1670 Tablet / comprime

Tab/Co. Orl 100 mg Apo-Medroxy 02267640 APX 1.2057 Tablet / comprime

Mefenamic Acid / Acide Mefenamique Cap/Caps Orl 250 mg Ponstan 00155225 AAP 0.3990 Capsule / capsule

Mefenamic 02229452 AAP 0.3990 Capsule / capsule

Megestrol / Megestrol Tab/Co. Orl 40 mg Megestrol 02195917 AAP 1.3340 Tablet / comprime

Tab/Co. Orl 160 mg Megestrol 02195925 AAP 5.8151 Tablet / comprime

Meloxicam / Meloxicam Tab/Co. Orl 7.5 mg Act Meloxicam 02250012 TEV 0.2003 Tablet / comprime

Apo-Meloxicam 02248973 APX 0.2003 Tablet / comprime

Auro-Meloxicam 02390884 ARO 0.2003 Tablet / comprime

Meloxicam 02353148 SAS 0.2003 Tablet / comprime

Teva-Meloxicam 02258315 TEV 0.2003 Tablet / comprime

pms-Meloxicam 02248267 PMS 0.2003 Tablet / comprime

Tab/Co. Orl 15 mg Act Meloxicam 02250020 TEV 0.2311 Tablet / comprime

Apo-Meloxicam 02248974 APX 0.2311 Tablet / comprime

Auro-Meloxicam 02390892 ARO 0.2311 Tablet / comprime

Meloxicam 02353156 SAS 0.2311 Tablet / comprime

Teva-Meloxicam 02258323 TEV 0.2311 Tablet / comprime

pms-Meloxicam 02248268 PMS 0.2311 Tablet / comprime

Mercaptopurine / Mercaptopurine Tab/Co. Orl 50 mg Purinethol 00004723 TEV 2.8372 Tablet / comprime

Mercaptopurine 02415275 STR 2.8372 Tablet / comprime

Meropenem / Meropenem Pws/Pds. Inj 500 mg Meropenem 02378787 SDZ 9.2225 Vial / fiole

Pws/Pds. Inj 1 g Meropenem 02436507 STR 18.4450 Vial / fiole

Mesalazine / Mesalazine ECT/Co.Ent Orl 400 mg Asacol 01997580 ALL 0.4758 Tablet / comprime

Teva-5-ASA 02171929 TEV 0.4758 Tablet / comprime

Sup/Supp. Rt 1 g Salofalk 02242146 AXC 1.8000 Suppository / suppositoire

Mezera 02474018 AVI 1.8000 Suppository / suppositoire

Pentasa 02153564 FEI 1.8000 Suppository / suppositoire

Metformin / Metformine Tab/Co. Orl 500 mg Glucophage 02099233 SAV 0.0247 Tablet / comprime

Act Metformin 02257726 TEV 0.0247 Tablet / comprime

Auro-Metformin 02438275 ARO 0.0247 Tablet / comprime

Jamp-Metformin 02380196 JPC 0.0247 Tablet / comprime

Metformin 02353377 SAS 0.0247 Tablet / comprime

Metformin FC 02385341 SIV 0.0247 Tablet / comprime

Pro-Metformin 02314908 PDL 0.0247 Tablet / comprime

Ran-Metformin 02269031 RAN 0.0247 Tablet / comprime

Sandoz Metformin FC 02246820 SDZ 0.0247 Tablet / comprime

pms-Metformin 02223562 PMS 0.0247 Tablet / comprime

Tab/Co. Orl 850 mg Glucophage 02162849 SAV 0.0339 Tablet / comprime

Act Metformin 02257734 TEV 0.0339 Tablet / comprime

Auro-Metformin 02438283 ARO 0.0339 Tablet / comprime

Jamp-Metformin 02380218 JPC 0.0339 Tablet / comprime

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Metformin 02353385 SAS 0.0339 Tablet / comprime

Metformin FC 02385368 SIV 0.0339 Tablet / comprime

Pro-Metformin 02314894 PDL 0.0339 Tablet / comprime

Ran-Metformin 02269058 RAN 0.0339 Tablet / comprime

Sandoz Metformin FC 02246821 SDZ 0.0339 Tablet / comprime

pms-Metformin 02242589 PMS 0.0339 Tablet / comprime

Methadone / Methadone Liq/Liq Orl 10 mg/mL Metadol-D 02244290 PAL 0.0113 Milligram / milligramme

Methadone Hydrochloride 02481979 SDZ 0.0113 Milligram / milligramme

Methadose 02394596 MAL 0.0113 Milligram / milligramme

Methadose Unflavoured 02394618 MAL 0.0113 Milligram / milligramme

Pws/Pds. Orl Opioid Dependence / dependance aux opiaces 00999734 0.0050 Milligram / milligramme

Pain Management / gestion de la douleur 00999801 0.0050 Milligram / milligramme

Methazolamide / Methazolamide Tab/Co. Orl 50 mg Methazolamide 02245882 AAP 0.4913 Tablet / comprime

Methotrexate / Methotrexate Liq/Liq SC 17.5 mg/0.35 mL Metoject Subcutaneous 02454769 MDX 68.5714 Millilitre / millilitre

Methotrexate Subcutaneous 02491338 AHI 68.5714 Millilitre / millilitre

Liq/Liq SC 20 mg/0.4 mL Metoject Subcutaneous 02454866 MDX 65.6250 Millilitre / millilitre

Methotrexate Subcutaneous 02491346 AHI 65.6250 Millilitre / millilitre

Liq/Liq SC 22.5 mg/0.45 mL Metoject Subcutaneous 02454777 MDX 58.3333 Millilitre / millilitre

Methotrexate Subcutaneous 02491354 AHI 58.3333 Millilitre / millilitre

Liq/Liq SC 25 mg/0.5 mL Metoject Subcutaneous 02454874 MDX 58.5000 Millilitre / millilitre

Methotrexate Subcutaneous 02491362 AHI 58.5000 Millilitre / millilitre

Liq/Liq Inj 25 mg/mL Methotrexate Inj USP 02182777 PFI 4.4600 Millilitre / millilitre

Methotrexate Inj USP (PF) 02182955 PFI 5.6250 Millilitre / millilitre

Methotrexate Inj USP (PF) 02099705 TEV 3.5101 Millilitre / millilitre

Tab/Co. Orl 2.5 mg pms-Methotrexate 02170698 PMS 0.6325 Tablet / comprime

Methotrexate 02182963 PFI 0.6325 Tablet / comprime

Methyldopa (Racemic) / Methyldopa (Racemique) Tab/Co. Orl 125 mg Methyldopa 00360252 AAP 0.1009 Tablet / comprime

Tab/Co. Orl 250 mg Methyldopa 00360260 AAP 0.1579 Tablet / comprime

Tab/Co. Orl 500 mg Methyldopa 00426830 AAP 0.2588 Tablet / comprime

Methylphenidate / Methylphenidate ERT/Co.L.P. Orl 18 mg Concerta ER 02247732 JAN 0.5099 Tablet / comprime

Act Methylphenidate ER 02441934 TEV 0.5099 Tablet / comprime

Apo-Methylphenidate ER 02452731 APX 0.5099 Tablet / comprime

ERT/Co.L.P. Orl 27 mg Concerta ER 02250241 JAN 0.5884 Tablet / comprime

Act Methylphenidate ER 02441942 TEV 0.5884 Tablet / comprime

Apo-Methylphenidate ER 02452758 APX 0.5884 Tablet / comprime

ERT/Co.L.P. Orl 36 mg Concerta ER 02247733 JAN 0.6669 Tablet / comprime

Act Methylphenidate ER 02441950 TEV 0.6669 Tablet / comprime

Apo-Methylphenidate ER 02452766 APX 0.6669 Tablet / comprime

ERT/Co.L.P. Orl 54 mg Concerta ER 02247734 JAN 0.8240 Tablet / comprime

Act Methylphenidate ER 02441969 TEV 0.8240 Tablet / comprime

Apo-Methylphenidate ER 02330377 APX 0.8240 Tablet / comprime

SRT/Co.L.L. Orl 20 mg Ritalin SR 00632775 NVR 0.2820 Tablet / comprime

Apo-Methylphenidate SR 02266687 APX 0.2820 Tablet / comprime

Sandoz Methylphenidate SR 02320312 SDZ 0.2820 Tablet / comprime

Tab/Co. Orl 5 mg Apo-Methylphenidate 02273950 APX 0.0947 Tablet / comprime

pms-Methylphenidate 02234749 PMS 0.0947 Tablet / comprime

Tab/Co. Orl 10 mg Ritalin 00005606 NVR 0.2216 Tablet / comprime

Apo-Methylphenidate 02249324 APX 0.2216 Tablet / comprime

pms-Methylphenidate 00584991 PMS 0.2216 Tablet / comprime

Tab/Co. Orl 20 mg Ritalin 00005614 NVR 0.2735 Tablet / comprime

Apo-Methylphenidate 02249332 APX 0.2735 Tablet / comprime

pms-Methylphenidate 00585009 PMS 0.2735 Tablet / comprime

Metoclopramide / Metoclopramide Liq/Liq Inj 5 mg/mL Metoclopramide 02185431 SDZ 3.3925 Millilitre / millilitre

Syr/Sir. Orl 1 mg/mL Metonia 02230433 PDP 0.0607 Millilitre / millilitre

Tab/Co. Orl 5 mg Metonia 02230431 PDP 0.0622 Tablet / comprime

Tab/Co. Orl 10 mg Metonia 02230432 PDP 0.0656 Tablet / comprime

Metoprolol / Metoprolol SRT/Co.L.L. Orl 100 mg Lopresor SR 00658855 NVR 0.4012 Tablet / comprime

Sandoz Metoprolol SR 02303396 SDZ 0.1415 Tablet / comprime

SRT/Co.L.L. Orl 200 mg Lopresor SR 00534560 NVR 0.7282 Tablet / comprime

Sandoz Metoprolol SR 02303418 SDZ 0.2568 Tablet / comprime

Tab/Co. Orl 25 mg Apo-Metoprolol 02246010 APX 0.0643 Tablet / comprime

Jamp-Metoprolol-L 02356813 JPC 0.0643 Tablet / comprime

pms-Metoprolol-L 02248855 PMS 0.0643 Tablet / comprime

Tab/Co. Orl 50 mg Apo-Metoprolol (uncoated) 00618632 APX 0.0624 Tablet / comprime

Apo-Metoprolol type "L" 00749354 APX 0.0624 Tablet / comprime

Jamp-Metoprolol-L 02356821 JPC 0.0624 Tablet / comprime

Metoprolol 02350394 SAS 0.0624 Tablet / comprime

Metoprolol-L 02442124 SIV 0.0624 Tablet / comprime

Teva-Metoprolol (coated) 00648035 TEV 0.0624 Tablet / comprime

Teva-Metoprolol (uncoated) 00842648 TEV 0.0624 Tablet / comprime

pms-Metoprolol-L 02230803 PMS 0.0624 Tablet / comprime

Tab/Co. Orl 100 mg Apo-Metoprolol (uncoated) 00618640 APX 0.1250 Tablet / comprime

Apo-Metoprolol type "L" 00751170 APX 0.1250 Tablet / comprime

September / septembre 2020 Page 35

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Jamp-Metoprolol-L 02356848 JPC 0.1250 Tablet / comprime

Metoprolol 02350408 SAS 0.1250 Tablet / comprime

Metoprolol-L 02442132 SIV 0.1250 Tablet / comprime

Teva-Metoprolol (coated) 00648043 TEV 0.1250 Tablet / comprime

Teva-Metoprolol (uncoated) 00842656 TEV 0.1250 Tablet / comprime

pms-Metoprolol-L 02230804 PMS 0.1250 Tablet / comprime

Metronidazole / Metronidazole Tab/Co. Orl 250 mg Metronidazole 00545066 AAP 0.0628 Tablet / comprime

Mexiletine / Mexiletine Cap/Caps Orl 100 mg Teva-Mexiletine 02230359 TEV 1.3264 Capsule / capsule

Cap/Caps Orl 200 mg Teva-Mexiletine 02230360 TEV 1.7762 Capsule / capsule

Miconazole / Miconazole Crm/Cr. Vag 2% Monistat 7 02084309 JNJ 0.2576 Gram / gramme

Micozole Vaginal 2% 02231106 TAR 0.2576 Gram / gramme

Midazolam / Midazolam Liq/Liq Inj 1 mg/mL Midazolam 02240285 SDZ 0.7800 Millilitre / millilitre

Liq/Liq Inj 5 mg/mL Midazolam 02240286 SDZ 4.1000 Millilitre / millilitre

Midodrine / Midodrine Tab/Co. Orl 2.5 mg Apo-Midodrine 02278677 APX 0.2305 Tablet / comprime

Mar-Midodrine 02473984 MAR 0.2305 Tablet / comprime

Tab/Co. Orl 5 mg Apo-Midodrine 02278685 APX 0.3842 Tablet / comprime

Mar-Midodrine 02473992 MAR 0.3842 Tablet / comprime

Minocycline / Minocycline Cap/Caps Orl 50 mg Minocycline 02084090 AAP 0.1101 Capsule / capsule

Cap/Caps Orl 100 mg Minocycline 02084104 AAP 0.2125 Capsule / capsule

Teva-Minocycline 02108151 TEV 0.2125 Capsule / capsule

Mirtazapine / Mirtazapine ODT/Co.D.O. Orl 15 mg Remeron RD 02248542 FRS 0.0975 Tablet / comprime

Auro-Mirtazapine OD 02299801 ARO 0.0975 Tablet / comprime

ODT/Co.D.O. Orl 30 mg Remeron RD 02248543 FRS 0.1950 Tablet / comprime

Auro-Mirtazapine OD 02299828 ARO 0.1950 Tablet / comprime

ODT/Co.D.O. Orl 45 mg Remeron RD 02248544 FRS 0.2925 Tablet / comprime

Auro-Mirtazapine OD 02299836 ARO 0.2925 Tablet / comprime

Tab/Co. Orl 15 mg Apo-Mirtazapine 02286610 APX 0.0975 Tablet / comprime

Auro-Mirtazapine 02411695 ARO 0.0975 Tablet / comprime

Mylan-Mirtazapine 02256096 MYL 0.0975 Tablet / comprime

Sandoz Mirtazapine 02250594 SDZ 0.0975 Tablet / comprime

pms-Mirtazapine 02273942 PMS 0.0975 Tablet / comprime

Tab/Co. Orl 30 mg Remeron 02243910 FRS 0.3100 Tablet / comprime

Apo-Mirtazapine 02286629 APX 0.3100 Tablet / comprime

Auro-Mirtazapine 02411709 ARO 0.3100 Tablet / comprime

Mirtazapine 02370689 SAS 0.3100 Tablet / comprime

Mylan-Mirtazapine 02256118 MYL 0.3100 Tablet / comprime

Sandoz Mirtazapine 02250608 SDZ 0.3100 Tablet / comprime

Teva-Mirtazapine 02259354 TEV 0.3100 Tablet / comprime

pms-Mirtazapine 02248762 PMS 0.3100 Tablet / comprime

Misoprostol / Misoprostol Tab/Co. Orl 100 mcg Misoprostol 02244022 AAP 0.2636 Tablet / comprime

Tab/Co. Orl 200 mcg Misoprostol 02244023 AAP 0.4389 Tablet / comprime

Mixed Salts Amphetamine / Sels Mixtes D'Amphetamine ERC/Caps.L.P. Orl 5 mg Adderall XR 02248808 SHI 0.5372 Capsule / capsule

Act Amphetamine XR 02439239 TEV 0.5372 Capsule / capsule

Apo-Amphetamine XR 02445492 APX 0.5372 Capsule / capsule

Sandoz Amphetamine XR 02457288 SDZ 0.5372 Capsule / capsule

pms-Amphetamines XR 02440369 PMS 0.5372 Capsule / capsule

ERC/Caps.L.P. Orl 10 mg Adderall XR 02248809 SHI 0.6105 Capsule / capsule

Act Amphetamine XR 02439247 TEV 0.6105 Capsule / capsule

Apo-Amphetamine XR 02445506 APX 0.6105 Capsule / capsule

Sandoz Amphetamine XR 02457296 SDZ 0.6105 Capsule / capsule

pms-Amphetamines XR 02440377 PMS 0.6105 Capsule / capsule

ERC/Caps.L.P. Orl 15 mg Adderall XR 02248810 SHI 0.6838 Capsule / capsule

Act Amphetamine XR 02439255 TEV 0.6838 Capsule / capsule

Apo-Amphetamine XR 02445514 APX 0.6838 Capsule / capsule

Sandoz Amphetamine XR 02457318 SDZ 0.6838 Capsule / capsule

pms-Amphetamines XR 02440385 PMS 0.6838 Capsule / capsule

ERC/Caps.L.P. Orl 20 mg Adderall XR 02248811 SHI 0.7572 Capsule / capsule

Act Amphetamine XR 02439263 TEV 0.7572 Capsule / capsule

Apo-Amphetamine XR 02445522 APX 0.7572 Capsule / capsule

Sandoz Amphetamine XR 02457326 SDZ 0.7572 Capsule / capsule

ERC/Caps.L.P. Orl 25 mg Adderall XR 02248812 SHI 0.8305 Capsule / capsule

Act Amphetamine XR 02439271 TEV 0.8305 Capsule / capsule

Apo-Amphetamine XR 02445530 APX 0.8305 Capsule / capsule

Sandoz Amphetamine XR 02457334 SDZ 0.8305 Capsule / capsule

pms-Amphetamines XR 02440407 PMS 0.8305 Capsule / capsule

ERC/Caps.L.P. Orl 30 mg Adderall XR 02248813 SHI 0.9038 Capsule / capsule

Act Amphetamine XR 02439298 TEV 0.9038 Capsule / capsule

Apo-Amphetamine XR 02445549 APX 0.9038 Capsule / capsule

Sandoz Amphetamine XR 02457342 SDZ 0.9038 Capsule / capsule

Moclobemide / Moclobemide Tab/Co. Orl 100 mg Moclobemide 02232148 AAP 0.3400 Tablet / comprime

Tab/Co. Orl 150 mg Manerix 00899356 MVL 0.5295 Tablet / comprime

Moclobemide 02232150 AAP 0.5295 Tablet / comprime

Tab/Co. Orl 300 mg Manerix 02166747 MVL 1.0399 Tablet / comprime

Moclobemide 02240456 AAP 1.0399 Tablet / comprime

September / septembre 2020 Page 36

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Modafinil / Modafinil Tab/Co. Orl 100 mg Alertec 02239665 TEV 0.3171 Tablet / comprime

Apo-Modafinil 02285398 APX 0.3171 Tablet / comprime

Auro-Modafinil 02430487 ARO 0.3171 Tablet / comprime

Mar-Modafinil 02432560 MAR 0.3171 Tablet / comprime

Teva-Modafinil 02420260 TEV 0.3171 Tablet / comprime

Mometasone / Mometasone Asp/Asp Nas 0.1% Nasonex Aqueous 02238465 FRS 0.0742 Dose / dose

Apo-Mometasone 02403587 APX 0.0742 Dose / dose

Sandoz Mometasone 02449811 SDZ 0.0742 Dose / dose

Teva-Mometasone 02475863 TEV 0.0742 Dose / dose

Crm/Cr. Top 0.1% Elocom 00851744 FRS 0.5542 Gram / gramme

Taro-Mometasone 02367157 TAR 0.5542 Gram / gramme

Lot/Lot Top 0.1% Elocom 00871095 FRS 0.3358 Gram / gramme

Taro-Mometasone 02266385 TAR 0.3358 Gram / gramme

Ont/Ont Top 0.1% Elocom 00851736 FRS 0.5440 Gram / gramme

Teva-Mometasone 02248130 TEV 0.5440 Gram / gramme

Montelukast / Montelukast Gran/Gran Orl 4 mg Singulair 02247997 FRS 1.3139 Sachet / sachet

Sandoz Montelukast 02358611 SDZ 1.3139 Sachet / sachet

Tab/Co. Orl 10 mg Singulair 02238217 FRS 0.4231 Tablet / comprime

Apo-Montelukast 02374609 APX 0.4231 Tablet / comprime

Auro-Montelukast 02401274 ARO 0.4231 Tablet / comprime

Jamp-Montelukast 02391422 JPC 0.4231 Tablet / comprime

Mar-Montelukast 02399997 MAR 0.4231 Tablet / comprime

Mint-Montelukast 02408643 MNT 0.4231 Tablet / comprime

Montelukast 02382474 SIV 0.4231 Tablet / comprime

Montelukast 02379333 SAS 0.4231 Tablet / comprime

Montelukast Sodium 02379236 AHI 0.4231 Tablet / comprime

NRA-Montelukast 02489821 NRA 0.4231 Tablet / comprime

Ran-Montelukast 02389517 RAN 0.4231 Tablet / comprime

Sandoz Montelukast 02328593 SDZ 0.4231 Tablet / comprime

Teva-Montelukast 02355523 TEV 0.4231 Tablet / comprime

pms-Montelukast 02373947 PMS 0.4231 Tablet / comprime

TabC/Co.C. Orl 4 mg Singulair 02243602 FRS 0.2758 Tablet / comprime

Apo-Montelukast 02377608 APX 0.2758 Tablet / comprime

Jamp-Montelukast 02442353 JPC 0.2758 Tablet / comprime

Mar-Montelukast 02399865 MAR 0.2758 Tablet / comprime

Mint-Montelukast 02408627 MNT 0.2758 Tablet / comprime

Montelukast 02382458 SIV 0.2758 Tablet / comprime

Sandoz Montelukast 02330385 SDZ 0.2758 Tablet / comprime

Teva-Montelukast 02355507 TEV 0.2758 Tablet / comprime

pms-Montelukast 02354977 PMS 0.2758 Tablet / comprime

TabC/Co.C. Orl 5 mg Singulair 02238216 FRS 0.3082 Tablet / comprime

Apo-Montelukast 02377616 APX 0.3082 Tablet / comprime

Jamp-Montelukast 02442361 JPC 0.3082 Tablet / comprime

Mar-Montelukast 02399873 MAR 0.3082 Tablet / comprime

Mint-Montelukast 02408635 MNT 0.3082 Tablet / comprime

Montelukast 02382466 SIV 0.3082 Tablet / comprime

Sandoz Montelukast 02330393 SDZ 0.3082 Tablet / comprime

Teva-Montelukast 02355515 TEV 0.3082 Tablet / comprime

pms-Montelukast 02354985 PMS 0.3082 Tablet / comprime

Morphine Sulfate / Morphine (Sulfate De) Liq/Liq Inj 10 mg/mL Morphine Sulfate 00392588 SDZ 2.3860 Millilitre / millilitre

Liq/Liq Inj 15 mg/mL Morphine Sulfate 00392561 SDZ 2.0940 Millilitre / millilitre

Liq/Liq Inj 50 mg/mL Morphine HP 50 00617288 SDZ 6.8195 Millilitre / millilitre

SRT/Co.L.L. Orl 15 mg MS Contin 02015439 PFR 0.2317 Tablet / comprime

Morphine SR 02350815 SAS 0.2317 Tablet / comprime

Sandoz Morphine SR 02244790 SDZ 0.2317 Tablet / comprime

Teva-Morphine SR 02302764 TEV 0.2317 Tablet / comprime

SRT/Co.L.L. Orl 30 mg MS Contin 02014297 PFR 0.3500 Tablet / comprime

Morphine SR 02350890 SAS 0.3500 Tablet / comprime

Sandoz Morphine SR 02244791 SDZ 0.3500 Tablet / comprime

Teva-Morphine SR 02302772 TEV 0.3500 Tablet / comprime

SRT/Co.L.L. Orl 60 mg MS Contin 02014300 PFR 0.6167 Tablet / comprime

Morphine SR 02350912 SAS 0.6167 Capsule / capsule

Sandoz Morphine SR 02244792 SDZ 0.6167 Capsule / capsule

Teva-Morphine SR 02302780 TEV 0.6167 Tablet / comprime

SRT/Co.L.L. Orl 100 mg MS Contin 02014319 PFR 1.5395 Tablet / comprime

Sandoz Morphine SR 02478889 SDZ 1.5395 Tablet / comprime

Teva-Morphine SR 02302799 TEV 1.5395 Tablet / comprime

SRT/Co.L.L. Orl 200 mg MS Contin 02014327 PFR 2.7718 Tablet / comprime

Sandoz Morphine SR 02478897 SDZ 2.7718 Tablet / comprime

Teva-Morphine SR 02302802 TEV 2.7718 Tablet / comprime

Moxifloxacin / Moxifloxacine Tab/Co. Orl 400 mg Apo-Moxifloxacin 02404923 APX 1.5230 Tablet / comprime

Auro-Moxifloxacin 02432242 ARO 1.5230 Tablet / comprime

Jamp-Moxifloxacin 02443929 JPC 1.5230 Tablet / comprime

Jamp-Moxifloxacin 02447061 JPC 1.5230 Tablet / comprime

September / septembre 2020 Page 37

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

M-Moxifloxacin 02472791 MRA 1.5230 Tablet / comprime

Mar-Moxifloxacin 02447053 MAR 1.5230 Tablet / comprime

Med-Moxifloxacin 02457814 GMP 1.5230 Tablet / comprime

Sandoz Moxifloxacin 02383381 SDZ 1.5230 Tablet / comprime

Teva-Moxifloxacin 02375702 TEV 1.5230 Tablet / comprime

Mupirocin / Mupirocine Ont/Ont Top 2% Bactroban 01916947 GCH 0.3712 Gram / gramme

Taro-Mupirocin 02279983 TAR 0.3712 Gram / gramme

Mycophenolic Acid / Acide Mycophenolique Cap/Caps Orl 250 mg Cellcept 02192748 HLR 0.3712 Capsule / capsule

Apo-Mycophenolate 02352559 APX 0.3712 Capsule / capsule

Jamp-Mycophenolate 02386399 JPC 0.3712 Capsule / capsule

Mycophenolate Mofetil 02383780 AHI 0.3712 Capsule / capsule

Mycophenolate Mofetil 02457369 SAS 0.3712 Capsule / capsule

Novo-Mycophenolate 02364883 TEV 0.3712 Capsule / capsule

Sandoz Mycophenolate 02320630 SDZ 0.3712 Capsule / capsule

ECT/Co.Ent Orl 180 mg Myfortic 02264560 NVR 1.4983 Tablet / comprime

Apo-Mycophenolic Acid 02372738 APX 1.4983 Tablet / comprime

ECT/Co.Ent Orl 360 mg Myfortic 02264579 NVR 2.9965 Tablet / comprime

Apo-Mycophenolic Acid 02372746 APX 2.9965 Tablet / comprime

Tab/Co. Orl 500 mg Cellcept 02237484 HLR 4.1612 Tablet / comprime

Apo-Mycophenolate 02352567 APX 0.7423 Tablet / comprime

Jamp-Mycophenolate 02380382 JPC 0.7423 Tablet / comprime

Mycophenolate Mofetil 02457377 SAS 0.7423 Tablet / comprime

Mycophenolate Mofetil 02378574 AHI 0.7423 Tablet / comprime

Sandoz Mycophenolate 02313855 SDZ 0.7423 Tablet / comprime

Teva-Mycophenolate 02348675 TEV 0.7423 Tablet / comprime

Nabilone / Nabilone Cap/Caps Orl 0.25 mg Cesamet 02312263 BSL 1.9015 Capsule / capsule

Teva-Nabilone 02392925 TEV 1.3962 Capsule / capsule

Cap/Caps Orl 0.5 mg Cesamet 02256193 BSL 0.7756 Capsule / capsule

Act Nabilone 02393581 TEV 0.7756 Capsule / capsule

Teva-Nabilone 02384884 TEV 0.7756 Capsule / capsule

pms-Nabilone 02380900 PMS 0.7756 Capsule / capsule

Cap/Caps Orl 1 mg Cesamet 00548375 BSL 1.5513 Capsule / capsule

Act Nabilone 02393603 TEV 1.5513 Capsule / capsule

Teva-Nabilone 02384892 TEV 1.5513 Capsule / capsule

pms-Nabilone 02380919 PMS 1.5513 Capsule / capsule

Nabumetone / Nabumetone Tab/Co. Orl 500 mg Nabumetone 02238639 AAP 0.6130 Tablet / comprime

Nadolol / Nadolol Tab/Co. Orl 40 mg Apo-Nadolol 00782505 APX 0.4512 Tablet / comprime

Tab/Co. Orl 80 mg Apo-Nadolol 00782467 APX 0.3710 Tablet / comprime

Tab/Co. Orl 160 mg Apo-Nadolol 00782475 APX 1.2046 Tablet / comprime

Naltrexone / Naltrexone Tab/Co. Orl 50 mg Revia 02213826 TEV 2.8075 Tablet / comprime

Apo-Naltrexone 02444275 APX 2.8075 Tablet / comprime

Naltrexone Hydrochloride 02451883 JPC 2.8075 Tablet / comprime

Naproxen / Naproxene ECT/Co.Ent Orl 250 mg Naproxen EC 02350785 SAS 0.1068 Tablet / comprime

Teva-Naprox EC 02243312 TEV 0.1068 Tablet / comprime

ECT/Co.Ent Orl 375 mg Naprosyn E 02162415 MTP 0.1458 Tablet / comprime

Apo-Naproxen EC 02246700 APX 0.1458 Tablet / comprime

Naproxen EC 02350793 SAS 0.1458 Tablet / comprime

Teva-Naprox EC 02243313 TEV 0.1458 Tablet / comprime

ECT/Co.Ent Orl 500 mg Naprosyn E 02162423 MTP 0.2426 Tablet / comprime

Apo-Naproxen EC 02246701 APX 0.2426 Tablet / comprime

Naproxen EC 02350807 SAS 0.2426 Tablet / comprime

Teva-Naprox EC 02243314 TEV 0.2426 Tablet / comprime

pms-Naproxen EC 02294710 PMS 0.2426 Tablet / comprime

Tab/Co. Orl 250 mg Apo-Naproxen 00522651 APX 0.1068 Tablet / comprime

Naproxen 02350750 SAS 0.1068 Tablet / comprime

Teva-Naproxen 00565350 TEV 0.1068 Tablet / comprime

Tab/Co. Orl 275 mg Anaprox 02162725 MTP 0.3422 Tablet / comprime

Apo-Napro-Na 00784354 APX 0.3422 Tablet / comprime

Naproxen Sodium 02351013 SAS 0.3422 Tablet / comprime

Teva-Naproxen Sodium 00778389 TEV 0.3422 Tablet / comprime

Tab/Co. Orl 375 mg Apo-Naproxen 00600806 APX 0.1458 Tablet / comprime

Naproxen 02350769 SAS 0.1458 Tablet / comprime

Teva-Naproxen 00627097 TEV 0.1458 Tablet / comprime

Tab/Co. Orl 500 mg Apo-Naproxen 00592277 APX 0.2110 Tablet / comprime

Naproxen 02350777 SAS 0.2110 Tablet / comprime

Teva-Naproxen 00589861 TEV 0.2110 Tablet / comprime

Tab/Co. Orl 550 mg Anaprox DS 02162717 MTP 0.6667 Tablet / comprime

Apo-Napro-Na DS 01940309 APX 0.6667 Tablet / comprime

Naproxen Sodium DS 02351021 SAS 0.6667 Tablet / comprime

Teva-Naproxen Sodium DS 02026600 TEV 0.6667 Tablet / comprime

Naratriptan / Naratriptan Tab/Co. Orl 1 mg Amerge 02237820 GSK 10.4114 Tablet / comprime

Teva-Naratriptan 02314290 TEV 10.4114 Tablet / comprime

Tab/Co. Orl 2.5 mg Amerge 02237821 GSK 6.1436 Tablet / comprime

Sandoz Naratriptan 02322323 SDZ 6.1436 Tablet / comprime

September / septembre 2020 Page 38

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Teva-Naratriptan 02314304 TEV 6.1436 Tablet / comprime

Neostigmine / Neostigmine Liq/Liq Inj 1 mg/mL Neostigmine Omega 02230592 OMG 1.0700 Millilitre / millilitre

Liq/Liq Inj 2.5 mg/mL Neostigmine Omega 02387166 OMG 3.4300 Millilitre / millilitre

Nevirapine / Nevirapine Tab/Co. Orl 200 mg Auro-Nevirapine 02318601 ARO 1.2346 Tablet / comprime

Jamp-Nevirapine 02405776 JPC 1.2346 Tablet / comprime

Mylan-Nevirapine 02387727 MYL 1.2346 Tablet / comprime

Nicotine / Nicotine Gum/Gom Orl 2 mg Actavis 80015240 ACT 0.1555 Gum / gomme

Compliments 80015240 SOB 0.1555 Gum / gomme

Exact 80025660 SDM 0.1555 Gum / gomme

Life Brand 80025660 SDM 0.1555 Gum / gomme

Personnelle 80015240 PJC 0.1555 Gum / gomme

Loz/Pas Orl 1 mg Nic-Hit (mini-lozenge) 80061161 NHI 0.1850 Lozenge / pastille

Loz/Pas Orl 2 mg Nic-Hit (mini-lozenge) 80059877 NHI 0.2000 Lozenge / pastille

Loz/Pas Orl 3 mg Nic-Hit (mini-lozenge) 80060747 NHI 0.2200 Lozenge / pastille

Loz/Pas Orl 4 mg Nic-Hit (mini-lozenge) 80059869 NHI 0.2400 Lozenge / pastille

Pth/Pth Trd 7 mg Actavis 80044393 ACT 2.2857 Patch / timbre cutane

Compliments 80044393 SOB 2.2857 Patch / timbre cutane

Equate 02241227 WAL 2.2857 Patch / timbre cutane

Exact 80014321 SDM 2.2857 Patch / timbre cutane

Life Brand 80014321 SDM 2.2857 Patch / timbre cutane

Personnelle 80044393 PJC 2.2857 Patch / timbre cutane

Pharmasave 02241227 PSV 2.2857 Patch / timbre cutane

Pharmasave 80014321 PSV 2.2857 Patch / timbre cutane

Pth/Pth Trd 14 mg Actavis 80044392 ACT 2.2857 Patch / timbre cutane

Compliments 80044392 SOB 2.2857 Patch / timbre cutane

Equate 02241226 WAL 2.2857 Patch / timbre cutane

Exact 80013549 SDM 2.2857 Patch / timbre cutane

Life Brand 80013549 SDM 2.2857 Patch / timbre cutane

Personnelle 80044392 PJC 2.2857 Patch / timbre cutane

Pharmasave 80013549 PSV 2.2857 Patch / timbre cutane

Pharmasave 02241226 PSV 2.2857 Patch / timbre cutane

Pth/Pth Trd 21 mg Actavis 80044389 ACT 2.2857 Patch / timbre cutane

Compliments 80044389 SOB 2.2857 Patch / timbre cutane

Equate 02241228 WAL 2.2857 Patch / timbre cutane

Exact 80014250 SDM 2.2857 Patch / timbre cutane

Life Brand 80014250 SDM 2.2857 Patch / timbre cutane

Personnelle 80044389 PJC 2.2857 Patch / timbre cutane

Pharmasave 80014250 PSV 2.2857 Patch / timbre cutane

Pharmasave 02241228 PSV 2.2857 Patch / timbre cutane

Nifedipine / Nifedipine Cap/Caps Orl 5 mg Nifedipine 00725110 AAP 0.3679 Capsule / capsule

Cap/Caps Orl 10 mg Nifedipine 00755907 AAP 0.4877 Capsule / capsule

ERT/Co.L.P. Orl 30 mg Adalat XL 02155907 TEV 0.6171 Tablet / comprime

Mylan-Nifedipine Extended Release 02349167 MYL 0.6171 Tablet / comprime

ERT/Co.L.P. Orl 60 mg Adalat XL 02155990 TEV 0.9374 Tablet / comprime

Mylan-Nifedipine Extended Release 02321149 MYL 0.9374 Tablet / comprime

Nitisinone / Nitisinone Cap/Caps Orl 2 mg Orfadin 02459698 BVT 12.9500 Capsule / capsule P

MDK-Nitisinone 02457717 MDK 12.9500 Capsule / capsule P

Cap/Caps Orl 5 mg Orfadin 02459701 BVT 25.0600 Capsule / capsule P

MDK-Nitisinone 02457725 MDK 25.0600 Capsule / capsule P

Cap/Caps Orl 10 mg Orfadin 02459728 BVT 47.4000 Capsule / capsule P

MDK-Nitisinone 02457733 MDK 47.4000 Capsule / capsule P

Cap/Caps Orl 20 mg Orfadin 02459736 BVT 128.1000 Capsule / capsule P

MDK-Nitisinone 02470055 MDK 128.1000 Capsule / capsule P

Nitrazepam / Nitrazepam Tab/Co. Orl 5 mg Mogadon 00511528 AAP 0.1534 Tablet / comprime

Tab/Co. Orl 10 mg Mogadon 00511536 AAP 0.2296 Tablet / comprime

Nitrofurantoin / Nitrofurantoine Cap/Caps Orl 50 mg Teva-Nitrofurantoin 02231015 TEV 0.3252 Capsule / capsule

Cap/Caps Orl 100 mg Macrobid 02063662 ALL 0.5974 Capsule / capsule

pms-Nitrofurantoin 02455676 PMS 0.5974 Capsule / capsule

Tab/Co. Orl 50 mg Nitrofurantoin 00319511 AAP 0.1703 Tablet / comprime

Tab/Co. Orl 100 mg Nitrofurantoin 00312738 AAP 0.2272 Tablet / comprime

Nitroglycerin (Glyceryl Trinitrate) / Nitroglycerine (Trinitrate De

Glyceryle)

Aem/Aem. Slg 0.4 mg Nitrolingual 02231441 SAV 0.0421 Dose / dose

Mylan-Nitro SL 02243588 MYL 0.0421 Dose / dose

Rho-Nitro 02238998 SDZ 0.0421 Dose / dose

Pth/Pth Trd 0.2 mg/hr Minitran 02162806 VLN 0.4463 Patch / timbre cutane

Nitro-Dur 01911910 RCH 0.4463 Patch / timbre cutane

Trinipatch 02230732 PAL 0.4463 Patch / timbre cutane

Mylan-Nitro Patch 02407442 MYL 0.4463 Patch / timbre cutane

Pth/Pth Trd 0.4 mg/hr Minitran 02163527 VLN 0.4704 Patch / timbre cutane

Nitro-Dur 01911902 RCH 0.4704 Patch / timbre cutane

Trinipatch 02230733 PAL 0.4704 Patch / timbre cutane

Mylan-Nitro Patch 02407450 MYL 0.4704 Patch / timbre cutane

Pth/Pth Trd 0.6 mg/hr Minitran 02163535 VLN 0.4704 Patch / timbre cutane

Nitro-Dur 01911929 RCH 0.4704 Patch / timbre cutane

September / septembre 2020 Page 39

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Trinipatch 02230734 PAL 0.4704 Patch / timbre cutane

Mylan-Nitro Patch 02407469 MYL 0.4704 Patch / timbre cutane

Pth/Pth Trd 0.8 mg/hr Nitro-Dur 02011271 RCH 0.8743 Patch / timbre cutane

Mylan-Nitro Patch 02407477 MYL 0.8743 Patch / timbre cutane

Norethisterone (Norethindrone) / Norethisterone

(Norethindrone)

Tab/Co. Orl 0.35 mg Micronor (28) 00037605 JAN 0.3925 Tablet / comprime

Jencycla (28) 02441306 LUP 0.3925 Tablet / comprime

Movisse (28) 02410303 MYL 0.3925 Tablet / comprime

Norfloxacin / Norfloxacine Tab/Co. Orl 400 mg Norfloxacin 02229524 AAP 1.0933 Tablet / comprime

Norgestimate and Ethinyl Estradiol / Norgestimate et

Ethinyloestradiol

Tab/Co. Orl 0.18 mg,0.215 mg,

0.25 mg / 0.035 mg

Tri-Cyclen (28) 02029421 JAN 0.7709 Tablet / comprime

Tri-Jordyna (28) 02486318 GLM 0.7709 Tablet / comprime

Tab/Co. Orl 0.215 mg,0.18 mg,

0.025 mg / 0.025 mg

Tri-Cyclen LO (21) 02258560 JAN 0.6377 Tablet / comprime

Tricira LO (21) 02401967 APX 0.6377 Tablet / comprime

Tab/Co. Orl 0.215 mg,0.18 mg,

0.025 mg / 0.025 mg

Tri-Cyclen LO (28) 02258587 JAN 0.4782 Tablet / comprime

Tricira LO (28) 02401975 APX 0.4782 Tablet / comprime

Nortriptyline / Nortriptyline Cap/Caps Orl 10 mg Aventyl 00015229 AAP 0.2570 Capsule / capsule

Cap/Caps Orl 25 mg Aventyl 00015237 AAP 0.5193 Capsule / capsule

Nystatin / Nystatine Crm/Cr. Top 100 000 IU Nyaderm 00716871 TAR 0.0633 Gram / gramme

Crm/Cr. Vag 100 000 IU ratio-Nystatin 02194163 RPH 0.3191 Gram / gramme

Ont/Ont Top 100 000 IU ratio-Nystatin 02194228 RPH 0.1277 Gram / gramme

Sus/Susp Orl 100 000 IU/mL Jamp-Nystatin 02433443 JPC 0.0518 Millilitre / millilitre

Teva-Nystatin 02194201 TEV 0.0518 Millilitre / millilitre

pms-Nystatin Suspension 00792667 PMS 0.0518 Millilitre / millilitre

Octreotide / Octreotide Liq/Liq Inj 0.05 mg/mL Sandostatin 00839191 NVR 1.7465 Millilitre / millilitre

Octreotide Acetate Omega 02248639 OMG 1.7465 Millilitre / millilitre

Liq/Liq Inj 0.1 mg/mL Sandostatin 00839205 NVR 3.2970 Millilitre / millilitre

Octreotide Acetate Omega 02248640 OMG 3.2970 Millilitre / millilitre

Liq/Liq Inj 0.2 mg/mL Sandostatin 02049392 NVR 6.3420 Millilitre / millilitre

Octreotide Acetate Omega 02248642 OMG 6.3420 Millilitre / millilitre

Liq/Liq Inj 0.5 mg/mL Octreotide Acetate Omega 02248641 OMG 15.4945 Millilitre / millilitre

Olanzapine / Olanzapine ODT/Co.D.O. Orl 5 mg Zyprexa Zydis 02243086 LIL 4.1154 Tablet / comprime

Apo-Olanzapine ODT 02360616 APX 0.3574 Tablet / comprime

Auro-Olanzapine ODT 02448726 ARO 0.3574 Tablet / comprime

Jamp-Olanzapine ODT 02406624 JPC 0.3574 Tablet / comprime

Mar-Olanzapine ODT 02389088 MAR 0.3574 Tablet / comprime

Mint-Olanzapine ODT 02436965 MNT 0.3574 Tablet / comprime

Olanzapine ODT 02338645 PDL 0.3574 Tablet / comprime

Olanzapine ODT 02343665 SIV 0.3574 Tablet / comprime

Ran-Olanzapine ODT 02414090 RAN 0.3574 Tablet / comprime

Sandoz Olanzapine ODT 02327775 SDZ 0.3574 Tablet / comprime

pms-Olanzapine ODT 02303191 PMS 0.3574 Tablet / comprime

ODT/Co.D.O. Orl 10 mg Zyprexa Zydis 02243087 LIL 0.7143 Tablet / comprime

Act Olanzapine ODT 02327570 TEV 0.7143 Tablet / comprime

Apo-Olanzapine ODT 02360624 APX 0.7143 Tablet / comprime

Auro-Olanzapine ODT 02448734 ARO 0.7143 Tablet / comprime

Jamp-Olanzapine ODT 02406632 JPC 0.7143 Tablet / comprime

Mar-Olanzapine ODT 02389096 MAR 0.7143 Tablet / comprime

Mint-Olanzapine ODT 02436973 MNT 0.7143 Tablet / comprime

Olanzapine ODT 02343673 SIV 0.7143 Tablet / comprime

Olanzapine ODT 02338653 PDL 0.7143 Tablet / comprime

Ran-Olanzapine ODT 02414104 RAN 0.7143 Tablet / comprime

Sandoz Olanzapine ODT 02327783 SDZ 0.7143 Tablet / comprime

pms-Olanzapine ODT 02303205 PMS 0.7143 Tablet / comprime

ODT/Co.D.O. Orl 15 mg Zyprexa Zydis 02243088 LIL 1.0711 Tablet / comprime

Act Olanzapine ODT 02327589 TEV 1.0711 Tablet / comprime

Apo-Olanzapine ODT 02360632 APX 1.0711 Tablet / comprime

Auro-Olanzapine ODT 02448742 ARO 1.0711 Tablet / comprime

Jamp-Olanzapine ODT 02406640 JPC 1.0711 Tablet / comprime

Mar-Olanzapine ODT 02389118 MAR 1.0711 Tablet / comprime

Mint-Olanzapine ODT 02436981 MNT 1.0711 Tablet / comprime

Olanzapine ODT 02352990 SAS 1.0711 Tablet / comprime

Olanzapine ODT 02338661 PDL 1.0711 Tablet / comprime

Olanzapine ODT 02343681 SIV 1.0711 Tablet / comprime

Ran-Olanzapine ODT 02414112 RAN 1.0711 Tablet / comprime

Sandoz Olanzapine ODT 02327791 SDZ 1.0711 Tablet / comprime

pms-Olanzapine ODT 02303213 PMS 1.0711 Tablet / comprime

ODT/Co.D.O. Orl 20 mg Zyprexa Zydis 02243089 LIL 1.4137 Tablet / comprime

Act Olanzapine ODT 02327597 TEV 1.4137 Tablet / comprime

Apo-Olanzapine ODT 02360640 APX 1.4137 Tablet / comprime

Auro-Olanzapine ODT 02448750 ARO 1.4137 Tablet / comprime

Jamp-Olanzapine ODT 02406659 JPC 1.4137 Tablet / comprime

Mar-Olanzapine ODT 02389126 MAR 1.4137 Tablet / comprime

September / septembre 2020 Page 40

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Olanzapine ODT 02425114 PDL 1.4137 Tablet / comprime

Olanzapine ODT 02343703 SIV 1.4137 Tablet / comprime

Sandoz Olanzapine ODT 02327805 SDZ 1.4137 Tablet / comprime

Tab/Co. Orl 2.5 mg Zyprexa 02229250 LIL 0.1772 Tablet / comprime

Apo-Olanzapine 02281791 APX 0.1772 Tablet / comprime

Jamp-Olanzapine FC 02417243 JPC 0.1772 Tablet / comprime

Mint-Olanzapine 02410141 MNT 0.1772 Tablet / comprime

Olanzapine 02311968 PDL 0.1772 Tablet / comprime

Olanzapine 02385864 SIV 0.1772 Tablet / comprime

Olanzapine 02372819 SAS 0.1772 Tablet / comprime

Sandoz Olanzapine 02310341 SDZ 0.1772 Tablet / comprime

Teva-Olanzapine 02276712 TEV 0.1772 Tablet / comprime

pms-Olanzapine 02303116 PMS 0.1772 Tablet / comprime

Tab/Co. Orl 5 mg Zyprexa 02229269 LIL 0.3544 Tablet / comprime

Apo-Olanzapine 02281805 APX 0.3544 Tablet / comprime

Jamp-Olanzapine FC 02417251 JPC 0.3544 Tablet / comprime

Mint-Olanzapine 02410168 MNT 0.3544 Tablet / comprime

Olanzapine 02372827 SAS 0.3544 Tablet / comprime

Olanzapine 02311976 PDL 0.3544 Tablet / comprime

Olanzapine 02385872 SIV 0.3544 Tablet / comprime

Sandoz Olanzapine 02310368 SDZ 0.3544 Tablet / comprime

Teva-Olanzapine 02276720 TEV 0.3544 Tablet / comprime

pms-Olanzapine 02303159 PMS 0.3544 Tablet / comprime

Tab/Co. Orl 7.5 mg Zyprexa 02229277 LIL 0.5316 Tablet / comprime

Apo-Olanzapine 02281813 APX 0.5316 Tablet / comprime

Jamp-Olanzapine FC 02417278 JPC 0.5316 Tablet / comprime

Mint-Olanzapine 02410176 MNT 0.5316 Tablet / comprime

Olanzapine 02385880 SIV 0.5316 Tablet / comprime

Olanzapine 02372835 SAS 0.5316 Tablet / comprime

Olanzapine 02311984 PDL 0.5316 Tablet / comprime

Sandoz Olanzapine 02310376 SDZ 0.5316 Tablet / comprime

Teva-Olanzapine 02276739 TEV 0.5316 Tablet / comprime

pms-Olanzapine 02303167 PMS 0.5316 Tablet / comprime

Tab/Co. Orl 10 mg Zyprexa 02229285 LIL 0.7088 Tablet / comprime

Apo-Olanzapine 02281821 APX 0.7088 Tablet / comprime

Jamp-Olanzapine FC 02417286 JPC 0.7088 Tablet / comprime

Mint-Olanzapine 02410184 MNT 0.7088 Tablet / comprime

Olanzapine 02311992 PDL 0.7088 Tablet / comprime

Olanzapine 02372843 SAS 0.7088 Tablet / comprime

Olanzapine 02385899 SIV 0.7088 Tablet / comprime

Sandoz Olanzapine 02310384 SDZ 0.7088 Tablet / comprime

Teva-Olanzapine 02276747 TEV 0.7088 Tablet / comprime

pms-Olanzapine 02303175 PMS 0.7088 Tablet / comprime

Tab/Co. Orl 15 mg Zyprexa 02238850 LIL 1.0631 Tablet / comprime

Apo-Olanzapine 02281848 APX 1.0631 Tablet / comprime

Jamp-Olanzapine FC 02417294 JPC 1.0631 Tablet / comprime

Mint-Olanzapine 02410192 MNT 1.0631 Tablet / comprime

Olanzapine 02372851 SAS 1.0631 Tablet / comprime

Olanzapine 02312018 PDL 1.0631 Tablet / comprime

Olanzapine 02385902 SIV 1.0631 Tablet / comprime

Sandoz Olanzapine 02310392 SDZ 1.0631 Tablet / comprime

Teva-Olanzapine 02276755 TEV 1.0631 Tablet / comprime

pms-Olanzapine 02303183 PMS 1.0631 Tablet / comprime

Tab/Co. Orl 20 mg Zyprexa 02238851 LIL 1.4378 Tablet / comprime

Apo-Olanzapine 02333015 APX 1.4378 Tablet / comprime

Jamp-Olanzapine FC 02417308 JPC 1.4378 Tablet / comprime

Olanzapine 02421704 PDL 1.4378 Tablet / comprime

Teva-Olanzapine 02359707 TEV 1.4378 Tablet / comprime

pms-Olanzapine 02367483 PMS 1.4378 Tablet / comprime

Olmesartan / Hydrochlorothiazide / Olmesartan /

Hydrochlorothiazide

Tab/Co. Orl 20 mg / 12.5 mg Olmetec Plus 02319616 FRS 0.3019 Tablet / comprime

ACH-Olmesartan HCTZ 02468948 AHI 0.3019 Tablet / comprime

Act Olmesartan HCT 02443112 TEV 0.3019 Tablet / comprime

Apo-Olmesartan/HCTZ 02453606 APX 0.3019 Tablet / comprime

Tab/Co. Orl 40 mg / 12.5 mg Olmetec Plus 02319624 FRS 0.3019 Tablet / comprime

ACH-Olmesartan HCTZ 02468956 AHI 0.3019 Tablet / comprime

Act Olmesartan HCT 02443120 TEV 0.3019 Tablet / comprime

Apo-Olmesartan/HCTZ 02453614 APX 0.3019 Tablet / comprime

Tab/Co. Orl 40 mg / 25 mg Olmetec Plus 02319632 FRS 1.3066 Tablet / comprime

ACH-Olmesartan HCTZ 02468964 AHI 0.3019 Tablet / comprime

Act Olmesartan HCT 02443139 TEV 0.3019 Tablet / comprime

Apo-Olmesartan/HCTZ 02453622 APX 0.3019 Tablet / comprime

Olmesartan Medoxomil / Olmesartan Medoxomil Tab/Co. Orl 20 mg Olmetec 02318660 FRS 1.3066 Tablet / comprime

Ach-Olmesartan 02456311 AHI 0.2763 Tablet / comprime

September / septembre 2020 Page 41

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Act Olmesartan 02442191 TEV 0.2763 Tablet / comprime

Apo-Olmesartan 02453452 APX 0.2763 Tablet / comprime

Auro-Olmesartan 02443864 ARO 0.2763 Tablet / comprime

Jamp-Olmesartan 02461641 JPC 0.2763 Tablet / comprime

Olmesartan 02481057 SAS 0.2763 Tablet / comprime

Sandoz Olmesartan 02443414 SDZ 0.2763 Tablet / comprime

pms-Olmesartan 02461307 PMS 0.2763 Tablet / comprime

Tab/Co. Orl 40 mg Olmetec 02318679 FRS 1.3066 Tablet / comprime

Ach-Olmesartan 02456338 AHI 0.2763 Tablet / comprime

Act Olmesartan 02442205 TEV 0.2763 Tablet / comprime

Apo-Olmesartan 02453460 APX 0.2763 Tablet / comprime

Auro-Olmesartan 02443872 ARO 0.2763 Tablet / comprime

Jamp-Olmesartan 02461668 JPC 0.2763 Tablet / comprime

Olmesartan 02481065 SAS 0.2763 Tablet / comprime

Sandoz Olmesartan 02443422 SDZ 0.2763 Tablet / comprime

pms-Olmesartan 02461315 PMS 0.2763 Tablet / comprime

Olopatadine / Olopatadine Liq/Liq Oph 0.1% Patanol 02233143 NVR 2.1714 Millilitre / millilitre

Apo-Olopatadine 02305054 APX 2.1714 Millilitre / millilitre

Jamp-Olopatadine 02458411 JPC 2.1714 Millilitre / millilitre

Sandoz Olopatadine 02358913 SDZ 2.1714 Millilitre / millilitre

Liq/Liq Oph 0.2% Pataday 02362171 NVR 4.3428 Millilitre / millilitre

Apo-Olopatadine 02402823 APX 4.3428 Millilitre / millilitre

Sandoz Olopatadine 02420171 SDZ 4.3428 Millilitre / millilitre

Omeprazole / Omeprazole SRC/Caps.L.L. Orl 20 mg Losec 00846503 AZE 0.2287 Capsule / capsule

Apo-Omeprazole 02245058 APX 0.2287 Capsule / capsule

Omeprazole 02348691 SAS 0.2287 Capsule / capsule

Omeprazole 02411857 SIV 0.2287 Capsule / capsule

Sandoz Omeprazole 02296446 SDZ 0.2287 Capsule / capsule

pms-Omeprazole 02320851 PMS 0.2287 Capsule / capsule

SRT/Co.L.L. Orl 20 mg Losec 02190915 AZE 0.2287 Tablet / comprime

Jamp-Omeprazole 02420198 JPC 0.2287 Tablet / comprime

Nat-Omeprazole DR 02439549 NAT 0.2287 Tablet / comprime

Omeprazole 02416549 AHI 0.2287 Tablet / comprime

Teva-Omeprazole 02295415 TEV 0.2287 Tablet / comprime

Ondansetron / Ondansetron Liq/Liq Inj 2 mg/mL Zofran 02213745 NVR 10.9190 Millilitre / millilitre

Zofran (PF) 02213745 NVR 10.9190 Millilitre / millilitre

Jamp-Ondansetron (PF) 02420414 JPC 3.4552 Millilitre / millilitre

Jamp-Ondansetron with preservative 02420422 JPC 3.4552 Millilitre / millilitre

Liq/Liq Orl 4 mg/5 mL Zofran 02229639 NVR 1.1360 Millilitre / millilitre

Jamp Ondansetron 02490617 JPC 1.1360 Millilitre / millilitre

Ondansetron 02291967 APX 1.1360 Millilitre / millilitre

ODT/Co.D.O. Slg 4 mg Zofran ODT 02239372 NVR 3.2720 Tablet / comprime

Mint-Ondansetron ODT 02487330 MNT 3.2720 Tablet / comprime

Ondansetron ODT 02481723 SDZ 3.2720 Tablet / comprime

Ondissolve 02389983 TAK 3.2720 Tablet / comprime

VPI-Ondansetron ODT 02444674 VPI 3.2720 Tablet / comprime

ODT/Co.D.O. Slg 8 mg Zofran ODT 02239373 NVR 4.9930 Tablet / comprime

Mint-Ondansetron ODT 02487349 MNT 4.9930 Tablet / comprime

Ondansetron ODT 02481731 SDZ 4.9930 Tablet / comprime

Ondissolve 02389991 TAK 4.9930 Tablet / comprime

VPI-Ondansetron ODT 02444682 VPI 4.9930 Tablet / comprime

Tab/Co. Orl 4 mg Zofran 02213567 NVR 3.2720 Tablet / comprime

Act Ondansetron 02296349 TEV 3.2720 Tablet / comprime

Apo-Ondansetron 02288184 APX 3.2720 Tablet / comprime

CCP-Ondansetron 02458810 CCM 3.2720 Tablet / comprime

Jamp-Ondansetron 02313685 JPC 3.2720 Tablet / comprime

Mar-Ondansetron 02371731 MAR 3.2720 Tablet / comprime

Mint-Ondansetron 02305259 MNT 3.2720 Tablet / comprime

Mylan-Ondansetron 02297868 MYL 3.2720 Tablet / comprime

Nat-Ondansetron 02417839 NAT 3.2720 Tablet / comprime

Ondansetron 02421402 SAS 3.2720 Tablet / comprime

Sandoz Ondansetron 02274310 SDZ 3.2720 Tablet / comprime

Septa-Ondansetron 02376091 SPT 3.2720 Tablet / comprime

pms-Ondansetron 02258188 PMS 3.2720 Tablet / comprime

Tab/Co. Orl 8 mg Zofran 02213575 NVR 4.9930 Tablet / comprime

Act Ondansetron 02296357 TEV 4.9930 Tablet / comprime

Apo-Ondansetron 02288192 APX 4.9930 Tablet / comprime

CCP-Ondansetron 02458802 CCM 4.9930 Tablet / comprime

Jamp-Ondansetron 02313693 JPC 4.9930 Tablet / comprime

Mar-Ondansetron 02371758 MAR 4.9930 Tablet / comprime

Mint-Ondansetron 02305267 MNT 4.9930 Tablet / comprime

Mylan-Ondansetron 02297876 MYL 4.9930 Tablet / comprime

Nat-Ondansetron 02417847 NAT 4.9930 Tablet / comprime

Ondansetron 02421410 SAS 4.9930 Tablet / comprime

September / septembre 2020 Page 42

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Sandoz Ondansetron 02274329 SDZ 4.9930 Tablet / comprime

Septa-Ondansetron 02376105 SPT 4.9930 Tablet / comprime

pms-Ondansetron 02258196 PMS 4.9930 Tablet / comprime

Orciprenaline / Orciprenaline Syr/Sir. Orl 2 mg/mL Orciprenaline 02236783 AAP 0.0574 Millilitre / millilitre

Orphenadrine / Orphenadrine SRT/Co.L.L. Orl 100 mg Sandoz Orphenadrine Citrate 02243559 SDZ 1.0842 Tablet / comprime

Oseltamivir / Oseltamivir Cap/Caps Orl 30 mg Tamiflu 02304848 HLR 1.0485 Capsule / capsule

Mint-Oseltamivir 02497441 MNT 1.0485 Capsule / capsule

Nat-Oseltamivir 02472635 NAT 1.0485 Capsule / capsule

Cap/Caps Orl 45 mg Tamiflu 02304856 HLR 2.3910 Capsule / capsule

Nat-Oseltamivir 02472643 NAT 2.3910 Capsule / capsule

Cap/Caps Orl 75 mg Tamiflu 02241472 HLR 2.0875 Capsule / capsule

Mint-Oseltamivir 02497476 MNT 2.0875 Capsule / capsule

Nat-Oseltamivir 02457989 NAT 2.0875 Capsule / capsule

Oxazepam / Oxazepam Tab/Co. Orl 10 mg Apo-Oxazepam 00402680 APX 0.0350 Tablet / comprime

Tab/Co. Orl 15 mg Apo-Oxazepam 00402745 APX 0.0550 Tablet / comprime

Tab/Co. Orl 30 mg Apo-Oxazepam 00402737 APX 0.0750 Tablet / comprime

Oxcarbazepine / Oxcarbazepine Tab/Co. Orl 150 mg Apo-Oxcarbazepine 02284294 APX 0.6209 Tablet / comprime

Tab/Co. Orl 300 mg Trileptal 02242068 NVR 0.9102 Tablet / comprime

Apo-Oxcarbazepine 02284308 APX 0.9102 Tablet / comprime

Tab/Co. Orl 600 mg Trileptal 02242069 NVR 1.8204 Tablet / comprime

Apo-Oxcarbazepine 02284316 APX 1.8204 Tablet / comprime

Oxybutynin / Oxybutynine Syr/Sir. Orl 1 mg pms-Oxybutynin 02223376 PMS 0.1337 Millilitre / millilitre

Tab/Co. Orl 2.5 mg pms-Oxybutynin 02240549 PMS 0.1736 Tablet / comprime

Tab/Co. Orl 5 mg Apo-Oxybutynin 02163543 APX 0.0986 Tablet / comprime

Novo-Oxybutynin 02230394 TEV 0.0986 Tablet / comprime

Oxybutynin 02350238 SAS 0.0986 Tablet / comprime

pms-Oxybutynin 02240550 PMS 0.0986 Tablet / comprime

Oxycodone / Oxycodone Sup/Supp. Rt 10 mg Supeudol 00392480 SDZ 3.8133 Suppository / suppositoire

Tab/Co. Orl 5 mg Oxy-IR 02231934 PFR 0.1419 Tablet / comprime

pms-Oxycodone IR 02319977 PMS 0.1419 Tablet / comprime

Tab/Co. Orl 10 mg Oxy-IR 02240131 PFR 0.2283 Tablet / comprime

Supeudol 00443948 SDZ 0.2283 Tablet / comprime

pms-Oxycodone IR 02319985 PMS 0.2283 Tablet / comprime

Tab/Co. Orl 20 mg Oxy-IR 02240132 PFR 0.3704 Tablet / comprime

Supeudol 02262983 SDZ 0.3704 Tablet / comprime

pms-Oxycodone IR 02319993 PMS 0.3704 Tablet / comprime

Pantoprazole Magnesium / Pantoprazole Magnesien ECT/Co.Ent Orl 40 mg Tecta 02267233 TAK 0.1875 Tablet / comprime

Mylan-Pantoprazole T 02408570 MYL 0.1875 Tablet / comprime

Pantoprazole Magnesium 02441853 ATS 0.1875 Tablet / comprime

Pantoprazole T 02466147 SAS 0.1875 Tablet / comprime

Teva-Pantoprazole Magnesium 02440628 TEV 0.1875 Tablet / comprime

Pantoprazole Sodium / Pantoprazole Sodique ECT/Co.Ent Orl 20 mg Pantoloc 02241804 TAK 0.1803 Tablet / comprime

Apo-Pantoprazole 02292912 APX 0.1803 Tablet / comprime

Jamp-Pantoprazole 02408414 JPC 0.1803 Tablet / comprime

Pantoprazole-20 02428172 SIV 0.1803 Tablet / comprime

Sandoz Pantoprazole 02301075 SDZ 0.1803 Tablet / comprime

Teva-Pantoprazole 02285479 TEV 0.1803 Tablet / comprime

ECT/Co.Ent Orl 40 mg Pantoloc 02229453 TAK 0.2016 Tablet / comprime

Apo-Pantoprazole 02292920 APX 0.2016 Tablet / comprime

Auro-Pantoprazole 02415208 ARO 0.2016 Tablet / comprime

Jamp-Pantoprazole 02357054 JPC 0.2016 Tablet / comprime

M-Pantoprazole 02467372 MRA 0.2016 Tablet / comprime

Mar-Pantoprazole 02416565 MAR 0.2016 Tablet / comprime

Mint-Pantoprazole 02417448 MNT 0.2016 Tablet / comprime

NRA-Pantoprazole 02471825 NRA 0.2016 Tablet / comprime

Pantoprazole 02370808 SAS 0.2016 Tablet / comprime

Pantoprazole 02437945 PMS 0.2016 Tablet / comprime

Pantoprazole 02318695 PDL 0.2016 Tablet / comprime

Pantoprazole-40 02428180 SIV 0.2016 Tablet / comprime

Ran-Pantoprazole 02305046 RAN 0.2016 Tablet / comprime

Sandoz Pantoprazole 02301083 SDZ 0.2016 Tablet / comprime

Teva-Pantoprazole 02285487 TEV 0.2016 Tablet / comprime

pms-Pantoprazole 02307871 PMS 0.2016 Tablet / comprime

Paracetamol (Acetaminophen) / Paracetamol (Acetaminophene) Sup/Supp. Rt 120 mg Acet - 120 02230434 PDP 0.5528 Suppository / suppositoire

Tab/Co. Orl 325 mg Acetaminophen 02252805 CCM 0.0121 Tablet / comprime

Novo-Gesic 00389218 TEV 0.0121 Tablet / comprime

Tab/Co. Orl 500 mg Acetaminophen 02252813 CCM 0.0143 Tablet / comprime

Novo-Gesic 00482323 TEV 0.0143 Tablet / comprime

Paroxetine / Paroxetine Tab/Co. Orl 10 mg Paxil 02027887 GSK 0.3046 Tablet / comprime

Apo-Paroxetine 02240907 APX 0.3046 Tablet / comprime

Auro-Paroxetine 02383276 ARO 0.3046 Tablet / comprime

Jamp-Paroxetine 02368862 JPC 0.3046 Tablet / comprime

Mar-Paroxetine 02411946 MAR 0.3046 Tablet / comprime

September / septembre 2020 Page 43

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Mint-Paroxetine 02421372 MNT 0.3046 Tablet / comprime

NRA-Paroxetine 02479753 NRA 0.3046 Tablet / comprime

Paroxetine 02388227 SIV 0.3046 Tablet / comprime

Teva-Paroxetine 02248556 TEV 0.3046 Tablet / comprime

pms-Paroxetine 02247750 PMS 0.3046 Tablet / comprime

Tab/Co. Orl 20 mg Paxil 01940481 GSK 0.3250 Tablet / comprime

Act Paroxetine 02262754 TEV 0.3250 Tablet / comprime

Apo-Paroxetine 02240908 APX 0.3250 Tablet / comprime

Auro-Paroxetine 02383284 ARO 0.3250 Tablet / comprime

Jamp-Paroxetine 02368870 JPC 0.3250 Tablet / comprime

Mar-Paroxetine 02411954 MAR 0.3250 Tablet / comprime

Mint-Paroxetine 02421380 MNT 0.3250 Tablet / comprime

NRA-Paroxetine 02479761 NRA 0.3250 Tablet / comprime

Paroxetine 02282852 SAS 0.3250 Tablet / comprime

Paroxetine 02388235 SIV 0.3250 Tablet / comprime

Paroxetine 02248914 PDL 0.3250 Tablet / comprime

Teva-Paroxetine 02248557 TEV 0.3250 Tablet / comprime

pms-Paroxetine 02247751 PMS 0.3250 Tablet / comprime

Tab/Co. Orl 30 mg Paxil 01940473 GSK 0.3453 Tablet / comprime

Apo-Paroxetine 02240909 APX 0.3453 Tablet / comprime

Auro-Paroxetine 02383292 ARO 0.3453 Tablet / comprime

Jamp-Paroxetine 02368889 JPC 0.3453 Tablet / comprime

Mar-Paroxetine 02411962 MAR 0.3453 Tablet / comprime

Mint-Paroxetine 02421399 MNT 0.3453 Tablet / comprime

NRA-Paroxetine 02479788 NRA 0.3453 Tablet / comprime

Paroxetine 02282860 SAS 0.3453 Tablet / comprime

Paroxetine 02388243 SIV 0.3453 Tablet / comprime

Paroxetine 02248915 PDL 0.3453 Tablet / comprime

Teva-Paroxetine 02248558 TEV 0.3453 Tablet / comprime

pms-Paroxetine 02247752 PMS 0.3453 Tablet / comprime

Pentoxifylline / Pentoxifylline SRT/Co.L.L. Orl 400 mg Pentoxifylline SR 02230090 AAP 0.8042 Tablet / comprime

Perindopril / Indapamide / Perindopril / Indapamide Tab/Co. Orl 4 mg / 1.25 mg Coversyl Plus 02246569 SEV 0.5113 Tablet / comprime

Sandoz Perindopril / Indapamide 02470438 SDZ 0.5113 Tablet / comprime

Teva-Perindopril / Indapamide 02464020 TEV 0.5113 Tablet / comprime

Tab/Co. Orl 8 mg / 2.5 mg Coversyl Plus HD 02321653 SEV 0.5718 Tablet / comprime

Sandoz Perindopril / Indapamide 02470446 SDZ 0.5718 Tablet / comprime

Teva-Perindopril / Indapamide 02464039 TEV 0.5718 Tablet / comprime

Perindopril / Perindopril Tab/Co. Orl 2 mg Coversyl 02123274 SEV 0.1632 Tablet / comprime

Apo-Perindopril 02289261 APX 0.1632 Tablet / comprime

Auro-Perindopril 02459817 ARO 0.1632 Tablet / comprime

Jamp-Perindopril 02477009 JPC 0.1632 Tablet / comprime

Mar-Perindopril 02474824 MAR 0.1632 Tablet / comprime

Mint-Perindopril 02476762 MNT 0.1632 Tablet / comprime

NRA-Perindopril 02489015 NRA 0.1632 Tablet / comprime

Perindopril Erbumine 02481634 SAS 0.1632 Tablet / comprime

Perindopril Erbumine 02479877 SIV 0.1632 Tablet / comprime

Sandoz Perindopril 02470225 SDZ 0.1632 Tablet / comprime

Teva-Perindopril 02464985 TEV 0.1632 Tablet / comprime

pms-Perindopril 02470675 PMS 0.1632 Tablet / comprime

Tab/Co. Orl 4 mg Coversyl 02123282 SEV 0.2042 Tablet / comprime

Apo-Perindopril 02289288 APX 0.2042 Tablet / comprime

Auro-Perindopril 02459825 ARO 0.2042 Tablet / comprime

Jamp-Perindopril 02477017 JPC 0.2042 Tablet / comprime

Mar-Perindopril 02474832 MAR 0.2042 Tablet / comprime

Mint-Perindopril 02476770 MNT 0.2042 Tablet / comprime

NRA-Perindopril 02489023 NRA 0.2042 Tablet / comprime

Perindopril Erbumine 02479885 SIV 0.2042 Tablet / comprime

Perindopril Erbumine 02481642 SAS 0.2042 Tablet / comprime

Sandoz Perindopril 02470233 SDZ 0.2042 Tablet / comprime

Teva-Perindopril 02464993 TEV 0.2042 Tablet / comprime

pms-Perindopril 02470683 PMS 0.2042 Tablet / comprime

Tab/Co. Orl 8 mg Coversyl 02246624 SEV 0.2831 Tablet / comprime

Apo-Perindopril 02289296 APX 0.2831 Tablet / comprime

Auro-Perindopril 02459833 ARO 0.2831 Tablet / comprime

Jamp-Perindopril 02477025 JPC 0.2831 Tablet / comprime

Mar-Perindopril 02474840 MAR 0.2831 Tablet / comprime

Mint-Perindopril 02476789 MNT 0.2831 Tablet / comprime

NRA-Perindopril 02489031 NRA 0.2831 Tablet / comprime

Perindopril Erbumine 02481650 SAS 0.2831 Tablet / comprime

Perindopril Erbumine 02479893 SIV 0.2831 Tablet / comprime

Sandoz Perindopril 02470241 SDZ 0.2831 Tablet / comprime

Teva-Perindopril 02465000 TEV 0.2831 Tablet / comprime

pms-Perindopril 02470691 PMS 0.2831 Tablet / comprime

Perphenazine / Perphenazine Tab/Co. Orl 2 mg Perphenazine 00335134 AAP 0.0639 Tablet / comprime

September / septembre 2020 Page 44

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Tab/Co. Orl 4 mg Perphenazine 00335126 AAP 0.0773 Tablet / comprime

Tab/Co. Orl 8 mg Perphenazine 00335118 AAP 0.0849 Tablet / comprime

Tab/Co. Orl 16 mg Perphenazine 00335096 AAP 0.1300 Tablet / comprime

Phenobarbital / Phenobarbital Elx/Elx Orl 5 mg/mL Phenobarbital 00645575 PDP 0.1424 Millilitre / millilitre

Liq/Liq Inj 30 mg/mL Phenobarbital Sodium 02304082 SDZ 14.0990 Millilitre / millilitre

Liq/Liq Inj 120 mg/mL Phenobarbital Sodium 02304090 SDZ 14.2730 Millilitre / millilitre

Tab/Co. Orl 15 mg Phenobarbital 00178799 PDP 0.1394 Tablet / comprime

Tab/Co. Orl 30 mg Phenobarbital 00178802 PDP 0.1580 Tablet / comprime

Tab/Co. Orl 60 mg Phenobarbital 00178810 PDP 0.2249 Tablet / comprime

Tab/Co. Orl 100 mg Phenobarbital 00178829 PDP 0.3078 Tablet / comprime

Phenoxymethylpenicillin (Penicillin V) /

Phenoxymethylpenicilline (Penicilline V)

Tab/Co. Orl 300 mg Pen VK 00642215 AAP 0.1873 Tablet / comprime

Phenytoin / Phenytoine Cap/Caps Orl 100 mg Dilantin 00022780 UJC 0.0665 Capsule / capsule

Apo-Phenytoin Sodium 02460912 APX 0.0665 Capsule / capsule

Liq/Liq Inj 50 mg/mL Phenytoin Sodium 00780626 SDZ 6.0783 Millilitre / millilitre

Sus/Susp Orl 125 mg/5 mL Dilantin 125 00023450 UJC 0.0428 Millilitre / millilitre

Taro-Phenytoin 02250896 TAR 0.0428 Millilitre / millilitre

Phytomenadione / Phytomenadione Liq/Liq IM 1 mg/0.5 mL Vitamin K 00781878 SDZ 10.3800 Millilitre / millilitre

Liq/Liq IM 10 mg/mL Vitamin K 00804312 SDZ 5.8800 Millilitre / millilitre

Pilocarpine / Pilocarpine Dps/Gttes Oph 2% Isopto Carpine 00000868 NVR 0.2840 Millilitre / millilitre

Dps/Gttes Oph 4% Isopto Carpine 00000884 NVR 0.3240 Millilitre / millilitre

Tab/Co. Orl 5 mg Salagen 02216345 MTP 1.4727 Tablet / comprime

Accel-Pilocarpine 02496119 ACC 1.2445 Tablet / comprime

Pimozide / Pimozide Tab/Co. Orl 2 mg Orap 00313815 AAP 0.3093 Tablet / comprime

Pimozide 02245432 AAP 0.3093 Tablet / comprime

Tab/Co. Orl 4 mg Orap 00313823 AAP 0.4136 Tablet / comprime

Pimozide 02245433 AAP 0.4136 Tablet / comprime

Pinaverium / Pinaverium Tab/Co. Orl 50 mg Dicetel 01950592 ABB 0.3066 Tablet / comprime

Apo-Pinaverium 02469677 APX 0.3066 Tablet / comprime

Tab/Co. Orl 100 mg Dicetel 02230684 ABB 0.5346 Tablet / comprime

Apo-Pinaverium 02469685 APX 0.5346 Tablet / comprime

Pindolol / Pindolol Tab/Co. Orl 5 mg Visken 00417270 ARZ 0.1361 Tablet / comprime

Apo-Pindol 00755877 APX 0.1361 Tablet / comprime

Teva-Pindolol 00869007 TEV 0.1361 Tablet / comprime

Tab/Co. Orl 10 mg Visken 00443174 ARZ 0.2323 Tablet / comprime

Apo-Pindol 00755885 APX 0.2323 Tablet / comprime

Teva-Pindolol 00869015 TEV 0.2323 Tablet / comprime

Tab/Co. Orl 15 mg Apo-Pindol 00755893 APX 0.8894 Tablet / comprime

Teva-Pindolol 00869023 TEV 0.8894 Tablet / comprime

Pioglitazone / Pioglitazone Tab/Co. Orl 15 mg Accel Pioglitazone 02303442 ACC 0.5809 Tablet / comprime

Ach-Pioglitazone 02391600 AHI 0.5809 Tablet / comprime

Act Pioglitazone 02302861 TEV 0.5809 Tablet / comprime

Apo-Pioglitazone 02302942 APX 0.5809 Tablet / comprime

Jamp-Pioglitazone 02397307 JPC 0.5809 Tablet / comprime

Mint-Pioglitazone 02326477 MNT 0.5809 Tablet / comprime

Ran-Pioglitazone 02375850 RAN 0.5809 Tablet / comprime

Sandoz Pioglitazone 02297906 SDZ 0.5809 Tablet / comprime

pms-Pioglitazone 02303124 PMS 0.5809 Tablet / comprime

Tab/Co. Orl 30 mg Accel Pioglitazone 02303450 ACC 0.8139 Tablet / comprime

Ach-Pioglitazone 02339587 AHI 0.8139 Tablet / comprime

Act Pioglitazone 02302888 TEV 0.8139 Tablet / comprime

Apo-Pioglitazone 02302950 APX 0.8139 Tablet / comprime

Jamp-Pioglitazone 02365529 JPC 0.8139 Tablet / comprime

Mint-Pioglitazone 02326485 MNT 0.8139 Tablet / comprime

Ran-Pioglitazone 02375869 RAN 0.8139 Tablet / comprime

Sandoz Pioglitazone 02297914 SDZ 0.8139 Tablet / comprime

pms-Pioglitazone 02303132 PMS 0.8139 Tablet / comprime

Tab/Co. Orl 45 mg Accel Pioglitazone 02303469 ACC 1.2237 Tablet / comprime

Ach-Pioglitazone 02339595 AHI 1.2237 Tablet / comprime

Act Pioglitazone 02302896 TEV 1.2237 Tablet / comprime

Apo-Pioglitazone 02302977 APX 1.2237 Tablet / comprime

Jamp-Pioglitazone 02365537 JPC 1.2237 Tablet / comprime

Mint-Pioglitazone 02326493 MNT 1.2237 Tablet / comprime

Ran-Pioglitazone 02375877 RAN 1.2237 Tablet / comprime

Sandoz Pioglitazone 02297922 SDZ 1.2237 Tablet / comprime

pms-Pioglitazone 02303140 PMS 1.2237 Tablet / comprime

Piperacillin / Tazobactam / Piperacilline / Tazobactam Pws/Pds. Inj 2 g / 0.25 g Piperacillin & Tazobactam 02308444 APX 4.1720 Vial / fiole

Piperacillin & Tazobactam 02401312 TLG 4.1720 Vial / fiole

Piperacillin & Tazobactam 02299623 SDZ 4.1720 Vial / fiole

Pws/Pds. Inj 3 g / 0.375 g Piperacillin & Tazobactam 02308452 APX 6.2591 Vial / fiole

Piperacillin & Tazobactam 02401320 TLG 6.2591 Vial / fiole

Piperacillin & Tazobactam 02299631 SDZ 6.2591 Vial / fiole

Piperacillin/Tazobactam 02370166 TEV 6.2591 Vial / fiole

Pws/Pds. Inj 4 g / 0.5 g Piperacillin & Tazobactam 02401339 TLG 8.3458 Vial / fiole

September / septembre 2020 Page 45

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Piperacillin & Tazobactam 02299658 SDZ 8.3458 Vial / fiole

Piperacillin & Tazobactam 02308460 APX 8.3458 Vial / fiole

Piperacillin/Tazobactam 02370174 TEV 8.3458 Vial / fiole

Piroxicam / Piroxicam Cap/Caps Orl 10 mg Novo-Pirocam 00695718 TEV 0.2213 Capsule / capsule

Cap/Caps Orl 20 mg Novo-Pirocam 00695696 TEV 0.3711 Capsule / capsule

Polystyrene Sulfonate / Polystyrene Sulfonate Pws/Pds. Orl 100% Kayexalate 02026961 SAV 0.2001 Gram / gramme

Solystat 00755338 PMS 0.2001 Gram / gramme

Sus/Susp Orl 250 mg/mL Solystat 00769541 PDP 0.1566 Millilitre / millilitre

Potassium Chloride / Chlorure De Potassium Liq/Liq Orl 100 mg/mL Jamp-Potassium Chloride 80024835 JPC 0.0390 Millilitre / millilitre

SRC/Caps.L.L. Orl 600 mg Micro-K 02042304 PAL 0.0822 Capsule / capsule

Jamp-Potassium Chloride ER 80062704 JPC 0.0822 Capsule / capsule

SRT/Co.L.L. Orl 600 mg Jamp-K8 80013005 JPC 0.0400 Tablet / comprime

Sandoz K 8 02246734 SDZ 0.0400 Tablet / comprime

SRT/Co.L.L. Orl 1 500 mg Jamp-K20 80013007 JPC 0.1995 Tablet / comprime

Odan K-20 80004415 ODN 0.1995 Tablet / comprime

Sandoz K 20 02242261 SDZ 0.1995 Tablet / comprime

Pramipexole / Pramipexole Tab/Co. Orl 0.25 mg Mirapex 02237145 BOE 0.1950 Tablet / comprime

Act Pramipexole 02297302 TEV 0.1950 Tablet / comprime

Apo-Pramipexole 02292378 APX 0.1950 Tablet / comprime

Auro-Pramipexole 02424061 ARO 0.1950 Tablet / comprime

Pramipexole 02309122 SIV 0.1950 Tablet / comprime

Sandoz Pramipexole 02315262 SDZ 0.1950 Tablet / comprime

Tab/Co. Orl 0.5 mg Act Pramipexole 02297310 TEV 0.4018 Tablet / comprime

Apo-Pramipexole 02292386 APX 0.4018 Tablet / comprime

Auro-Pramipexole 02424088 ARO 0.4018 Tablet / comprime

Pramipexole 02309130 SIV 0.4018 Tablet / comprime

Sandoz Pramipexole 02315270 SDZ 0.4018 Tablet / comprime

Tab/Co. Orl 1 mg Act Pramipexole 02297329 TEV 0.3901 Tablet / comprime

Apo-Pramipexole 02292394 APX 0.3901 Tablet / comprime

Auro-Pramipexole 02424096 ARO 0.3901 Tablet / comprime

Pramipexole 02309149 SIV 0.3901 Tablet / comprime

Sandoz Pramipexole 02315289 SDZ 0.3901 Tablet / comprime

Tab/Co. Orl 1.5 mg Act Pramipexole 02297337 TEV 0.3901 Tablet / comprime

Apo-Pramipexole 02292408 APX 0.3901 Tablet / comprime

Auro-Pramipexole 02424118 ARO 0.3901 Tablet / comprime

Pramipexole 02309157 SIV 0.3901 Tablet / comprime

Sandoz Pramipexole 02315297 SDZ 0.3901 Tablet / comprime

Pravastatin / Pravastatine Tab/Co. Orl 10 mg Ach-Pravastatin 02440644 AHI 0.2916 Tablet / comprime

Apo-Pravastatin 02243506 APX 0.2916 Tablet / comprime

Auro-Pravastatin 02458977 ARO 0.2916 Tablet / comprime

Jamp-Pravastatin 02330954 JPC 0.2916 Tablet / comprime

Mar-Pravastatin 02432048 MAR 0.2916 Tablet / comprime

Mint-Pravastatin 02317451 MNT 0.2916 Tablet / comprime

Pravastatin 02389703 SIV 0.2916 Tablet / comprime

Pravastatin 02356546 SAS 0.2916 Tablet / comprime

Pravastatin-10 02243824 PDL 0.2916 Tablet / comprime

Sandoz Pravastatin 02468700 SDZ 0.2916 Tablet / comprime

Taro-Pravastatin 02284421 SUN 0.2916 Tablet / comprime

Teva-Pravastatin 02247008 TEV 0.2916 Tablet / comprime

pms-Pravastatin 02247655 PMS 0.2916 Tablet / comprime

Tab/Co. Orl 20 mg Pravachol 00893757 BRI 0.3440 Tablet / comprime

Ach-Pravastatin 02440652 AHI 0.3440 Tablet / comprime

Apo-Pravastatin 02243507 APX 0.3440 Tablet / comprime

Auro-Pravastatin 02458985 ARO 0.3440 Tablet / comprime

Jamp-Pravastatin 02330962 JPC 0.3440 Tablet / comprime

Mar-Pravastatin 02432056 MAR 0.3440 Tablet / comprime

Mint-Pravastatin 02317478 MNT 0.3440 Tablet / comprime

Pravastatin 02356554 SAS 0.3440 Tablet / comprime

Pravastatin 02389738 SIV 0.3440 Tablet / comprime

Pravastatin-20 02243825 PDL 0.3440 Tablet / comprime

Sandoz Pravastatin 02468719 SDZ 0.3440 Tablet / comprime

Taro-Pravastatin 02284448 SUN 0.3440 Tablet / comprime

Teva-Pravastatin 02247009 TEV 0.3440 Tablet / comprime

pms-Pravastatin 02247656 PMS 0.3440 Tablet / comprime

Tab/Co. Orl 40 mg Pravachol 02222051 BRI 0.4143 Tablet / comprime

Ach-Pravastatin 02440660 AHI 0.4143 Tablet / comprime

Apo-Pravastatin 02243508 APX 0.4143 Tablet / comprime

Auro-Pravastatin 02458993 ARO 0.4143 Tablet / comprime

Jamp-Pravastatin 02330970 JPC 0.4143 Tablet / comprime

Mar-Pravastatin 02432064 MAR 0.4143 Tablet / comprime

Mint-Pravastatin 02317486 MNT 0.4143 Tablet / comprime

Pravastatin 02356562 SAS 0.4143 Tablet / comprime

Pravastatin 02389746 SIV 0.4143 Tablet / comprime

Pravastatin-40 02243826 PDL 0.4143 Tablet / comprime

September / septembre 2020 Page 46

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Sandoz Pravastatin 02468727 SDZ 0.4143 Tablet / comprime

Taro-Pravastatin 02284456 SUN 0.4143 Tablet / comprime

Teva-Pravastatin 02247010 TEV 0.4143 Tablet / comprime

pms-Pravastatin 02247657 PMS 0.4143 Tablet / comprime

Prazosin / Prazosine Tab/Co. Orl 1 mg Teva-Prazin 01934198 TEV 0.1371 Tablet / comprime

Tab/Co. Orl 2 mg Teva-Prazin 01934201 TEV 0.1862 Tablet / comprime

Tab/Co. Orl 5 mg Teva-Prazin 01934228 TEV 0.2560 Tablet / comprime

Prednisolone / Prednisolone Liq/Liq Orl 5 mg/5 mL Pediapred 02230619 SAV 0.0953 Millilitre / millilitre

pms-Prednisolone 02245532 PMS 0.0953 Millilitre / millilitre

Sus/Susp Oph 1% Pred Forte 00301175 ALL 1.9400 Millilitre / millilitre

Sandoz Prednisolone 01916203 SDZ 1.9400 Millilitre / millilitre

Teva-Prednisolone 00700401 TEV 1.9400 Millilitre / millilitre

Prednisone / Prednisone Tab/Co. Orl 1 mg Winpred 00271373 AAP 0.1072 Tablet / comprime

Tab/Co. Orl 5 mg Apo-Prednisone 00312770 APX 0.0220 Tablet / comprime

Teva-Prednisone 00021695 TEV 0.0220 Tablet / comprime

Tab/Co. Orl 50 mg Apo-Prednisone 00550957 APX 0.1735 Tablet / comprime

Teva-Prednisone 00232378 TEV 0.1735 Tablet / comprime

Pregabalin / Pregabaline Cap/Caps Orl 25 mg Lyrica 02268418 UJC 0.1481 Capsule / capsule

Apo-Pregabalin 02394235 APX 0.1481 Capsule / capsule

Auro-Pregabalin 02433869 ARO 0.1481 Capsule / capsule

Jamp-Pregabalin 02435977 JPC 0.1481 Capsule / capsule

Mint-Pregabalin 02423804 MNT 0.1481 Capsule / capsule

NRA-Pregabalin 02479117 NRA 0.1481 Capsule / capsule

Nat-Pregabalin 02494841 NAT 0.1481 Capsule / capsule

Pregabalin 02405539 SAS 0.1481 Capsule / capsule

Pregabalin 02396483 PDL 0.1481 Capsule / capsule

Pregabalin 02403692 SIV 0.1481 Capsule / capsule

Sandoz Pregabalin 02390817 SDZ 0.1481 Capsule / capsule

Taro-Pregabalin 02392801 SUN 0.1481 Capsule / capsule

Teva-Pregabalin 02361159 TEV 0.1481 Capsule / capsule

pms-Pregabalin 02359596 PMS 0.1481 Capsule / capsule

Cap/Caps Orl 50 mg Lyrica 02268426 UJC 0.2324 Capsule / capsule

Apo-Pregabalin 02394243 APX 0.2324 Capsule / capsule

Auro-Pregabalin 02433877 ARO 0.2324 Capsule / capsule

Jamp-Pregabalin 02435985 JPC 0.2324 Capsule / capsule

Mint-Pregabalin 02423812 MNT 0.2324 Capsule / capsule

NRA-Pregabalin 02479125 NRA 0.2324 Capsule / capsule

Nat-Pregabalin 02494868 NAT 0.2324 Capsule / capsule

Pregabalin 02405547 SAS 0.2324 Capsule / capsule

Pregabalin 02403706 SIV 0.2324 Capsule / capsule

Pregabalin 02396505 PDL 0.2324 Capsule / capsule

Sandoz Pregabalin 02390825 SDZ 0.2324 Capsule / capsule

Taro-Pregabalin 02392828 SUN 0.2324 Capsule / capsule

Teva-Pregabalin 02361175 TEV 0.2324 Capsule / capsule

pms-Pregabalin 02359618 PMS 0.2324 Capsule / capsule

Cap/Caps Orl 75 mg Lyrica 02268434 UJC 0.3007 Capsule / capsule

Apo-Pregabalin 02394251 APX 0.3007 Capsule / capsule

Auro-Pregabalin 02433885 ARO 0.3007 Capsule / capsule

Jamp-Pregabalin 02435993 JPC 0.3007 Capsule / capsule

Mint-Pregabalin 02424185 MNT 0.3007 Capsule / capsule

NRA-Pregabalin 02479133 NRA 0.3007 Capsule / capsule

Nat-Pregabalin 02494876 NAT 0.3007 Capsule / capsule

Pregabalin 02405555 SAS 0.3007 Capsule / capsule

Pregabalin 02396513 PDL 0.3007 Capsule / capsule

Pregabalin 02403714 SIV 0.3007 Capsule / capsule

Sandoz Pregabalin 02390833 SDZ 0.3007 Capsule / capsule

Taro-Pregabalin 02392836 SUN 0.3007 Capsule / capsule

Teva-Pregabalin 02361183 TEV 0.3007 Capsule / capsule

pms-Pregabalin 02359626 PMS 0.3007 Capsule / capsule

Cap/Caps Orl 150 mg Lyrica 02268450 UJC 0.4145 Capsule / capsule

Apo-Pregabalin 02394278 APX 0.4145 Capsule / capsule

Auro-Pregabalin 02433907 ARO 0.4145 Capsule / capsule

Jamp-Pregabalin 02436000 JPC 0.4145 Capsule / capsule

Mint-Pregabalin 02424207 MNT 0.4145 Capsule / capsule

NRA-Pregabalin 02479168 NRA 0.4145 Capsule / capsule

Nat-Pregabalin 02494884 NAT 0.4145 Capsule / capsule

Pregabalin 02396521 PDL 0.4145 Capsule / capsule

Pregabalin 02403722 SIV 0.4145 Capsule / capsule

Pregabalin 02405563 SAS 0.4145 Capsule / capsule

Sandoz Pregabalin 02390841 SDZ 0.4145 Capsule / capsule

Taro-Pregabalin 02392844 SUN 0.4145 Capsule / capsule

Teva-Pregabalin 02361205 TEV 0.4145 Capsule / capsule

pms-Pregabalin 02359634 PMS 0.4145 Capsule / capsule

Cap/Caps Orl 225 mg Lyrica 02268477 UJC 0.5757 Capsule / capsule

September / septembre 2020 Page 47

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Nat-Pregabalin 02494892 NAT 0.5757 Capsule / capsule

Taro-Pregabalin 02392852 SUN 0.5757 Capsule / capsule

Teva-Pregabalin 02361221 TEV 0.5757 Capsule / capsule

pms-Pregabalin 02398079 PMS 0.5757 Capsule / capsule

Cap/Caps Orl 300 mg Lyrica 02268485 UJC 0.4145 Capsule / capsule

Apo-Pregabalin 02394294 APX 0.4145 Capsule / capsule

Jamp-Pregabalin 02436019 JPC 0.4145 Capsule / capsule

Nat-Pregabalin 02494906 NAT 0.4145 Capsule / capsule

Pregabalin 02405598 SAS 0.4145 Capsule / capsule

Pregabalin 02396548 PDL 0.4145 Capsule / capsule

Pregabalin 02403730 SIV 0.4145 Capsule / capsule

Sandoz Pregabalin 02390868 SDZ 0.4145 Capsule / capsule

Taro-Pregabalin 02392860 SUN 0.4145 Capsule / capsule

Teva-Pregabalin 02361248 TEV 0.4145 Capsule / capsule

pms-Pregabalin 02359642 PMS 0.4145 Capsule / capsule

Primidone / Primidone Tab/Co. Orl 125 mg Primidone 00399310 AAP 0.0564 Tablet / comprime

Tab/Co. Orl 250 mg Primidone 00396761 AAP 0.0887 Tablet / comprime

Prochlorperazine / Prochlorperazine Sup/Supp. Rt 10 mg Sandoz Prochlorperazine 00789720 SDZ 1.8200 Suppository / suppositoire

Tab/Co. Orl 5 mg Prochlorazine 00886440 AAP 0.1659 Tablet / comprime

Tab/Co. Orl 10 mg Prochlorazine 00886432 AAP 0.2025 Tablet / comprime

Procyclidine / Procyclidine Elx/Elx Orl 2.5 mg/5 mL pdp-Procyclidine 00587362 PDP 0.2833 Millilitre / millilitre

Tab/Co. Orl 5 mg pdp-Procyclidine 00587354 PDP 0.1448 Tablet / comprime

Propafenone / Propafenone Tab/Co. Orl 150 mg Rythmol 00603708 BGP 0.2965 Tablet / comprime

Apo-Propafenone 02243324 APX 0.2965 Tablet / comprime

Mylan-Propafenone 02457172 MYL 0.2965 Tablet / comprime

Propafenone 02343053 SAS 0.2965 Tablet / comprime

Tab/Co. Orl 300 mg Rythmol 00603716 BGP 0.5227 Tablet / comprime

Apo-Propafenone 02243325 APX 0.5227 Tablet / comprime

Mylan-Propafenone 02457164 MYL 0.5227 Tablet / comprime

Propafenone 02343061 SAS 0.5227 Tablet / comprime

Propranolol / Propranolol Tab/Co. Orl 10 mg Teva-Propranolol 00496480 TEV 0.0631 Tablet / comprime

Tab/Co. Orl 20 mg Teva-Propranolol 00740675 TEV 0.1086 Tablet / comprime

Tab/Co. Orl 40 mg Teva-Propranolol 00496499 TEV 0.1142 Tablet / comprime

Tab/Co. Orl 80 mg Teva-Propranolol 00496502 TEV 0.1805 Tablet / comprime

Propylthiouracil / Propylthiouracile Tab/Co. Orl 50 mg PTU (Temporary Benefit) 09858122 PCI 0.3900 Tablet / comprime

Propyl-Thyracil 00010200 PAL 0.2800 Tablet / comprime

Tab/Co. Orl 100 mg Propyl-Thyracil 00010219 PAL 0.4380 Tablet / comprime

Pyrazinamide / Pyrazinamide Tab/Co. Orl 500 mg pdp-Pyrazinamde 00618810 PMS 1.3163 Tablet / comprime

Quetiapine / Quetiapine ERT/Co.L.P. Orl 50 mg Seroquel XR 02300184 AZE 0.2501 Tablet / comprime

Apo-Quetiapine XR 02457229 APX 0.2501 Tablet / comprime

Quetiapine XR 02417359 SIV 0.2501 Tablet / comprime

Sandoz Quetiapine XR 02407671 SDZ 0.2501 Tablet / comprime

Teva-Quetiapine XR 02395444 TEV 0.2501 Tablet / comprime

ERT/Co.L.P. Orl 150 mg Seroquel XR 02321513 AZE 0.4926 Tablet / comprime

Apo-Quetiapine XR 02457237 APX 0.4926 Tablet / comprime

Quetiapine XR 02417367 SIV 0.4926 Tablet / comprime

Sandoz Quetiapine XR 02407698 SDZ 0.4926 Tablet / comprime

Teva-Quetiapine XR 02395452 TEV 0.4926 Tablet / comprime

ERT/Co.L.P. Orl 200 mg Seroquel XR 02300192 AZE 0.6661 Tablet / comprime

Apo-Quetiapine XR 02457245 APX 0.6661 Tablet / comprime

Quetiapine XR 02417375 SIV 0.6661 Tablet / comprime

Sandoz Quetiapine XR 02407701 SDZ 0.6661 Tablet / comprime

Teva-Quetiapine XR 02395460 TEV 0.6661 Tablet / comprime

ERT/Co.L.P. Orl 300 mg Seroquel XR 02300206 AZE 0.9776 Tablet / comprime

Apo-Quetiapine XR 02457253 APX 0.9776 Tablet / comprime

Quetiapine XR 02417383 SIV 0.9776 Tablet / comprime

Sandoz Quetiapine XR 02407728 SDZ 0.9776 Tablet / comprime

Teva-Quetiapine XR 02395479 TEV 0.9776 Tablet / comprime

ERT/Co.L.P. Orl 400 mg Seroquel XR 02300214 AZE 1.3270 Tablet / comprime

Apo-Quetiapine XR 02457261 APX 1.3270 Tablet / comprime

Quetiapine XR 02417391 SIV 1.3270 Tablet / comprime

Sandoz Quetiapine XR 02407736 SDZ 1.3270 Tablet / comprime

Teva-Quetiapine XR 02395487 TEV 1.3270 Tablet / comprime

Tab/Co. Orl 25 mg Seroquel 02236951 AZE 0.0494 Tablet / comprime

Act Quetiapine 02316080 TEV 0.0494 Tablet / comprime

Apo-Quetiapine 02313901 APX 0.0494 Tablet / comprime

Auro-Quetiapine 02390205 ARO 0.0494 Tablet / comprime

Jamp-Quetiapine 02330415 JPC 0.0494 Tablet / comprime

Mar-Quetiapine 02399822 MAR 0.0494 Tablet / comprime

Mint-Quetiapine 02438003 MNT 0.0494 Tablet / comprime

Nat-Quetiapine 02439158 NAT 0.0494 Tablet / comprime

Pro-Quetiapine 02317346 PDL 0.0494 Tablet / comprime

Quetiapine 02353164 SAS 0.0494 Tablet / comprime

Quetiapine 02387794 AHI 0.0494 Tablet / comprime

September / septembre 2020 Page 48

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Quetiapine 02317893 SIV 0.0494 Tablet / comprime

Ran-Quetiapine 02397099 RAN 0.0494 Tablet / comprime

Sandoz Quetiapine 02313995 SDZ 0.0494 Tablet / comprime

pms-Quetiapine 02296551 PMS 0.0494 Tablet / comprime

Tab/Co. Orl 100 mg Seroquel 02236952 AZE 0.1318 Tablet / comprime

Act Quetiapine 02316099 TEV 0.1318 Tablet / comprime

Apo-Quetiapine 02313928 APX 0.1318 Tablet / comprime

Auro-Quetiapine 02390213 ARO 0.1318 Tablet / comprime

Jamp-Quetiapine 02330423 JPC 0.1318 Tablet / comprime

Mar-Quetiapine 02399830 MAR 0.1318 Tablet / comprime

Mint-Quetiapine 02438011 MNT 0.1318 Tablet / comprime

Nat-Quetiapine 02439166 NAT 0.1318 Tablet / comprime

Pro-Quetiapine 02317354 PDL 0.1318 Tablet / comprime

Quetiapine 02387808 AHI 0.1318 Tablet / comprime

Quetiapine 02317907 SIV 0.1318 Tablet / comprime

Quetiapine 02353172 SAS 0.1318 Tablet / comprime

Ran-Quetiapine 02397102 RAN 0.1318 Tablet / comprime

Sandoz Quetiapine 02314002 SDZ 0.1318 Tablet / comprime

pms-Quetiapine 02296578 PMS 0.1318 Tablet / comprime

Tab/Co. Orl 150 mg Nat-Quetiapine 02439174 NAT 1.0195 Tablet / comprime

Tab/Co. Orl 200 mg Seroquel 02236953 AZE 0.2647 Tablet / comprime

Act Quetiapine 02316110 TEV 0.2647 Tablet / comprime

Apo-Quetiapine 02313936 APX 0.2647 Tablet / comprime

Auro-Quetiapine 02390248 ARO 0.2647 Tablet / comprime

Jamp-Quetiapine 02330458 JPC 0.2647 Tablet / comprime

Mar-Quetiapine 02399849 MAR 0.2647 Tablet / comprime

Mint-Quetiapine 02438046 MNT 0.2647 Tablet / comprime

Nat-Quetiapine 02439182 NAT 0.2647 Tablet / comprime

Pro-Quetiapine 02317362 PDL 0.2647 Tablet / comprime

Quetiapine 02353199 SAS 0.2647 Tablet / comprime

Quetiapine 02387824 AHI 0.2647 Tablet / comprime

Quetiapine 02317923 SIV 0.2647 Tablet / comprime

Ran-Quetiapine 02397110 RAN 0.2647 Tablet / comprime

Sandoz Quetiapine 02314010 SDZ 0.2647 Tablet / comprime

pms-Quetiapine 02296594 PMS 0.2647 Tablet / comprime

Tab/Co. Orl 300 mg Seroquel 02244107 AZE 0.3863 Tablet / comprime

Act Quetiapine 02316129 TEV 0.3863 Tablet / comprime

Apo-Quetiapine 02313944 APX 0.3863 Tablet / comprime

Auro-Quetiapine 02390256 ARO 0.3863 Tablet / comprime

Jamp-Quetiapine 02330466 JPC 0.3863 Tablet / comprime

Mar-Quetiapine 02399857 MAR 0.3863 Tablet / comprime

Mint-Quetiapine 02438054 MNT 0.3863 Tablet / comprime

Nat-Quetiapine 02439190 NAT 0.3863 Tablet / comprime

Pro-Quetiapine 02317370 PDL 0.3863 Tablet / comprime

Quetiapine 02317931 SIV 0.3863 Tablet / comprime

Quetiapine 02353202 SAS 0.3863 Tablet / comprime

Quetiapine 02387832 AHI 0.3863 Tablet / comprime

Ran-Quetiapine 02397129 RAN 0.3863 Tablet / comprime

Sandoz Quetiapine 02314029 SDZ 0.3863 Tablet / comprime

pms-Quetiapine 02296608 PMS 0.3863 Tablet / comprime

Quinapril / Hydrochlorothiazide / Quinapril / Hydrochlorothiazide Tab/Co. Orl 10 mg / 12.5 mg Accuretic 02237367 PFI 0.4786 Tablet / comprime

Apo-Quinapril/HCTZ 02408767 APX 0.4786 Tablet / comprime

Auro-Quinapril HCTZ 02473291 ARO 0.4786 Tablet / comprime

Tab/Co. Orl 20 mg / 12.5 mg Accuretic 02237368 PFI 0.9840 Tablet / comprime

Apo-Quinapril/HCTZ 02408775 APX 0.4786 Tablet / comprime

Auro-Quinapril HCTZ 02473305 ARO 0.4786 Tablet / comprime

Tab/Co. Orl 20 mg / 25 mg Accuretic 02237369 PFI 0.9423 Tablet / comprime

Apo-Quinapril/HCTZ 02408783 APX 0.4602 Tablet / comprime

Auro-Quinapril HCTZ 02473321 ARO 0.4602 Tablet / comprime

Quinapril / Quinapril Tab/Co. Orl 5 mg Accupril 01947664 PFI 0.4642 Tablet / comprime

Apo-Quinapril 02248499 APX 0.4642 Tablet / comprime

pms-Quinapril 02340550 PMS 0.4642 Tablet / comprime

Tab/Co. Orl 10 mg Accupril 01947672 PFI 0.4642 Tablet / comprime

Apo-Quinapril 02248500 APX 0.4642 Tablet / comprime

pms-Quinapril 02340569 PMS 0.4642 Tablet / comprime

Tab/Co. Orl 20 mg Accupril 01947680 PFI 0.4642 Tablet / comprime

Apo-Quinapril 02248501 APX 0.4642 Tablet / comprime

pms-Quinapril 02340577 PMS 0.4642 Tablet / comprime

Tab/Co. Orl 40 mg Accupril 01947699 PFI 0.4642 Tablet / comprime

Apo-Quinapril 02248502 APX 0.4642 Tablet / comprime

pms-Quinapril 02340585 PMS 0.4642 Tablet / comprime

Rabeprazole / Rabeprazole ECT/Co.Ent Orl 10 mg Pariet 02243796 JAN 0.0669 Tablet / comprime

Rabeprazole 02385449 SIV 0.0669 Tablet / comprime

September / septembre 2020 Page 49

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Rabeprazole EC 02356511 SAS 0.0669 Tablet / comprime

Ran-Rabeprazole 02298074 RAN 0.0669 Tablet / comprime

Sandoz Rabeprazole 02314177 SDZ 0.0669 Tablet / comprime

Teva-Rabeprazole EC 02296632 TEV 0.0669 Tablet / comprime

pms-Rabeprazole EC 02310805 PMS 0.0669 Tablet / comprime

ECT/Co.Ent Orl 20 mg Pariet 02243797 JAN 0.1338 Tablet / comprime

Rabeprazole 02385457 SIV 0.1338 Tablet / comprime

Rabeprazole EC 02356538 SAS 0.1338 Tablet / comprime

Ran-Rabeprazole 02298082 RAN 0.1338 Tablet / comprime

Sandoz Rabeprazole 02314185 SDZ 0.1338 Tablet / comprime

Teva-Rabeprazole EC 02296640 TEV 0.1338 Tablet / comprime

pms-Rabeprazole EC 02310813 PMS 0.1338 Tablet / comprime

Raloxifene / Raloxifene Tab/Co. Orl 60 mg Evista 02239028 LIL 0.4583 Tablet / comprime

Act Raloxifene 02358840 TEV 0.4583 Tablet / comprime

Apo-Raloxifene 02279215 APX 0.4583 Tablet / comprime

pms-Raloxifene 02358921 PMS 0.4583 Tablet / comprime

Ramipril / Hydrochlorothiazide / Ramipril / Hydrochlorothiazide Tab/Co. Orl 2.5 mg / 12.5 mg Altace HCT 02283131 SAV 0.1495 Tablet / comprime

Taro-Ramipril HCTZ 02449439 SUN 0.1495 Tablet / comprime

Tab/Co. Orl 5 mg / 12.5 mg Altace HCT 02283158 SAV 0.4266 Tablet / comprime

Taro-Ramipril HCTZ 02449447 SUN 0.2011 Tablet / comprime

Tab/Co. Orl 5 mg / 25 mg Altace HCT 02283174 SAV 0.2872 Tablet / comprime

Taro-Ramipril HCTZ 02449463 SUN 0.2872 Tablet / comprime

Tab/Co. Orl 10 mg / 12.5 mg Altace HCT 02283166 SAV 0.2634 Tablet / comprime

Taro-Ramipril HCTZ 02449455 SUN 0.2634 Tablet / comprime

pms-Ramipril-HCTZ 02342154 PMS 0.2634 Tablet / comprime

Tab/Co. Orl 10 mg / 25 mg Altace HCT 02283182 SAV 0.2634 Tablet / comprime

Taro-Ramipril HCTZ 02449471 SUN 0.2634 Tablet / comprime

pms-Ramipril-HCTZ 02342170 PMS 0.2634 Tablet / comprime

Ramipril / Ramipril Cap/Caps Orl 1.25 mg Altace 02221829 SAV 0.0708 Capsule / capsule

Apo-Ramipril 02251515 APX 0.0708 Capsule / capsule

Auro-Ramipril 02387387 ARO 0.0708 Capsule / capsule

Mar-Ramipril 02420457 MAR 0.0708 Capsule / capsule

Pro-Ramipril 02310023 PDL 0.0708 Capsule / capsule

Ramipril 02308363 SIV 0.0708 Capsule / capsule

Taro-Ramipril 02310503 SUN 0.0708 Capsule / capsule

pharma-Ramipril 02469057 PMS 0.0708 Capsule / capsule

Cap/Caps Orl 2.5 mg Altace 02221837 SAV 0.0817 Capsule / capsule

Apo-Ramipril 02251531 APX 0.0817 Capsule / capsule

Auro-Ramipril 02387395 ARO 0.0817 Capsule / capsule

Jamp-Ramipril 02331128 JPC 0.0817 Capsule / capsule

Mar-Ramipril 02420465 MAR 0.0817 Capsule / capsule

Mint-Ramipril 02421305 MNT 0.0817 Capsule / capsule

NRA-Ramipril 02486172 NRA 0.0817 Capsule / capsule

Pro-Ramipril 02310066 PDL 0.0817 Capsule / capsule

Ramipril 02374846 SAS 0.0817 Capsule / capsule

Ramipril 02287927 SIV 0.0817 Capsule / capsule

Taro-Ramipril 02310511 SUN 0.0817 Capsule / capsule

Teva-Ramipril 02247945 TEV 0.0817 Capsule / capsule

pharma-Ramipril 02469065 PMS 0.0817 Capsule / capsule

pms-Ramipril 02247917 PMS 0.0817 Capsule / capsule

Cap/Caps Orl 5 mg Altace 02221845 SAV 0.0817 Capsule / capsule

Apo-Ramipril 02251574 APX 0.0817 Capsule / capsule

Auro-Ramipril 02387409 ARO 0.0817 Capsule / capsule

Jamp-Ramipril 02331136 JPC 0.0817 Capsule / capsule

Mar-Ramipril 02420473 MAR 0.0817 Capsule / capsule

Mint-Ramipril 02421313 MNT 0.0817 Capsule / capsule

NRA-Ramipril 02486180 NRA 0.0817 Capsule / capsule

Pro-Ramipril 02310074 PDL 0.0817 Capsule / capsule

Ramipril 02287935 SIV 0.0817 Capsule / capsule

Ramipril 02374854 SAS 0.0817 Capsule / capsule

Taro-Ramipril 02310538 SUN 0.0817 Capsule / capsule

Teva-Ramipril 02247946 TEV 0.0817 Capsule / capsule

pharma-Ramipril 02469073 PMS 0.0817 Capsule / capsule

pms-Ramipril 02247918 PMS 0.0817 Capsule / capsule

Cap/Caps Orl 10 mg Altace 02221853 SAV 0.1034 Capsule / capsule

Apo-Ramipril 02251582 APX 0.1034 Capsule / capsule

Auro-Ramipril 02387417 ARO 0.1034 Capsule / capsule

Jamp-Ramipril 02331144 JPC 0.1034 Capsule / capsule

Mar-Ramipril 02420481 MAR 0.1034 Capsule / capsule

Mint-Ramipril 02421321 MNT 0.1034 Capsule / capsule

NRA-Ramipril 02486199 NRA 0.1034 Capsule / capsule

Pro-Ramipril 02310104 PDL 0.1034 Capsule / capsule

Ramipril 02374862 SAS 0.1034 Capsule / capsule

September / septembre 2020 Page 50

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Ramipril 02287943 SIV 0.1034 Capsule / capsule

Taro-Ramipril 02310546 SUN 0.1034 Capsule / capsule

Teva-Ramipril 02247947 TEV 0.1034 Capsule / capsule

pharma-Ramipril 02469081 PMS 0.1034 Capsule / capsule

pms-Ramipril 02247919 PMS 0.1034 Capsule / capsule

Cap/Caps Orl 15 mg Altace 02281112 SAV 0.8550 Capsule / capsule

Apo-Ramipril 02325381 APX 0.8550 Capsule / capsule

Ranitidine / Ranitidine Liq/Liq Orl 15 mg/mL Apo-Ranitidine 02280833 APX 0.1480 Millilitre / millilitre

Teva-Ranidine 02242940 TEV 0.1480 Millilitre / millilitre

Tab/Co. Orl 150 mg Act Ranitidine 02248570 TEV 0.1197 Tablet / comprime

Apo-Ranitidine 00733059 APX 0.1197 Tablet / comprime

Jamp-Ranitidine 02463717 JPC 0.1197 Tablet / comprime

Mar-Ranitidine 02443708 MAR 0.1197 Tablet / comprime

Ran-Ranitidine 02336480 RAN 0.1197 Tablet / comprime

Ranitidine 02353016 SAS 0.1197 Tablet / comprime

Ranitidine 02385953 SIV 0.1197 Tablet / comprime

Sandoz Ranitidine 02243229 SDZ 0.1197 Tablet / comprime

pms-Ranitidine 02242453 PMS 0.1197 Tablet / comprime

Tab/Co. Orl 300 mg Act Ranitidine 02248571 TEV 0.2253 Tablet / comprime

Apo-Ranitidine 00733067 APX 0.2253 Tablet / comprime

Jamp-Ranitidine 02463725 JPC 0.2253 Tablet / comprime

Mar-Ranitidine 02443716 MAR 0.2253 Tablet / comprime

Ran-Ranitidine 02336502 RAN 0.2253 Tablet / comprime

Ranitidine 02385961 SIV 0.2253 Tablet / comprime

Ranitidine 02353024 SAS 0.2253 Tablet / comprime

Sandoz Ranitidine 02243230 SDZ 0.2253 Tablet / comprime

pms-Ranitidine 02242454 PMS 0.2253 Tablet / comprime

Repaglinide / Repaglinide Tab/Co. Orl 0.5 mg Gluconorm 02239924 NNO 0.0808 Tablet / comprime

Act Repaglinide 02321475 TEV 0.0808 Tablet / comprime

Auro-Repaglinide 02424258 ARO 0.0808 Tablet / comprime

Jamp-Repaglinide 02354926 JPC 0.0808 Tablet / comprime

Sandoz Repaglinide 02357453 SDZ 0.0808 Tablet / comprime

Tab/Co. Orl 1 mg Gluconorm 02239925 NNO 0.0840 Tablet / comprime

Act Repaglinide 02321483 TEV 0.0840 Tablet / comprime

Auro-Repaglinide 02424266 ARO 0.0840 Tablet / comprime

Jamp-Repaglinide 02354934 JPC 0.0840 Tablet / comprime

Sandoz Repaglinide 02357461 SDZ 0.0840 Tablet / comprime

Tab/Co. Orl 2 mg Gluconorm 02239926 NNO 0.0873 Tablet / comprime

Act Repaglinide 02321491 TEV 0.0873 Tablet / comprime

Auro-Repaglinide 02424274 ARO 0.0873 Tablet / comprime

Jamp-Repaglinide 02354942 JPC 0.0873 Tablet / comprime

Sandoz Repaglinide 02357488 SDZ 0.0873 Tablet / comprime

Rifampicin / Rifampicine Cap/Caps Orl 150 mg Rofact 00393444 BSL 0.6765 Capsule / capsule

Rifadin 02091887 SAV 0.6765 Capsule / capsule

Cap/Caps Orl 300 mg Rofact 00343617 BSL 1.1753 Capsule / capsule

Rifadin 02092808 SAV 1.0649 Capsule / capsule

Riluzole / Riluzole Tab/Co. Orl 50 mg Rilutek 02242763 SAV 3.4361 Tablet / comprime

Apo-Riluzole 02352583 APX 3.4361 Tablet / comprime

Mylan-Riluzole 02390299 MYL 3.4361 Tablet / comprime

Risedronic Acid / Acide Risedronic Tab/Co. Orl 5 mg Teva-Risedronate 02298376 TEV 1.3661 Tablet / comprime

Tab/Co. Orl 30 mg Teva-Risedronate 02298384 TEV 10.0300 Tablet / comprime

Tab/Co. Orl 35 mg Actonel 02246896 ALL 1.9787 Tablet / comprime

Apo-Risedronate 02353687 APX 1.9787 Tablet / comprime

Auro-Risedronate 02406306 ARO 1.9787 Tablet / comprime

Jamp-Risedronate 02368552 JPC 1.9787 Tablet / comprime

Risedronate 02347474 PDL 1.9787 Tablet / comprime

Risedronate 02411407 SIV 1.9787 Tablet / comprime

Risedronate 02370255 SAS 1.9787 Tablet / comprime

Sandoz Risedronate 02327295 SDZ 1.9787 Tablet / comprime

Teva-Risedronate 02298392 TEV 1.9787 Tablet / comprime

pms-Risedronate 02302209 PMS 1.9787 Tablet / comprime

Risperidone / Risperidone Liq/Liq Orl 1 mg/mL Risperdal 02236950 JAN 0.4662 Millilitre / millilitre

Jamp-Risperidone 02454319 JPC 0.4662 Millilitre / millilitre

pms-Risperidone 02279266 PMS 0.4662 Millilitre / millilitre

ODT/Co.D.O. Orl 0.5 mg Mylan-Risperidone ODT 02413485 MYL 0.5588 Tablet / comprime

ODT/Co.D.O. Orl 1 mg Mylan-Risperidone ODT 02413493 MYL 0.5150 Tablet / comprime

ODT/Co.D.O. Orl 2 mg Mylan-Risperidone ODT 02413507 MYL 1.0187 Tablet / comprime

ODT/Co.D.O. Orl 3 mg Mylan-Risperidone ODT 02413515 MYL 1.5275 Tablet / comprime

ODT/Co.D.O. Orl 4 mg Mylan-Risperidone ODT 02413523 MYL 2.0425 Tablet / comprime

Tab/Co. Orl 0.25 mg Apo-Risperidone 02282119 APX 0.1036 Tablet / comprime

Jamp-Risperidone 02359529 JPC 0.1036 Tablet / comprime

Mar-Risperidone 02371766 MAR 0.1036 Tablet / comprime

Mint-Risperidone 02359790 MNT 0.1036 Tablet / comprime

Ran-Risperidone 02328305 RAN 0.1036 Tablet / comprime

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Risperidone 02356880 SAS 0.1036 Tablet / comprime

Sandoz Risperidone 02303655 SDZ 0.1036 Tablet / comprime

Teva-Risperidone 02282690 TEV 0.1036 Tablet / comprime

pms-Risperidone 02252007 PMS 0.1036 Tablet / comprime

Tab/Co. Orl 0.5 mg Apo-Risperidone 02282127 APX 0.1735 Tablet / comprime

Jamp-Risperidone 02359537 JPC 0.1735 Tablet / comprime

Mar-Risperidone 02371774 MAR 0.1735 Tablet / comprime

Mint-Risperidone 02359804 MNT 0.1735 Tablet / comprime

Ran-Risperidone 02328313 RAN 0.1735 Tablet / comprime

Risperidone 02356899 SAS 0.1735 Tablet / comprime

Sandoz Risperidone 02303663 SDZ 0.1735 Tablet / comprime

pms-Risperidone 02252015 PMS 0.1735 Tablet / comprime

Tab/Co. Orl 1 mg Apo-Risperidone 02282135 APX 0.2397 Tablet / comprime

Jamp-Risperidone 02359545 JPC 0.2397 Tablet / comprime

Mar-Risperidone 02371782 MAR 0.2397 Tablet / comprime

Mint-Risperidone 02359812 MNT 0.2397 Tablet / comprime

Ran-Risperidone 02328321 RAN 0.2397 Tablet / comprime

Risperidone 02356902 SAS 0.2397 Tablet / comprime

Sandoz Risperidone 02279800 SDZ 0.2397 Tablet / comprime

Teva-Risperidone 02264196 TEV 0.2397 Tablet / comprime

pms-Risperidone 02252023 PMS 0.2397 Tablet / comprime

Tab/Co. Orl 2 mg Apo-Risperidone 02282143 APX 0.4795 Tablet / comprime

Jamp-Risperidone 02359553 JPC 0.4795 Tablet / comprime

Mar-Risperidone 02371790 MAR 0.4795 Tablet / comprime

Mint-Risperidone 02359820 MNT 0.4795 Tablet / comprime

Ran-Risperidone 02328348 RAN 0.4795 Tablet / comprime

Risperidone 02356910 SAS 0.4795 Tablet / comprime

Sandoz Risperidone 02279819 SDZ 0.4795 Tablet / comprime

Teva-Risperidone 02264218 TEV 0.4795 Tablet / comprime

pms-Risperidone 02252031 PMS 0.4795 Tablet / comprime

Tab/Co. Orl 3 mg Apo-Risperidone 02282151 APX 0.7180 Tablet / comprime

Jamp-Risperidone 02359561 JPC 0.7180 Tablet / comprime

Mar-Risperidone 02371804 MAR 0.7180 Tablet / comprime

Mint-Risperidone 02359839 MNT 0.7180 Tablet / comprime

Ran-Risperidone 02328364 RAN 0.7180 Tablet / comprime

Risperidone 02356929 SAS 0.7180 Tablet / comprime

Sandoz Risperidone 02279827 SDZ 0.7180 Tablet / comprime

Teva-Risperidone 02264226 TEV 0.7180 Tablet / comprime

pms-Risperidone 02252058 PMS 0.7180 Tablet / comprime

Tab/Co. Orl 4 mg Apo-Risperidone 02282178 APX 0.9574 Tablet / comprime

Jamp-Risperidone 02359588 JPC 0.9574 Tablet / comprime

Mar-Risperidone 02371812 MAR 0.9574 Tablet / comprime

Mint-Risperidone 02359847 MNT 0.9574 Tablet / comprime

Ran-Risperidone 02328372 RAN 0.9574 Tablet / comprime

Risperidone 02356937 SAS 0.9574 Tablet / comprime

Sandoz Risperidone 02279835 SDZ 0.9574 Tablet / comprime

Teva-Risperidone 02264234 TEV 0.9574 Tablet / comprime

pms-Risperidone 02252066 PMS 0.9574 Tablet / comprime

Rivastigmine / Rivastigmine Cap/Caps Orl 1.5 mg Exelon 02242115 NVR 0.6514 Capsule / capsule

Apo-Rivastigmine 02336715 APX 0.6514 Capsule / capsule

Jamp-Rivastigmine 02485362 JPC 0.6514 Capsule / capsule

Med-Rivastigmine 02401614 GMP 0.6514 Capsule / capsule

Sandoz Rivastigmine 02324563 SDZ 0.6514 Capsule / capsule

Cap/Caps Orl 3 mg Exelon 02242116 NVR 0.6514 Capsule / capsule

Apo-Rivastigmine 02336723 APX 0.6514 Capsule / capsule

Jamp-Rivastigmine 02485370 JPC 0.6514 Capsule / capsule

Med-Rivastigmine 02401622 GMP 0.6514 Capsule / capsule

Sandoz Rivastigmine 02324571 SDZ 0.6514 Capsule / capsule

Cap/Caps Orl 4.5 mg Exelon 02242117 NVR 0.6514 Capsule / capsule

Apo-Rivastigmine 02336731 APX 0.6514 Capsule / capsule

Jamp-Rivastigmine 02485389 JPC 0.6514 Capsule / capsule

Med-Rivastigmine 02401630 GMP 0.6514 Capsule / capsule

Sandoz Rivastigmine 02324598 SDZ 0.6514 Capsule / capsule

Cap/Caps Orl 6 mg Exelon 02242118 NVR 0.6514 Capsule / capsule

Apo-Rivastigmine 02336758 APX 0.6514 Capsule / capsule

Jamp-Rivastigmine 02485397 JPC 0.6514 Capsule / capsule

Med-Rivastigmine 02401649 GMP 0.6514 Capsule / capsule

Sandoz Rivastigmine 02324601 SDZ 0.6514 Capsule / capsule

Rizatriptan / Rizatriptan ODT/Co.D.O. Orl 5 mg Maxalt RPD 02240518 FRS 3.7050 Tablet / comprime

CCP-Rizatriptan ODT 02458764 CCM 3.7050 Tablet / comprime

Jamp-Rizatriptan ODT 02465086 JPC 3.7050 Tablet / comprime

Mar-Rizatriptan ODT 02462788 MAR 3.7050 Tablet / comprime

Mylan-Rizatriptan ODT 02379198 MYL 3.7050 Tablet / comprime

Nat-Rizatriptan ODT 02436604 NAT 3.7050 Tablet / comprime

September / septembre 2020 Page 52

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Rizatriptan ODT 02446111 SIV 3.7050 Tablet / comprime

Rizatriptan ODT 02442906 SAS 3.7050 Tablet / comprime

Sandoz Rizatriptan ODT 02351870 SDZ 3.7050 Tablet / comprime

Teva-Rizatriptan ODT 02396661 TEV 3.7050 Tablet / comprime

pms-Rizatriptan RDT 02393360 PMS 3.7050 Tablet / comprime

ODT/Co.D.O. Orl 10 mg Maxalt RPD 02240519 FRS 3.7050 Tablet / comprime

CCP-Rizatriptan ODT 02458772 CCM 3.7050 Tablet / comprime

Jamp-Rizatriptan ODT 02465094 JPC 3.7050 Tablet / comprime

Mar-Rizatriptan ODT 02462796 MAR 3.7050 Tablet / comprime

Mylan-Rizatriptan ODT 02379201 MYL 3.7050 Tablet / comprime

Nat-Rizatriptan ODT 02436612 NAT 3.7050 Tablet / comprime

Rizatriptan ODT 02442914 SAS 3.7050 Tablet / comprime

Rizatriptan ODT 02446138 SIV 3.7050 Tablet / comprime

Sandoz Rizatriptan ODT 02351889 SDZ 3.7050 Tablet / comprime

Teva-Rizatriptan ODT 02396688 TEV 3.7050 Tablet / comprime

pms-Rizatriptan RDT 02393379 PMS 3.7050 Tablet / comprime

Tab/Co. Orl 5 mg Apo-Rizatriptan 02393468 APX 3.7050 Tablet / comprime

Jamp-Rizatriptan 02380455 JPC 3.7050 Tablet / comprime

Jamp-Rizatriptan IR 02429233 JPC 3.7050 Tablet / comprime

Tab/Co. Orl 10 mg Maxalt 02240521 FRS 3.7050 Tablet / comprime

Act Rizatriptan 02381702 TEV 3.7050 Tablet / comprime

Apo-Rizatriptan 02393476 APX 3.7050 Tablet / comprime

Auro-Rizatriptan 02441144 ARO 3.7050 Tablet / comprime

Jamp-Rizatriptan 02380463 JPC 3.7050 Tablet / comprime

Jamp-Rizatriptan IR 02429241 JPC 3.7050 Tablet / comprime

Mar-Rizatriptan 02379678 MAR 3.7050 Tablet / comprime

Ropinirole / Ropinirole Tab/Co. Orl 0.25 mg Act Ropinirole 02316846 TEV 0.0709 Tablet / comprime

Jamp-Ropinirole 02352338 JPC 0.0709 Tablet / comprime

Ran-Ropinirole 02314037 RAN 0.0709 Tablet / comprime

Ropinirole 02353040 SAS 0.0709 Tablet / comprime

Tab/Co. Orl 1 mg Act Ropinirole 02316854 TEV 0.2838 Tablet / comprime

Jamp-Ropinirole 02352346 JPC 0.2838 Tablet / comprime

Ran-Ropinirole 02314053 RAN 0.2838 Tablet / comprime

Ropinirole 02353059 SAS 0.2838 Tablet / comprime

Tab/Co. Orl 2 mg Act Ropinirole 02316862 TEV 0.3122 Tablet / comprime

Jamp-Ropinirole 02352354 JPC 0.3122 Tablet / comprime

Ran-Ropinirole 02314061 RAN 0.3122 Tablet / comprime

Tab/Co. Orl 5 mg Act Ropinirole 02316870 TEV 0.8596 Tablet / comprime

Jamp-Ropinirole 02352362 JPC 0.8596 Tablet / comprime

Ran-Ropinirole 02314088 RAN 0.8596 Tablet / comprime

Rosiglitazone / Rosiglitazone Tab/Co. Orl 2 mg Avandia 02241112 GSK 1.0316 Tablet / comprime

Rosiglitazone 02403366 AAP 1.0316 Tablet / comprime

Tab/Co. Orl 4 mg Avandia 02241113 GSK 1.6188 Tablet / comprime

Rosiglitazone 02403374 AAP 1.6188 Tablet / comprime

Tab/Co. Orl 8 mg Rosiglitazone 02403382 AAP 2.3150 Tablet / comprime

Rosuvastatin / Rosuvastatine Tab/Co. Orl 5 mg Crestor 02265540 AZE 0.1284 Tablet / comprime

ACH-Rosuvastatin 02438917 AHI 0.1284 Tablet / comprime

Apo-Rosuvastatin 02337975 APX 0.1284 Tablet / comprime

Auro-Rosuvastatin 02442574 ARO 0.1284 Tablet / comprime

Jamp-Rosuvastatin 02391252 JPC 0.1284 Tablet / comprime

Ran-Rosuvastatin 02382644 SUN 0.1284 Tablet / comprime

Rosuvastatin 02405628 SAS 0.1284 Tablet / comprime

Rosuvastatin 02411628 SIV 0.1284 Tablet / comprime

Rosuvastatin 02381176 PDL 0.1284 Tablet / comprime

Sandoz Rosuvastatin 02338726 SDZ 0.1284 Tablet / comprime

Teva-Rosuvastatin 02354608 TEV 0.1284 Tablet / comprime

pms-Rosuvastatin 02378523 PMS 0.1284 Tablet / comprime

Tab/Co. Orl 10 mg Crestor 02247162 AZE 0.1354 Tablet / comprime

ACH-Rosuvastatin 02438925 AHI 0.1354 Tablet / comprime

Apo-Rosuvastatin 02337983 APX 0.1354 Tablet / comprime

Auro-Rosuvastatin 02442582 ARO 0.1354 Tablet / comprime

Jamp-Rosuvastatin 02391260 JPC 0.1354 Tablet / comprime

Ran-Rosuvastatin 02382652 SUN 0.1354 Tablet / comprime

Rosuvastatin 02405636 SAS 0.1354 Tablet / comprime

Rosuvastatin 02411636 SIV 0.1354 Tablet / comprime

Rosuvastatin 02381184 PDL 0.1354 Tablet / comprime

Sandoz Rosuvastatin 02338734 SDZ 0.1354 Tablet / comprime

Teva-Rosuvastatin 02354616 TEV 0.1354 Tablet / comprime

pms-Rosuvastatin 02378531 PMS 0.1354 Tablet / comprime

Tab/Co. Orl 20 mg Crestor 02247163 AZE 0.1692 Tablet / comprime

ACH-Rosuvastatin 02438933 AHI 0.1692 Tablet / comprime

Apo-Rosuvastatin 02337991 APX 0.1692 Tablet / comprime

Auro-Rosuvastatin 02442590 ARO 0.1692 Tablet / comprime

Jamp-Rosuvastatin 02391279 JPC 0.1692 Tablet / comprime

September / septembre 2020 Page 53

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Ran-Rosuvastatin 02382660 SUN 0.1692 Tablet / comprime

Rosuvastatin 02411644 SIV 0.1692 Tablet / comprime

Rosuvastatin 02381192 PDL 0.1692 Tablet / comprime

Rosuvastatin 02405644 SAS 0.1692 Tablet / comprime

Sandoz Rosuvastatin 02338742 SDZ 0.1692 Tablet / comprime

Teva-Rosuvastatin 02354624 TEV 0.1692 Tablet / comprime

pms-Rosuvastatin 02378558 PMS 0.1692 Tablet / comprime

Tab/Co. Orl 40 mg Crestor 02247164 AZE 0.1990 Tablet / comprime

ACH-Rosuvastatin 02438941 AHI 0.1990 Tablet / comprime

Apo-Rosuvastatin 02338009 APX 0.1990 Tablet / comprime

Auro-Rosuvastatin 02442604 ARO 0.1990 Tablet / comprime

Jamp-Rosuvastatin 02391287 JPC 0.1990 Tablet / comprime

Ran-Rosuvastatin 02382679 SUN 0.1990 Tablet / comprime

Rosuvastatin 02381206 PDL 0.1990 Tablet / comprime

Rosuvastatin 02411652 SIV 0.1990 Tablet / comprime

Rosuvastatin 02405652 SAS 0.1990 Tablet / comprime

Sandoz Rosuvastatin 02338750 SDZ 0.1990 Tablet / comprime

Teva-Rosuvastatin 02354632 TEV 0.1990 Tablet / comprime

pms-Rosuvastatin 02378566 PMS 0.1990 Tablet / comprime

Salbutamol / Salbutamol Aem/Aem. Inh 100 mcg Airomir 02232570 VLN 0.0250 Dose / dose

Ventolin 02241497 GSK 0.0250 Dose / dose

Apo-Salvent CFC Free 02245669 APX 0.0250 Dose / dose

Novo-Salbutamol HFA 02326450 TEV 0.0250 Dose / dose

Salamol CFC-Free (Temporary Benefit) 09858115 TEV 0.0250 Dose / dose

Salbuhaler (Temporary Benefit) 09858119 SDZ 0.0250 Dose / dose

Salbutamol Aldo-Union (Temporary Benefit) 09858116 JPC 0.0438 Dose / dose

Salbutamol HFA 02419858 SAS 0.0250 Dose / dose

Liq/Liq Inh 1 mg/mL Ventolin Nebules P.F. 02213419 GSK 0.1446 Millilitre / millilitre

Teva-Salbutamol Sterinebs 01926934 TEV 0.1446 Millilitre / millilitre

pms-Salbutamol 02208229 PMS 0.1446 Millilitre / millilitre

Liq/Liq Inh 2 mg/mL Ventolin Nebules P.F. 02213427 GSK 0.2700 Millilitre / millilitre

Teva-Salbutamol Sterinebs 02173360 TEV 0.2700 Millilitre / millilitre

pms-Salbutamol 02208237 PMS 0.2700 Millilitre / millilitre

Salmeterol and Fluticasone / Salmeterol et Fluticasone Pwr/Pd. Inh 50 mcg / 100 mcg Advair Diskus 02240835 GSK 0.7068 Dose / dose

Wixela Inhub 02495597 MYL 0.7068 Dose / dose

pms-Fluticasone Propionate/Salmeterol 02494507 PMS 0.7068 Dose / dose

Pwr/Pd. Inh 50 mcg / 250 mcg Advair Diskus 02240836 GSK 0.8460 Dose / dose

Wixela Inhub 02495600 MYL 0.8460 Dose / dose

pms-Fluticasone Propionate/Salmeterol 02494515 PMS 0.8460 Dose / dose

Pwr/Pd. Inh 50 mcg / 500 mcg Advair Diskus 02240837 GSK 1.2010 Dose / dose

Wixela Inhub 02495619 MYL 1.2010 Dose / dose

pms-Fluticasone Propionate/Salmeterol 02494523 PMS 1.2010 Dose / dose

Scopolamine / Scopolamine Liq/Liq Inj 0.4 mg/mL Scopolamine Hydrobromide 02242810 OMG 5.3000 Millilitre / millilitre

Liq/Liq Inj 20 mg/mL Buscopan 00363839 SAV 4.5200 Millilitre / millilitre

Hyoscine Butylbromide 02229868 SDZ 4.5200 Millilitre / millilitre

Selegiline / Selegiline Tab/Co. Orl 5 mg Apo-Selegiline 02230641 APX 0.5021 Tablet / comprime

Novo-Selegiline 02068087 TEV 0.5021 Tablet / comprime

Sertraline / Sertraline Cap/Caps Orl 25 mg Zoloft 02132702 UJC 0.1516 Capsule / capsule

Apo-Sertraline 02238280 APX 0.1516 Capsule / capsule

Auro-Sertraline 02390906 ARO 0.1516 Capsule / capsule

Jamp-Sertraline 02357143 JPC 0.1516 Capsule / capsule

Mar-Sertraline 02399415 MAR 0.1516 Capsule / capsule

Mint-Sertraline 02402378 MNT 0.1516 Capsule / capsule

Sertraline 02469626 JPC 0.1516 Capsule / capsule

Sertraline 02386070 SIV 0.1516 Capsule / capsule

Sertraline 02353520 SAS 0.1516 Capsule / capsule

Teva-Sertraline 02240485 TEV 0.1516 Capsule / capsule

pms-Sertraline 02244838 PMS 0.1516 Capsule / capsule

Cap/Caps Orl 50 mg Zoloft 01962817 UJC 0.3032 Capsule / capsule

Apo-Sertraline 02238281 APX 0.3032 Capsule / capsule

Auro-Sertraline 02390914 ARO 0.3032 Capsule / capsule

Jamp-Sertraline 02357151 JPC 0.3032 Capsule / capsule

Mar-Sertraline 02399423 MAR 0.3032 Capsule / capsule

Mint-Sertraline 02402394 MNT 0.3032 Capsule / capsule

Sertraline 02353539 SAS 0.3032 Capsule / capsule

Sertraline 02386089 SIV 0.3032 Capsule / capsule

Sertraline 02469634 JPC 0.3032 Capsule / capsule

Teva-Sertraline 02240484 TEV 0.3032 Capsule / capsule

pms-Sertraline 02244839 PMS 0.3032 Capsule / capsule

Cap/Caps Orl 100 mg Zoloft 01962779 UJC 0.3303 Capsule / capsule

Apo-Sertraline 02238282 APX 0.3303 Capsule / capsule

Auro-Sertraline 02390922 ARO 0.3303 Capsule / capsule

Jamp-Sertraline 02357178 JPC 0.3303 Capsule / capsule

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Mar-Sertraline 02399431 MAR 0.3303 Capsule / capsule

Mint-Sertraline 02402408 MNT 0.3303 Capsule / capsule

Sandoz Sertraline 02245161 SDZ 0.3303 Capsule / capsule

Sertraline 02469642 JPC 0.3303 Capsule / capsule

Sertraline 02386097 SIV 0.3303 Capsule / capsule

Sertraline 02353547 SAS 0.3303 Capsule / capsule

Teva-Sertraline 02240481 TEV 0.3303 Capsule / capsule

pms-Sertraline 02244840 PMS 0.3303 Capsule / capsule

Sevelamer / Sevelamer Tab/Co. Orl 800 mg Renagel 02244310 SAV 1.2634 Tablet / comprime

Accel-Sevelamer 02461501 ACC 1.2634 Tablet / comprime

Sildenafil / Sildenafil Tab/Co. Orl 20 mg Revatio 02279401 UJC 5.7765 Tablet / comprime

ratio-Sildenafil R 02319500 TEV 5.7765 Tablet / comprime

Simvastatin / Simvastatine Tab/Co. Orl 5 mg Apo-Simvastatin 02247011 APX 0.1023 Tablet / comprime

Auro-Simvastatin 02405148 ARO 0.1023 Tablet / comprime

Jamp-Simvastatin 02375591 JPC 0.1023 Tablet / comprime

Mint-Simvastatin 02372932 MNT 0.1023 Tablet / comprime

Simvastatin 02386291 SIV 0.1023 Tablet / comprime

Taro-Simvastatin 02329131 SUN 0.1023 Tablet / comprime

Teva-Simvastatin 02250144 TEV 0.1023 Tablet / comprime

pharma-Simvastatin 02469979 PMS 0.1023 Tablet / comprime

Tab/Co. Orl 10 mg Zocor 00884332 FRS 0.2023 Tablet / comprime

Apo-Simvastatin 02247012 APX 0.2023 Tablet / comprime

Auro-Simvastatin 02405156 ARO 0.2023 Tablet / comprime

Jamp-Simvastatin 02375605 JPC 0.2023 Tablet / comprime

Mar-Simvastatin 02375044 MAR 0.2023 Tablet / comprime

Mint-Simvastatin 02372940 MNT 0.2023 Tablet / comprime

Simvastatin 02386305 SIV 0.2023 Tablet / comprime

Simvastatin-10 02247221 PDL 0.2023 Tablet / comprime

Taro-Simvastatin 02329158 SUN 0.2023 Tablet / comprime

Teva-Simvastatin 02250152 TEV 0.2023 Tablet / comprime

pharma-Simvastatin 02469987 PMS 0.2023 Tablet / comprime

Tab/Co. Orl 20 mg Zocor 00884340 FRS 0.2501 Tablet / comprime

Apo-Simvastatin 02247013 APX 0.2501 Tablet / comprime

Auro-Simvastatin 02405164 ARO 0.2501 Tablet / comprime

Jamp-Simvastatin 02375613 JPC 0.2501 Tablet / comprime

Mar-Simvastatin 02375052 MAR 0.2501 Tablet / comprime

Mint-Simvastatin 02372959 MNT 0.2501 Tablet / comprime

Simvastatin 02386313 SIV 0.2501 Tablet / comprime

Simvastatin-20 02247222 PDL 0.2501 Tablet / comprime

Taro-Simvastatin 02329166 SUN 0.2501 Tablet / comprime

Teva-Simvastatin 02250160 TEV 0.2501 Tablet / comprime

pharma-Simvastatin 02469995 PMS 0.2501 Tablet / comprime

Tab/Co. Orl 40 mg Zocor 00884359 FRS 0.2501 Tablet / comprime

Apo-Simvastatin 02247014 APX 0.2501 Tablet / comprime

Auro-Simvastatin 02405172 ARO 0.2501 Tablet / comprime

Jamp-Simvastatin 02375621 JPC 0.2501 Tablet / comprime

Mar-Simvastatin 02375060 MAR 0.2501 Tablet / comprime

Mint-Simvastatin 02372967 MNT 0.2501 Tablet / comprime

Simvastatin 02386321 SIV 0.2501 Tablet / comprime

Simvastatin-40 02247223 PDL 0.2501 Tablet / comprime

Taro-Simvastatin 02329174 SUN 0.2501 Tablet / comprime

Teva-Simvastatin 02250179 TEV 0.2501 Tablet / comprime

pharma-Simvastatin 02470004 PMS 0.2501 Tablet / comprime

Tab/Co. Orl 80 mg Apo-Simvastatin 02247015 APX 0.2501 Tablet / comprime

Auro-Simvastatin 02405180 ARO 0.2501 Tablet / comprime

Jamp-Simvastatin 02375648 JPC 0.2501 Tablet / comprime

Mint-Simvastatin 02372975 MNT 0.2501 Tablet / comprime

Simvastatin 02386348 SIV 0.2501 Tablet / comprime

Simvastatin-80 02247224 PDL 0.2501 Tablet / comprime

Taro-Simvastatin 02329182 SUN 0.2501 Tablet / comprime

Teva-Simvastatin 02250187 TEV 0.2501 Tablet / comprime

pharma-Simvastatin 02470012 PMS 0.2501 Tablet / comprime

Sodium Acid Phosphate / Sodium Bicarbonate / Potassium /

Phosphate Acide De Sodium / Bicarbonate De Sodium /

Potassium

Evt/Co.Eff. Orl 500 mg / 469 mg / 123

mg

Jamp-Sodium Phosphate 80047562 JPC 1.4010 Tablet / comprime

Sodium Bicarbonate / Bicarbonate De Sodium Tab/Co. Orl 500 mg Jamp-Sodium Bicarbonate 80030520 JPC 0.0684 Tablet / comprime

Sandoz Sodium Bicarbonate 80022194 SDZ 0.0684 Tablet / comprime

Sodium Chloride, Hypertonic / Chlorure De Sodium,

Hypertonique

Dps/Gttes Oph 5% Muro 128 00750824 BSH 0.6880 Millilitre / millilitre

Odan-Sodium Chloride 80046737 ODN 0.5570 Millilitre / millilitre

Ont/Ont Oph 5% Muro 128 00750816 BSH 2.8086 Gram / gramme

Odan-Sodium Chloride 80046696 ODN 2.3874 Gram / gramme

Solifenacin / Solifenacine Tab/Co. Orl 5 mg Vesicare 02277263 ASL 0.3041 Tablet / comprime

Auro-Solifenacin 02446375 ARO 0.3041 Tablet / comprime

Jamp-Solifenacin 02424339 JPC 0.3041 Tablet / comprime

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Sandoz Solifenacin 02399032 SDZ 0.3041 Tablet / comprime

Solifenacin 02458241 SAS 0.3041 Tablet / comprime

Taro-Solifenacin 02437988 SUN 0.3041 Tablet / comprime

Teva-Solifenacin 02397900 TEV 0.3041 Tablet / comprime

pms-Solifenacin 02417723 PMS 0.3041 Tablet / comprime

Tab/Co. Orl 10 mg Vesicare 02277271 ASL 0.3041 Tablet / comprime

Auro-Solifenacin 02446383 ARO 0.3041 Tablet / comprime

Jamp-Solifenacin 02424347 JPC 0.3041 Tablet / comprime

Sandoz Solifenacin 02399040 SDZ 0.3041 Tablet / comprime

Solifenacin 02458268 SAS 0.3041 Tablet / comprime

Taro-Solifenacin 02437996 SUN 0.3041 Tablet / comprime

Teva-Solifenacin 02397919 TEV 0.3041 Tablet / comprime

pms-Solifenacin 02417731 PMS 0.3041 Tablet / comprime

Sotalol / Sotalol Tab/Co. Orl 80 mg Apo-Sotalol 02210428 APX 0.2966 Tablet / comprime

Jamp-Sotalol 02368617 JPC 0.2966 Tablet / comprime

Sotalol 02385988 SIV 0.2966 Tablet / comprime

pms-Sotalol 02238326 PMS 0.2966 Tablet / comprime

Tab/Co. Orl 160 mg Apo-Sotalol 02167794 APX 0.1623 Tablet / comprime

Jamp-Sotalol 02368625 JPC 0.1623 Tablet / comprime

Sotalol 02385996 SIV 0.1623 Tablet / comprime

pms-Sotalol 02238327 PMS 0.1623 Tablet / comprime

Spironolactone / Spironolactone Tab/Co. Orl 25 mg Aldactone 00028606 PFI 0.0810 Tablet / comprime

Mint-Spironolactone 02488140 MNT 0.0810 Tablet / comprime

Teva-Spironolactone 00613215 TEV 0.0810 Tablet / comprime

Tab/Co. Orl 100 mg Aldactone 00285455 PFI 0.1910 Tablet / comprime

Mint-Spironolactone 02488159 MNT 0.1910 Tablet / comprime

Teva-Spiroton 00613223 TEV 0.1910 Tablet / comprime

Sucralfate / Sucralfate Tab/Co. Orl 1 g Sulcrate 02100622 AXC 0.3089 Tablet / comprime

Apo-Sulcralfate 02125250 APX 0.3089 Tablet / comprime

Teva-Sulcralfate 02045702 TEV 0.3089 Tablet / comprime

Sulfamethoxasole and Trimethoprim / Sulfamethoxasole et

Trimethoprime

Sus/Susp Orl 40 mg / 8 mg Teva-Trimel 00726540 TEV 0.1026 Millilitre / millilitre

Tab/Co. Orl 100 mg / 20 mg Sulfatrim 00445266 AAP 0.0911 Tablet / comprime

Tab/Co. Orl 400 mg / 80 mg Sulfatrim 00445274 AAP 0.0482 Tablet / comprime

Teva-Trimel 00510637 TEV 0.0482 Tablet / comprime

Tab/Co. Orl 800 mg / 160 mg Sulfatrim DS 00445282 AAP 0.2074 Tablet / comprime

Sulfasalazine / Sulfasalazine ECT/Co.Ent Orl 500 mg Salazopyrin EN 02064472 PFI 0.3641 Tablet / comprime

pms-Sulfasalazine EC 00598488 PMS 0.3641 Tablet / comprime

Tab/Co. Orl 500 mg Salazopyrin 02064480 PFI 0.2392 Tablet / comprime

pms-Sulfasalazine 00598461 PMS 0.2392 Tablet / comprime

Sulfinpyrazone / Sulfinpyrazone Tab/Co. Orl 200 mg Sulfinpyrazone 00441767 AAP 0.3057 Tablet / comprime

Sulindac / Sulindac Tab/Co. Orl 150 mg Teva-Sundac 00745588 TEV 0.4216 Tablet / comprime

Tab/Co. Orl 200 mg Teva-Sundac 00745596 TEV 0.4765 Tablet / comprime

Sumatriptan / Sumatriptan Liq/Liq SC 6 mg/0.5 mL Imitrex 02212188 GSK 66.3500 Millilitre / millilitre

Taro-Sumatriptan 02361698 TAR 66.3500 Millilitre / millilitre

Tab/Co. Orl 50 mg Imitrex DF 02212153 GSK 2.7732 Tablet / comprime

Apo-Sumatriptan 02268388 APX 2.7732 Tablet / comprime

Mylan-Sumatriptan 02268914 MYL 2.7732 Tablet / comprime

Sandoz Sumatriptan 02263025 SDZ 2.7732 Tablet / comprime

Sumatriptan 02286521 SAS 2.7732 Tablet / comprime

Sumatriptan DF 02385570 SIV 2.7732 Tablet / comprime

Teva-Sumatriptan DF 02286823 TEV 2.7732 Tablet / comprime

pms-Sumatriptan 02256436 PMS 2.7732 Tablet / comprime

Tab/Co. Orl 100 mg Imitrex DF 02212161 GSK 3.0549 Tablet / comprime

Apo-Sumatriptan 02268396 APX 3.0549 Tablet / comprime

Mylan-Sumatriptan 02268922 MYL 3.0549 Tablet / comprime

Sandoz Sumatriptan 02263033 SDZ 3.0549 Tablet / comprime

Sumatriptan 02286548 SAS 3.0549 Tablet / comprime

Sumatriptan DF 02385589 SIV 3.0549 Tablet / comprime

Teva-Sumatriptan 02239367 TEV 3.0549 Tablet / comprime

Teva-Sumatriptan DF 02286831 TEV 3.0549 Tablet / comprime

pms-Sumatriptan 02256444 PMS 3.0549 Tablet / comprime

Tacrolimus / Tacrolimus Cap/Caps Orl 0.5 mg Prograf 02243144 ASL 1.4775 Capsule / capsule

Sandoz Tacrolimus 02416816 SDZ 1.4775 Capsule / capsule

Cap/Caps Orl 1 mg Prograf 02175991 ASL 1.8900 Capsule / capsule

Sandoz Tacrolimus 02416824 SDZ 1.8900 Capsule / capsule

Cap/Caps Orl 5 mg Prograf 02175983 ASL 9.4650 Capsule / capsule

Sandoz Tacrolimus 02416832 SDZ 9.4650 Capsule / capsule

Tamoxifen / Tamoxifene Tab/Co. Orl 10 mg Apo-Tamox 00812404 APX 0.1750 Tablet / comprime

Teva-Tamoxifen 00851965 TEV 0.1750 Tablet / comprime

Tab/Co. Orl 20 mg Nolvadex-d 02048485 AZE 0.3500 Tablet / comprime

Apo-Tamox 00812390 APX 0.3500 Tablet / comprime

Teva-Tamoxifen 00851973 TEV 0.3500 Tablet / comprime

Tamsulosin / Tamsulosine ERT/Co.L.P. Orl 0.4 mg Flomax CR 02270102 BOE 0.1500 Tablet / comprime

September / septembre 2020 Page 56

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Apo-Tamsulosin CR 02362406 APX 0.1500 Tablet / comprime

Sandoz Tamsulosin CR 02340208 SDZ 0.1500 Tablet / comprime

Tamsulosin CR 02427117 SAS 0.1500 Tablet / comprime

Tamsulosin CR 02429667 SIV 0.1500 Tablet / comprime

Teva-Tamsulosin CR 02368242 TEV 0.1500 Tablet / comprime

SRC/Caps.L.L. Orl 0.4 mg Sandoz Tamsulosin 02319217 SDZ 0.1500 Capsule / capsule

Tars / Goudrons Liq/Liq Top 20% Odans LCD 00358495 ODN 0.0890 Millilitre / millilitre

Telmisartan / Hydrochlorothiazide / Telmisartan /

Hydrochlorothiazide

Tab/Co. Orl 80 mg / 12.5 mg Micardis Plus 02244344 BOE 0.2098 Tablet / comprime

ACH-Telmisartan HCTZ 02419114 AHI 0.2098 Tablet / comprime

Auro-Telmisartan HCTZ 02456389 ARO 0.2098 Tablet / comprime

Sandoz Telmisartan HCT 02393557 SDZ 0.2098 Tablet / comprime

Telmisartan HCTZ 02390302 SIV 0.2098 Tablet / comprime

Telmisartan/HCTZ 02395355 SAS 0.2098 Tablet / comprime

Teva-Telmisartan HCTZ 02330288 TEV 0.2098 Tablet / comprime

Tab/Co. Orl 80 mg / 25 mg Micardis Plus 02318709 BOE 0.2098 Tablet / comprime

ACH-Telmisartan HCTZ 02419122 AHI 0.2098 Tablet / comprime

Auro-Telmisartan HCTZ 02456397 ARO 0.2098 Tablet / comprime

Sandoz Telmisartan HCT 02393565 SDZ 0.2098 Tablet / comprime

Telmisartan HCTZ 02390310 SIV 0.2098 Tablet / comprime

Telmisartan/HCTZ 02395363 SAS 0.2098 Tablet / comprime

Teva-Telmisartan HCTZ 02379252 TEV 0.2098 Tablet / comprime

Telmisartan / Telmisartan Tab/Co. Orl 40 mg Micardis 02240769 BOE 0.2161 Tablet / comprime

Auro-Telmisartan 02453568 ARO 0.2161 Tablet / comprime

Mint-Telmisartan 02486369 MNT 0.2161 Tablet / comprime

Sandoz Telmisartan 02375958 SDZ 0.2161 Tablet / comprime

Telmisartan 02407485 AHI 0.2161 Tablet / comprime

Telmisartan 02390345 SIV 0.2161 Tablet / comprime

Telmisartan 02388944 SAS 0.2161 Tablet / comprime

Teva-Telmisartan 02320177 TEV 0.2161 Tablet / comprime

Tab/Co. Orl 80 mg Micardis 02240770 BOE 0.2161 Tablet / comprime

Auro-Telmisartan 02453576 ARO 0.2161 Tablet / comprime

Mint-Telmisartan 02486377 MNT 0.2161 Tablet / comprime

Sandoz Telmisartan 02375966 SDZ 0.2161 Tablet / comprime

Telmisartan 02390353 SIV 0.2161 Tablet / comprime

Telmisartan 02407493 AHI 0.2161 Tablet / comprime

Telmisartan 02388952 SAS 0.2161 Tablet / comprime

Teva-Telmisartan 02320185 TEV 0.2161 Tablet / comprime

Temazepam / Temazepam Cap/Caps Orl 15 mg Restoril 00604453 AAP 0.2112 Capsule / capsule

Cap/Caps Orl 30 mg Restoril 00604461 AAP 0.2556 Capsule / capsule

Temozolomide / Temozolomide Cap/Caps Orl 5 mg Temodal 02241093 FRS 3.9000 Capsule / capsule

Act Temozolomide 02441160 ATV 3.9000 Capsule / capsule

Taro-Temozolomide 02443473 TAR 3.9000 Capsule / capsule

Cap/Caps Orl 20 mg Temodal 02241094 FRS 15.6000 Capsule / capsule

Act Temozolomide 02395274 ATV 15.6000 Capsule / capsule

Taro-Temozolomide 02443481 TAR 15.6000 Capsule / capsule

Cap/Caps Orl 100 mg Temodal 02241095 FRS 78.0030 Capsule / capsule

Act Temozolomide 02395282 ATV 78.0030 Capsule / capsule

Taro-Temozolomide 02443511 TAR 78.0030 Capsule / capsule

Cap/Caps Orl 140 mg Temodal 02312794 FRS 109.2050 Capsule / capsule

Act Temozolomide 02395290 ATV 109.2050 Capsule / capsule

Taro-Temozolomide 02443538 TAR 109.2050 Capsule / capsule

Cap/Caps Orl 250 mg Temodal 02241096 FRS 195.0020 Capsule / capsule

Act Temozolomide 02395312 ATV 195.0020 Capsule / capsule

Taro-Temozolomide 02443554 TAR 195.0020 Capsule / capsule

Tenofovir Disoproxil / Tenofovir Disoproxil Tab/Co. Orl 300 mg Viread 02247128 GIL 4.8884 Tablet / comprime

Apo-Tenofovir 02451980 APX 4.8884 Tablet / comprime

Auro-Tenofovir 02460173 ARO 4.8884 Tablet / comprime

Jamp-Tenofovir 02479087 JPC 4.8884 Tablet / comprime

Mylan-Tenofovir Disoproxil 02452634 MYL 4.8884 Tablet / comprime

Nat-Tenofovir 02472511 NAT 4.8884 Tablet / comprime

Teva-Tenofovir 02403889 TEV 4.8884 Tablet / comprime

pms-Tenofovir 02453940 PMS 4.8884 Tablet / comprime

Tenofovir Disoproxil and Emtricitabine / Tenofovir Disoproxil et

Emtricitabine

Tab/Co. Orl 300 mg / 200 mg Truvada 02274906 GIL 7.0582 Tablet / comprime

Apo- Emtricitabine-Tenofovir 02452006 APX 7.0582 Tablet / comprime

Jamp-Emtricitabine-Tenofovir Disoproxil

Fumarate

02487012 JPC 7.0582 Tablet / comprime

Mylan-Emtricitabine/Tenofovir Disoproxil 02443902 MYL 7.0582 Tablet / comprime

Teva-Emtricitabine/Tenofovir 02399059 TEV 7.0582 Tablet / comprime

pms-Emtricitabine-Tenofovir 02461110 PMS 7.0582 Tablet / comprime

Tenoxicam / Tenoxicam Tab/Co. Orl 20 mg Tenoxicam 02230661 AAP 1.1783 Tablet / comprime

Terazosin / Terazosine Tab/Co. Orl 1 mg Apo-Terazosin 02234502 APX 0.1835 Tablet / comprime

Terazosin 02350475 SAS 0.1835 Tablet / comprime

Teva-Terazosin 02230805 TEV 0.1835 Tablet / comprime

September / septembre 2020 Page 57

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

pms-Terazosin 02243518 PMS 0.1835 Tablet / comprime

Tab/Co. Orl 2 mg Apo-Terazosin 02234503 APX 0.2333 Tablet / comprime

Terazosin 02350483 SAS 0.2333 Tablet / comprime

Teva-Terazosin 02230806 TEV 0.2333 Tablet / comprime

pms-Terazosin 02243519 PMS 0.2333 Tablet / comprime

Tab/Co. Orl 5 mg Apo-Terazosin 02234504 APX 0.3168 Tablet / comprime

Terazosin 02350491 SAS 0.3168 Tablet / comprime

Teva-Terazosin 02230807 TEV 0.3168 Tablet / comprime

pms-Terazosin 02243520 PMS 0.3168 Tablet / comprime

Tab/Co. Orl 10 mg Apo-Terazosin 02234505 APX 0.4637 Tablet / comprime

Terazosin 02350505 SAS 0.4637 Tablet / comprime

Teva-Terazosin 02230808 TEV 0.4637 Tablet / comprime

pms-Terazosin 02243521 PMS 0.4637 Tablet / comprime

Terbinafine / Terbinafine Tab/Co. Orl 250 mg Lamisil 02031116 NVR 0.7714 Tablet / comprime

Act Terbinafine 02254727 TEV 0.7714 Tablet / comprime

Apo-Terbinafine 02239893 APX 0.7714 Tablet / comprime

Auro-Terbinafine 02320134 ARO 0.7714 Tablet / comprime

Terbinafine 02353121 SAS 0.7714 Tablet / comprime

Terbinafine 02385279 SIV 0.7714 Tablet / comprime

pms-Terbinafine 02294273 PMS 0.7714 Tablet / comprime

Terconazole / Terconazole Crm/Cr. Vag 0.4% Taro-Terconazole 02247651 TAR 0.6353 Gram / gramme

Testosterone / Testosterone Gel/Gel Top 25 mg AndroGel Packets 02245345 BGP 0.6690 Gram / gramme

Taro-Testosterone Gel 02463792 TAR 0.6690 Gram / gramme

Gel/Gel Top 50 mg AndroGel Packets 02245346 BGP 0.5915 Gram / gramme

Taro-Testosterone Gel 02463806 TAR 0.5915 Gram / gramme

Testosterone Undecanoate / Undecanoate De Testosterone Cap/Caps Orl 40 mg Taro-Testosterone 02421186 TAR 0.4700 Capsule / capsule

pms-Testosterone 02322498 PMS 0.4700 Capsule / capsule

Tetrabenazine / Tetrabenazine Tab/Co. Orl 25 mg Nitoman 02199270 VLN 3.3746 Tablet / comprime

Apo-Tetrabenazine 02407590 APX 3.3746 Tablet / comprime

pms-Tetrabenazine 02402424 PMS 3.3746 Tablet / comprime

Tetracycline / Tetracycline Cap/Caps Orl 250 mg Tetra 00580929 AAP 0.0670 Capsule / capsule

Theophylline / Theophylline SRT/Co.L.L. Orl 100 mg AA-Theo LA 00692689 AAP 0.1624 Tablet / comprime

SRT/Co.L.L. Orl 200 mg AA-Theo LA 00692697 AAP 0.1805 Tablet / comprime

SRT/Co.L.L. Orl 300 mg AA-Theo LA 00692700 AAP 0.2186 Tablet / comprime

SRT/Co.L.L. Orl 400 mg Uniphyl 02014165 PFR 0.3362 Tablet / comprime

Theo ER 02360101 AAP 0.3362 Tablet / comprime

SRT/Co.L.L. Orl 600 mg Uniphyl 02014181 PFR 0.4072 Tablet / comprime

Theo ER 02360128 AAP 0.4072 Tablet / comprime

Thiamazole / Thiamazole Tab/Co. Orl 5 mg Tapazole 00015741 PAL 0.2297 Tablet / comprime

Mar-Methimazole 02480107 MAR 0.2297 Tablet / comprime

Tab/Co. Orl 10 mg Tapazole 02296039 PAL 0.5181 Tablet / comprime

Mar-Methimazole 02480115 MAR 0.5181 Tablet / comprime

Tiaprofenic Acid / Acide Tiaprofenique Tab/Co. Orl 200 mg Teva-Tiaprofenic 02179679 TEV 0.5455 Tablet / comprime

Tab/Co. Orl 300 mg Teva-Tiaprofenic 02179687 TEV 0.8070 Tablet / comprime

Ticlopidine / Ticlopidine Tab/Co. Orl 250 mg Ticlopidine 02237701 AAP 1.0679 Tablet / comprime

Timolol / Dorzolamide / Timolol / Dorzolamide Liq/Liq Oph 0.5% / 2% Cosopt 02240113 ELV 1.9887 Millilitre / millilitre

Apo-Dorzo-Timop 02299615 APX 1.9887 Millilitre / millilitre

Dorzolamide and Timolol 02489635 TLG 1.9887 Millilitre / millilitre

Jamp-Dorzolamide-Timolol 02457539 JPC 1.9887 Millilitre / millilitre

Med-Dorzolamide-Timolol 02437686 GMP 1.9887 Millilitre / millilitre

Riva-Dorzolamide/Timolol 02441659 RIV 1.9887 Millilitre / millilitre

Sandoz Dorzolamide/Timolol 02344351 SDZ 1.9887 Millilitre / millilitre

Timolol / Latanoprost / Timolol / Latanoprost Liq/Liq Oph 0.5% / 0.005% GD-Latanoprost/Timolol 02373068 UJC 4.4268 Millilitre / millilitre

Sandoz Latanoprost/Timolol 02394685 SDZ 4.4268 Millilitre / millilitre

Liq/Liq Oph 0.5% / 0.005% Xalacom 02246619 UJC 4.4268 Millilitre / millilitre

Act Latanoprost/Timolol 02436256 TEV 4.4268 Millilitre / millilitre

Jamp-Latanoprost-Timolol 02453770 JPC 4.4268 Millilitre / millilitre

Med-Latanoprost-Timolol 02454505 GMP 4.4268 Millilitre / millilitre

Timolol / Timolol Dps/Gttes Oph 0.25% Sandoz Timolol Maleate 02166712 SDZ 0.9678 Millilitre / millilitre

pms-Timolol 02083353 PMS 0.9678 Millilitre / millilitre

Dps/Gttes Oph 0.5% Timoptic Oph 00451207 ELV 5.7100 Millilitre / millilitre

Apo-Timop 00755834 APX 1.2145 Millilitre / millilitre

Jamp-Timolol 02447800 JPC 1.2145 Millilitre / millilitre

Sandoz Timolol Maleate 02166720 SDZ 1.2145 Millilitre / millilitre

Timo-Stulln (Temporary Benefit) 09858120 PST 1.2145 Millilitre / millilitre

Liq/Liq Oph 0.25% Timoptic-XE Oph 02171880 PFR 3.2159 Millilitre / millilitre

Timolol Maleate-EX 02242275 SDZ 3.2159 Millilitre / millilitre

Liq/Liq Oph 0.5% Timoptic-XE Oph 02171899 ELV 7.3000 Millilitre / millilitre

Timolol Maleate-EX 02242276 SDZ 3.8480 Millilitre / millilitre

Tab/Co. Orl 5 mg Timolol 00755842 AAP 0.2077 Tablet / comprime

Tab/Co. Orl 10 mg Timolol 00755850 AAP 0.3239 Tablet / comprime

Tab/Co. Orl 20 mg Timolol 00755869 AAP 0.6304 Tablet / comprime

Timolol / Travoprost / Timolol / Travoprost Liq/Liq Oph 0.5% / 0.004% Duo Trav PQ 02278251 NVR 8.8425 Millilitre / millilitre

September / septembre 2020 Page 58

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Apo-Travoprost-Timop 02415305 APX 8.8425 Millilitre / millilitre

Tizanidine / Tizanidine Tab/Co. Orl 4 mg Pal-Tizanidine 02239170 PAL 0.7198 Tablet / comprime

Tizanidine 02259893 AAP 0.7198 Tablet / comprime

Tobramycin / Tobramycine Liq/Liq Oph 0.3% Tobrex 00513962 NVR 1.3620 Millilitre / millilitre

Sandoz Tobramycin 02241755 SDZ 1.3620 Millilitre / millilitre

Liq/Liq Inj 40 mg/mL Tobramycin (PF) 02241210 SDZ 3.3700 Millilitre / millilitre

Liq/Liq Inh 300 mg/5 mL Tobi 02239630 BGP 5.4763 Millilitre / millilitre P

Teva-Tobramycin 02389622 TEV 5.4763 Millilitre / millilitre P

Tobramycin Inhalation Solution 02443368 SDZ 5.4763 Millilitre / millilitre P

Tolterodine / Tolterodine ERC/Caps.L.P. Orl 2 mg Detrol LA 02244612 UJC 0.4911 Capsule / capsule

Mylan-Tolterodine ER 02404184 MYL 0.4911 Capsule / capsule

Sandoz Tolterodine LA 02413140 SDZ 0.4911 Capsule / capsule

Teva-Tolterodine LA 02412195 TEV 0.4911 Capsule / capsule

ERC/Caps.L.P. Orl 4 mg Detrol LA 02244613 UJC 0.4911 Capsule / capsule

Mylan-Tolterodine ER 02404192 MYL 0.4911 Capsule / capsule

Sandoz Tolterodine LA 02413159 SDZ 0.4911 Capsule / capsule

Teva-Tolterodine LA 02412209 TEV 0.4911 Capsule / capsule

Tab/Co. Orl 1 mg Detrol 02239064 UJC 0.2455 Tablet / comprime

Mint-Tolterodine 02423308 MNT 0.2455 Tablet / comprime

Teva-Tolterodine 02299593 TEV 0.2455 Tablet / comprime

Tab/Co. Orl 2 mg Detrol 02239065 UJC 0.2455 Tablet / comprime

Mint-Tolterodine 02423316 MNT 0.2455 Tablet / comprime

Teva-Tolterodine 02299607 TEV 0.2455 Tablet / comprime

Topiramate / Topiramate Tab/Co. Orl 25 mg Topamax 02230893 JAN 0.2433 Tablet / comprime

Apo-Topiramate 02279614 APX 0.2433 Tablet / comprime

Auro-Topiramate 02345803 ARO 0.2433 Tablet / comprime

Jamp-Topiramate 02435608 JPC 0.2433 Tablet / comprime

Mint-Topiramate 02315645 MNT 0.2433 Tablet / comprime

Mylan-Topiramate 02263351 MYL 0.2433 Tablet / comprime

Sandoz Topiramate Tablets 02431807 SDZ 0.2433 Tablet / comprime

Teva-Topiramate 02248860 TEV 0.2433 Tablet / comprime

Topiramate 02389460 SIV 0.2433 Tablet / comprime

Topiramate 02356856 SAS 0.2433 Tablet / comprime

Topiramate 02395738 AHI 0.2433 Tablet / comprime

pms-Topiramate 02262991 PMS 0.2433 Tablet / comprime

Tab/Co. Orl 50 mg pms-Topiramate 02312085 PMS 1.2434 Tablet / comprime

Tab/Co. Orl 100 mg Topamax 02230894 JAN 0.4583 Tablet / comprime

Apo-Topiramate 02279630 APX 0.4583 Tablet / comprime

Auro-Topiramate 02345838 ARO 0.4583 Tablet / comprime

Jamp-Topiramate 02435616 JPC 0.4583 Tablet / comprime

Mint-Topiramate 02315653 MNT 0.4583 Tablet / comprime

Mylan-Topiramate 02263378 MYL 0.4583 Tablet / comprime

Sandoz Topiramate Tablets 02431815 SDZ 0.4583 Tablet / comprime

Teva-Topiramate 02248861 TEV 0.4583 Tablet / comprime

Topiramate 02389487 SIV 0.4583 Tablet / comprime

Topiramate 02395746 AHI 0.4583 Tablet / comprime

Topiramate 02356864 SAS 0.4583 Tablet / comprime

pms-Topiramate 02263009 PMS 0.4583 Tablet / comprime

Tab/Co. Orl 200 mg Topamax 02230896 JAN 0.6748 Tablet / comprime

Apo-Topiramate 02279649 APX 0.6748 Tablet / comprime

Auro-Topiramate 02345846 ARO 0.6748 Tablet / comprime

Jamp-Topiramate 02435624 JPC 0.6748 Tablet / comprime

Mint-Topiramate 02315661 MNT 0.6748 Tablet / comprime

Mylan-Topiramate 02263386 MYL 0.6748 Tablet / comprime

Sandoz Topiramate Tablets 02431823 SDZ 0.6748 Tablet / comprime

Teva-Topiramate 02248862 TEV 0.6748 Tablet / comprime

Topiramate 02356872 SAS 0.6748 Tablet / comprime

Topiramate 02395754 AHI 0.6748 Tablet / comprime

pms-Topiramate 02263017 PMS 0.6748 Tablet / comprime

Trandolapril / Trandolapril Cap/Caps Orl 0.5 mg Mavik 02231457 BGP 0.0698 Capsule / capsule

Auro-Trandolapril 02471868 ARO 0.0698 Capsule / capsule

Sandoz Trandolapril 02325721 SDZ 0.0698 Capsule / capsule

Teva-Trandolapril 02415429 TEV 0.0698 Capsule / capsule

pms-Trandolapril 02357755 PMS 0.0698 Capsule / capsule

Cap/Caps Orl 1 mg Mavik 02231459 BGP 0.1762 Capsule / capsule

Auro-Trandolapril 02471876 ARO 0.1762 Capsule / capsule

Sandoz Trandolapril 02325748 SDZ 0.1762 Capsule / capsule

Teva-Trandolapril 02415437 TEV 0.1762 Capsule / capsule

pms-Trandolapril 02357763 PMS 0.1762 Capsule / capsule

Cap/Caps Orl 2 mg Mavik 02231460 BGP 0.2025 Capsule / capsule

Auro-Trandolapril 02471884 ARO 0.2025 Capsule / capsule

Sandoz Trandolapril 02325756 SDZ 0.2025 Capsule / capsule

Teva-Trandolapril 02415445 TEV 0.2025 Capsule / capsule

pms-Trandolapril 02357771 PMS 0.2025 Capsule / capsule

September / septembre 2020 Page 59

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Cap/Caps Orl 4 mg Mavik 02239267 BGP 0.2498 Capsule / capsule

Auro-Trandolapril 02471892 ARO 0.2498 Capsule / capsule

Sandoz Trandolapril 02325764 SDZ 0.2498 Capsule / capsule

Teva-Trandolapril 02415453 TEV 0.2498 Capsule / capsule

pms-Trandolapril 02357798 PMS 0.2498 Capsule / capsule

Tranexamic Acid / Acide Tranexamique Tab/Co. Orl 500 mg Cyklokapron 02064405 PFI 0.2967 Tablet / comprime

GD-Tranexamic Acid 02409097 GMD 0.2967 Tablet / comprime

Mar-Tranexamic Acid 02496232 MAR 0.2967 Tablet / comprime

Tranexamic Acid 02401231 STR 0.2967 Tablet / comprime

Travoprost / Travoprost Liq/Liq Oph 0.004% Travatan Z 02318008 NVR 11.7920 Millilitre / millilitre

Apo-Travoprost Z 02415739 APX 4.0264 Millilitre / millilitre

Sandoz Travoprost 02413167 SDZ 4.0264 Millilitre / millilitre

Trazodone / Trazodone Tab/Co. Orl 50 mg Apo-Trazodone 02147637 APX 0.0554 Tablet / comprime

Teva-Trazodone 02144263 TEV 0.0554 Tablet / comprime

Trazodone 02348772 SAS 0.0554 Tablet / comprime

pms-Trazodone 01937227 PMS 0.0554 Tablet / comprime

Tab/Co. Orl 100 mg Apo-Trazodone 02147645 APX 0.0989 Tablet / comprime

Teva-Trazodone 02144271 TEV 0.0989 Tablet / comprime

Trazodone 02348780 SAS 0.0989 Tablet / comprime

pms-Trazodone 01937235 PMS 0.0989 Tablet / comprime

Tab/Co. Orl 150 mg Teva-Trazodone 02144298 TEV 0.1453 Tablet / comprime

Trazodone 02348799 SAS 0.1453 Tablet / comprime

Triamcinolone / Neomycin / Nystatin / Gramicidin /

Triamcinolone / Neomycine / Nystatine / Gramicidine

Crm/Cr. Top 1 mg / 2.5 mg / 100 000

IU / 0.25 mg

Viaderm K-C 00717002 TAR 0.2571 Gram / gramme

Ont/Ont Top 1 mg / 2.5 mg / 100 000

IU / 0.25 mg

Viaderm K-C 00717029 TAR 0.6230 Gram / gramme

Triamcinolone / Triamcinolone Pst/Pst Den 0.1% Oracort 01964054 TAR 1.4040 Gram / gramme

Sus/Susp IA 40 mg/mL Kenalog-40 01999869 BRI 4.7700 Millilitre / millilitre

Triamcinolone Acetonide 01977563 STR 4.7700 Millilitre / millilitre

Triazolam / Triazolam Tab/Co. Orl 0.25 mg Triazolam 00808571 AAP 0.2551 Tablet / comprime

Trifluoperazine / Trifluoperazine Tab/Co. Orl 1 mg Trifluoperazine 00345539 AAP 0.1340 Tablet / comprime

Tab/Co. Orl 2 mg Trifluoperazine 00312754 AAP 0.1793 Tablet / comprime

Tab/Co. Orl 5 mg Trifluoperazine 00312746 AAP 0.2375 Tablet / comprime

Tab/Co. Orl 10 mg Trifluoperazine 00326836 AAP 0.2846 Tablet / comprime

Trifluridine / Trifluridine Liq/Liq Oph 1% Viroptic 00687456 VLN 3.4533 Millilitre / millilitre

Trihexyphenidyl / Trihexyphenidyle Tab/Co. Orl 2 mg Trihex 00545058 AAP 0.0376 Tablet / comprime

Tab/Co. Orl 5 mg Trihex 00545074 AAP 0.0681 Tablet / comprime

Trimebutine / Trimebutine Tab/Co. Orl 100 mg Trimebutine 02245663 AAP 0.2869 Tablet / comprime

Tab/Co. Orl 200 mg Trimebutine 02245664 AAP 0.5537 Tablet / comprime

Trimethoprim / Trimethoprime Tab/Co. Orl 100 mg Trimethoprim 02243116 AAP 0.2617 Tablet / comprime

Tab/Co. Orl 200 mg Trimethoprim 02243117 AAP 0.5378 Tablet / comprime

Trimipramine / Trimipramine Tab/Co. Orl 12.5 mg Trimipramine 00740799 AAP 0.2156 Tablet / comprime

Tab/Co. Orl 25 mg Trimipramine 00740802 AAP 0.2931 Tablet / comprime

Tab/Co. Orl 50 mg Trimipramine 00740810 AAP 0.5737 Tablet / comprime

Tab/Co. Orl 75 mg Trimipramine 02070987 AAP 0.7721 Tablet / comprime

Tab/Co. Orl 100 mg Trimipramine 00740829 AAP 0.9789 Tablet / comprime

Trospium / Trospium Tab/Co. Orl 20 mg Trosec 02275066 SNV 0.6108 Tablet / comprime

Mar-Trospium 02488353 MAR 0.6108 Tablet / comprime

Tryptophan / Tryptophane Cap/Caps Orl 500 mg Tryptan 00718149 VLN 0.3955 Capsule / capsule

Apo-Tryptophan 02248540 APX 0.3955 Capsule / capsule

Teva-Tryptophan 02240334 TEV 0.3955 Capsule / capsule

Tab/Co. Orl 500 mg Tryptan 02029456 VLN 0.3563 Tablet / comprime

Apo-Tryptophan 02248538 APX 0.3563 Tablet / comprime

Teva-Tryptophan 02240333 TEV 0.3563 Tablet / comprime

Tab/Co. Orl 750 mg Tryptan 02239327 VLN 0.9889 Tablet / comprime

Apo-Tryptophan 02458721 APX 0.9889 Tablet / comprime

Tab/Co. Orl 1 000 mg Tryptan 00654531 VLN 0.7126 Tablet / comprime

Apo-Tryptophan 02248539 APX 0.7126 Tablet / comprime

Teva-Tryptophan 02237250 TEV 0.7126 Tablet / comprime

Ursodeoxycholic Acid (Ursodiol) / Acide Ursodeoxycholique

(Ursodiol)

Tab/Co. Orl 250 mg Urso 02238984 AXC 0.3818 Tablet / comprime

Jamp-Ursodiol 02472392 JPC 0.3818 Tablet / comprime

Ursodiol 02426900 GLM 0.3818 Tablet / comprime

pms-Ursodiol C 02273497 PMS 0.3818 Tablet / comprime

Tab/Co. Orl 500 mg Urso DS 02245894 AXC 0.7242 Tablet / comprime

Jamp-Ursodiol 02472406 JPC 0.7242 Tablet / comprime

Ursodiol 02426919 GLM 0.7242 Tablet / comprime

pms-Ursodiol C 02273500 PMS 0.7242 Tablet / comprime

Valacyclovir / Valacyclovir Tab/Co. Orl 500 mg Valtrex 02219492 GSK 0.6198 Tablet / comprime

Apo-Valacyclovir 02295822 APX 0.6198 Tablet / comprime

Auro-Valacyclovir 02405040 ARO 0.6198 Tablet / comprime

Jamp-Valacyclovir 02441454 JPC 0.6198 Tablet / comprime

Mylan-Valacyclovir 02351579 MYL 0.6198 Tablet / comprime

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Sandoz Valacyclovir 02347091 SDZ 0.6198 Tablet / comprime

Teva-Valacyclovir 02357534 TEV 0.6198 Tablet / comprime

Valacyclovir 02442000 SIV 0.6198 Tablet / comprime

Valacyclovir 02454645 SAS 0.6198 Tablet / comprime

pms-Valacyclovir 02298457 PMS 0.6198 Tablet / comprime

Tab/Co. Orl 1 000 mg Valtrex 02246559 GSK 1.7218 Tablet / comprime

Apo-Valacyclovir 02354705 APX 1.7218 Tablet / comprime

Mylan-Valacyclovir 02351560 MYL 1.7218 Tablet / comprime

Valacyclovir 02442019 SIV 1.7218 Tablet / comprime

pms-Valacyclovir 02381230 PMS 1.7218 Tablet / comprime

Valganciclovir / Valganciclovir Tab/Co. Orl 450 mg Valcyte 02245777 HLR 5.8553 Tablet / comprime

Auro-Valganciclovir 02435179 ARO 5.8553 Tablet / comprime

Mint-Valganciclovir 02495457 MNT 5.8553 Tablet / comprime

Teva-Valganciclovir 02413825 TEV 5.8553 Tablet / comprime

Valproic Acid / Acide Valproique Cap/Caps Orl 250 mg Apo-Valproic 02238048 APX 0.2905 Capsule / capsule

pms-Valproic Acid 02230768 PMS 0.2905 Capsule / capsule

ECC/Caps.Ent Orl 500 mg pms-Valproic Acid 02229628 PMS 0.6356 Capsule / capsule

ECT/Co.Ent Orl 125 mg Epival 00596418 BGP 0.0724 Tablet / comprime

Apo-Divalproex 02239698 APX 0.0724 Tablet / comprime

Mylan-Divalproex 02458926 MYL 0.0724 Tablet / comprime

ECT/Co.Ent Orl 250 mg Epival 00596426 BGP 0.1301 Tablet / comprime

Apo-Divalproex 02239699 APX 0.1301 Tablet / comprime

Mylan-Divalproex 02458934 MYL 0.1301 Tablet / comprime

Novo-Divalproex 02239702 TEV 0.1301 Tablet / comprime

ECT/Co.Ent Orl 500 mg Epival 00596434 BGP 0.2604 Tablet / comprime

Apo-Divalproex 02239700 APX 0.2604 Tablet / comprime

Mylan-Divalproex 02459019 MYL 0.2604 Tablet / comprime

Novo-Divalproex 02239703 TEV 0.2604 Tablet / comprime

Syr/Sir. Orl 250 mg/5 mL Depakene 00443832 BGP 0.0605 Millilitre / millilitre

Apo-Valproic Acid 02238370 APX 0.0605 Millilitre / millilitre

pms-Valproic 02236807 PMS 0.0605 Millilitre / millilitre

Valsartan / Hydrochlorothiazide / Valsartan /

Hydrochlorothiazide

Tab/Co. Orl 80 mg / 12.5 mg Diovan HCT 02241900 NVR 0.2213 Tablet / comprime

Auro-Valsartan HCT 02408112 ARO 0.2213 Tablet / comprime

Sandoz Valsartan HCT 02356694 SDZ 0.2213 Tablet / comprime

Teva-Valsartan/ HCTZ 02356996 TEV 0.2213 Tablet / comprime

Valsartan HCT 02384736 SIV 0.2213 Tablet / comprime

Valsartan/HCTZ 02367009 SAS 0.2213 Tablet / comprime

Tab/Co. Orl 160 mg / 12.5 mg Diovan HCT 02241901 NVR 0.2240 Tablet / comprime

Auro-Valsartan HCT 02408120 ARO 0.2240 Tablet / comprime

Sandoz Valsartan HCT 02356708 SDZ 0.2240 Tablet / comprime

Teva-Valsartan/ HCTZ 02357003 TEV 0.2240 Tablet / comprime

Valsartan HCT 02384744 SIV 0.2240 Tablet / comprime

Valsartan/HCTZ 02367017 SAS 0.2240 Tablet / comprime

Tab/Co. Orl 160 mg / 25 mg Diovan HCT 02246955 NVR 0.2238 Tablet / comprime

Auro-Valsartan HCT 02408139 ARO 0.2238 Tablet / comprime

Sandoz Valsartan HCT 02356716 SDZ 0.2238 Tablet / comprime

Teva-Valsartan/ HCTZ 02357011 TEV 0.2238 Tablet / comprime

Valsartan HCT 02384752 SIV 0.2238 Tablet / comprime

Valsartan/HCTZ 02367025 SAS 0.2238 Tablet / comprime

Tab/Co. Orl 320 mg / 12.5 mg Diovan HCT 02308908 NVR 0.2235 Tablet / comprime

Auro-Valsartan HCT 02408147 ARO 0.2235 Tablet / comprime

Sandoz Valsartan HCT 02356724 SDZ 0.2235 Tablet / comprime

Teva-Valsartan/ HCTZ 02357038 TEV 0.2235 Tablet / comprime

Valsartan HCT 02384760 SIV 0.2235 Tablet / comprime

Valsartan/HCTZ 02367033 SAS 0.2235 Tablet / comprime

Tab/Co. Orl 320 mg / 25 mg Diovan HCT 02308916 NVR 0.2231 Tablet / comprime

Auro-Valsartan HCT 02408155 ARO 0.2231 Tablet / comprime

Sandoz Valsartan HCT 02356732 SDZ 0.2231 Tablet / comprime

Teva-Valsartan/ HCTZ 02357046 TEV 0.2231 Tablet / comprime

Valsartan/HCTZ 02367041 SAS 0.2231 Tablet / comprime

Valsartan / Valsartan Tab/Co. Orl 40 mg Diovan 02270528 NVR 1.2700 Tablet / comprime

Auro-Valsartan 02414201 ARO 0.2211 Tablet / comprime

Sandoz Valsartan 02356740 SDZ 0.2211 Tablet / comprime

Taro-Valsartan 02363062 SUN 0.2211 Tablet / comprime

Teva-Valsartan 02356643 TEV 0.2211 Tablet / comprime

Tab/Co. Orl 80 mg Diovan 02244781 NVR 1.2975 Tablet / comprime

Auro-Valsartan 02414228 ARO 0.2159 Tablet / comprime

Sandoz Valsartan 02356759 SDZ 0.2159 Tablet / comprime

Taro-Valsartan 02363100 SUN 0.2159 Tablet / comprime

Teva-Valsartan 02356651 TEV 0.2159 Tablet / comprime

Valsartan 02366959 SAS 0.2159 Tablet / comprime

Tab/Co. Orl 160 mg Diovan 02244782 NVR 1.2932 Tablet / comprime

Auro-Valsartan 02414236 ARO 0.2159 Tablet / comprime

September / septembre 2020 Page 61

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Sandoz Valsartan 02356767 SDZ 0.2159 Tablet / comprime

Taro-Valsartan 02363119 SUN 0.2159 Tablet / comprime

Teva-Valsartan 02356678 TEV 0.2159 Tablet / comprime

Valsartan 02366967 SAS 0.2159 Tablet / comprime

Tab/Co. Orl 320 mg Diovan 02289504 NVR 1.2582 Tablet / comprime

Auro-Valsartan 02414244 ARO 0.2098 Tablet / comprime

Sandoz Valsartan 02356775 SDZ 0.2098 Tablet / comprime

Teva-Valsartan 02356686 TEV 0.2098 Tablet / comprime

Valsartan 02366975 SAS 0.2098 Tablet / comprime

Vancomycin / Vancomycine Cap/Caps Orl 125 mg Vancocin 00800430 SLP 5.1800 Capsule / capsule

Jamp-Vancomycin 02407744 JPC 5.1800 Capsule / capsule

Pws/Pds. Inj 500 mg Sterile Vancomycin 02230191 PFI 31.0500 Vial / fiole

Sterile Vancomycin HCl 02139375 FKB 31.0500 Vial / fiole

Vancomycin 02394626 SDZ 31.0500 Vial / fiole

Vancomycin 02342855 STR 31.0500 Vial / fiole

Pws/Pds. Inj 1 g Vancomycin 02342863 STR 58.9900 Vial / fiole

Vancomycin 02394634 SDZ 58.9900 Vial / fiole

Vancomycin HCl 02139383 FKB 58.9900 Vial / fiole

Varenicline / Varenicline Kit/Tro Orl 0.5 mg, 1 mg Champix Starter Kit 02298309 PFI 0.9203 Tablet / comprime

Apo-Varenicline 02435675 APX 0.9203 Tablet / comprime

Teva-Varenicline 02426781 TEV 0.9203 Tablet / comprime

Tab/Co. Orl 0.5 mg Champix 02291177 PFI 0.9237 Tablet / comprime

Apo-Varenicline 02419882 APX 0.9237 Tablet / comprime

Teva-Varenicline 02426226 TEV 0.9237 Tablet / comprime

Tab/Co. Orl 1 mg Champix 02291185 PFI 0.9235 Tablet / comprime

Apo-Varenicline 02419890 APX 0.9235 Tablet / comprime

Teva-Varenicline 02426234 TEV 0.9235 Tablet / comprime

Venlafaxine / Venlafaxine SRC/Caps.L.L. Orl 37.5 mg Effexor XR 02237279 UJC 0.0913 Capsule / capsule

Act Venlafaxine XR 02304317 TEV 0.0913 Capsule / capsule

Apo-Venlafaxine XR 02331683 APX 0.0913 Capsule / capsule

Auro-Venlafaxine XR 02452839 ARO 0.0913 Capsule / capsule

Ran-Venlafaxine XR 02380072 SUN 0.0913 Capsule / capsule

Sandoz Venlafaxine XR 02310317 SDZ 0.0913 Capsule / capsule

Teva-Venlafaxine XR 02275023 TEV 0.0913 Capsule / capsule

Venlafaxine XR 02354713 SAS 0.0913 Capsule / capsule

Venlafaxine XR 02339242 PDL 0.0913 Capsule / capsule

Venlafaxine XR 02385929 SIV 0.0913 Capsule / capsule

pms-Venlafaxine XR 02278545 PMS 0.0913 Capsule / capsule

SRC/Caps.L.L. Orl 75 mg Effexor XR 02237280 UJC 0.1825 Capsule / capsule

Act Venlafaxine XR 02304325 TEV 0.1825 Capsule / capsule

Apo-Venlafaxine XR 02331691 APX 0.1825 Capsule / capsule

Auro-Venlafaxine XR 02452847 ARO 0.1825 Capsule / capsule

Ran-Venlafaxine XR 02380080 SUN 0.1825 Capsule / capsule

Sandoz Venlafaxine XR 02310325 SDZ 0.1825 Capsule / capsule

Teva-Venlafaxine XR 02275031 TEV 0.1825 Capsule / capsule

Venlafaxine XR 02339250 PDL 0.1825 Capsule / capsule

Venlafaxine XR 02354721 SAS 0.1825 Capsule / capsule

Venlafaxine XR 02385937 SIV 0.1825 Capsule / capsule

pms-Venlafaxine XR 02278553 PMS 0.1825 Capsule / capsule

SRC/Caps.L.L. Orl 150 mg Effexor XR 02237282 UJC 0.1927 Capsule / capsule

Act Venlafaxine XR 02304333 TEV 0.1927 Capsule / capsule

Apo-Venlafaxine XR 02331705 APX 0.1927 Capsule / capsule

Auro-Venlafaxine XR 02452855 ARO 0.1927 Capsule / capsule

Ran-Venlafaxine XR 02380099 SUN 0.1927 Capsule / capsule

Sandoz Venlafaxine XR 02310333 SDZ 0.1927 Capsule / capsule

Teva-Venlafaxine XR 02275058 TEV 0.1927 Capsule / capsule

Venlafaxine XR 02354748 SAS 0.1927 Capsule / capsule

Venlafaxine XR 02385945 SIV 0.1927 Capsule / capsule

Venlafaxine XR 02339269 PDL 0.1927 Capsule / capsule

pms-Venlafaxine XR 02278561 PMS 0.1927 Capsule / capsule

Verapamil / Verapamil SRT/Co.L.L. Orl 120 mg Isoptin SR 01907123 BGP 1.5237 Tablet / comprime

Apo-Verapamil SR 02246893 APX 0.5078 Tablet / comprime

Mylan-Verapamil SR 02210347 MYL 0.5078 Tablet / comprime

SRT/Co.L.L. Orl 180 mg Isoptin SR 01934317 BGP 0.5204 Tablet / comprime

Apo-Verap SR 02246894 APX 0.5204 Tablet / comprime

Mylan-Verapamil SR 02450488 MYL 0.5204 Tablet / comprime

SRT/Co.L.L. Orl 240 mg Isoptin SR 00742554 BGP 0.5075 Tablet / comprime

Apo-Verap SR 02246895 APX 0.5075 Tablet / comprime

Mylan-Verapamil SR 02450496 MYL 0.5075 Tablet / comprime

pms-Verapamil SR 02237791 PMS 0.5075 Tablet / comprime

Tab/Co. Orl 80 mg Apo-Verap 00782483 APX 0.2735 Tablet / comprime

Mylan-Verapamil 02237921 MYL 0.2735 Tablet / comprime

Tab/Co. Orl 120 mg Apo-Verap 00782491 APX 0.4250 Tablet / comprime

Mylan-Verapamil 02237922 MYL 0.4250 Tablet / comprime

September / septembre 2020 Page 62

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Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Voriconazole / Voriconazole Tab/Co. Orl 50 mg Vfend 02256460 PFI 6.7818 Tablet / comprime P

Sandoz Voriconazole 02399245 SDZ 6.7818 Tablet / comprime P

Teva-Voriconazole 02396866 TEV 6.7818 Tablet / comprime P

Tab/Co. Orl 200 mg Vfend 02256479 PFI 26.4807 Tablet / comprime P

Sandoz Voriconazole 02399253 SDZ 26.4807 Tablet / comprime P

Teva-Voriconazole 02396874 TEV 26.4807 Tablet / comprime P

Warfarin / Warfarine Tab/Co. Orl 1 mg Coumadin 01918311 BRI 0.0780 Tablet / comprime

Apo-Warfarin 02242924 APX 0.0780 Tablet / comprime

Taro-Warfarin 02242680 TAR 0.0780 Tablet / comprime

Tab/Co. Orl 2 mg Coumadin 01918338 BRI 0.0825 Tablet / comprime

Apo-Warfarin 02242925 APX 0.0825 Tablet / comprime

Taro-Warfarin 02242681 TAR 0.0825 Tablet / comprime

Tab/Co. Orl 2.5 mg Coumadin 01918346 BRI 0.0660 Tablet / comprime

Apo-Warfarin 02242926 APX 0.0660 Tablet / comprime

Taro-Warfarin 02242682 TAR 0.0660 Tablet / comprime

Tab/Co. Orl 3 mg Coumadin 02240205 BRI 0.1023 Tablet / comprime

Apo-Warfarin 02245618 APX 0.1023 Tablet / comprime

Taro-Warfarin 02242683 TAR 0.1023 Tablet / comprime

Tab/Co. Orl 4 mg Coumadin 02007959 BRI 0.1023 Tablet / comprime

Apo-Warfarin 02242927 APX 0.1023 Tablet / comprime

Taro-Warfarin 02242684 TAR 0.1023 Tablet / comprime

Tab/Co. Orl 5 mg Coumadin 01918354 BRI 0.0662 Tablet / comprime

Apo-Warfarin 02242928 APX 0.0662 Tablet / comprime

Taro-Warfarin 02242685 TAR 0.0662 Tablet / comprime

Tab/Co. Orl 6 mg Coumadin 02240206 BRI 0.1753 Tablet / comprime

Taro-Warfarin 02242686 TAR 0.1753 Tablet / comprime

Tab/Co. Orl 10 mg Coumadin 01918362 BRI 0.1187 Tablet / comprime

Apo-Warfarin 02242929 APX 0.1187 Tablet / comprime

Taro-Warfarin 02242687 TAR 0.1187 Tablet / comprime

Zidovudine / Zidovudine Cap/Caps Orl 100 mg Retrovir 01902660 VIV 1.3977 Capsule / capsule

Apo-Zidovudine 01946323 APX 1.3977 Capsule / capsule

Zidovudine and Lamivudine / Zidovudine et Lamivudine Tab/Co. Orl 300 mg / 150 mg Combivir 02239213 VIV 2.6103 Tablet / comprime

Apo-Lamivudine/Zidovudine 02375540 APX 2.6103 Tablet / comprime

Auro-Lamivudine/Zidovudine 02414414 ARO 2.6103 Tablet / comprime

Zidovudine, Lamivudine and Abacavir / Zidovudine, Lamivudine

et Abacavir

Tab/Co. Orl 300 mg / 150 mg /

300 mg

Apo-Abacavir-Lamivudine-Zidovudine 02416255 APX 13.6425 Tablet / comprime

Ziprasidone / Ziprasidone Cap/Caps Orl 20 mg Zeldox 02298597 UJC 1.3648 Capsule / capsule

Auro-Ziprasidone 02449544 ARO 1.3648 Capsule / capsule

Cap/Caps Orl 40 mg Zeldox 02298600 UJC 1.5634 Capsule / capsule

Auro-Ziprasidone 02449552 ARO 1.5634 Capsule / capsule

Cap/Caps Orl 60 mg Zeldox 02298619 UJC 1.5634 Capsule / capsule

Auro-Ziprasidone 02449560 ARO 1.5634 Capsule / capsule

Cap/Caps Orl 80 mg Zeldox 02298627 UJC 1.5634 Capsule / capsule

Auro-Ziprasidone 02449579 ARO 1.5634 Capsule / capsule

Zoledronic Acid / Acide Zoledronique Liq/Liq IV 5 mg/100 mL Aclasta 02269198 NVR 3.3540 Millilitre / millilitre

Taro-Zoledronic Acid 02415100 TAR 3.3540 Millilitre / millilitre

Zoledronic Acid 02422433 RCH 3.3540 Millilitre / millilitre

Zolmitriptan / Zolmitriptan ODT/Co.D.O. Orl 2.5 mg Zomig Rapimelt 02243045 AZE 3.4313 Tablet / comprime

Jamp-Zolmitriptan ODT 02428237 JPC 3.4313 Tablet / comprime

Sandoz Zolmitriptan ODT 02362996 SDZ 3.4313 Tablet / comprime

Septa-Zolmitriptan ODT 02428474 SPT 3.4313 Tablet / comprime

Teva-Zolmitriptan OD 02342545 TEV 3.4313 Tablet / comprime

Zolmitriptan ODT 02442671 SAS 3.4313 Tablet / comprime

pms-Zolmitriptan ODT 02324768 PMS 3.4313 Tablet / comprime

Tab/Co. Orl 2.5 mg Zomig 02238660 AZE 3.4292 Tablet / comprime

CCP-Zolmitriptan 02458780 CCM 3.4292 Tablet / comprime

Jamp-Zolmitriptan 02421623 JPC 3.4292 Tablet / comprime

Jamp-Zolmitriptan 02477106 JPC 3.4292 Tablet / comprime

Mar-Zolmitriptan 02399458 MAR 3.4292 Tablet / comprime

Nat-Zolmitriptan 02421534 NAT 3.4292 Tablet / comprime

Sandoz Zolmitriptan 02362988 SDZ 3.4292 Tablet / comprime

Teva-Zolmitriptan 02313960 TEV 3.4292 Tablet / comprime

pms-Zolmitriptan 02324229 PMS 3.4292 Tablet / comprime

Zopiclone / Zopiclone Tab/Co. Orl 5 mg Imovane 02216167 SAV 0.0990 Tablet / comprime

Apo-Zopiclone 02245077 APX 0.0990 Tablet / comprime

Jamp-Zopiclone 02406969 JPC 0.0990 Tablet / comprime

Mar-Zopiclone 02386771 MAR 0.0990 Tablet / comprime

Mint-Zopiclone 02391716 MNT 0.0990 Tablet / comprime

NRA-Zopiclone 02477378 NRA 0.0990 Tablet / comprime

Taro-Zopiclone 02267918 SUN 0.0990 Tablet / comprime

Zopiclone 02344122 SAS 0.0990 Tablet / comprime

Zopiclone 02385821 SIV 0.0990 Tablet / comprime

pms-Zopiclone 02243426 PMS 0.0990 Tablet / comprime

ratio-Zopiclone 02246534 TEV 0.0990 Tablet / comprime

September / septembre 2020 Page 63

Page 64: Maximum Allowable Price (MAP) list for NB Drug Plans Liste ... · Maximum Allowable Price (MAP) list for NB Drug Plans Liste des prix admissibles maximums (PAM) pour régimes médicaments

Maximum Allowable Price (MAP) list for NB Drug Plans

Liste des prix admissibles maximums (PAM) pour régimes médicaments du N.-B.

Tab/Co. Orl 7.5 mg Imovane 01926799 SAV 0.1250 Tablet / comprime

Rhovane 02008203 SDZ 0.1250 Tablet / comprime

Apo-Zopiclone 02218313 APX 0.1250 Tablet / comprime

Jamp-Zopiclone 02406977 JPC 0.1250 Tablet / comprime

Mar-Zopiclone 02386798 MAR 0.1250 Tablet / comprime

Mint-Zopiclone 02391724 MNT 0.1250 Tablet / comprime

NRA-Zopiclone 02477386 NRA 0.1250 Tablet / comprime

Taro-Zopiclone 02267926 SUN 0.1250 Tablet / comprime

Zopiclone 02385848 SIV 0.1250 Tablet / comprime

Zopiclone 02282445 SAS 0.1250 Tablet / comprime

pms-Zopiclone 02240606 PMS 0.1250 Tablet / comprime

ratio-Zopiclone 02242481 TEV 0.1250 Tablet / comprime

Generic Name / Nom Générique Chemical Substance / Substance chimique

Strength / Dosage Dosage Form, Route and Strength / Forme posologique, voie et concentration

Tradename / Marque de Commerce Brand or Manufacturers' product name / Appellation commerciale ou nom du produit donné

DIN / PIN Drug Identification Number / Identification numérique de drogue

MFR / FAB Manufacturers' identification code / Code d'identification du fabricant

MAP / PAM Maximum Allowable Price / Prix admissibles maximums

Unit / Unité Quantity for Claim Submission / Quantité à utiliser pour les soumission de demande de règlement

Designated high cost drugs that are subject to a maximum days supply /

Médicaments plus coûteux désignés qui sont assujettis à un nombrede jours d’approvisionnement maximum

MAP greyed / PAM grisée MAP increased due to category shortage / PAM augmentation en raison de la pénurie de catégorie

* indicates / * indique MAP based on package size specified / PAM selon la taille du paquet spécifiée

Legend / Légende

September / septembre 2020 Page 64