- arthritis - nhf.org.jm · tramdol-bm caps 50mg tab/cap $36.40 tramadol & paracetamol...

Arthritis - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 1

HEAD OFFICE6th Floor, the Towers25 Dominica Drive, Kingston 5Tel: 1-888-NHFCARE (643-2273) or 906-1106Fax: 906-1105Business Hours: Monday- Thursday 7:00am to 4:30pm Fridays 7:00am to 3:30pmCall Cantre Hours: Monday – Friday 7:00am – 7:00pm

HELP DESKS- Cornwall Regional Hospital - Tel: 971-6571- Mandeville Regional Hospital - Tel: 625-6299- St. Ann’s Bay Hospital - Tel: 972-1683 - Drug Serv Union Square Pharmacy – Tel: 908-5479- Drug Serv May Pen Hospital – Tel: 786-4200- Drug Serv Greater Portmore Health Centre- Drug Serv KPHBusiness Hours: Monday to Thursday 8:00 am – 4 :00 pm Friday 8:00 am – 3:00 pm

[email protected]

/NHFJamaica

- ARTHRITISINDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS

Release Date: Oct. 3, 2017Revision #: 1

ACECLOFENACLABEL PRSNTN SUBSIDYACICROF-F 100 TAB 100mg TAB/CAP $31.00ALGIC TAB 100mg TAB/CAP $31.00ZERODOL TAB 100mg TAB/CAP $31.00

ACECLOFENAC CONTROLLED RELEASEZERODOL CR TAB 200mg TAB/CAP $62.00

ACECLOFENAC & PARACETAMOLACICROF-P TAB 100mg/500mg TAB/CAP $43.77ALGIC-P TAB 100mg/500mg TAB/CAP $43.77ZERODOL-P TAB 100mg/500mg TAB/CAP $43.77

ADALIMUMABHUMIRA INJECTION 40mg/.8ml - pack of 2 syringes INJECTION $75,037.50

AZATHIOPRINEAZORAN TAB 50mg TAB/CAP $65.77IMURAN TAB 50mg TAB/CAP $65.77

CELECOXIBAPO-CELECOXIB CAP 200mg TAB/CAP $79.04CELEBREX CAP 100mg TAB/CAP $39.52CELEBREX CAP 200mg TAB/CAP $79.04CELECOXIB-SDZ CAP 200mg TAB/CAP $79.04

DEFLAZACORTCALCORT TAB 30mg TAB/CAP $301.90CALCORT TAB 6mg TAB/CAP $60.38

2 | INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS - Arthritis

DEFLAZACORT

CALCORT TAB 30mg TAB/CAP $301.90CALCORT TAB 6mg TAB/CAP $60.38

DICLOFENAC POTASSIUMAPO-DICLO TAB RAPIDE 50mg TAB/CAP $13.99CATAFLAM LIQ. CAPS 50mg TAB/CAP $13.99CATAFLAM DISP. TAB 46.5mg TAB/CAP $12.97CATAFLAM DROPS LIQUID $510.80CATAFLAM SUSP 9mg/5ml LIQUID $490.36CATAFLAM TAB 25mg TAB/CAP $7.01CATAFLAM TAB 50mg TAB/CAP $13.99DICLO- K 50mg TAB TAB/CAP $13.99DICLOFENAC-H2K TAB 50 mg TAB/CAP $13.99DICLOFENAC-P TAB 25mg TAB/CAP $7.01DICLOFENAC-P TAB 50mg TAB/CAP $13.99DICLOTAS TAB 50mg TAB/CAP $13.99

LABEL PRSNTN SUBSIDY

DEXKETOPROFENINFEN-25 TABLETS 25mg TAB/CAP $34.75

DICLOFENAC + VIT. B1, B6, B12DOLO-NEUROBION N TAB 50mg/50mg/50mg/1mg TAB/CAP $23.32DOLO-NEUROBION XR TAB 100mg/100mg/100mg/1mg TAB/CAP $55.63

DICLOFENAC SODIUMACTERIC TAB 150mg ER TAB/CAP $41.99APO-DICLO EC TAB 25mg TAB/CAP $7.01APO-DICLO EC TAB 50mg TAB/CAP $13.99APO-DICLO TAB SR 100mg TAB/CAP $27.97APO-DICLO TAB SR 75mg TAB/CAP $20.99DICLO DENK RETD TAB 100mg TAB/CAP $27.97DICLO DENK TAB 25mg TAB/CAP $7.01DICLO DENK TAB 50 mg TAB/CAP $13.99DICLOFEN SR TAB 100mg TAB/CAP $27.97DICLOFENAC- MK DROPS 1.5% LIQUID $510.80DICLOFENAC-H2K SR TAB 75 mg TAB/CAP $20.99DICLOFENAC-H2K TAB 100 mg TAB/CAP $27.97DICLOFENAC-LAS SR TAB 100mg TAB/CAP $27.97DICLOFENAC-S EC- MAC SR TAB 75mg TAB/CAP $20.99DICLOFENAC-S EC- MAC TAB 25mg TAB/CAP $7.01DICLOFENAC-S EC- MAC TAB 50mg TAB/CAP $13.99DICLOMAX-50 EC TAB TAB/CAP $13.99NAKLOFEN DUO CAPS 75mg TAB/CAP $20.99NOVO-DIFENAC TAB 100mg TAB/CAP $27.97NOVO-DIFENAC TAB 75mg TAB/CAP $20.99REMETHAN TAB 50mg TAB/CAP $13.99VOLTAREN RETARD TAB 100mg TAB/CAP $27.97VOLTAREN SR TAB 75mg TAB/CAP $20.99VOLTAREN TAB 25mg EC TAB/CAP $7.01VOLTAREN TAB 50mg EC TAB/CAP $13.99

ETANERCEPTENBREL INJ. 25mg -Single Vial INJECTION $9,436.81ENBREL INJ. 50mg -Single Syringe INJECTION $18,873.62

Arthritis - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 3

ETORICOXIBLABEL PRSNTN SUBSIDYARCOXIA TAB 30mg TAB/CAP $30.58ARCOXIA TAB 120mg TAB/CAP $122.30ARCOXIA TAB 60mg TAB/CAP $61.15ARCOXIA TAB 90mg TAB/CAP $91.73ETOZOX CAP 60mg TAB/CAP $61.15ETOZOX CAP 90mg TAB/CAP $91.73ETOZOX CAP 120mg TAB/CAP $122.30

GOLIMUMABSIMPONI INJ. 50MG - 0.5ml INJECTION $105,896.05

HYDROXYCHLOROQUINE SULFATEAPO-HYDROXYQUINE TAB 200MG TAB/CAP $32.61HCQS TAB 200mg TAB/CAP $32.61PLAQUENIL TAB 200mg TAB/CAP $32.61

IBUPROFENAPO-IBUPROFEN TAB 400mg TAB/CAP $3.23APO-IBUPROFEN TAB 600mg TAB/CAP $4.84BRUFEN TAB 400mg TAB/CAP $3.23BRUFEN TAB 600mg TAB/CAP $4.84IBUPROFEN-ALP TAB 400MG TAB/CAP $3.23IBUPROFEN-H2K TAB 400MG TAB/CAP $3.23IBUPROFEN-H2K TAB 600MG TAB/CAP $4.84IBUPROFEN-LAS TAB 400mg TAB/CAP $3.23IBUPROFEN-LAS TAB 600mg TAB/CAP $4.84

INFLIXIMABREMICADE 100mg INJECTION INJECTION $37,158.81

KETOPROFEN CRBI-PROFENID TAB 150mg TAB/CAP $69.34ORUVAIL CAP 200mg ER TAB/CAP $92.43 LEFLUNOMIDEARAVA TAB 20mg TAB/CAP $200.93LEFUMIDE-10 TAB 10mg TAB/CAP $100.46LEFUMIDE-20 TAB 20mg TAB/CAP $200.93LEFRA TAB 20mg TAB/CAP $200.93

MELOXICAMMELOFLAM TAB 15MG TAB/CAP $26.06MELFLAM TAB 15MG TAB/CAP $26.06MELFLAM TAB 7.5MG TAB/CAP $13.03MELOFLAM TAB 7.5MG TAB/CAP $13.03MELOXICAM-H2K TAB 15mg TAB/CAP $26.06MELOXICAM-H2K TAB 7.5mg TAB/CAP $13.03MELOXICAM-MAC TAB 15mg TAB/CAP $26.06MELOXICAM-MAC TAB 7.5mg TAB/CAP $13.03MELOXICAM-PMS TAB 15mg TAB/CAP $26.06MELOXICAM-PMS TAB 7.5mg TAB/CAP $13.03MOBIC TAB 15mg TAB/CAP $26.06MOBIC TAB 7.5mg TAB/CAP $13.03MUVERA TAB 15mg TAB/CAP $26.06MUVERA TAB 7.5mg TAB/CAP $13.03

4 | INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS - Arthritis

PREDNISONEAPO-PREDNISONE TAB 5mg TAB/CAP $3.18APO-PREDNISONE TAB 50mg TAB/CAP $31.77NOVO-PREDNISONE TAB 5mg TAB/CAP $3.18

TOCILIZUMABACTEMRA INJ. 80mg - 4ml INJECTION $11,027.20ACTEMRA INJ. 162mg - 0.9ml INJECTION $22,329.92ACTEMRA INJ. 200mg - 10ml INJECTION $27,568.00

METHOTREXATE SODIUMEMTHEX INJ 50mg/2ml INJECTION $356.98EMTHEX TAB 2.5mg TAB/CAP $16.19IMUTREX-2.5 TAB 2.5mg TAB/CAP $16.19METHOTREXATE-EBW INJ 50mg/5ml INJECTION $356.98METHOTREX-LDL INJ 50mg/2ml INJECTION $356.98

TRAMADOLADAMON CAP 50mg TAB/CAP $36.40ADAMON DROPS 100mg/ml -10ml TAB/CAP $650.00TRAMADOL DENK 50 EFFERVESCENT TAB 50mg - 10s TAB/CAP $36.40TRAMAL CAP 50mg TAB/CAP $36.40TRAMAL DROPS 100mg/ml -10ml TAB/CAP $650.00TRAMAL L.A. TAB 100mg TAB/CAP $72.80TRAMDOL-BM CAPS 50mg TAB/CAP $36.40

TRAMADOL & PARACETAMOLAPO-TRAMADOL& ACETAMINOPHEN TABS 37.5mg/325mg TAB/CAP $92.80TRAMACET TAB 37.5mg/325mg TAB/CAP $92.80

METHOTREXATE

METHOTREX SOD-EBW TAB 10mg TAB/CAP $64.75METHOTREXATE-LAS TAB 2.5mg TAB/CAP $16.19METHOTREXATE-LDL TAB 2.5mg TAB/CAP $16.19METHOTREX-EBW TAB 2.5mg TAB/CAP $16.19


NAPROXENAPO-NAPROXEN TAB 500mg TAB/CAP $20.30NAPROSYN EC TAB 500mg TAB/CAP $20.30

PIROXICAMAPO-PIROXICAM CAP 10mg TAB/CAP $5.66APO-PIROXICAM CAP 20mg TAB/CAP $11.29HOTEMIN CAP 10mg TAB/CAP $5.66HOTEMIN CAP 20mg TAB/CAP $11.29PIROXICAM-LAS CAP 20mg TAB/CAP $11.29

PREDNISOLONEPREDCORT DS SYRUP 10mg/5ml - 125ml LIQUID $652.76PREDCORT DS SYRUP 10mg/5ml - 30ml LIQUID $156.67PREDNISOLONE-PMS 5mg/5ml -120ml LIQUID $313.46PRELONE SYP 15mg/5ml -120ml LIQUID $941.58PRELONE SYP 15mg/5ml - 60ml LIQUID $470.78PREDNISOLONE-FP TAB 5mg TAB/CAP $3.18

RITUXIMABREDITUX INJ. 100MG - 10ml INJECTION $13,233.00REDITUX INJ. 500MG - 50ml INJECTION $66,165.00

Asthma - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 1

INDIVIDUAL BENEFITS ASTHMAFOR PRESCRIPTION DRUGS

BECLOMETHASONE DIPROPIONATELABEL PRSNTN SUBSIDYASABEC AER INH 50mcg - 200Ds INHALER $274.93BECLAZONE AER INH 50mcg - 200Ds INHALER $274.93BECLAZONE-IVAX AER INH 250mcg - 200Ds INHALER $1,374.67BECLAZONE-IVAX AER INH 50mcg - 200Ds INHALER $274.93BECLATE 50 INH – 200Ds INHALER $274.93BECLATE 250 AER INH 250mcg – 200Ds INHALER $1,374.67BECLOCIP HFA AER INH 100mcg - 200Ds INHALER $549.87BECLOFORTE AER INH 250mcg - 200Ds INHALER $1,374.67BECLOMETHAS-LAS AER INH 50mcg - 200Ds INHALER $274.93BECLOMETHAS-LAS AER INH 200mcg - 200Ds INHALER $1,099.73BECLOMETHAS-LAS AER INH 250mcg - 200Ds INHALER $1,374.67BECLOMETHASONE-H2K AER INH 50mcg - 200Ds INHALER $274.93BECLOVAIRE 100 HFA AER INH - 200Ds INHALER $549.87BECLOVAIRE 50 HFA AER INH - 200Ds INHALER $274.93BECOTIDE AER INH 50mcg- 200Ds INHALER $274.93CORTIFLOW INHALER 50-200D INHALER $274.93IBICAR 50 AEROSOL-200D INHALER $274.93IBICAR 100 AEROSOL-200D INHALER $549.87IBICAR 200 AEROSOL-200D INHALER $1,099.73

BUDESONIDEBUDISON NEBULES 0.25mg/2ml -5s NEB SOLN $72.62MIFLONIDE INH CAP 200Mcg-SINGLE CAP TAB/CAP $18.20MIFLONIDE INH CAP 400Mcg-SINGLE CAP TAB/CAP $36.40PULMICORT HFA pMD INHALER 200mcg - 120DS INHALER $849.32PULMICORT INH 200Mcg INHALER $707.77PULMICORT NEB. 0.25mg/ml in 2mlSINGLE AMP. NEB SOLN $72.62PULMICORT NEB. 0.5mg/ml in 2ml SINGLE AMP. NEB SOLN $145.25PULMICORT TURBUHALER 200Mcg INHALER $707.77

DEFLAZACORT

FLUTICASONE PROPIONATEFLIXOTIDE AER INH 125mcg - 60Ds INHALER $1,057.19FLIXOTIDE AER INH 250mcg - 60Ds INHALER $2,114.38FLIXOTIDE AER INH 50mcg - 120Ds INHALER $845.74FLIXOTIDE AER INH 50mcg - 60Ds INHALER $422.87FLOHALE AER INH 50mcg -120Ds INHALER $845.74FLOHALE AER INH 125mcg -120Ds INHALER $845.74

CALCORT TAB 30mg TAB/CAP $301.90CALCORT TAB 6mg TAB/CAP $60.38

FORMOTEROL FUMARATEFORADIL DRY CAP PWD INH 12MCGSINGLE CAP TAB/CAP $45.12

FORMOTEROL/BUDESONIDEFORMECORT 100 HFA INH. -120Ds INHALER $1,593.28FORMECORT 200 HFA INH. -120Ds INHALER $1,951.88SYMBICORT 4.5/160mcg TURBUHAL -120Ds INHALER $2,885.38SYMBICORT 4.5/160mcg TURBUHAL - 60Ds INHALER $1,442.69SYMBICORT 4.5/80mcg TURBUHAL - 120Ds INHALER $2,288.42SYMBICORT 4.5/80mcg TURBUHAL - 60Ds INHALER $1,144.21SYMBICORT 9/320mcg TURBUHAL - 60Ds INHALER $2,885.38SYMBICORT RAPIHALER 4.5/80mcg - 120Ds INHALER $2,288.42SYMBICORT RAPIHALER 4.5/160mcg - 120Ds INHALER $2,885.38VANNAIR 4.5/160mcg pMDInhaler -120Ds INHALER $2,885.38VANNAIR 4.5/80mcg pMDInhaler - 120Ds INHALER $2,288.42


IPRATROPIUM BROMIDEAPO-IPRAVENT NEB. SOLN. 0.025% NEB SOLN $1,081.89ATROVENT AER INH 20mcg -200Ds INHALER $1,040.92ATROVENT HFA AER INH 20mcg -200Ds INHALER $1,040.92ATROVENT NEB SOLN. 0.02% -20ml NEB SOLN $865.51IPRATROPIUM-H2K AER INH .20mcg INHALER $1,040.92IPRATROPIUM-LAS NEB. SOLN 0.025% -15ml NEB SOLN $811.41IPRATROP-LAS INH AER.20mcg -200Ds INHALER $1,040.92IPRAVENT INHALER 20mcg – 200Ds INHALER $1,040.92

2 | INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS - Hypertension

LEVOCETIRIZINE DIHYDROCHLORIDE & MONTELUKAST SODIUMLABEL PRSNTN SUBSIDY

SALBUTAMOLLABEL PRSNTN SUBSIDY

BREATHEZY-L TAB 5mg/10mg - 30s TAB/CAP $69.34L-MONTUS TAB 5mg/10mg - 10s TAB/CAP $69.34

MONTELUKASTBREATHEZY TAB 10mg TAB/CAP $100.20BREATHEZY CHEWABLE TAB 4mg TAB/CAP $40.08BREATHEZY CHEWABLE TAB 5mg TAB/CAP $50.10BRONCULAIR TAB 10mg TAB/CAP $100.20GLEMONT - CT 4 TABLETS 4mg - 30s TAB/CAP $40.08GLEMONT - CT 5 TABLETS 5mg - 30s TAB/CAP $50.10GLEMONT- IR 10 TAB 10mg TAB/CAP $100.20MONTELUKAST-PMS CHEWABLE TAB 4mg TAB/CAP $40.08MONTELUKAST-PMS CHEWABLE TAB 5mg TAB/CAP $50.10MONTELUKAST-SDZ CHEWABLE TAB 4mg TAB/CAP $40.08MONTELUKAST-SDZ CHEWABLE TAB 5mg TAB/CAP $50.10APO-MONTELUKAST TAB 10mg TAB/CAP $100.20MONTELUKAST-PMS TAB 10mg TAB/CAP $100.20MONTELUKAST-SDZ TAB 10mg TAB/CAP $100.20SINGLON TAB 10mg TAB/CAP $100.20SINGULAIR ORAL GRANULES 4mg- Single Packet GRANULE $40.08SINGULAIR TAB 10mg TAB/CAP $100.20SINGULAIR TAB 4mg TAB/CAP $40.08SINGULAIR TAB 5mg TAB/CAP $50.10UXIGRIL CHEWABLE TAB 4mg TAB/CAP $40.08UXIGRIL CHEWABLE TAB 5mg TAB/CAP $50.10UXIGRIL TAB 10mg TAB/CAP $100.20

APO-SALBUTAMOL NEB. SOLN. -10ml NEB SOLN $316.14APO-SALVENT TAB 4mg TAB/CAP $2.29BONCH-AIR SALBUTAMOL PRESSURISEDHFA INHALER INHALER $296.36BRONCLAIR LIQUID -125ml LIQUID $234.94FEDBUTAMOL SYP 2mg/5ml - 120ml LIQUID $225.47FEDBUTAMOL SYP 2mg/5ml - 150ml LIQUID $281.82FEDBUTAMOL TAB 2mg TAB/CAP $1.15FEDBUTAMOL TAB 4mg TAB/CAP $2.29SALAMOL-IVAX AER INH 100mcg INHALER $296.36SALAMOL-IVAX NEB. SOLN. 0.1% -Pack OF 20 NEB SOLN $316.14SALAMOL-IVAX NEB. SOLN. 0.2% -Pack OF 20 NEB SOLN $632.28SALBUTAMOL-H2K AER INH 100mcg -200Ds INHALER $296.36SALBUTAMOL-H2K AER INH 100mcg- CFCFREE -200Ds INHALER $296.36SALBUTAMOL-LAS NEB. SOLN. -15ml NEB SOLN $474.22SALBUTAMOL-LAS SYRUP 2mg/5ml -100ml LIQUID $187.95SALBUTAMOL-LAS TAB 4mg TAB/CAP $2.29SALBUTAMOL-Sandoz AER 100mcg INHALER $296.36SALBUTAMOL-PMS SYP 2mg/5ml LIQUID $187.95SALBUTAMOL-SPM TAB 4mg TAB/CAP $2.29SALBUTAVENT HFA AER INH 100mcg -200Ds INHALER $296.36VENTOLIN NEB SOLN 0.5% -20ml NEB SOLN $632.27VENTOLIN NEB SOLN 0.5% -2.5ml NEB SOLN $316.14VENTOLIN NEB SOLN. 0.1% -PACK OF 20 NEB SOLN $316.14VENTOLIN SYR 2mg/5ml -150ml LIQUID $281.82

SALBUTAMOL-BECLOMETHASONEAERODAY INHALER 100mcg/50mcg - 200Ds INHALER $450.42BECLOSAL HFA AER 100/50mcg INHALER $450.42IBICAR S AEROSOL(100/50mcg) 200D INHALER $450.42

PREDNISOLONEPREDCORT DS SYRUP 10mg/5ml - 125ml LIQUID $652.76PREDCORT DS SYRUP 10mg/5ml - 30ml LIQUID $156.67PREDNISOLONE-PMS 5mg/5ml- 120ml LIQUID $313.46PRELONE SYRUP 15mg/5ml 120ml LIQUID $941.58PRELONE SYRUP 15mg/5ml 60ml LIQUID $470.78PREDNISOLONE-FP TAB 5mg TAB/CAP $3.01


LEVOSALBUTAMOLLEVOLIN HFA AER INH 50mcg - 200Ds INHALER $520.00

AIR-O-VENT INHALER 100mcg - 200D INHALER $296.36BUTAHALE AER INH 100mcg -200Ds INHALER $296.36SALBULIN AER INH 100mcg -250Ds INHALER $370.44SALBUTAMOL-LAS AER INH 100mcg -200Ds INHALER $296.36SALOMOL AER INH 100mcg -200Ds INHALER $296.36VENTOLIN AER INH 100mcg -200Ds INHALER $296.36VENTOLIN ORAL SOLUTION2mg/5ML - 200ml LIQUID $375.76

SALBUTAMOL SULFATE

Asthma - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 3

SALBUTAMOLLABEL PRSNTN SUBSIDY

SALBUTAMOL-BECLOMETHASONE

LABEL PRSNTN SUBSIDYSALBUTAMOL-BECLOMETHASONE cont’d

COMBIWAVE SF AEROSOL 50 (25/50mcg) 150D INHALER $3,162.00COMBIWAVE SF AEROSOL 125 (25/125mcg) 150D INHALER $3,295.00COMBIWAVE SF AEROSOL 250 (25/250mcg)150D INHALER $3,672.00SALMETIDE HFA AER. INH 25mcg/125mcg120Ds INHALER $2,636.00SALMETIDE HFA AER INH 25mcg/250mcg200Ds INHALER $2,937.23SERETIDE EVO 25/125mcg (GLAXO WELL.)120Ds INHALER $2,636.00SERETIDE DISKUS AER 50/100mcg(GLAXO WELL.)-60Ds INHALER $2,529.30SERETIDE DISKUS AER 50/250mcg (GLAXO WELL.) -60Ds INHALER $2,636.00SERETIDE DISKUS AER 50/500mcg (GSK)60Ds INHALER $2,937.23SERETIDE EVOHALER 25/50mcg (GLAXO WELL.)120Ds INHALER $2,529.30SERETIDE EVOHALER 25/125mcg (GSK)120Ds INHALER $2,636.00SERETIDE EVOHALER 25/250mcg (GSK)120Ds INHALER 2,937.23 SERETIDE EVOHALER-GSK 25mcg/50mcg120Ds INHALER $2,529.30SEROFLO 125 AER INHALER 25/125mcg - 120Ds INHALER $2,636.00SEROFLO 250 AER INHALER 25/250mcg -120Ds INHALER $2,937.23SEROFLO 500 MULTIHALER 30Ds INHALER $1,468.62SEROFLO AER INHALER 50/500mcg-30Ds INHALER $1,468.62

COMBIVENT AER INH INHALER $1,218.44COMBIVENT INHALATION SOLUTION- SINGLE VIAL INHALER $191.80

SALMETEROL & FLUTICASONE

SERETIDE DISKUS AER 50/250mcg(GLAXO WELL.) -60Ds INHALER $2,636.00SERETIDE DISKUS AER 50/500mcg (GSK) -60Ds INHALER $2,937.23SERETIDE EVOHALER 25/50mcg(GLAXO WELL.)-120Ds INHALER $2,529.30SERETIDE EVOHALER 25/125mcg (GSK)- 120Ds INHALER $2,636.00SERETIDE EVOHALER 25/250mcg (GSK) -120Ds INHALER $2,937.23SERETIDE EVOHALER-GSK 25mcg/50mcg-120Ds INHALER $2,529.30SEROFLO 125 AER INHALER 25/125mcg -120Ds INHALER $2,636.00SEROFLO-LAS AER INHALER 25/125mcg INHALER $2,636.00SEROFLO 250 AER INHALER 25/250mcg -120Ds INHALER $2,937.23SEROFLO-LAS AER INHALER 25/250mcg -120Ds INHALER $2,937.23SEROFLO 500 MULTIHALER 30Ds INHALER $1,468.62

TIOTROPIUM SPIRIVA INH. PWD. CAPS 18mcg- PACK OF 30 INHALER $4,061.48SPIRIVA RESPIMAT INHALER 2.5mcg- PACK OF 60 INHALER $4,061.48TIOVA AER INHALER 9mcg - 120Ds INHALER $8,122.96


SALMETEROL XINAFOATESEREVENT AER 25MCG/DS - 120Ds INHALER $1,791.05

SALMETEROL XINA-FLUTICASONE

AIRFLUSAL FOSPIRO POW. FOR INHAL. 50mg/250mg - 60Ds INHALER $2,636.00AIRFLUSAL FOSPIRO POW. FOR INHAL. 50mg/500mg - 60Ds INHALER $2,937.23BEXITROL-F HFA AER INH. 25mcg/125mcg - 120Ds INHALER $2,636.00BEXITROL-F HFA AER INH. 25mcg/250mcg - 120Ds INHALER $2,937.23

SALMETEROL XINA-FLUTICASONE

SALBUTAMOL SULFATE

SALBUTAMOL-IPRATROPIUM

LAS SALBUTAMOL & BECLOMETHAS. AER 100/50mcg INHALER $450.42SALBUTAMOL & BECLOMETHAS.-H2K AER 100/50mcg INHALER $450.42


ASTHMA - RESPIRATORY DEVICESMASK

ABLE SPACER MASK - INFANT DEVICE $501.56ABLE SPACER MASK - ADULT DEVICE $501.56ABLE SPACER MASK - CHILD DEVICE $501.56BABY MASK-CIPLA DEVICE $501.56BABY MASK-H2K DEVICE $501.56BABY MASK-LAS DEVICE $501.56


SPACERABLE SPACER DEVICE $778.51AEROCHAMBER PLUS SPACER AND MOUTHPIECE-ADULT DEVICE $778.51SPACER-H2K DEVICE $778.51VOLUMATIC SPACER DEVICE $778.51ZEROSTAT- LAS SPACER DEVICE $778.51ZEROSTAT VT SPACER DEVICE $778.51

SPACER & MASKAEROCHAMBER PLUS SPACER AND MASKINFANT DEVICE $1,256.54AEROCHAMBER PLUS SPACER AND MASKPAED. DEVICE $1,256.54HUF PUF KIT DEVICE $1,256.54

CONTACT INFORMATION:OFFICE6th Floor, the Towers25 Dominica Drive, Kingston 5Tel: 1-888-NHFCARE (643-2273) or 906-1106Fax: 906-1105Business Hours: Monday- Thursday 7:00am to 4:30pm | Fridays 7:00am to 3:30pmCall Cantre Hours: Monday – Friday 7:00am – 7:00pm

HELP DESKS- Cornwall Regional Hospital - Tel: 971-6571- Mandeville Regional Hospital - Tel: 625-6299- St. Ann’s Bay Hospital - Tel: 972-1683 - Drug Serv Union Square Pharmacy – Tel: 908-5479- Drug Serv May Pen Hospital – Tel: 786-4200

Business Hours: Monday- Thursday 8:30am to 5:00pm | Friday 8:30am to 4:30pm

www.nhf.org.jm/NHFJamaica

Benign Prostatic Hyperplasia - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 1



[email protected]

/NHFJamaica

- BENIGN PROSTATIC HYPERPLASIAINDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS


DOXAZOSINLABEL PRSNTN SUBSIDYAPO-DOXAZOSIN TAB 2mg TAB/CAP $28.93APO-DOXAZOSIN TAB 4mg TAB/CAP $57.86CARDURA TAB 2mg TAB/CAP $28.93CARDURA TAB 4mg TAB/CAP $57.86

DUTASTERIDEAVODART CAP 0.5mg TAB/CAP $108.09

DUTASTERIDE AND TAMSULOSINDUODART CAP 0.5mg/0.4mg TAB/CAP $130.80

FINASTERIDEFINASTERIDE-H2K TAB 5mg TAB/CAP $65.93FINASTERIDE-LAS TAB 5mg TAB/CAP $65.93FINCAR TAB 5MG TAB/CAP $65.93PROSCAR TAB 5mg TAB/CAP $65.93PROTRIDE 5 TAB 5mg TAB/CAP $65.93

SILODOSINSILOREL-4 CAP 4mg TAB/CAP $31.20SILOREL-8 CAP 8mg TAB/CAP $62.40SILOTRIF CAP 4mg TAB/CAP $31.20SILOTRIF CAP 8mg TAB/CAP $62.40

2 | INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS - Benign Prostatic Hyperplasia

TERAZOSINLABEL PRSNTN SUBSIDYAPO-TERAZOSIN TAB 1mg TAB/CAP $6.75APO-TERAZOSIN TAB 2mg TAB/CAP $13.50APO-TERAZOSIN TAB 5mg TAB/CAP $33.75APO-TERAZOSIN TAB 10mg TAB/CAP $67.50HYTRIN STARTER PACK TAB/CAP $559.60HYTRIN TAB 2mg TAB/CAP $13.50HYTRIN TAB 5mg TAB/CAP $33.75HYTRIN TAB 10mg TAB/CAP $67.50SETEGIS TAB 5mg TAB/CAP $33.75TERAPRESS-1 TAB 1mg TAB/CAP $6.75TERAPRESS-5 TAB 5mg TAB/CAP $33.75TERAZOSIN-PMS TAB 1mg TAB/CAP $6.75TERAZOSIN-PMS TAB 2mg TAB/CAP $13.50TERAZOSIN-PMS TAB 5mg TAB/CAP $33.75TERAZOSIN-PMS TAB 10mg TAB/CAP $67.50

TAMSULOSINFLOMAX CR TAB 0.4 mg TAB/CAP $64.82FLOMAX CAP 0.4mg TAB/CAP $64.82KUDOS MR CAPSULE 0.4mg TAB/CAP $64.82TAMSOL PR CAPSULE 0.4mg TAB/CAP $64.82TAMSULOSIN-H2K TAB 0.4mg TAB/CAP $64.82URIMAX MR TAB 0.4mg TAB/CAP $64.82VELTAM MR TAB 0.4mg TAB/CAP $64.82

Breast Cancer - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 1



[email protected]

/NHFJamaica

- BREAST CANCERINDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS


ANASTROZOLELABEL PRSNTN SUBSIDYANASTROZOLE-DENK 1 TABLETS 1mg - 30s TAB/CAP $434.11AREMED TAB 1mg TAB/CAP $434.11ARIMIDEX TAB 1mg TAB/CAP $434.11ASTROL TAB 1mg TAB/CAP $434.11ZENSTRA TAB 1mg TAB/CAP $434.11

CYCLOPHOSPHAMIDEENDOXAN-ASTA INJ 1Gm INJECTION $1,031.75ENDOXAN-ASTA INJ 500mg INJECTION $515.88ENDOXAN-BXT INJ 1 Gm INJECTION $1,031.75ENDOXAN-BXT INJ 200mg INJECTION $206.35ENDOXAN-BXT INJ 500mg INJECTION $515.88ONCOMIDE INJ 200mg INJECTION $206.35ONCOMIDE INJ 500mg INJECTION $515.88ONCOMIDE INJ 1 Gm INJECTION $1,031.75

DOCETAXELDAXOTEL INJ. 20mg/0.5ml INJECTION $5,267.47DAXOTEL INJ. 80mg/2ml INJECTION $21,069.89DOCETAX INJ. 20mg/0.5ml INJECTION $5,267.47DOCETAX INJ. 80mg/2ml INJECTION $21,069.89DOCETAXEL-EBWE INJ. 20mg/2ml INJECTION $5,267.47DOCETAXEL-EBWE INJ. 80mg/8ml INJECTION $21,069.89DOCETAXEL-DRS INJ. 20mg/1ml INJECTION $5,267.47DOCETAXEL-DRS INJ. 80mg/4ml INJECTION $21,069.89

2 | INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS - Breast Cancera

DOCETAXEL cont’dLABEL PRSNTN SUBSIDY

DOXORUBICIN HCLDOXORUBA INJ. 10mg/5ml INJECTION $544.74DOXORUBA INJ. 50mg/25ml INJECTION $2,723.70DOXORUBICIN-EBW INJ. 2mg/ml-5ml INJECTION $544.74DOXORUBICIN-EBW INJ. 2mg/ml-25ml INJECTION $2,723.00DOXORUBICIN-H2K INJ. 10mg INJECTION $544.74DOXORUBICIN-H2K INJ. 50mg INJECTION $2,723.70DOXORUBICIN-NPD INJ. 10mg INJECTION $544.74DOXORUBICIN-NPD INJ. 50mg INJECTION $2,723.70

EXEMESTANEAROMASIN TAB 25mg TAB/CAP $413.17

FLUOROURACILFLUOROURACIL-EBW INJ 1Gm NJECTION $439.11FLUOROURACIL-EBW INJ 250mg INJECTION $109.78FLUOROURACIL-EBW INJ 500mg INJECTION $219.56

GOSERELINZOLADEX DEPOT INJ. 10.8mg- 1vial INJECTION $47,539.18ZOLADEX DEPOT INJ. 3.6mg- 1vial INJECTION $15,846.40

LETROZOLEAPO-LETROZOLE TAB 2.5mg TAB/CAP $303.72FEMARA TAB 2.5mg TAB/CAP $303.72FEMPRO TAB 2.5mg TAB/CAP $303.72LETROL TAB 2.5mg TAB/CAP $303.72ORETA TAB 2.5mg TAB/CAP $303.72

LEUPROLIDELECTRUM DEPOT INJ. 11.25mg-1 vial INJECTION $23,715.83LECTRUM DEPOT INJ. 3.75mg-1 vial INJECTION $7,905.28LECTRUM DEPOT INJ. 7.5mg-1 vial INJECTION $15,810.55LUCRIN DEPOT INJ. 11.25mg- 1vial INJECTION $23,715.83LUCRIN DEPOT INJ. 3.75mg- 1vial INJECTION $7,905.28

DOCETERE INJ. 120mg /3ml INJECTION $31,604.82DOCETERE INJ. 20mg /0.5ml INJECTION $5,267.47DOCETERE INJ. 80mg /2ml INJECTION $21,069.89TAXEWELL INJ. 120mg/3ml INJECTION $31,604.82TAXOTERE INJ. 20mg/0.5ml INJECTION $5,267.47TAXOTERE INJ. 80mg/2ml INJECTION $21,069.89

FULVESTRANTFASLODEX INJ. 250MG/5ml INJECTION $38,314.90

GEMCITABINE GEMCIT INJ. 200mg INJECTION $2,080.00GEMCIT INJ. 1G INJECTION $10,400.00ONCOGEM INJ. 200mg INJECTION $2,080.00ONCOGEM INJ. 1G INJECTION $10,400.00

Breast Cancer - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 3

PACLITAXELCYTAX Inj. 30mg /5ml - 1 vial INJECTION $3,182.40CYTAX Inj. 100mg /16.7ml INJECTION $10,608.00CYTAX Inj. 300mg /50ml INJECTION $31,824.00EBETAXEL (EBWE) Inj. 100mg /16.7ml INJECTION $10,608.00EBETAXEL (EBWE) Inj. 150mg /25ml INJECTION $15,912.00EBETAXEL (EBWE) Inj. 300mg /50ml INJECTION $31,824.00EBETAXEL (EBWE) Inj. 30mg /5ml INJECTION $3,182.40INTAXEL INJ.100mg /17ml INJECTION $10,608.00INTAXEL INJ.300mg /50ml INJECTION $31,824.00MITOTAX INJ.100mg/16.7ml INJECTION $10,608.00MITOTAX INJ.250mg/41.7ml INJECTION $26,520.00MITOTAX INJ.300mg/50ml INJECTION $31,824.00MITOTAX INJ.30mg/5ml INJECTION $3,182.40PACLITAXEL-LAS Inj. 100mg/16.7ml INJECTION $10,608.00PACLITAXEL-LAS Inj. 30mg/5ml INJECTION $3,182.40TAXOL Inj. 30mg/5ml INJECTION $3,182.40

TAMOXIFEN CITRATEAPO-TAMOX TAB 10mg TAB/CAP $9.29APO-TAMOX TAB 20mg TAB/CAP $18.62NOLVADEX TAB 10mg TAB/CAP $9.29NOLVADEX-D TAB 20mg TAB/CAP $18.62TAMOXIFEN-EBW TAB 20mg TAB/CAP $18.62ZITAZONIUM TAB 10mg TAB/CAP $9.29

METHOTREXATE SODIUMMETHOTREXATE-EBW INJ 50mg/5ml INJECTION $356.98METHOTREX-LDL INJ 50mg/2ml INJECTION $356.98ZEXATE INJ. 25mg/ml- 2ml INJECTION $356.98

TRAMADOLADAMON CAP 50mg TAB/CAP $36.40ADAMON DROPS 100mg/ml -10ml TAB/CAP $650.00TRAMAL CAP 50mg TAB/CAP $36.40TRAMADOL DENK 50 EFFERVESCENT TAB 50mg - 10s TAB/CAP $36.40TRAMAL DROPS 100mg/ml -10ml TAB/CAP $650.00TRAMAL L.A. TAB 100mg TAB/CAP $72.80TRAMDOL-BM CAPS 50mg TAB/CAP $36.40

BREAST CANCER - ADJUNCT


EMTHEX INJ 50mg/2ml INJECTION $356.98EMTHEX TAB 2.5mg TAB/CAP $16.19IMUTREX-2.5 TAB 2.5mg TAB/CAP $16.19METHOTREX SOD-EBW TAB 10mg TAB/CAP $64.75METHOTREXATE-LAS TAB 2.5mg TAB/CAP $16.19METHOTREXATE-LDL TAB 2.5mg TAB/CAP $16.19METHOTREX-EBW TAB 2.5mg TAB/CAP $16.19

METHOTREXATELABEL PRSNTN SUBSIDY

4 | INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS - Breast Cancera

TEST PRSNTN SUBSIDY BREAST RECEPTOR STUDIES PER TEST $4,800.00

BREAST CANCER - DIAGNOSTIC PROCEDURE

Diabetes- INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 1

INDIVIDUAL BENEFITS DIABETESFOR PRESCRIPTION DRUGS

ACARBOSELABEL PRSNTN SUBSIDYACARBAY TAB 25mg TAB/CAP $8.12ACARBAY TAB 50mg TAB/CAP $16.24GLUCOBAY TAB 100mg TAB/CAP $32.47GLUCOBAY TAB 50mg TAB/CAP $16.24

GLIMEPIRIDE

AMARYL TAB 4mg TAB/CAP $58.62APO-GLIMEPIRIDE TAB 2mg TAB/CAP $29.31APO-GLIMEPIRIDE TAB 4mg TAB/CAP $58.62GLIMEPIRIDE (Sandoz)TAB 4mg TAB/CAP $58.62GLIMEPIRIDE(Sandoz) TAB 2mg TAB/CAP $29.31GLIMEPIRIDE-DENK TAB 2mg TAB/CAP $29.31GLIMEPIRIDE-DENK TAB 3mg TAB/CAP $43.97GLIMEPIRIDE-H2K TAB 2mg TAB/CAP $29.31GLIMULIN -2 TAB TAB/CAP $29.31GLIMY TABLETS 2mg TAB/CAP $29.31GLIMY TABLETS 4mg TAB/CAP $58.62GLIRIDE -2 TAB TAB/CAP $29.31GLYREE-2 TAB TAB/CAP $29.31GLYREE-4 TAB TAB/CAP $58.62ZORYL TAB 2mg TAB/CAP $29.31ZORYL TAB 4mg TAB/CAP $58.62


GLIBENCLAMIDEAPO-GLYBURIDE TAB 5mg TAB/CAP $3.35BETANASE TAB 5mg TAB/CAP $3.35DAONIL TAB 5mg TAB/CAP $3.35GLIBENCLAMIDE- LAS TAB 5mg TAB/CAP $3.35GLITISOL TAB 5mg TAB/CAP $3.35

GLIBENCLAMIDE(MICRONISED)GLYNASE TAB 1.5mg TAB/CAP $1.74GLYNASE TAB 3mg TAB/CAP $3.50GLYNASE TAB 6mg TAB/CAP $6.99

GLICLAZIDEAPO-GLICLAZIDE MR TAB 30mg TAB/CAP $9.67APO-GLICLAZIDE TAB 80mg TAB/CAP $9.67DIAMICRON MR TAB 30mg TAB/CAP $9.67DIAMICRON MR TAB 60mg TAB/CAP $19.34GLYCINORM-MR TAB 30mg TAB/CAP $9.67GLICADA SR TAB 30mg TAB/CAP $9.67GLICLAZIDE-AUR TAB 80mg TAB/CAP $9.67GLICLAZIDE-H2K TAB 80mg TAB/CAP $9.67GLICLAZIDE-LAS TAB 80mg TAB/CAP $9.67GLYCINORM -80 TAB 80mg TAB/CAP $9.67GLYCINORM-MR TAB 80mg TAB/CAP $9.67GLIDON MR TAB 30mg TAB/CAP $9.67GLIDON MR TAB 60mg TAB/CAP $19.34RECLIDE MR TAB 60mg TAB/CAP $19.34RECLIDE MR TAB 30mg TAB/CAP $9.67RECLIDE TAB 80mg TAB/CAP $9.67

GLIMEPIRIDE & METFORMINAMARYL-M TAB 2mg /1000mg TAB/CAP $36.17AMARYL-M TAB 2mg /500mg TAB/CAP $26.34AMARYL-M TAB 4mg /1000mg TAB/CAP $52.68GLIMY MET 2 TAB 2mg/500mg TAB/CAP $26.34GLIMULIN-MF ER TAB 1mg/500mg TAB/CAP $18.10GLIMULIN-2MF ER TAB 2mg/500mg TAB/CAP $26.34GLYREE M1 TAB 1mg/500mg TAB/CAP $18.10GLYREE M2 TAB 2mg/500mg TAB/CAP $26.34ILET B2 TAB 2mg/500mg TAB/CAP $26.34AMARYL-M TAB 2mg /500mg TAB/CAP $26.34

GLIPIZIDE CRGLUCOTROL XL TAB 10mg TAB/CAP $57.92GLUCOTROL XL TAB 5mg TAB/CAP $28.96

INSULIN ASPARTNOVORAPID FLEXPEN INJ. 3ml-Single Pen INJECTION $774.18NOVORAPID INJ. PENFILL 3ml-Single cartridge INJECTION $774.18

2 | INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS - Diabetes

INSULIN ASPART & ASPART PROTAMINELABEL PRSNTN SUBSIDY

METFORMIN HCLLABEL PRSNTN SUBSIDY

NOVOMIX 30 FLEXPEN INJ. 3ml-Single Pen INJECTION $774.18NOVOMIX 30 INJ. PENFILL 3ml-Single cartridge INJECTION $774.18

APO-METFORMIN TAB 500mg TAB/CAP $3.53APO-METFORMIN TAB 850mg TAB/CAP $5.99AUROMET TAB 500mg TAB/CAP $3.53BARI-MET TAB 500mg TAB/CAP $3.53FEDFORMIN TAB 500mg TAB/CAP $3.53GLIDARA 500 TAB 500mg TAB/CAP $3.53GLIDARA 850 TAB 850mg TAB/CAP $5.99GLUCOPHAGE XR TAB 1000mg TAB/CAP $7.04GLUCOPHAGE XR TAB 500mg TAB/CAP $3.44GLUCOPHAGE XR TAB 750mg TAB/CAP $5.30GLUCOPHAGE 1000mg TAB/CAP $7.04GLUCOPHAGE TAB 500mg TAB/CAP $3.53GLUCOPHAGE TAB 850mg TAB/CAP $5.99GLYFORMIN TAB 500mg TAB/CAP $3.53METFIL TAB 500mg TAB/CAP $3.53METFOR-500 TAB TAB/CAP $3.53METFORMIN-ALP TAB 500mg TAB/CAP $3.53METFORMIN-BPS TABLETS 500mg TAB/CAP $3.53METFORMIN-BPS TABLETS 850mg TAB/CAP $5.99METFORMIN-DENK TAB 1000mg TAB/CAP $7.04METFORMIN-DENK TAB 500mg TAB/CAP $3.53METFORMIN-DENK TAB 850mg TAB/CAP $5.99METFORMIN-H2K TAB 500mg TAB/CAP $3.53METFORMIN-H2K TAB 850mg TAB/CAP $5.99METFORMIN-H2K TAB XR 500mg TAB/CAP $3.53METFORMIN-LAS TAB 500mg TAB/CAP $3.53METFORMIN-LAS TAB 850mg TAB/CAP $5.83METFORMIN-LAS TAB XR 500mg TAB/CAP $3.53METFORMIN-PMS TAB 500mg TAB/CAP $3.53METSAFE ER TAB 500mg TAB/CAP $3.53METSAFE ER TAB 1000mg TAB/CAP $7.04ORABET TAB 500mg TAB/CAP $3.53XMET TAB 500mg TAB/CAP $3.53X-MET ER TAB 500mg TAB/CAP $3.53ZOMET TAB 500mg TAB/CAP $3.53

INSULIN GLARGINELANTUS INJ -10ml vial INJECTION $3,686.44LANTUS INJ -3ml Single cartridge INJECTION $1,105.92LANTUS SOLOSTAR PRE-FILLED PEN INJ -3ml INJECTION $1,105.92APIDRA INJ.3ml-10ml vial INJECTION $2,580.51APIDRA INJ.3ml-Single cartridge INJECTION $774.18APIDRA SOLOSTAR PRE-FILLED PEN INJ. -3ml INJECTION $774.18HUMULIN N INJ U-100 INJECTION $907.47HUMULIN N INJ. PENFILL 3ml-Single cartridge INJECTION $272.25NOVOLIN N INJ PENFILL 3ml Single cartridge INJECTION $272.25NOVOLIN N INJ U-100 INJECTION $907.47HUMALOG INJ PENFILL 3ml-Single cartridge INJECTION $774.18

INSULIN LISPROHUMALOG KWIKPEN INJ.100U/ml-3ml INJECTION $774.18HUMALOG INJ U-100 INJECTION $2,580.51

INSULIN LISPRO& PROTAMINEHUMALOG MIX 75/25 KWIKPEN INJ. 100U/ml-3ml INJECTION $774.18HUMALOG MIX 25 PENFILL 3ml (Single cartridge) INJECTION $774.18

INSULIN REGULAR & ISOPHANE (HUMAN)70/30 HUMULIN INJ 70/30 INJECTION $907.47NOVOLIN INJ 70/30 INJECTION $907.47RECOMULIN INJ 70/30 INJECTION $907.47NOVOLIN INJ 70/30 PENFILL1.5ml-Single cartridge INJECTION $136.13

INSULIN REGULAR (HUMAN)HUMULIN R INJ PENFILL 3ml-Single cartridge INJECTION $272.25HUMULIN R INJ U-100 INJECTION $907.47NOVOLIN R INJ PENFILL 3ml Single cartridge INJECTION $272.25NOVOLIN R INJ U-100 INJECTION $907.47

INSULIN REGULAR&ISOPHANE(HUMAN) 70/30HUMULIN INJ 70/30PENFILL 3ml Single cartridge INJECTION $272.25NOVOLIN INJ 70/30 PENFILL 3ml Single cartridge INJECTION $272.25

LINAGLIPTINTRAJENTA TAB 5mg TAB/CAP $103.83

METFORMIN-GLIBENCLAMIDEGLIFIL M FORTE TAB 5mg-500mg TAB/CAP $30.09GLUCOVANCE TAB 1000-5mg TAB/CAP $45.24GLUCOVANCE TAB 250-1.25mg TAB/CAP $11.34GLUCOVANCE TAB 500-2.5mg TAB/CAP $22.69GLUCOVANCE TAB 500-5mg TAB/CAP $30.09


METFORMIN HCLLABEL PRSNTN SUBSIDY LABEL PRSNTN SUBSIDY LABEL PRSNTN SUBSIDY

PIOGLITAZONE

ACTOS TAB 15mg TAB/CAP $107.17ACTOS TAB 30mg TAB/CAP $214.32ACTOS TAB 45mg TAB/CAP $321.49DIAVISTA 15 mg TAB TAB/CAP $107.17DIAVISTA 30 mg TAB TAB/CAP $214.32GLITOZ TAB 15mg TAB/CAP $107.17GLITOZ TAB 30mg TAB/CAP $214.32PIOGLIT TAB 15mg TAB/CAP $107.17PIOGLIT TAB 30mg TAB/CAP $214.32PIOZ TAB 15mg TAB/CAP $107.17PIOZ TAB 30mg TAB/CAP $214.32PIOZ TAB 45mg TAB/CAP $321.49

ATORVASTATIN CALCIUM cont’d

CANDESARTANCANDESARTAN SANDOZ TAB 8mg TAB/CAP $44.62CANDESARTAN SANDOZ TAB 16mg TAB/CAP $89.25CANDESARTAN SANDOZ TAB 32mg TAB/CAP $89.25

CANDESARTAN CILEXETILATACAND TAB 16mg TAB/CAP $89.25ATACAND TAB 32mg TAB/CAP $89.25ATACAND TAB 8mg TAB/CAP $44.62BLOPRESS TAB 16mg TAB/CAP $89.25BLOPRESS TAB 8mg TAB/CAP $44.62CANDIZAR-4 TAB 4mg TAB/CAP $22.31CANDIZAR-8 TAB 8mg TAB/CAP $44.62

PIOGLITAZONE & METFORMIN HCLDIAVISTA MET 15 SR TAB 15mg/500mg TAB/CAP $88.24DIAVISTA MET 30 SR TAB 30mg/500mg TAB/CAP $149.66

SAXAGLIPTIN & METFORMIN CHLORHIDRATEKOMBIGLYZE XR TAB 5mg/1G TAB/CAP $111.78KOMBIGLYZE XR TAB 2.5mg/1G TAB/CAP $55.90

SITAGLIPTINJANUVIA TAB 100mg TAB/CAP $94.40JANUVIA TAB 25mg TAB/CAP $23.60JANUVIA TAB 50mg TAB/CAP $47.20

SITAGLIPTIN & METFORMINJANUMET TAB 50mg /500mg TAB/CAP $49.40JANUMET TAB 50mg /1000mg TAB/CAP $51.60

VILDAGLIPTINGALVUS TAB 50mg TAB/CAP $43.00

VILDAGLIPTIN & METFORMIN HCIGALVUS MET TAB 50mg/500mg TAB/CAP $42.71GALVUS MET TAB 50mg/850mg TAB/CAP $42.88GALVUS MET TAB 50mg/1000mg TAB/CAP $40.86

DIABETES - ADJUNCTATORVASTATIN CALCIUMAPO- ATORVASTATIN TAB 10mg TAB/CAP $69.88APO- ATORVASTATIN TAB 20mg TAB/CAP $139.77APO- ATORVASTATIN TAB 40mg TAB/CAP $139.77ATOR TAB 10mg TAB/CAP $69.88

ATOR TAB 20mg TAB/CAP $139.77ATOREM TAB 10mg TAB/CAP $69.88ATOREM TAB 20mg TAB/CAP $139.77ATOREM TAB 40mg TAB/CAP $139.77ATORIS TAB 10mg TAB/CAP $69.88ATORIS TAB 20mg TAB/CAP $139.77ATORIS TAB 40mg TAB/CAP $139.77ATORVASTATIN-H2K TAB 10mg TAB/CAP $69.88ATORVASTATIN-H2K TAB 20mg TAB/CAP $139.77CADITOR TAB 10mg TAB/CAP $69.88CADITOR TAB 20mg TAB/CAP $139.77CADITOR TAB 40mg TAB/CAP $139.77LIPIREST TAB 10mg TAB/CAP $69.88LIPIREST TAB 20mg TAB/CAP $139.77LIPIREST TAB 40mg TAB/CAP $139.77LIPITOR TAB 10mg TAB/CAP $69.88LIPITOR TAB 20mg TAB/CAP $139.77LIPITOR TAB 40mg TAB/CAP $139.77LIPITOR TAB 80mg TAB/CAP $139.77X’TOR TAB 20mg TAB/CAP $139.77

CANDESARTAN & HYDROCHLOROTHIAZIDEATACAND PLUS 16mg/12.5mg TAB TAB/CAP $87.38ATACAND PLUS 32mg/12.5mg TAB TAB/CAP $87.38ATACAND PLUS 32mg/25mg TAB TAB/CAP $87.38CANDESARTAN/HCTZ-SDZ TAB 16mg/12.5mg TAB/CAP $87.38CANDESARTAN/HCTZ-SDZ TAB 32mg/12.5mg TAB/CAP $87.38CANDESARTAN/HCTZ-SDZ TAB 32mg/25mg TAB/CAP $87.38BLOPRESS PLUS 16mg/12.5mg TAB TAB/CAP $87.38


CANDESARTAN CILEXETIL cont’dLABEL PRSNTN SUBSIDY LABEL PRSNTN SUBSIDY

APO-ENALAPRIL TAB 10mg TAB/CAP $8.66APO-ENALAPRIL TAB 20mg TAB/CAP $17.38APO-ENALAPRIL TAB 5mg TAB/CAP $4.33BQL 10 TAB TAB/CAP $8.66BQL 5 TAB TAB/CAP $4.33EDNYT TAB 10mg TAB/CAP $8.66EDNYT TAB 20mg TAB/CAP $17.38EDNYT TAB 5mg TAB/CAP $4.33ENA-DENK TAB 10mg TAB/CAP $8.66ENA-DENK TAB 20mg TAB/CAP $17.38ENALAPRIL-H2K TAB 10mg TAB/CAP $8.66ENALAPRIL-H2K TAB 20mg TAB/CAP $17.38ENALAPRIL-H2K TAB 5mg TAB/CAP $4.33ENALAPRIL-LAS TAB 10mg TAB/CAP $8.66ENALAPRIL-LAS TAB 5mg TAB/CAP $4.33ENAM TAB 10mg TAB/CAP $8.66ENAM TAB 2.5mg TAB/CAP $2.19ENAM TAB 20mg TAB/CAP $17.38ENAM TAB 5mg TAB/CAP $4.33ENATEC TAB 10mg TAB/CAP $8.66ENATEC TAB 5mg TAB/CAP $4.33ENVAS TAB 10mg TAB/CAP $8.66ENVAS TAB 5mg TAB/CAP $4.33INVORIL TAB 10mg TAB/CAP $8.66INVORIL TAB 20mg TAB/CAP $17.38INVORIL TAB 5mg TAB/CAP $4.33REDOPRIL TAB 5mg TAB/CAP $4.33VASOTEC TAB 10mg TAB/CAP $8.66VASOTEC TAB 20mg TAB/CAP $17.38VASOTEC TAB 5mg TAB/CAP $4.33

CAPTOPRILAPO-CAPTO TAB 12.5mg TAB/CAP $3.08APO-CAPTO TAB 25mg TAB/CAP $6.17APO-CAPTO TAB 50mg TAB/CAP $12.33CAPOTEN TAB 25mg TAB/CAP $6.17CAPOTEN TAB 50mg TAB/CAP $12.33CAPTOPRIL-APT TAB 12.5mg TAB/CAP $3.08CAPTOPRIL-APT TAB 25mg TAB/CAP $6.17CAPTOPRIL-APT TAB 50mg TAB/CAP $12.33CAPTOPRIL-DENK TAB 25mg TAB/CAP $6.17CAPTOPRIL-H2K TAB 25mg TAB/CAP $6.17CAPTOPRIL-H2K TAB 50mg TAB/CAP $12.33CAPTOPRIL-LAS TAB 25mg TAB/CAP $6.17NOVO-CAPTORIL TAB 25mg TAB/CAP $6.17NOVO-CAPTORIL TAB 50mg TAB/CAP $12.33TENSIOMIN TAB 50mg TAB/CAP $12.33

CANDIZAR-16 TAB 16mg TAB/CAP $89.25

CARBAMAZEPINEAPO-CARBAMAZEP TAB 200mg TAB/CAP $12.63CARBATOL TAB 200mg TAB/CAP $12.63CARZATOL 200mg TAB TAB/CAP $12.63STORILAT 200mg TAB TAB/CAP $12.63TEGRETOL SUSP. 100mg/5ml LIQUID $240.00TEGRETOL TAB 100mg TAB/CAP $6.32TEGRETOL TAB 200mg TAB/CAP $12.63TERIL TAB 200mg TAB/CAP $12.63

CARBAMAZEPINE CRTEGRETOL CR TAB 200mg TAB/CAP $12.63TEGRETOL CR TAB 400mg TAB/CAP $25.27TERIL CR TAB 200mg TAB/CAP $12.63TERIL CR TAB 400mg TAB/CAP $25.27CARBATOL CR TAB 200mg TAB/CAP $12.63CARBATOL CR TAB 400mg TAB/CAP $25.27ZEN RETARD ER TAB 400mg TAB/CAP $25.27

ENALAPRIL & HYDROCHLOROTHIAZIDEENA +HCTZ- DENK TAB 20mg/12.5mg TAB/CAP $67.45VASERETIC TAB 10-25mg TAB/CAP $33.75VASERETIC TAB 20-12.5mg TAB/CAP $67.45

ENALAPRIL MALEATE

EZETIMIBEEZETROL TAB 10mg TAB/CAP $83.20ZETIA TAB 10mg TAB/CAP $83.20

EZETIMIBE & SIMVASTATINVYTORIN TAB 10mg/10mg TAB/CAP $92.49VYTORIN TAB 10mg/20mg TAB/CAP $92.49VYTORIN TAB 10mg/40mg TAB/CAP $139.66VYTORIN TAB 10mg/80mg TAB/CAP $139.66

FLUVASTATIN SODIUMLESCOL CAP 20mg TAB/CAP $41.76LESCOL CAP 40mg TAB/CAP $83.49


LABEL PRSNTN SUBSIDYGABAPENTINLABEL PRSNTN SUBSIDY LABEL PRSNTN SUBSIDYAPO-GABAPENTIN CAP 100mg TAB/CAP $17.60APO-GABAPENTIN CAP 300mg TAB/CAP $52.80APO-GABAPENTIN CAP 400mg TAB/CAP $70.40GABAPENTIN (Sandoz) CAP 300mg TAB/CAP $52.80GABAPENTIN- PMS CAP 100mg TAB/CAP $17.60GABAPENTIN- PMS CAP 300mg TAB/CAP $52.80GABAPENTIN- PMS CAP 400mg TAB/CAP $70.40GABAPENTIN(Sandoz) CAP 400mg TAB/CAP $70.40GABATON CAP 300mg TAB/CAP $52.80NEURONTIN CAP 100mg TAB/CAP $17.60NEURONTIN CAP 300mg TAB/CAP $52.80NEURONTIN CAP 400mg TAB/CAP $70.40

KETANSERINSUFREXAL GEL -78Gm GEL $2,026.26

LISINOPRIL cont’d

LISINOPRIL & HYDROCHLOROTHIAZIDE LISOPRESS HCT TAB 10mg/12.5mg TAB/CAP $15.48LISOPRESS HCT TAB 20mg/12.5mg TAB/CAP $29.80ZESTORETIC TAB 20-12.5mg TAB/CAP $29.80

LOSARTAN POT. & HYDROCHLOROTHIAZIDEAPO-LOSARTAN/HCTZ TABS 50mg/12.5mg TAB/CAP $41.17APO-LOSARTAN/HCTZ TABS 100mg/25mg TAB/CAP $82.36COLOSAR-DENK TAB 50/12.5mg TAB/CAP $41.17COLOSAR-DENK TAB 100/12.5mg TAB/CAP $98.31HYZAAR TAB 100/12.5mg TAB/CAP $98.31PRESARTAN H TAB 50mg/12.5mg TAB/CAP $41.17RESILO-H TAB 50mg/12.5mg TAB/CAP $41.17RESILO-H TAB 100mg/25mg TAB/CAP $82.36TRISARTAN-H TAB 50mg/12.5mg TAB/CAP $41.17HOSART TAB 50/12.5mg TAB/CAP $41.17HYZAAR TAB 100/25mg TAB/CAP $82.36HYZAAR TAB 50/12.5mg TAB/CAP $41.17

IRBESARTANAPROVEL TAB 150mg TAB/CAP $51.49APROVEL TAB 300mg TAB/CAP $102.98IRBESARTAN-SDZ TAB 150mg TAB/CAP $51.49IRBESARTAN-SDZ TAB 300mg TAB/CAP $102.98

IRBESARTAN & HYDROCHLOROTHIAZIDECoAPROVEL TAB 150mg/12.5mg TAB/CAP $52.52CoAPROVEL TAB 300mg/12.5mg TAB/CAP $67.97CoAPROVEL TAB 300mg/25mg TAB/CAP $73.31IRBESARTAN/HCTZ-PMS TAB 150mg/12.5mg TAB/CAP $52.52IRBESARTAN/HCTZ-PMS TAB 300mg/12.5mg TAB/CAP $67.97IRBESARTAN/HCTZ-PMS TAB 300mg/25mg TAB/CAP $73.31IRBESARTAN/HCTZ-SDZ TAB 150mg/12.5mg TAB/CAP $52.52IRBESARTAN/HCTZ-SDZ TAB 300mg/25mg TAB/CAP $73.31

LISINOPRILAPO-LISINOPRIL TAB 10mg TAB/CAP $12.82APO-LISINOPRIL TAB 20mg TAB/CAP $25.64APO-LISINOPRIL TAB 5mg TAB/CAP $6.41LINOTEN TAB 10mg TAB/CAP $12.82LISDENE TAB 20mg TAB/CAP $25.64LISDENE TAB 10mg TAB/CAP $12.82LISDENE TAB 5mg TAB/CAP $6.41LISINOPRIL -H2K TAB 2.5mg TAB/CAP $3.21

LISINOPRIL- H2K TAB 5mg TAB/CAP $6.41LISINOPRIL- H2K TAB 10mg TAB/CAP $12.82LISOPRESS TAB 10mg TAB/CAP $12.82LISOPRESS TAB 20mg TAB/CAP $25.64LISOPRESS TAB 5mg TAB/CAP $6.41LISORIL TAB 10mg TAB/CAP $12.82LISORIL TAB 20mg TAB/CAP $25.64LISORIL TAB 5mg TAB/CAP $6.41LISTRIL TAB 10mg TAB/CAP $12.82LISTRIL TAB 5mg TAB/CAP $6.41ZESTRIL TAB 10mg TAB/CAP $12.82ZESTRIL TAB 20mg TAB/CAP $25.64ZESTRIL TAB 5mg TAB/CAP $6.41

LOSARTAN POTASSIUM

COVANCE TAB 50mg TAB/CAP $24.76COZAAR TAB 100mg TAB/CAP $49.52COZAAR TAB 50mg TAB/CAP $24.76LOSAR-DENK TAB 100mg TAB/CAP $49.52LOSAR-DENK TAB 50mg TAB/CAP $24.76LOSARTAN-H2K TAB 25mg TAB/CAP $12.38LOSARTAN-H2K TAB 50mg TAB/CAP $24.76LOSARTAS TAB 50mg TAB/CAP $24.76


LOSARTAN POTASSIUM cont’dLABEL PRSNTN SUBSIDY LABEL PRSNTN SUBSIDY

APO-PRAVASTATIN TAB 10mg TAB/CAP $21.29APO-PRAVASTATIN TAB 20mg TAB/CAP $42.59APO-PRAVASTATIN TAB 40mg TAB/CAP $85.18PRAVACHOL TAB 10mg TAB/CAP $21.29PRAVACHOL TAB 20mg TAB/CAP $42.59PRAVACHOL TAB 40mg TAB/CAP $85.18PRAVASTATIN-PMS TAB 10mg TAB/CAP $21.29PRAVASTATIN-PMS TAB 20mg TAB/CAP $42.59PRAVASTATIN-PMS TAB 40mg TAB/CAP $85.18PRAVATOR TAB 20mg TAB/CAP $42.59

LOVASTATINAPO-LOVASTATIN TAB 20mg TAB/CAP $42.31LOSTATIN TAB 20mg TAB/CAP $42.31LOVASTATIN-PMS TAB 20mg TAB/CAP $42.31LOVASTATIN-PMS TAB 40mg TAB/CAP $84.61MEVACOR TAB 20mg TAB/CAP $42.31

NICOTINIC ACID (NIACIN) CRNIASPAN ER TAB 500mg TAB/CAP $99.00NIASPAN ER TAB 750mg TAB/CAP $148.50

PRAVASTATIN SODIUM

PREGABALINGABATIN-75 CAP 75mg TAB/CAP $87.19GABATIN-150 CAP 150mg TAB/CAP $174.38LYRICA CAP 150mg TAB/CAP $174.38LYRICA CAP 300mg TAB/CAP $348.77LYRICA CAP 50mg TAB/CAP $58.13LYRICA CAP 75mg TAB/CAP $87.19NEUROBALIN-75 CAP 75mg TAB/CAP $87.19NEUROBALIN-150 CAP 150mg TAB/CAP $174.38PREGASAFE 75 CAP 75mg TAB/CAP $87.19PREGASAFE 150 CAP 150mg TAB/CAP $174.38PREGABALIN-SDZ CAP 75mg TAB/CAP $87.19PREGABALIN-SDZ CAP 150mg TAB/CAP $174.38

LOSARTO TAB 25mg TAB/CAP $12.38LOSARTO TAB 50mg TAB/CAP $24.76LOSARTO TAB 100mg TAB/CAP $49.52LOSATENSIL TAB 50mg TAB/CAP $24.76LOSIUM TAB 100mg TAB/CAP $49.52LOSIUM TAB 25mg TAB/CAP $12.38LOSIUM TAB 50mg TAB/CAP $24.76PRESARTAN-25 TAB TAB/CAP $12.38PRESARTAN-50 TAB TAB/CAP $24.76RESILO TAB 25mg TAB/CAP $12.38RESILO TAB 50mg TAB/CAP $24.76TOZAAR TAB 25mg TAB/CAP $12.38TOZAAR TAB 50mg TAB/CAP $24.76ZAART TAB 25mg TAB/CAP $12.38ZAART TAB 50mg TAB/CAP $24.76

OXCARBAZEPINETRILEPTAL SUSP 300mg/5ML LIQUID. $663.22TRILEPTAL TAB 300mg TAB/CAP $49.92TRILEPTAL TAB 600mg TAB/CAP $99.84

PERINDOPRIL ARGININECOVERSYL TAB 10mg TAB/CAP $77.60COVERSYL TAB 5mg TAB/CAP $38.80

PERINDOPRIL ARGININE & INDAPAMIDEPRETERAX TAB 10mg/2.5mg TAB/CAP $61.02PRETERAX TAB 2.5mg/0.625mg TAB/CAP $26.18PRETERAX TAB 5mg/1.25mg TAB/CAP $52.36PERINDAX TAB 2.5mg/0.625mg TAB/CAP $26.18PERINDAX PLUS TAB 4mg/1.25mg TAB/CAP $52.36

QUINAPRIL HCLACCUPRIL TAB 10mg TAB/CAP $28.49ACCUPRIL TAB 20mg TAB/CAP $56.95ACCUPRIL TAB 5mg TAB/CAP $14.24

RAMIPRIL APO-RAMIPRIL CAP 10mg TAB/CAP $74.88APO-RAMIPRIL CAP 2.5mg TAB/CAP $18.72APO-RAMIPRIL CAP 5mg TAB/CAP $37.44RAMCOR TAB 10mg TAB/CAP $74.88RAMCOR TAB 5mg TAB/CAP $37.44RAMIPRES-5 TAB TAB/CAP $37.44RAMIPRES TABS 10mg TAB/CAP $74.88TRITACE PREVENT CAP 10mg TAB/CAP $74.88


LABEL PRSNTN SUBSIDYRAMIPRIL & HYDROCHLOROTHIAZIDELABEL PRSNTN SUBSIDY LABEL PRSNTN SUBSIDY

RAMIPRIL-HCTZ-PMS TAB 2.5mg/12.5mg TAB/CAP $22.25RAMIPRIL-HCTZ-PMS TAB 5mg/12.5mg TAB/CAP $20.78RAMIPRIL-HCTZ-PMS TAB 5mg/25mg TAB/CAP $44.50RAMIPRIL-HCTZ-PMS TAB 10mg/12.5mg TAB/CAP $32.06RAMIPRIL-HCTZ-PMS TAB 10mg/25mg TAB/CAP $41.55TRITACE HCT TAB 2.5/12.5mg TAB/CAP $22.25

SIMVASTATINAPO-SIMVASTATIN TAB 10mg TAB/CAP $24.87APO-SIMVASTATIN TAB 20mg TAB/CAP $49.74APO-SIMVASTATIN TAB 40mg TAB/CAP $99.47SIMLO TAB 10mg TAB/CAP $24.87SIMLO TAB 20mg TAB/CAP $49.74SIMLO TAB 40mg TAB/CAP $99.47

SIMVASTATIN cont’d

TELMISARTANMICARDIS TAB 80mg TAB/CAP $65.97TELMA 40 TAB 40mg TAB/CAP $32.99TELMA 80 TAB 80mg TAB/CAP $65.97TELMIFAST-40 TAB 40mg TAB/CAP $32.99TELMIFAST-80 TAB 80mg TAB/CAP $65.97TELMIMARK 40 TAB 40mg TAB/CAP $32.99TELI TAB 40mg TAB/CAP $32.99TELSARTAN TAB 40mg TAB/CAP $32.99TELSARTAN TAB 80mg TAB/CAP $65.97TOLURA TAB 40mg TAB/CAP $32.99

ROSUVASTATINAPO-ROSUVASTATIN TAB 5mg TAB/CAP $24.13APO-ROSUVASTATIN TAB 10mg TAB/CAP $48.26APO-ROSUVASTATIN TAB 20mg TAB/CAP $96.51CRESTOR TAB 5mg TAB/CAP $24.13CRESTOR TAB 10mg TAB/CAP $48.26CRESTOR TAB 20mg TAB/CAP $96.51CRESTOR TAB 40mg TAB/CAP $163.20LDNIL TAB 10mg TAB/CAP $48.26LDNIL TAB 20mg TAB/CAP $96.51ROSUVASTATIN SANDOZ TAB 10mg TAB/CAP $48.26ROSUVASTATIN SANDOZ TAB 20mg TAB/CAP $96.51ROSUVASTATIN SANDOZ TAB 40mg TAB/CAP $163.20ROSWERA TAB 5mg TAB/CAP $24.13ROSWERA TAB 10mg TAB/CAP $48.26ROSWERA TAB 20mg TAB/CAP $96.51ROVAS 20 TAB 20mg TAB/CAP $96.51ROZAT 10 TAB 10mg TAB/CAP $48.26ROZAT 20 TAB 20mg TAB/CAP $96.51XOLSTAT TABLETS 10mg TAB/CAP $48.26XOLSTAT TABLETS 20mg TAB/CAP $96.51

SIMPLAQOR TAB 10mg TAB/CAP $24.87SIMPLAQOR TAB 20mg TAB/CAP $49.74SIMPLAQOR TAB 40mg TAB/CAP $99.47SIMSTATIN TAB 20mg TAB/CAP $49.74SIMSTATIN TAB 40mg TAB/CAP $99.47SIMTAS TAB 10mg TAB/CAP $24.87SIMTAS TAB 20mg TAB/CAP $49.74SIMVA TAB 10mg TAB/CAP $24.87SIMVA TAB 20mg TAB/CAP $49.74SIMVA TAB 40mg TAB/CAP $99.47SIMVA-DENK TAB 20mg TAB/CAP $49.74SIMVA-DENK TAB 40mg TAB/CAP $99.47SIMVASTATIN-BPS TABS 10mg TAB/CAP $24.87SIMVASTATIN-BPS TABS 20mg TAB/CAP $49.74SIMVASTATIN-BPS TABS 40mg TAB/CAP $99.47SIMVASTATIN-H2K TAB 20mg TAB/CAP $49.74SIMVASTATIN-H2K TAB 40mg TAB/CAP $99.47SIMVASTATIN-LAS TAB 10mg TAB/CAP $24.87SIMVASTATIN-LAS TAB 20mg TAB/CAP $49.74SIMVASTATIN-PMS TAB 20mg TAB/CAP $49.74SIMVASTATIN-PMS TAB 40mg TAB/CAP $99.47SIMVOR TAB 10mg TAB/CAP $24.87SIMVOR TAB 20mg TAB/CAP $49.74SIMVOR TAB 40mg TAB/CAP $99.47VASILIP TAB 10mg TAB/CAP $24.87VASILIP TAB 20mg TAB/CAP $49.74VASILIP TAB 40mg TAB/CAP $99.47ZOCOR TAB 10mg TAB/CAP $24.87ZOCOR TAB 20mg TAB/CAP $49.74

RAMIPRIL & HYDROCHLOROTHIAZIDE

TRITACE TAB 10mg TAB/CAP $74.88TRITACE TAB 2.5mg TAB/CAP $18.72TRITACE TAB 5mg TAB/CAP $37.44


TELMISARTAN & HYDROCHLOROTHIAZIDE LABEL PRSNTN SUBSIDY LABEL PRSNTN SUBSIDY

VALSARTAN-HYDROCHLOROTHIAZIDECO-DIOVAN TAB 160/12.5mg TAB/CAP $67.34CO-DIOVAN TAB 160/25mg TAB/CAP $68.59CO-DIOVAN TAB 320mg/12.5mg TAB/CAP $93.53CO-DIOVAN TAB 320mg/25mg TAB/CAP $94.78CO-DIOVAN TAB 80/12.5mg TAB/CAP $34.29COVALSAR-DENK TAB 80mg/12.5mg TAB/CAP $34.29COVALSAR-DENK TAB 160mg/12.5mg TAB/CAP $67.34

VALSARTAN-HYDROCHLOROTHIAZIDE cont’d

VALSARTANCARDISAR TAB 80MG TAB/CAP $30.06CARDISAR TAB 160MG TAB/CAP $60.13DIOVAN CAP 160mg TAB/CAP $60.13DIOVAN CAP 80mg TAB/CAP $30.06DIOVAN TAB 160mg TAB/CAP $60.13DIOVAN TAB 320mg TAB/CAP $83.96NORVITAN TAB 80mg TAB/CAP $30.06NORVITAN TAB 160mg TAB/CAP $60.13VALSACOR TAB 80mg TAB/CAP $30.06VALSACOR TAB 160mg TAB/CAP $60.13VALSACOR TAB 320mg TAB/CAP $83.96VALSAR-DENK 40 TAB 40mg TAB/CAP $15.03VALSAR-DENK 80 TAB 80mg TAB/CAP $30.06VALSAR-DENK 160 TAB 160mg TAB/CAP $60.13VALSAR-DENK 320 TAB 320mg TAB/CAP $83.96VALTAN 80 TAB 80mg TAB/CAP $30.06VALTAN TAB 320mg TAB/CAP $83.96

MICARDIS PLUS TAB 80mg / 12.5mg TAB/CAP $67.00MICARDIS PLUS TAB 80mg / 25mg TAB/CAP $66.24SAFETELMI-H TAB 40mg/12.5mg TAB/CAP $33.12SAFETELMI-H TAB 80mg/12.5mg TAB/CAP $67.00TELMA H TAB 40mg/12.5mg TAB/CAP $33.12TELMA H TAB 80mg/12.5mg TAB/CAP $67.00TOLUCOMBI TAB 40mg/12.5mg TAB/CAP $33.12TOLUCOMBI TABLETS 80mg/12.5mg TAB/CAP $67.00TOLUCOMBI TABLETS 80mg/25mg TAB/CAP $66.24

DIABETES - DIAGNOSTIC PROCEDURETEST PRSNTN SUBSIDYNYCO-HBA1C PER TEST $400.00SDA1C - HBAIC PER TEST $400.00

DIABETES - DIAGNOSTIC SUPPLIES

LABEL PRSNTN SUBSIDYGLUCOMETER BLOOD GLUCOSE TEST STRIP

ACCU-CHEK ACTIVE BLOOD GLUCOSE TEST STRIPS STRIP $1,693.01ACCU-CHEK ADVANTAGE BLOOD GLUCOSE TEST STRIPS STRIP $1,693.01ACCU-CHEK PERFORMA BLOOD GLUCOSE TEST STRIPS STRIP $1,693.01ADVOCATE BLOOD GLUCOSE TEST STRIPS STRIP $1,693.01ADVOCATE REDI-CODE BLOOD GLUCOSE TEST STRIPS STRIP $1,693.01EZ SMART BLOOD GLUCOSE TEST STRIPS STRIP $1,693.01FREESTYLE BLOOD GLUCOSE TEST STRIPS STRIP $1,693.01FREESTYLE LITE BLOOD GLUCOSE TEST STRIPS STRIP $1,693.01FREESTYLE OPTIUM BLOOD GLUCOSE TEST STRIPS STRIP $1,693.01FREESTYLE PRECISION BLOOD GLUCOSE TEST STRIPS STRIP $1,693.01GLUCOLAB BLOOD GLUCOSE TEST STRIPS STRIP $1,693.01ON-CALL PLUS BLOOD GLUCOSE TEST

COVALSAR-DENK TAB 320mg/12.5mg TAB/CAP $93.53VALSADEN TAB 80mg/12.5mg TAB/CAP $34.29VALSADEN TAB 160mg/12.5mg TAB/CAP $67.34VALSADEN TAB 160mg/25mg TAB/CAP $68.59VALSADEN TAB 320mg/25mg TAB/CAP $94.78VALSADEN TAB 320mg/12.5mg TAB/CAP $93.53

TELMISARTAN & HYDROCHLOROTHIAZIDE

TOLURA TAB 80mg TAB/CAP $65.97SAFETELMI TAB 80mg TAB/CAP $65.97

ZINC HYALURONATECURIOSIN GEL -15 Gm GEL $847.60


LABEL PRSNTN SUBSIDYGLUCOMETER BLOOD GLUCOSE TEST STRIP cont’dLABEL PRSNTN SUBSIDY LABEL PRSNTN SUBSIDY

INSULIN SYRINGEADVOCATE INSULIN SYRINGES 1cc/29G/1/2ins SYRINGE $11.78ADVOCATE INSULIN SYRINGES 0.5cc/30G/5/16ins SYRINGE $11.78ADVOCATE INSULIN SYRINGES 1cc/30G/5/16ins SYRINGE $11.78ADVOCATE INSULIN SYRINGES 0.5cc/31G/5/16ins SYRINGE $11.78B-D Insulin Syringes 0.5/2cc /28G / I/2 ins SYRINGE $11.78B-D Insulin Syringes 0.5/2cc /29G / I/2 ins SYRINGE $11.78B-D Insulin Syringes 1/2cc /28G / I/2 ins SYRINGE $11.78B-D Insulin Syringes 1/2cc /29G / I/2 ins SYRINGE $11.78B-D Insulin Syringes 1cc /29G / I/2 ins SYRINGE $11.78B-D Insulin Syringes 1cc 30Gx 8mm SYRINGE $11.78

INSULIN SYRINGE cont’d

B-D Insulin Syringes 1cc/ 28G / 1/2 ins SYRINGE $11.78EASY TOUCH INSULIN SYRINGES .5cc x 30G x 5/16 ins SYRINGE $11.78EASY TOUCH INSULIN SYRINGES .5cc x 31G x 5/16 ins SYRINGE $11.78EASY TOUCH INSULIN SYRINGES 1cc x 30G x 5/16 ins SYRINGE $11.78EASY TOUCH INSULIN SYRINGES 1cc x 31G x 5/16 ins SYRINGE $11.78INSULIN SYRINGES-TERUMO 1/2 cc /29G/ 1/2ins SYRINGE $11.78INSULIN SYRINGES-TERUMO 1/2cc /28G / 1/2ins SYRINGE $11.78INSULIN SYRINGES-TERUMO1cc/ 29G / 1/2 ins SYRINGE $11.78LITE TOUCH INSULIN SYRINGES 0.3cc/ 31 G/ 8mm SYRINGE $11.78LITE TOUCH INSULIN SYRINGES 1/2cc /30G/8mm SYRINGE $11.78LITE TOUCH INSULIN SYRINGES 1/2cc/ 29 G/ 1/2ins SYRINGE $11.78LITE TOUCH INSULIN SYRINGES 1/2cc/ 31 G/ 8mm SYRINGE $11.78LITE TOUCH INSULIN SYRINGES 1cc / 29 G/1/2ins SYRINGE $11.78LITE TOUCH INSULIN SYRINGES 1cc / 30 G/8mm SYRINGE $11.78PRECISION INSULIN SYRINGES1/2 cc / 30G/ 5/16. SYRINGE $11.78PRECISION INSULIN SYRINGES 1cc/29G/ 1/2ins SYRINGE $11.78SURE COMFORT INSULIN SYRINGES .3cc/31G/ 5/16 ins SYRINGE $11.78SURE COMFORT INSULIN SYRINGES .5cc/30G/ 1/2 ins SYRINGE $11.78SURE COMFORT INSULIN SYRINGES .5cc/31G/ 5/16 ins SYRINGE $11.78SURE COMFORT INSULIN SYRINGES 1cc/30G/ 1/2ins SYRINGE $11.78SURE COMFORT INSULIN SYRINGES 1cc/31G/ 5/16 ins SYRINGE $11.78

TEST PRSNTN SUBSIDY


STRIPS - 30s STRIP $1,015.81ON-CALL PLUS BLOOD GLUCOSE TEST STRIPS - 50s STRIP $1,693.01ON-CALL PLUS BLOOD GLUCOSE TEST STRIPS - 25s STRIP $846.50ON-CALL PLUS BLOOD GLUCOSE TEST STRIPS - 100s STRIP $3,386.02ON-CALL SIMPLE BLOOD GLUCOSE TESTSTRIPS - 50s STRIP $1,693.01OPTIUM BLOOD GLUCOSE TEST STRIPS STRIP $1,693.01PERFECT 3 BLOOD GLUCOSE TEST STRIPS STRIP $1,693.01PRECISION XTRA BLOOD GLUCOSE TESTSTRIPS STRIP $1,693.01PRESTIGE BLOOD GLUCOSE TEST STRIPS STRIP $1,693.01PRODIGY AUTOCODE BLOOD GLUCOSE TEST STRIPS #52800 STRIP $1,693.01PRODIGY BLOOD GLUCOSE TEST STRIPS STRIP $1,693.01STANDARD DIAGNOSTICS(SD) CODE FREE BLOOD GLUCOSE TEST STRIPS STRIP $1,693.01TRUEBALANCE BLOOD GLUCOSE TESTSTRIPS-25s STRIP $846.50TRUEBALANCE BLOOD GLUCOSE TESTSTRIPS STRIP $1,693.01TRUEREAD BLOOD GLUCOSE TEST STRIPS STRIP $1,693.01TRUE TEST BLOOD GLUCOSE TEST STRIPS STRIP $1693.01TRUETRACK BLOOD GLUCOSE TEST STRIPS STRIP $1,693.01


LANCETLABEL PRSNTN SUBSIDY

TEST REAGENTNYCO HbA1c BLOOD GLUCOSE TEST LIQUID $400.00

INSULIN PEN NEEDLE(FOR USE WITH HUMAPENS) 31G - Single NEEDLE $15.63NOVOFINE NEEDLE 31G - Single NEEDLE $15.63SURE COMFORT PEN NEEDLE 31G - Single NEEDLE $15.63UNIFINE PENTIP NEEDLES 32G 4mm – 100s NEEDLE $15.63UNIFINE PENTIP 3G NEEDLES 5mm - Single NEEDLE $15.63UNIFINE PENTIP NEEDLES 6mm - Single NEEDLE $15.63UNIFINE PENTIP NEEDLES 8mm - Single NEEDLE $15.63

URINE TEST STRIPCLINISTIX REAGENT STRIPS STRIP $391.26LABSTIX STRIP $1,740.39MISSION 10 URINALYSIS REAGENT TEST STRIPS STRIP $1,377.63MISSION 5 URINALYSIS REAGENT TEST STRIPS STRIP $1,731.62URISTIX STRIP $1,052.12

CONTACT INFORMATION:

OFFICE6th Floor, the Towers25 Dominica Drive, Kingston 5Tel: 1-888-NHFCARE (643-2273) or 906-1106Fax: 906-1105Business Hours: Monday- Thursday 7:00am to 4:30pm Fridays 7:00am to 3:30pmCall Cantre Hours: Monday – Friday 7:00am – 7:00pm


Business Hours: Monday- Thursday 8:30am to 5:00pm Friday 8:30am to 4:30pm

www.nhf.org.jm/NHFJamaicaPENFILL NEEDLE

ACCU-CHEK SOFTCLIX 11 Lancets - Single LANCET $3.28ADVOCATE LANCETS- 26G - Single LANCET $3.28ADVOCATE LANCETS- 30G - Single LANCET $3.28ADVOCATE SAFETY LANCETS- 30G - Single LANCET $3.28ADVOCATE TWIST TOP LANCETS- 30G - Single LANCET $3.28EZ SMART LANCETS - Single LANCET $3.28FREESTYLE LANCETS - Single LANCET $3.28JT FINE LANCETS - Single LANCET $3.28LITE TOUCH MICRO THIN LANCETS – 100s LANCET $3.28MEDISENSE LANCETS - Single LANCET $3.28MPD ULTRA THIN LANCETS - Single LANCET $3.28ON- CALL PLUS LANCETS - Single LANCET $3.28PRODIGY TWIST TOP 28G LANCET $3.28PROMISEMED BLOOD 30G LANCETS - Single LANCET $3.28SURE COMFORT 30G LANCETS - Single LANCET $3.28VITALCARE LANCETS 28G - Single LANCET $3.28VITALCARE LANCETS 30G - Single LANCET $3.28VITALCARE SAFETY LANCETS 26G - Single LANCET $3.28

Epilepsy - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 1



[email protected]

/NHFJamaica

- EPILEPSYINDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS


CARBAMAZEPINELABEL PRSNTN SUBSIDYAPO-CARBAMAZEP TAB 200mg TAB/CAP $12.63CARBATOL 200mg TAB TAB/CAP $12.63CARZATOL 200mg TAB TAB/CAP $12.63STORILAT 200mg TAB TAB/CAP $12.63TEGRETOL SUSP. 100mg/5ml LIQUID $240.00TEGRETOL TAB 100mg TAB/CAP $6.32TEGRETOL TAB 200mg TAB/CAP $12.63TERIL TAB 200mg TAB/CAP $12.63

CARBAMAZEPINE CRTEGRETOL CR TAB 200mg TAB/CAP $12.63TEGRETOL CR TAB 400mg TAB/CAP $25.27TEGRETOL CR TAB TAB 200mg TAB/CAP $12.63TERIL CR TAB 200mg TAB/CAP $12.63TERIL CR TAB 400mg TAB/CAP $25.27CARBATOL CR 200mg TAB TAB/CAP $12.63CARBATOL CR 400mg TAB TAB/CAP $25.27ZEN RETARD ER TAB 400mg TAB/CAP $25.27

DIVALPROEX SODIUMDEPAKOTE ER TAB 500mg TAB/CAP $30.86DEPAKOTE ER TAB 250mg TAB/CAP $15.43DEPAKOTE TAB 250mg TAB/CAP $15.43DEPAKOTE TAB 500mg TAB/CAP $29.58

2 | INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS - Epilepsy

GABAPENTINLABEL PRSNTN SUBSIDY APO-GABAPENTIN CAP 100mg TAB/CAP $17.60APO-GABAPENTIN CAP 300mg TAB/CAP $52.80APO-GABAPENTIN CAP 400mg TAB/CAP $70.40GABAPENTIN (Sandoz) CAP 300mg TAB/CAP $52.80 GABAPENTIN- PMS CAP 100mg TAB/CAP $17.60GABAPENTIN- PMS CAP 300mg TAB/CAP $52.80GABAPENTIN- PMS CAP 400mg TAB/CAP $70.40GABAPENTIN(Sandoz) CAP 400mg TAB/CAP $70.40GABATON CAP 300mg TAB/CAP $52.80NEURONTIN CAP 100mg TAB/CAP $17.60NEURONTIN CAP 300mg TAB/CAP $52.80NEURONTIN CAP 400mg TAB/CAP $70.40

LAMOTRIGINELAMICTAL CHW. DISP. TAB 100 mg TAB/CAP $72.38LAMICTAL CHW. DISP. TAB 25mg TAB/CAP $18.09LAMICTAL CHW. DISP. TAB 50mg TAB/CAP $36.19LAMOTRIGINE -PMS TAB 100mg TAB/CAP $72.38LAMOTRIGINE -PMS TAB 25mg TAB/CAP $18.09LAMOTRIGINE -PMS TAB 150mg TAB/CAP $108.57

LEVETIRACETAM KEPPRA 10% SOLUTION -300ml LIQUID $3,796.00KEPPRA TAB 1000mg TAB/CAP $128.00KEPPRA TAB 500mg TAB/CAP $64.00

OXCARBAZEPINETRILEPTAL SUSP 300mg/5ml-100ml LIQUID. $754.76TRILEPTAL TAB 300mg TAB/CAP $56.81TRILEPTAL TAB 600mg TAB/CAP $113.62

PHENOBARBITALBARBIFED TAB 30mg TAB/CAP $2.69

PHENYTOINDILANTIN CHW 50mg TAB/CAP $10.92

PHENYTOIN SODIUMDILANTIN CAP 100mg TAB/CAP $23.72EPILANTIN TAB 100mg TAB/CAP $23.72NOVO-PHENYTOIN CAP 100mg TAB/CAP $23.72

PREGABALINGABATIN-75 CAP 75MG TAB/CAP $87.19GABATIN-150 CAP 150MG TAB/CAP $174.38LYRICA CAP 150mg TAB/CAP $174.38LYRICA CAP 300mg TAB/CAP $348.77LYRICA CAP 50mg TAB/CAP $58.13LYRICA CAP 75mg TAB/CAP $87.19NEUROBALIN-75 CAP 75mg TAB/CAP $87.19NEUROBALIN-150 CAP 150mg TAB/CAP $174.38PREGASAFE 75 CAP 75mg TAB/CAP $87.19PREGASAFE 150 CAP 150mg TAB/CAP $174.38PREGABALIN-SDZ CAP 75mg TAB/CAP $87.19PREGABALIN-SDZ CAP 150mg TAB/CAP $174.38

Epilepsy - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 3

TOPIRAMATETOPAMAX TAB 100mg TAB/CAP $102.83TOPAMAX TAB 25mg TAB/CAP $25.71TOPAMAX TAB 50mg TAB/CAP $51.42TOPAZ TAB 100mg TAB/CAP $102.83TOPAZ TAB 25mg TAB/CAP $25.71TOPAZ TAB 50mg TAB/CAP $51.42TOPIRAMATE -PMS TAB 25mg TAB/CAP $25.71TOPIRAMATE -PMS TAB 100mg TAB/CAP $102.83TOPIRAMATE (Sandoz) TAB 100mg TAB/CAP $102.83TOPIRAMATE (Sandoz) TAB 25mg TAB/CAP $25.71TOPIRAMATE (Sandoz) TAB 50mg TAB/CAP $51.42

VALPROIC ACIDDEPAKENE CAP 250mg TAB/CAP $17.30VALPORIC ACID-PMS CAP 250mg TAB/CAP $17.30DEPAKENE SYP 250/5ml - 1ml LIQUID $3.36DEPAKENE SOLN. 250/5ml - 240ml LIQUID $807.83

SODIUM VALPROATE

LABEL PRSNTN SUBSIDY EPILIM CHRONO TAB 200mg TAB/CAP $13.27EPILIM CHRONO TAB 300mg TAB/CAP $19.91EPILIM CHRONO TAB 500mg TAB/CAP $33.18EPILIM TAB 200mg TAB/CAP $13.27EPILIM SYP 200mg/5ml LIQUID $1,459.76

Glaucoma - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 1



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- GLAUCOMAINDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS


ACETAZOLAMIDELABEL PRSNTN SUBSIDYAPO-ACETAZOLAM TAB 250mg TAB/CAP $3.50

BETAXOLOL HCLACCULOL SOL 0.5% OP SOLUTION $856.15BETOPTIC-S SUS 0.25% OP - 10ml SUSPENSION $1,712.30BETOPTIC-S SUS 0.25% OP - 5ml SUSPENSION $856.15

BIMATOPROSTLUMIGAN SOL 0.01% OP - 2.5ml SOLUTION $1,766.92LUMIGAN SOL 0.03% OP - 2.5ml SOLUTION $1,766.92ALPHAGAN P SOL 0.1% OP - 10ml SOLUTION $1,757.60ALPHAGAN P SOL 0.1% OP - 5ml SOLUTION $878.80ALPHAGAN P SOL 0.15% OP - 10ml SOLUTION $1,757.60ALPHAGAN P SOL 0.15% OP - 5ml SOLUTION $878.80BRIMOGAN OPTHALMIC SOL 0.2% OP - 5ml SOLUTION $878.80BRIMONIDINE TARTRATE SOL 0.2% OP - 5ml SOLUTION $878.80BRIMOPRESS SOL 0.2% OP - 5ml SOLUTION $878.80

BRIMONIDINE & TIMOLOLBRIMOPRESS T OPTHALMIC SOL 0.2%/0.5% - 5ML SOLUTION $1,449.51BRIMOTIM OPTHALMIC SOL 0.2% / 0.5% OP - 10ml SOLUTION $2,899.02COMBIGAN SOL 0.2% / 0.5% OP - 5ml SOLUTION $1,449.51

2 | INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS - Glaucoma

BRINZOLAMIDELABEL PRSNTN SUBSIDYAZOPT SUSP. 1% OP - 10ml SUSPENSION $2,221.65AZOPT SUSP. 1% OP - 5ml SUSPENSION $1,110.83BRINZOTEN SUSP. 1% OP - 5ml SUSPENSION $1,110.83

BRINZOLAMIDE & TIMOLOLAZARGA OPTHALMIC SUSPENSION 1.0%/0.5% - 5ml SUSPENSION $1,673.88

CANABIS SATIVACANASOL DROPS 0.1% OP - 5ml SOLUTION $590.68

DORZOLAMIDE HCLDORZOLAMIDE -H2K SOL 2% OP - 5ml SOLUTION $1,147.54DORZOPT EYE DROPS 2% OP-5ml SOLUTION $1,147.54DORZOPT OPH SOLUTION 2% - 5ml SOLUTION $1,147.54GLAUCOTENSIL D SOL 2% OP - 5ml SOLUTION $1,147.54TRUSOPT SOL 2% OP - 5ml SOLUTION $1,147.54

DORZOLAMIDE-TIMOLOLCOSOPT SOL 2.5% OP - 5ml SOLUTION $1,930.24DORZOTIM OPH SOLUTION (2%/0.5%) - 5ml SOLUTION $1,930.24GLAUCOTENSIL TD SOL 2% & 0.5% OP - 5ml SOLUTION $1,930.24

LATANOPROSTLOUTEN SOL 0.005% OP - 2.5ml SOLUTION $1,852.50XALATAN SOL 0.005% OP - 2.5ml SOLUTION $1,852.50

LATANOPROST & TIMOLOLLOUTEN-T SOL 0.005%/0.5% OP - 2.5ml SOLUTION $1,434.24XALACOM SOL 0.005%/0.5% OP - 2.5ml SOLUTION $1,434.24

PILOCARPINE HCLISOPTO CARP SOL 2% OP - 15ml SOLUTION $283.54ISOPTO CARP SOL 4% OP - 15ml SOLUTION $567.07PILOCAR SOL 2% OP - 5ml SOLUTION $94.52PILOCAR SOL 4% OP- 5ml SOLUTION $189.02PILOCARPINE-FLC SOL 4% OP - 15ml SOLUTION $567.07PILOCARPINE-MTD SOL 1% OP -10ml SOLUTION $94.52PILOCARPINE-MTD SOL 2% OP - 10ml SOLUTION $189.02PILOCARPINE-MTD SOL 3% OP- 10ml SOLUTION $283.54PILOCARPINE-MTD SOL 4% OP - 10ml SOLUTION $378.04PILOCARPINE-SHN SOL 2% OP - 15ml SOLUTION $283.54PILOCARPINE-SHN SOL 4% OP - 15ml SOLUTION $567.07

TAFLUPROST SAFLUTAN EYE DROPS 0.0015% OP-30 X 0.3ml SOLUTION $1,829.10SAFLUTAN OPHTHALMIC SOLUTION SOLUTION $1,829.10

TIMOLOL MALEATEARISTOMOL SOL 0.5% OP - 5ml SOLUTION $346.84APO-TIMOP SOL 0.25% OP - 5ml SOLUTION $173.43APO-TIMOP SOL 0.5% OP - 10ml SOLUTION $693.68APO-TIMOP SOL 0.5% OP - 5ml SOLUTION $346.84IOTIM SOL 0.5% OP - 5ml SOLUTION $346.84NYOLOL GEL 0.1% OP - 5ml SOLUTION $346.84OCUPRES-E SOL 0.5% OP - 5ml SOLUTION $346.84OCUTIM SOL 0.5% OP - 5ml SOLUTION $346.84OPTIMOL SOL 0.5% OP - 5ml SOLUTION $346.84

Glaucoma - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 3


TRAVOPROSTAVATAN SOL. .004% OP - 3ml SOLUTION $1,702.27GLAUCOPROST SOL .004% OP - 3ml SOLUTION $1,702.27TRAVATAN BAK-FREE SOL. .004% OP - 2.5ml SOLUTION $1,418.56TRAVATAN SOL. .004% OP - 2.5ml SOLUTION $1,418.56TRAVOPT SOL. .004% OP - 3ml SOLUTION $1,702.27

TRAVOPROST & TIMOLOLDUOTRAV BAK-FREE DROPS. .004% / 0.5% - 2.5ml SOLUTION $1,591.98TRAVOTIM EYE DROPS .004% / 0.5% - 3ml SOLUTION $1,910.37

TIMOLOL MALEATE cont’d

POENTIMOL SOL 0.5% - 5ml SOLUTION $346.84TIMOLOC SOL 0.5% - 5ml SOLUTION $346.84TIMOLOL-H2K SOL 0.5% OP - 5ml SOLUTION $346.84TIMOLOL-LAS SOL 0.25% OP - 5ml SOLUTION $173.43TIMOLOL-LAS SOL 0.5% OP - 5ml SOLUTION $346.84TIMOLOL-MTD SOL 0.25% OP - 5ml SOLUTION $173.43TIMOLOL-MTD SOL 0.5% OP - 5ml SOLUTION $346.84TIMOPTIC SOL 0.25% OP - 5ml SOLUTION $173.43TIMOPTIC SOL 0.5% OP - 5ml SOLUTION $346.84TIMOPTIC-XE SOL 0.25% OP - 2.5ml SOLUTION $173.43TIMOPTIC-XE SOL 0.5% OP - 2.5ml SOLUTION $346.84VYTIM SOL 0.5% OP - 5ml SOLUTION $346.84

High Cholesterol - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 1



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- HIGH CHOLESTEROLINDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS

ATORVASTATIN CALCIUM

LABEL PRSNTN SUBSIDYAPO- ATORVASTATIN TAB 10mg TAB/CAP $69.88APO- ATORVASTATIN TAB 20mg TAB/CAP $139.77APO- ATORVASTATIN TAB 40mg TAB/CAP $139.77ATOR TAB 10mg TAB/CAP $69.88ATOR TAB 20mg TAB/CAP $139.77ATOREM TAB 10mg TAB/CAP $69.88ATOREM TAB 20mg TAB/CAP $139.77ATOREM TAB 40mg TAB/CAP $139.77ATORIS TAB 20mg TAB/CAP $139.77ATORIS TAB 40mg TAB/CAP $139.77ATORVASTATIN-H2K TAB 10mg TAB/CAP $69.88ATORVASTATIN-H2K TAB 20mg TAB/CAP $139.77CADITOR TAB 10mg TAB/CAP $69.88CADITOR TAB 20mg TAB/CAP $139.77CADITOR TAB 40mg TAB/CAP $139.77LIPIREST TAB 10mg TAB/CAP $69.88LIPIREST TAB 20mg TAB/CAP $139.77LIPIREST TAB 40mg TAB/CAP $139.77LIPITOR TAB 10mg TAB/CAP $69.88


2 | INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS - High Cholesterol

ATORVASTATIN CALCIUM cont’d



LOVASTATINAPO-LOVASTATIN TAB 20mg TAB/CAP $42.31LOSTATIN TAB 20mg TAB/CAP $42.31LOVASTATIN-PMS TAB 20mg TAB/CAP $42.31LOVASTATIN-PMS TAB 40mg TAB/CAP $84.61MEVACOR TAB 20mg TAB/CAP $42.31

LIPITOR TAB 20mg TAB/CAP $139.77LIPITOR TAB 40mg TAB/CAP $139.77LIPITOR TAB 80mg TAB/CAP $139.77X’TOR TAB 20mg TAB/CAP $139.77

PRAVASTATIN SODIUMAPO-PRAVASTATIN TAB 10mg TAB/CAP $21.29APO-PRAVASTATIN TAB 20mg TAB/CAP $42.59APO-PRAVASTATIN TAB 40mg TAB/CAP $85.18PRAVACHOL TAB 10mg TAB/CAP $21.29PRAVACHOL TAB 20mg TAB/CAP $42.59PRAVACHOL TAB 40mg TAB/CAP $85.18PRAVASTATIN-PMS TAB 10mg TAB/CAP $21.29PRAVASTATIN-PMS TAB 20mg TAB/CAP $42.59PRAVASTATIN-PMS TAB 40mg TAB/CAP $85.18PRAVATOR TAB 20mg TAB/CAP $42.59

ROSUVASTATINAPO-ROSUVASTATIN TAB 5mg TAB/CAP $24.13APO-ROSUVASTATIN TAB 10mg TAB/CAP $48.26APO-ROSUVASTATIN TAB 20mg TAB/CAP $96.51CRESTOR TAB 10mg TAB/CAP $48.26CRESTOR TAB 20mg TAB/CAP $96.51CRESTOR TAB 40mg TAB/CAP $163.20CRESTOR TAB 5mg TAB/CAP $24.13LDNIL TAB 10mg TAB/CAP $48.26LDNIL TAB 20mg TAB/CAP $96.51


High Cholesterol - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 3

ROSUVASTATIN cont’d


SIMVASTATINAPO-SIMVASTATIN TAB. 10mg TAB/CAP $24.87APO-SIMVASTATIN TAB 20mg TAB/CAP $49.74APO-SIMVASTATIN TAB 40mg TAB/CAP $99.47SIMLO TAB 10mg TAB/CAP $24.87SIMLO TAB 20mg TAB/CAP $49.74SIMLO TAB 40mg TAB/CAP $99.47SIMPLAQOR TAB 10mg TAB/CAP $24.87SIMPLAQOR TAB 20mg TAB/CAP $49.74SIMPLAQOR TAB 40mg TAB/CAP $99.47SIMSTATIN TAB 20mg TAB/CAP $49.74SIMSTATIN TAB 40mg TAB/CAP $99.47SIMTAS TAB 10mg TAB/CAP $24.87SIMTAS TAB 20mg TAB/CAP $49.74SIMVA TAB 10mg TAB/CAP $24.87SIMVA TAB 20mg TAB/CAP $49.74SIMVA TAB 40mg TAB/CAP $99.47SIMVA-DENK TAB. 20mg TAB/CAP $49.74SIMVA-DENK TAB. 40mg TAB/CAP $99.47SIMVASTATIN-BPS TABS 10mg TAB/CAP $24.87SIMVASTATIN-BPS TABS 20mg TAB/CAP $49.74SIMVASTATIN-BPS TABS 40mg TAB/CAP $99.47SIMVASTATIN-H2K TAB 20mg TAB/CAP $49.74SIMVASTATIN-H2K TAB 40mg TAB/CAP $99.47SIMVASTATIN-LAS TAB 10mg TAB/CAP $24.87SIMVASTATIN-LAS TAB 20mg TAB/CAP $49.74SIMVASTATIN-PMS TAB 20mg TAB/CAP $49.74SIMVASTATIN-PMS TAB 40mg TAB/CAP $99.47SIMVOR TAB 10mg TAB/CAP $24.87SIMVOR TAB 20mg TAB/CAP $49.74SIMVOR TAB 40mg TAB/CAP $99.47VASILIP TAB 10mg TAB/CAP $24.87

ROSUVASTATIN SANDOZ TAB 10mg TAB/CAP $48.26ROSUVASTATIN SANDOZ TAB 20mg TAB/CAP $96.51ROSUVASTATIN SANDOZ TAB 40mg TAB/CAP $163.20ROSWERA TAB 5mg TAB/CAP $24.13ROSWERA TAB 10mg TAB/CAP $48.26ROSWERA TAB 20mg TAB/CAP $96.51ROVAS 20 TAB 20mg TAB/CAP $96.51ROZAT 10 TAB 10mg TAB/CAP $48.26ROZAT 20 TAB 20mg TAB/CAP $96.51XOLSTAT TABLETS 10mg TAB/CAP $48.26XOLSTAT TABLETS 20mg TAB/CAP $96.51

4 | INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS - High Cholesterol

LABEL PRSNTN SUBSIDYVASILIP TAB 20mg TAB/CAP $49.74VASILIP TAB 40mg TAB/CAP $99.47ZOCOR TAB 10mg TAB/CAP $24.87ZOCOR TAB 20mg TAB/CAP $49.74ZOCOR TAB 40mg TAB/CAP $99.47

SIMVASTATIN cont’d

Hypertension - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 1

INDIVIDUAL BENEFITS HYPERTENSIONFOR PRESCRIPTION DRUGS

AMLODIPINE BESYLATELABEL PRSNTN SUBSIDYAPO-AMLODIPINE TAB 5mg TAB/CAP $14.56APO-AMLODIPINE TAB 10mg TAB/CAP $29.11AMDEPIN TAB 5mg TAB/CAP $14.56AMDEPIN TAB 10mg TAB/CAP $29.11AMLOCARD TAB 5mg TAB/CAP $14.56AMLOCARD TAB 10mg TAB/CAP $29.11AMLOCOR TAB 10mg TAB/CAP $29.11AMLO-DENK TAB 10mg TAB/CAP $29.11AMLODOPINE-H2K TAB 5mg TAB/CAP $14.56AMLODOPINE-H2K TAB 10mg TAB/CAP $29.11AMLODIPINE-LAS TAB 5mg TAB/CAP $14.56AMLODIPINE-LAS TAB 10mg TAB/CAP $29.11AMLODIPINE-PMS TAB 5mg TAB/CAP $14.56AMLODIPINE-PMS TAB 10mg TAB/CAP $29.11AMLODIPINE-SDZ TAB 5mg TAB/CAP $14.56AMLODIPINE-SDZ TAB 10mg TAB/CAP $29.11AMLO-DENK TAB 5mg TAB/CAP $14.56AMTAS TAB 5mg TAB/CAP $14.56AMTAS TAB 10mg TAB/CAP $29.11BARAMLO TAB 5mg TAB/CAP $14.56BARAMLO TAB 10mg TAB/CAP $29.11CALCHEK TAB 5mg TAB/CAP $14.56CALCHEK TAB 10mg TAB/CAP $29.11NORVASC TAB 5mg TAB/CAP $14.56NORVASC TAB 10mg TAB/CAP $29.11STAMLO TAB 5mg TAB/CAP $14.56STAMLO TAB 10mg TAB/CAP $29.11TENOX TAB 5mg TAB/CAP $14.56TENOX TAB 10mg TAB/CAP $29.11

S-AMLODIPINE BESILATEASOMEX-2.5 TAB 2.5mg TAB/CAP $7.29ASOMEX-5 TAB 5mg TAB/CAP $14.56ESEM 2.5 TAB 2.5mg TAB/CAP $7.29ESEM 5.0 TAB 5mg TAB/CAP $14.56

AMLODIPINE BESILATE & ATENOLOL

AMLODIPINE BESILATE & ATORVASTATINCADUET TAB 5mg/10mg TAB/CAP $94.71CADUET TAB 5mg/20mg TAB/CAP $178.78

S-AMLODIPINE & HYDROCHLOROTHIAZIDEASOMEX D TAB 2.5mg/12.5mg TAB/CAP $5.46

CALCHEK-A TAB 5mg/50mg TAB/CAP $22.16

AMLODIPINE & INDAPAMIDE

NATRIXAM MR TAB 5MG/1.5MG TAB/CAP $26.16NATRIXAM MR TAB 10MG/1.5MG TAB/CAP $35.01

AMLODIPINE BESILATE & LISINOPRIL DIHYDRATELISONORM TAB 5mg/10mg TAB/CAP $23.55LISONORM TAB 10mg/20mg TAB/CAP $47.09

S-AMLODIPINE & LOSARTANASOMEX LT TAB 2.5mg/50mg TAB/CAP $29.19

AMLODIPINE & VALSARTAN

AMLOVAL TAB 5mg/80mg TAB/CAP $36.05AMLOVAL 5/160 TAB 5mg/160mg TAB/CAP $63.25AMLOVAL 10/160 TAB 10mg/160mg TAB/CAP $72.10EXFORGE TAB 5mg/80mg TAB/CAP $36.05EXFORGE TAB 5mg/160mg TAB/CAP $63.25EXFORGE TAB 10mg/160mg TAB/CAP $72.10EXFORGE TAB 5mg/320mg TAB/CAP $84.81VALSARTAN & AMLODIPINE PRO TAB 5mg/80mg TAB/CAP $36.05VALSARTAN & AMLODIPINE PRO TAB 5mg/160mg TAB/CAP $63.25VALSARTAN & AMLODIPINE PRO TAB 10mg/160mg TAB/CAP $72.10



AMLODIPINE & VALSARTAN cont’dLABEL PRSNTN SUBSIDY

ATENOLOL cont’dLABEL PRSNTN SUBSIDY

VALSARTAN & AMLODIPINE PRO TAB 5mg/320mg TAB/CAP $84.81VALSARTAN & AMLODIPINE PRO TAB 10mg/320mg TAB/CAP $93.66EXFORGE TAB 10mg/320mg TAB/CAP $93.66

AMLODIPINE & VALSARTAN & HYDROCHLOROTHIAZIDEEXFORGE HCT TAB 5mg/160mg/12.5mg TAB/CAP $64.28EXFORGE HCT TAB 5mg/160mg/25mg TAB/CAP $65.31EXFORGE HCT TAB 10mg/160mg/12.5mg TAB/CAP $73.13EXFORGE HCT TAB 10mg/160mg/25mg TAB/CAP $74.16EXFORGE HCT TAB 10mg/320mg/25mg TAB/CAP $95.72

ATENOLOLAPO-ATENOL TAB 100mg TAB/CAP $9.41APO-ATENOL TAB 50mg TAB/CAP $4.71ATEN TAB 100mg TAB/CAP $9.41ATENO TAB 100mg TAB/CAP $9.41ATENO TAB 50mg TAB/CAP $4.71ATENOLOL-BPS TAB 50mg TAB/CAP $4.71ATENOLOL-BPS TAB 100mg TAB/CAP $9.41ATENOLOL- H2K TAB 50mg TAB/CAP $4.71ATENOLOL-ACT TAB 100mg TAB/CAP $9.41ATENOLOL-ACT TAB 25mg TAB/CAP $2.35ATENOLOL-ACT TAB 50mg TAB/CAP $4.71ATENOLOL-ALP TAB 100mg TAB/CAP $9.41ATENOLOL-ALP TAB 25mg TAB/CAP $2.35ATENOLOL-ALP TAB 50mg TAB/CAP $4.71ATENOLOL-DENK TAB 50mg TAB/CAP $4.71ATENOLOL-H2K TAB 100mg TAB/CAP $9.41ATENOLOL-PMS 50mg TAB/CAP $4.71ATENOLOL-PMS 100mg TAB/CAP $9.41ATENOLOL-SHN TAB 100mg TAB/CAP $9.41ATENOLOL-SHN TAB 50mg TAB/CAP $4.71BETACARD TAB 100mg TAB/CAP $9.41BETACARD TAB 50mg TAB/CAP $4.71BLOCOTENOL TAB 100mg TAB/CAP $9.41

AMILORIDE & HYDROCHLOROTHIAZIDEAPO-AMILZIDE TAB 5mg/50mg TAB/CAP $4.59MILOREX TAB 5mg/50mg TAB/CAP $4.59

BLOCOTENOL TAB 50mg TAB/CAP $4.71BLOKIUM 100 TAB TAB/CAP $9.41 BLOKIUM 50 TAB TAB/CAP $4.71NOVO-ATENOL TAB 100mg TAB/CAP $9.41TENORMIN TAB 100mg TAB/CAP $9.41TENORMIN TAB 50mg TAB/CAP $4.71TOTAMOL TAB 50mg TAB/CAP $4.71VELORIN TAB 100mg TAB/CAP $9.41

S-ATENOLOLATPURE TAB 25mg TAB/CAP $4.71ATPURE TAB 50mg TAB/CAP $9.41

ATENOLOL & CHLORTHALIDONEBLOKIUM DIU TAB 100mg/25mg TAB/CAP $32.94TENORETIC TAB 50mg/12.5mg TAB/CAP $16.47TENORETIC TAB 100mg/25mg TAB/CAP $32.94

BENDROFLUAZIDEBEZIDE HS TAB 2.5mg TAB/CAP $1.53BEZIDE TAB 5mg TAB/CAP $3.05

ATENOLOL & NIFEDIPINENIF-TEN TAB 50mg/20mg TAB/CAP $14.00

BENDROFLUAZIDE & RESERPINECOMBEZIDE B TAB TAB/CAP $4.22

BISOPROLOL & AMLODIPINE

CONCUR AM TAB 5mg/5mg TAB/CAP $68.27CONCUR AM TAB 10mg/5mg TAB/CAP $127.72

BENDROFLUMETHIAZIDEBENDROFLUMETHIAZIDE -ALP TAB 5mg TAB/CAP $2.87

BISOPROLOLCONCOR TAB 10mg TAB/CAP $118.87CONCOR TAB 2.5mg TAB/CAP $29.71CONCOR TAB 5mg TAB/CAP $59.42

BISOPROLOL & HYDROCHLOROTHIAZIDEZIAC TAB 10mg/6.25mg TAB/CAP $78.04ZIAC TAB 2.5mg/6.25mg TAB/CAP $51.79ZIAC TAB 5mg/6.25mg TAB/CAP $64.81


ATENOLOL cont’dLABEL PRSNTN SUBSIDY

BLOKIUM DIU TAB 100mg/25mg TAB/CAP $32.94TENORETIC TAB 50mg/12.5mg TAB/CAP $16.47TENORETIC TAB 100mg/25mg TAB/CAP $32.94

BENDROFLUAZIDE

BENDROFLUAZIDE & RESERPINECOMBEZIDE B TAB TAB/CAP $4.22

BISOPROLOL & AMLODIPINE

BENDROFLUMETHIAZIDE

BISOPROLOL

BISOPROLOL & HYDROCHLOROTHIAZIDE

LABEL PRSNTN SUBSIDY LABEL PRSNTN SUBSIDYCANDESARTAN & HYDROCHLOROTHIAZIDE

ATACAND PLUS 16mg/12.5mg TAB TAB/CAP $87.38ATACAND PLUS 32mg/12.5mg TAB TAB/CAP $87.38ATACAND PLUS 32mg/25mg TAB TAB/CAP $87.38CANDESARTAN/HCTZ-SDZ TAB 16mg/12.5mg TAB/CAP $87.38CANDESARTAN/HCTZ-SDZ TAB 32mg/12.5mg TAB/CAP $87.38CANDESARTAN/HCTZ-SDZ TAB 32mg/25mg TAB/CAP $87.38BLOPRESS PLUS 16mg/12.5mg TAB TAB/CAP $87.38

CANDESARTAN CILEXETILATACAND TAB 16mg TAB/CAP $89.25ATACAND TAB 32mg TAB/CAP $89.25ATACAND TAB 8mg TAB/CAP $44.62BLOPRESS TAB 16mg TAB/CAP $89.25BLOPRESS TAB 8mg TAB/CAP $44.62CANDESARTAN SANDOZ TAB 8mg TAB/CAP $44.62CANDESARTAN SANDOZ TAB 16mg TAB/CAP $89.25CANDESARTAN SANDOZ TAB 32mg TAB/CAP $89.25CANDIZAR-4 TAB 4mg TAB/CAP $22.31CANDIZAR-8 TAB 8mg TAB/CAP $44.62CANDIZAR-16 TAB 16mg TAB/CAP $89.25

CAPTOPRILAPO-CAPTO TAB 12.5mg TAB/CAP $3.08APO-CAPTO TAB 25mg TAB/CAP $6.17APO-CAPTO TAB 50mg TAB/CAP $12.33CAPOTEN TAB 25mg TAB/CAP $6.17CAPOTEN TAB 50mg TAB/CAP $12.33CAPTOPRIL-APT TAB 12.5mg TAB/CAP $3.08CAPTOPRIL-APT TAB 25mg TAB/CAP $6.17CAPTOPRIL-APT TAB 50mg TAB/CAP $12.33CAPTOPRIL-DENK TAB 25mg TAB/CAP $6.17CAPTOPRIL-H2K TAB 25mg TAB/CAP $6.17CAPTOPRIL-H2K TAB 50mg TAB/CAP $12.33CAPTOPRIL-LAS TAB 25mg TAB/CAP $6.17NOVO-CAPTORIL TAB 25mg TAB/CAP $6.17NOVO-CAPTORIL TAB 50mg TAB/CAP $12.33TENSIOMIN TAB 50mg TAB/CAP $12.33

CARVEDILOL

AKRIDOL TAB 6.25mg TAB/CAP $9.20AKRIDOL TAB 12.5mg TAB/CAP $18.39APO-CARVEDILOL TAB 12.5mg TAB/CAP $18.39APO-CARVEDILOL TAB 25mg TAB/CAP $36.77APO-CARVEDILOL TAB 6.25mg TAB/CAP $9.20CARCA TAB 12.5mg TAB/CAP $18.39CARCA TAB 6.25mg TAB/CAP $9.20CARLOC TABLETS 6.25mg TAB/CAP $9.20CARLOC TABLETS 12.5mg TAB/CAP $18.39CARLOC TABLETS 25mg TAB/CAP $36.77CARVEDI-DENK TAB 6.25mg TAB/CAP $9.20CARVEDI-DENK TAB 25mg TAB/CAP $36.77CARVEDILOL -H2K TAB 12.5mg TAB/CAP $18.39CARVEDILOL -H2K TAB 6.25mg TAB/CAP $9.20CARVEDILOL-PMS TAB 3.125mg TAB/CAP $4.60CARVEDILOL-PMS TAB 6.25mg TAB/CAP $9.20CARVEDILOL-PMS TAB 12.5mg TAB/CAP $18.39CARVEDILOL-PMS TAB 25mg TAB/CAP $36.77CARVIDEX TAB 12.5mg TAB/CAP $18.39CARVIDEX TAB 25mg TAB/CAP $36.77CARVIDEX TAB 6.25mg TAB/CAP $9.20COREG TAB 12.5mg TAB/CAP $18.39COREG TAB 25mg TAB/CAP $36.77COREG TAB 6.25mg TAB/CAP $9.20TALLITON TAB 12.5mg TAB/CAP $18.39TALLITON TAB 25mg TAB/CAP $36.77TALLITON TAB 6.25mg TAB/CAP $9.20

DILTIAZEM HCLAPO-DILTIAZ TAB 30mg TAB/CAP $13.55APO-DILTIAZ TAB 60mg TAB/CAP $27.07DILZEM RETARD TAB 180mg TAB/CAP $81.25DILZEM RETARD TAB 90mg TAB/CAP $40.62DILZEM TAB 60mg TAB/CAP $27.07

ENALAPRIL & HYDROCHLOROTHIAZIDEENA +HCTZ- DENK TAB 20mg/12.5mg TAB/CAP $67.45VASERETIC TAB 10/25mg TAB/CAP $33.75VASERETIC TAB 20/12.5mg TAB/CAP $67.45


ENALAPRIL MALEATELABEL PRSNTN SUBSIDY

FUROSEMIDELABEL PRSNTN SUBSIDY

APO-ENALAPRIL TAB 10mg TAB/CAP $8.66APO-ENALAPRIL TAB 20mg TAB/CAP $17.38APO-ENALAPRIL TAB 5mg TAB/CAP $4.33BQL 10 TAB TAB/CAP $8.66BQL 5 TAB TAB/CAP $4.33EDNYT TAB 10mg TAB/CAP $8.66EDNYT TAB 20mg TAB/CAP $17.38EDNYT TAB 5mg TAB/CAP $4.33ENA-DENK TAB 10mg TAB/CAP $8.66ENA-DENK TAB 20mg TAB/CAP $17.38ENALAPRIL-H2K TAB 10mg TAB/CAP $8.66ENALAPRIL-H2K TAB 20mg TAB/CAP $17.38ENALAPRIL-H2K TAB 5mg TAB/CAP $4.33ENALAPRIL-LAS TAB 10mg TAB/CAP $8.66ENALAPRIL-LAS TAB 5mg TAB/CAP $4.33ENAM TAB 10mg TAB/CAP $8.66ENAM TAB 2.5mg TAB/CAP $2.19ENAM TAB 5mg TAB/CAP $4.33ENATEC TAB 10mg TAB/CAP $8.66ENATEC TAB 5mg TAB/CAP $4.33ENVAS TAB 10mg TAB/CAP $8.66ENVAS TAB 5mg TAB/CAP $4.33INVORIL TAB 10mg TAB/CAP $8.66INVORIL TAB 20mg TAB/CAP $17.38INVORIL TAB 5mg TAB/CAP $4.33REDOPRIL TAB 5mg TAB/CAP $4.33VASOTEC TAB 10mg TAB/CAP $8.66VASOTEC TAB 20mg TAB/CAP $17.38VASOTEC TAB 5mg TAB/CAP $4.33

APO-FUROSEMIDE TAB 40mg TAB/CAP $7.15FEDFRUSEMIDE TAB 40mg TAB/CAP $7.15FRUSEMIDE-ALP TAB 40mg TAB/CAP $7.15FRUSIX-40 TAB 40mg TAB/CAP $7.15FURO-DENK TAB 40mg TAB/CAP $7.15LASIX TAB 40mg TAB/CAP $7.15

HYDRALAZINE HCLAPO-HYDRALAZINE TAB 25mg TAB/CAP $3.06APO-HYDRALAZINE TAB 50mg TAB/CAP $5.03HYDRALAZINE-ALP TAB 25mg TAB/CAP $3.06

HYDROCHLOROTHIAZIDEAPO-HYDRO TAB 25mg TAB/CAP $3.22APO-HYDRO TAB 50mg TAB/CAP $6.45HYDROCHLORTHZ-COX TAB 25mg TAB/CAP $3.22HYDROCHLORTHZ-SPM TAB 50mg TAB/CAP $6.45

INDAPAMIDEINALIX SR TAB 1.5MG TAB/CAP $17.31INDAP SR TAB 1.5MG TAB/CAP $17.31INDITOR-SR TAB 1.5mg TAB/CAP $17.31LORVAS SR TAB 1.5MG TAB/CAP $17.31LORVAS TAB 2.5MG TAB/CAP $17.31NATRILIX SR TAB 1.5mg TAB/CAP $17.31RAWEL SR TAB 1.5mg TAB/CAP $17.31

EPLERENONEEPNONE TAB 25mg TAB/CAP $97.50EPNONE TAB 50mg TAB/CAP $195.00

FELODIPINEPLENDIL TAB 10mg TAB/CAP $45.62PLENDIL TAB 5mg TAB/CAP $22.81

IRBESARTANAPROVEL TAB 150mg TAB/CAP $51.49APROVEL TAB 300mg TAB/CAP $102.98IRBESARTAN-SDZ TAB 150mg TAB/CAP $51.49IRBESARTAN-SDZ TAB 300mg TAB/CAP $102.98

IRBESARTAN & AMLODIPINEAPROVASC TAB 150mg/5mg TAB/CAP $60.34APROVASC TAB 300mg/5mg TAB/CAP $111.83APROVASC TABLETS 300mg/10mg TAB/CAP $120.68


FUROSEMIDELABEL PRSNTN SUBSIDYAPO-FUROSEMIDE TAB 40mg TAB/CAP $7.15FEDFRUSEMIDE TAB 40mg TAB/CAP $7.15FRUSEMIDE-ALP TAB 40mg TAB/CAP $7.15FRUSIX-40 TAB 40mg TAB/CAP $7.15FURO-DENK TAB 40mg TAB/CAP $7.15LASIX TAB 40mg TAB/CAP $7.15

HYDRALAZINE HCLAPO-HYDRALAZINE TAB 25mg TAB/CAP $3.06APO-HYDRALAZINE TAB 50mg TAB/CAP $5.03HYDRALAZINE-ALP TAB 25mg TAB/CAP $3.06

HYDROCHLOROTHIAZIDE

LABEL PRSNTN SUBSIDY LABEL PRSNTN SUBSIDYIRBESARTAN & HYDROCHLOROTHIAZIDE

CoAPROVEL TAB 150mg/12.5mg TAB/CAP $52.52CoAPROVEL TAB 300mg/12.5mg TAB/CAP $67.97CoAPROVEL TAB 300mg/25mg TAB/CAP $73.31IRBESARTAN/HCTZ-PMS TAB 150mg/12.5mg TAB/CAP $52.52IRBESARTAN/HCTZ-PMS TAB 300mg/12.5mg TAB/CAP $67.97IRBESARTAN/HCTZ-PMS TAB 300mg/25mg TAB/CAP $73.31IRBESARTAN/HCTZ-SDZ TAB 150mg/12.5mg TAB/CAP $52.52IRBESARTAN/HCTZ-SDZ TAB 300mg/25mg TAB/CAP $73.31

LACIDIPINELACIPIL TAB 4mg TAB/CAP $46.08

LISINOPRILAPO-LISINOPRIL TAB 10mg TAB/CAP $12.82APO-LISINOPRIL TAB 20mg TAB/CAP $25.64APO-LISINOPRIL TAB 5mg TAB/CAP $6.41LINOTEN TAB 10mg TAB/CAP $12.82LISDENE TAB 20mg TAB/CAP $25.64LISDENE TAB 10mg TAB/CAP $12.82LISDENE TAB 5mg TAB/CAP $6.41LISINOPRIL -H2K TAB 2.5mg TAB/CAP $3.21LISINOPRIL- H2K TAB 5mg TAB/CAP $6.41LISINOPRIL- H2K TAB10mg TAB/CAP $12.82LISOPRESS TAB 10mg TAB/CAP $12.82LISOPRESS TAB 20mg TAB/CAP $25.64LISOPRESS TAB 5mg TAB/CAP $6.41LISORIL TAB 10mg TAB/CAP $12.82LISORIL TAB 20mg TAB/CAP $25.64LISORIL TAB 5mg TAB/CAP $6.41LISTRIL TAB 10mg TAB/CAP $12.82LISTRIL TAB 5mg TAB/CAP $6.41ZESTRIL TAB 10mg TAB/CAP $12.82ZESTRIL TAB 20mg TAB/CAP $25.64ZESTRIL TAB 5mg TAB/CAP $6.41

LISINOPRIL & HYDROCHLOROTHIAZIDE

COZAAR XQ TABLETS 50mg/5mg TAB/CAP $53.67COZAAR XQ TABLETS 100mg/5mg TAB/CAP $93.20

LOSARTAN AND AMLODIPINEAPO-DILTIAZ TAB 30mg TAB/CAP $13.55APO-DILTIAZ TAB 60mg TAB/CAP $27.07DILZEM RETARD TAB 180mg TAB/CAP $81.25DILZEM RETARD TAB 90mg TAB/CAP $40.62DILZEM TAB 60mg TAB/CAP $27.07

LOSARTAN POTASSIUMCOVANCE TAB 50mg TAB/CAP $24.76COZAAR TAB 100mg TAB/CAP $49.52COZAAR TAB 50mg TAB/CAP $24.76LOSAR-DENK TAB 100mg TAB/CAP $49.52LOSAR-DENK TAB 50mg TAB/CAP $24.76LOSARTAN-H2K TAB 25mg TAB/CAP $12.38LOSARTAN-H2K TAB 50mg TAB/CAP $24.76LOSARTAS TAB 50mg TAB/CAP $24.76LOSARTO TAB 25mg TAB/CAP $12.38LOSARTO TAB 50mg TAB/CAP $24.76LOSARTO TAB 100mg TAB/CAP $49.52LOSATENSIL TAB 50mg TAB/CAP $24.76LOSIUM TAB 100mg TAB/CAP $49.52LOSIUM TAB 25mg TAB/CAP $12.38LOSIUM TAB 50mg TAB/CAP $24.76PRESARTAN-25 TAB TAB/CAP $12.38PRESARTAN-50 TAB TAB/CAP $24.76RESILO TAB 25mg TAB/CAP $12.38RESILO TAB 50mg TAB/CAP $24.76TOZAAR TAB 25mg TAB/CAP $12.38TOZAAR TAB 50mg TAB/CAP $24.76ZAART TAB 25mg TAB/CAP $12.38ZAART TAB 50mg TAB/CAP $24.76

LISINOPRILLISORIL TAB 20mg TAB/CAP $25.64LISORIL TAB 5mg TAB/CAP $6.41LISTRIL TAB 10mg TAB/CAP $12.82LISTRIL TAB 5mg TAB/CAP $6.41ZESTRIL TAB 10mg TAB/CAP $12.82ZESTRIL TAB 20mg TAB/CAP $25.64ZESTRIL TAB 5mg TAB/CAP $6.41

LOSARTAN POT. & HYDROCHLOROTHIAZIDEAPO-LOSARTAN/HCTZ TAB 50mg/12.5mg TAB/CAP $41.17APO-LOSARTAN/HCTZ TAB 100mg/25mg TAB/CAP $82.36COLOSAR-DENK TAB 50/12.5mg TAB/CAP $41.17COLOSAR-DENK TAB 100/12.5mg TAB/CAP $98.31HOSART TAB 50/12.5mg TAB/CAP $41.17


LOSARTAN POT. & HYDROCHLOROTHIAZIDE cont’dLABEL PRSNTN SUBSIDY

PERINDOPRIL ARGININELABEL PRSNTN SUBSIDYCOVERSYL TAB 10mg TAB/CAP $77.60COVERSYL TAB 5mg TAB/CAP $38.80

PERINDOPRIL ARGININE & AMLODIPINECOVERAM TAB 5mg/5mg TAB/CAP $47.65COVERAM TAB 10mg/5mg TAB/CAP $86.45COVERAM TAB 5mg/10mg TAB/CAP $56.50COVERAM TAB 10mg/10mg TAB/CAP $95.30PRETERAX TAB 10mg/2.5mg TAB/CAP $61.02PRETERAX TAB 2.5mg/0.625mg TAB/CAP $26.18PRETERAX TAB 5mg/1.25mg TAB/CAP $52.36PERINDAX TAB 2.5mg/0.625mg TAB/CAP $26.18

POTASSIUM CHLORIDEAPO-K TAB 600mg TAB/CAP $4.67SLOW-K TAB 600mg CR TAB/CAP $4.67

PROPRANOLOL HCLAPO-PROPRANOLOL TAB 10mg TAB/CAP $0.57APO-PROPRANOLOL TAB 20mg TAB/CAP $1.13APO-PROPRANOLOL TAB 40mg TAB/CAP $2.26APO-PROPRANOLOL TAB 80mg TAB/CAP $4.53PROPRANOLOL-ALP TAB 40mg TAB/CAP $2.26PROPRANOLOL-COX TAB 10mg TAB/CAP $0.57PROPRANOLOL-COX TAB 40mg TAB/CAP $2.26PROPRANOLOL-COX TAB 80mg TAB/CAP $4.53PROPRANOLOL-SPM TAB 40mg TAB/CAP $2.26

METHYLDOPAALDOMET TAB 250mg TAB/CAP $5.17ALDOMET TAB 500mg TAB/CAP $10.35DOPEGYT TAB 250mg TAB/CAP $5.17DOPEGYT TAB 500mg TAB/CAP $10.35EMDOPA TAB 250mg TAB/CAP $5.17METHYLDOPA-ALP TAB 250mg TAB/CAP $5.17METHYLDOPA-SK H2K TAB 250mg TAB/CAP $5.17

METOPROLOL TARTRATELOPRESSOR DIVITAB 200mg TAB/CAP $59.05LOPRESSOR TAB 100mg TAB/CAP $29.53LOPRESSOR TAB 50mg TAB/CAP $14.77


RAMIPRILAPO-RAMIPRIL CAP 10mg TAB/CAP $74.88APO-RAMIPRIL CAP 2.5mg TAB/CAP $18.72APO-RAMIPRIL CAP 5mg TAB/CAP $37.44RAMCOR TABS 10mg TAB/CAP $74.88RAMCOR TABS 5mg TAB/CAP $37.44

HYZAAR TAB 100/12.5mg TAB/CAP $98.31HYZAAR TAB 100/25mg TAB/CAP $82.36HYZAAR TAB 50/12.5mg TAB/CAP $41.17PRESARTAN H TAB 50mg/12.5mg TAB/CAP $41.17RESILO-H TAB 50mg/12.5mg TAB/CAP $41.17RESILO-H TAB 100mg/25mg TAB/CAP $82.36TRISARTAN-H TAB 50mg/12.5mg TAB/CAP $41.17

NEBIVOLOLNEBICARD TAB 5mg TAB/CAP $31.70NEBIEM TAB 5mg TAB/CAP $31.70NEBIEM TAB 10mg TAB/CAP $63.40

NIFEDIPINEADALAT CAP 10mg TAB/CAP $5.49ADALAT OROS TAB 30mg TAB/CAP $22.09ADALAT OROS TAB 60mg TAB/CAP $44.19ADALAT RETARD TAB 20mg TAB/CAP $11.05APO-NIFED CAP 10mg TAB/CAP $5.49APO-NIFED PA TAB 10mg TAB/CAP $5.49APO-NIFED PA TAB 20mg TAB/CAP $11.05CALCIGARD RET. TAB 20mg TAB/CAP $11.05CALNIF RETARD TAB 20mg TAB/CAP $11.05CORDAFLEX RETD TAB 20mg TAB/CAP $11.05EPILAT RETARD TAB 20mg TAB/CAP $11.05NIFEDI-DENK GEL CAP 10mg TAB/CAP $5.49NIFEDI-DENK RETD TAB 10mg TAB/CAP $5.49NIFEDI-DENK RETD TAB 20mg TAB/CAP $11.05NIFEDIPINE SR-H2K TAB 20mg TAB/CAP $11.05

PERINDOPRIL & INDAPAMIDE & AMLODIPINETRIPLIXAM TAB 10mg/2.5MG/10mg TAB/CAP $95.55TRIPLIXAM TAB 10mg/2.5MG/5mg TAB/CAP $95.55TRIPLIXAM TAB 5mg/1.25MG/5mg TAB/CAP $67.79


PERINDOPRIL ARGININELABEL PRSNTN SUBSIDY LABEL PRSNTN SUBSIDY LABEL PRSNTN SUBSIDY

RAMIPRIL AND AMLODIPINE

RAMLON CAPSULES 5mg/5mg TAB/CAP $46.29RAMLON CAPSULES 10mg/5mg TAB/CAP $83.73RAMLON CAPSULES 10mg/10mg TAB/CAP $92.58

RAMIPRIL & HYDROCHLOROTHIAZIDERAMIPRIL-HCTZ-PMS TAB 2.5mg/12.5mg TAB/CAP $22.25RAMIPRIL-HCTZ-PMS TAB 5mg/12.5mg TAB/CAP $20.78RAMIPRIL-HCTZ-PMS TAB 5mg/25mg TAB/CAP $44.50RAMIPRIL-HCTZ-PMS TAB 10mg/12.5mg TAB/CAP $32.06RAMIPRIL-HCTZ-PMS TAB 10mg/25mg TAB/CAP $41.55TRITACE HCT TAB 2.5/12.5mg TAB/CAP $22.25

SPIRONOLACTONEALDACTONE TAB 25mg TAB/CAP $26.53

TELMISARTAN & HYDROCHLOROTHIAZIDE cont’d

CARDISAR TAB 80MG TAB/CAP $30.06CARDISAR TAB 160MG TAB/CAP $60.13DIOVAN CAP 160mg TAB/CAP $60.13DIOVAN CAP 80mg TAB/CAP $30.06DIOVAN TAB 320mg TAB/CAP $83.96NORVITAN TAB 80mg TAB/CAP $30.06NORVITAN TAB 160mg TAB/CAP $60.13VALSACOR TAB 80mg TAB/CAP $30.06VALSACOR TAB 160mg TAB/CAP $60.13VALSACOR TAB 320mg TAB/CAP $83.96VALSAR-DENK 40 TAB 40mg TAB/CAP $15.03VALSAR-DENK 80 TAB 80mg TAB/CAP $30.06VALSAR-DENK 160 TAB 160mg TAB/CAP $60.13VALSAR-DENK 320 TAB 320mg TAB/CAP $83.96VALTAN 80 TAB 80mg TAB/CAP $30.06VALTAN TAB 320mg TAB/CAP $83.96

VALSARTAN-HYDROCHLOROTHIAZIDECO-DIOVAN TAB 160/12.5mg TAB/CAP $67.34CO-DIOVAN TAB 160/25mg TAB/CAP $68.59CO-DIOVAN TAB 320mg/12.5mg TAB/CAP $93.53CO-DIOVAN TAB 320mg/25mg TAB/CAP $94.78CO-DIOVAN TAB 80MG/12.5mg TAB/CAP $34.29COVALSAR-DENK TAB 80mg/12.5mg TAB/CAP $34.29COVALSAR-DENK TAB 160mg/12.5mg TAB/CAP $67.34COVALSAR-DENK TAB 320mg/12.5mg TAB/CAP $93.53VALSADEN TAB 80mg/12.5mg TAB/CAP $34.29VALSADEN TAB 160mg/12.5mg TAB/CAP $67.34VALSADEN TAB 160mg/25mg TAB/CAP $68.59VALSADEN TAB 320mg/12.5mg TAB/CAP $93.53

TELMISARTANMICARDIS TAB 80mg TAB/CAP $65.97SAFETELMI TAB 80mg TAB/CAP $65.97TELI TAB 40mg TAB/CAP $32.88TELMA 40 TAB 40mg TAB/CAP $32.99TELMA 80 TAB 80mg TAB/CAP $65.97TELMIMARK 40 TAB 40mg TAB/CAP $32.99TELSARTAN TAB 40mg TAB/CAP $32.99TELSARTAN TAB 80mg TAB/CAP $65.97TOLURA TAB 40mg TAB/CAP $32.99TOLURA TAB 80mg TAB/CAP $65.97

TELMISARTAN & AMLODIPINETWYNSTA TAB 80mg/5mg TAB/CAP $74.82TWYNSTA TAB 80mg/10mg TAB/CAP $83.67

TELMISARTAN & HYDROCHLOROTHIAZIDEMICARDIS PLUS TAB 80mg / 12.5mg TAB/CAP $67.00MICARDIS PLUS TAB 80mg / 25mg TAB/CAP $66.24SAFETELMI-H TAB 40mg/12.5mg TAB/CAP $33.12SAFETELMI-H TAB 80mg/12.5mg TAB/CAP $67.00TELMA H TAB 40mg/12.5mg TAB/CAP $33.12

VERAPAMIL HCLAPO-VERAP TAB 80mg TAB/CAP $12.85VERAPAMIL-CHN TAB 80mg TAB/CAP $12.85

RAMIPRIL AND AMLODIPINE

RAMIPRES-5 TABS TAB/CAP $37.44RAMIPRES TABS 10mg TAB/CAP $74.88TRITACE PREVENT CAP 10mg TAB/CAP $74.88TRITACE TAB 10mg TAB/CAP $74.88TRITACE TAB 2.5mg TAB/CAP $18.72TRITACE TAB 5mg TAB/CAP $37.44 VALSARTAN

TELMA H TAB 80mg/12.5mg TAB/CAP $67.00TOLUCOMBI TAB 40mg/12.5mg TAB/CAP $33.12TOLUCOMBI TABLETS 80mg/12.5mg TAB/CAP $67.00TOLUCOMBI TABLETS 80mg/25mg TAB/CAP $66.24


ATORVASTATIN CALCIUMLABEL PRSNTN SUBSIDY

LOVASTATINLABEL PRSNTN SUBSIDY

APO-PRAVASTATIN TAB 10mg TAB/CAP $21.29APO-PRAVASTATIN TAB 20mg TAB/CAP $42.59APO-PRAVASTATIN TAB 40mg TAB/CAP $85.18PRAVACHOL TAB 10mg TAB/CAP $21.29PRAVACHOL TAB 20mg TAB/CAP $42.59PRAVACHOL TAB 40mg TAB/CAP $85.18PRAVASTATIN-PMS TAB 10mg TAB/CAP $21.29PRAVASTATIN-PMS TAB 20mg TAB/CAP $42.59PRAVASTATIN-PMS TAB 40mg TAB/CAP $85.18PRAVATOR TAB 20mg TAB/CAP $42.59

ROSUVASTATIN APO-ROSUVASTATIN TAB 5mg TAB/CAP $24.13APO-ROSUVASTATIN TAB 10mg TAB/CAP $48.26APO-ROSUVASTATIN TAB 20mg TAB/CAP $96.51CRESTOR TAB 10mg TAB/CAP $48.26CRESTOR TAB 20mg TAB/CAP $96.51CRESTOR TAB 40mg TAB/CAP $163.20CRESTOR TAB 5mg TAB/CAP $24.13LDNIL TAB 10mg TAB/CAP $48.26LDNIL TAB 20mg TAB/CAP $96.51ROSUVASTATIN SANDOZ TAB 10mg TAB/CAP $48.26ROSUVASTATIN SANDOZ TAB 20mg TAB/CAP $96.51ROSUVASTATIN SANDOZ TAB 40mg TAB/CAP $163.20ROSWERA TAB 5mg TAB/CAP $24.13ROSWERA TAB 10mg TAB/CAP $48.26ROSWERA TAB 20mg TAB/CAP $96.51ROVAS 20 TAB 20mg TAB/CAP $96.51ROZAT 10 TAB 10mg TAB/CAP $48.26ROZAT 20 TAB 20mg TAB/CAP $96.51XOLSTAT TABLETS 10mg TAB/CAP $48.26XOLSTAT TABLETS 20mg TAB/CAP $96.51


APO- ATORVASTATIN TAB 10mg TAB/CAP $69.88APO- ATORVASTATIN TAB 20mg TAB/CAP $139.77APO- ATORVASTATIN TAB 40mg TAB/CAP $139.77ATOR TAB 10mg TAB/CAP $69.88ATOR TAB 20mg TAB/CAP $139.77ATOREM TAB 10mg TAB/CAP $69.88ATOREM TAB 20mg TAB/CAP $139.77ATOREM TAB 40mg TAB/CAP $139.77ATORIS TAB 10mg TAB/CAP $69.88ATORIS TAB 20mg TAB/CAP $139.77ATORIS TAB 40mg TAB/CAP $139.77ATORVASTATIN-H2K TAB 10mg TAB/CAP $69.88ATORVASTATIN-H2K TAB 20mg TAB/CAP $139.77CADITOR TAB 10mg TAB/CAP $69.88CADITOR TAB 20mg TAB/CAP $139.77CADITOR TAB 40mg TAB/CAP $139.77LIPIREST TAB 10mg TAB/CAP $69.88LIPIREST TAB 20mg TAB/CAP $139.77LIPIREST TAB 40mg TAB/CAP $139.77LIPITOR TAB 10mg TAB/CAP $69.88LIPITOR TAB 20mg TAB/CAP $139.77LIPITOR TAB 40mg TAB/CAP $139.77LIPITOR TAB 80mg TAB/CAP $139.77X’TOR TAB 20mg TAB/CAP $139.77


HYPERTENSION - ADJUNCT

APO-LOVASTATIN TAB 20mg TAB/CAP $42.31LOSTATIN TAB 20mg TAB/CAP $42.31LOVASTATIN-PMS TAB 20mg TAB/CAP $42.31LOVASTATIN-PMS TAB 40mg TAB/CAP $84.61MEVACOR TAB 20mg TAB/CAP $42.31

PRAVASTATIN SODIUM

VERAPAMIL HCL CR

ISOPTIN SR TAB 120mg TAB/CAP $19.25ISOPTIN SR TAB 240mg TAB/CAP $38.50VERAPAMIL-PMS SR TAB 240mg TAB/CAP $38.50



LOVASTATINLABEL PRSNTN SUBSIDY LABEL PRSNTN SUBSIDY

SIMVASTATIN

APO-SIMVASTATIN TAB. 10mg TAB/CAP $24.87APO-SIMVASTATIN TAB. 20mg TAB/CAP $49.74APO-SIMVASTATIN TAB. 40mg TAB/CAP $99.47SIMLO TAB 10mg TAB/CAP $24.87SIMLO TAB 20mg TAB/CAP $49.74SIMLO TAB 40mg TAB/CAP $99.47SIMPLAQOR TAB 10mg TAB/CAP $24.87SIMPLAQOR TAB 20mg TAB/CAP $49.74SIMPLAQOR TAB 40mg TAB/CAP $99.47SIMSTATIN TAB 20mg TAB/CAP $49.74SIMSTATIN TAB 40mg TAB/CAP $99.47SIMTAS TAB 20mg TAB/CAP $49.74SIMVA TAB 10mg TAB/CAP $24.87SIMVA TAB 20mg TAB/CAP $49.74SIMVA TAB 40mg TAB/CAP $99.47SIMVA-DENK TAB. 20mg TAB/CAP $49.74SIMVA-DENK TAB. 40mg TAB/CAP $99.47SIMVASTATIN-BPS TABS 10mg TAB/CAP $24.87SIMVASTATIN-BPS TABS 20mg TAB/CAP $49.74SIMVASTATIN-BPS TABS 40mg TAB/CAP $99.47SIMVASTATIN-H2K TAB 20mg TAB/CAP $49.74SIMVASTATIN-H2K TAB 40mg TAB/CAP $99.47SIMVASTATIN-LAS TAB 10mg TAB/CAP $24.87SIMVASTATIN-LAS TAB 20mg TAB/CAP $49.74SIMVASTATIN-PMS TAB 20mg TAB/CAP $49.74SIMVASTATIN-PMS TAB 40mg TAB/CAP $99.47SIMVOR TAB 10mg TAB/CAP $24.87SIMVOR TAB 20mg TAB/CAP $49.74SIMVOR TAB 40mg TAB/CAP $99.47VASILIP TAB 10mg TAB/CAP $24.87VASILIP TAB 20mg TAB/CAP $49.74VASILIP TAB 40mg TAB/CAP $99.47ZOCOR TAB 10 mg TAB/CAP $24.87ZOCOR TAB 20 mg TAB/CAP $49.74ZOCOR TAB 40 mg TAB/CAP $99.47






PRAVASTATIN SODIUM

Ischaemic Heart Disease - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 1



[email protected]

/NHFJamaica

- ISCHAEMIC HEART DISEASEINDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS


AMLODIPINE BESYLATE


AMDEPIN TAB 5mg TAB/CAP $14.56AMDEPIN TAB 10mg TAB/CAP $29.11AMLOCARD TAB 5mg TAB/CAP $14.56AMLOCARD TAB 10mg TAB/CAP $29.11 AMLOCOR TAB 10mg TAB/CAP $29.11AMLO-DENK TAB 10mg TAB/CAP $29.11AMLODOPINE-H2K TAB 5mg TAB/CAP $14.56AMLODOPINE-H2K TAB 10mg TAB/CAP $29.11AMLODIPINE-LAS TAB 5mg TAB/CAP $14.56AMLODIPINE-LAS TAB 10mg TAB/CAP $29.11AMLODIPINE-PMS TAB 5mg TAB/CAP $14.56AMLODIPINE-PMS TAB 10mg TAB/CAP $29.11AMLODIPINE-SDZ TAB 5mg TAB/CAP $14.56AMLODIPINE-SDZ TAB 10mg TAB/CAP $29.11AMLO-DENK TAB 5mg TAB/CAP $14.56AMTAS TAB 5mg TAB/CAP $14.56 AMTAS TAB 10mg TAB/CAP $29.11

AMLODIPINE BESILATE

APO-AMLODIPINE TAB 5mg TAB/CAP $14.56APO-AMLODIPINE TAB 10mg TAB/CAP $29.11

2 | INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS - Ischaemic Heart Disease

AMLODIPINE BESILATE cont’d


S-AMLODIPINE BESYLATEESEM 2.5 TAB 2.5mg TAB/CAP $7.29ESEM 5.0 TAB 5mg TAB/CAP $14.26

AMLODIPINE BESILATE & ATENOLOL

AMLODIPINE BESILATE & ATORVASTATINCADUET TAB 5mg/10mg TAB/CAP $94.71CADUET TAB 5mg/20mg TAB/CAP $178.78

ASOMEX-2.5 TAB 2.5mg TAB/CAP $7.29ASOMEX-5 TAB 5mg TAB/CAP $14.56BARAMLO TAB 5mg TAB/CAP $14.56BARAMLO TAB 10mg TAB/CAP $29.11CALCHEK TAB 5mg TAB/CAP $14.56CALCHEK TAB 10mg TAB/CAP $29.11NORVASC TAB 5mg TAB/CAP $14.56NORVASC TAB 10mg TAB/CAP $29.11STAMLO TAB 5mg TAB/CAP $14.56STAMLO TAB 10mg TAB/CAP $29.11TENOX TAB 5mg TAB/CAP $14.56TENOX TAB 10mg TAB/CAP $29.11

CALCHEK-A TAB 5mg/50mg TAB/CAP $22.16

AMLODIPINE BESILATE & LISINOPRIL DIHYDRATELISONORM TAB 5mg/10mg TAB/CAP $23.55LISONORM TAB 10mg/20mg TAB/CAP $47.09

ASPIRINASPIRIN-MAC EC TAB 81mg TAB/CAP $4.69BAYER ASPIRIN EC TAB 81mg TAB/CAP $4.69ENTROPHEN EC TAB 81mg TAB/CAP $4.69

ATENOLOLAPO-ATENOL TAB 100mg TAB/CAP $9.41APO-ATENOL TAB 50mg TAB/CAP $4.71ATEN TAB 100mg TAB/CAP $9.41ATENO TAB 100mg TAB/CAP $9.41ATENO TAB 50mg TAB/CAP $4.71ATENOLOL- H2K TAB 50mg TAB/CAP $4.71ATENOLOL-ACT TAB 100mg TAB/CAP $9.41ATENOLOL-ACT TAB 25mg TAB/CAP $2.35ATENOLOL-ACT TAB 50mg TAB/CAP $4.71ATENOLOL-ALP TAB 100mg TAB/CAP $9.41


ATENOLOL cont’d

LABEL PRSNTN SUBSIDYASOMEX-2.5 TAB 2.5mg TAB/CAP $7.29ASOMEX-5 TAB 5mg TAB/CAP $14.56BARAMLO TAB 5mg TAB/CAP $14.56BARAMLO TAB 10mg TAB/CAP $29.11CALCHEK TAB 5mg TAB/CAP $14.56CALCHEK TAB 10mg TAB/CAP $29.11NORVASC TAB 5mg TAB/CAP $14.56NORVASC TAB 10mg TAB/CAP $29.11STAMLO TAB 5mg TAB/CAP $14.56STAMLO TAB 10mg TAB/CAP $29.11TENOX TAB 5mg TAB/CAP $14.56TENOX TAB 10mg TAB/CAP $29.11

S-ATENOLOLATPURE TAB 25mg TAB/CAP $4.71ATPURE TAB 50mg TAB/CAP $9.41

ATENOLOL & CHLORTHALIDONEBLOKIUM DIU TAB 100mg/25mg TAB/CAP $32.94TENORETIC TAB 100mg/25mg TAB/CAP $32.94TENORETIC TAB 100mg/25mg TAB/CAP $32.94

ATENOLOL-ALP TAB 25mg TAB/CAP $2.35ATENOLOL-ALP TAB 50mg TAB/CAP $4.71ATENOLOL-BPS TAB 50mg TAB/CAP $4.71ATENOLOL-BPS TAB 100mg TAB/CAP $9.41ATENOLOL-DENK TAB 50mg TAB/CAP $4.71ATENOLOL-H2K TAB 100mg TAB/CAP $9.41ATENOLOL-PMS 10mg TAB/CAP $4.71ATENOLOL-PMS 20mg TAB/CAP $9.41ATENOLOL-SHN TAB 100mg TAB/CAP $9.41ATENOLOL-SHN TAB 50mg TAB/CAP $4.71BETACARD TAB 100mg TAB/CAP $9.41BETACARD TAB 50mg TAB/CAP $4.71BLOCOTENOL TAB 100mg TAB/CAP $9.41BLOCOTENOL TAB 50mg TAB/CAP $4.71BLOKIUM 100 TAB TAB/CAP $9.41BLOKIUM 50 TAB TAB/CAP $4.71NOVO-ATENOL TAB 100mg TAB/CAP $9.41TENORMIN TAB 100mg TAB/CAP $9.41TENORMIN TAB 50mg TAB/CAP $4.71TOTAMOL TAB 50mg TAB/CAP $4.71VELORIN TAB 100mg TAB/CAP $9.41

ATENOLOL & NIFEDIPINENIF-TEN TAB 50mg/20mg TAB/CAP $14.00

BISOPROLOLCONCOR TAB 10mg TAB/CAP $118.87CONCOR TAB 2.5mg TAB/CAP $29.71CONCOR TAB 5mg TAB/CAP $59.42

BISOPROLOL & AMLODIPINECONCUR AM TAB 5mg/5mg TAB/CAP $68.27CONCUR AM TAB 10mg/5mg TAB/CAP $127.72


CAPTOPRIL


APO-CAPTOPRIL TAB 12.5mg TAB/CAP $3.08APO-CAPTO TAB 25mg TAB/CAP $6.17APO-CAPTO TAB 50mg TAB/CAP $12.33CAPOTEN TAB 25mg TAB/CAP $6.17CAPOTEN TAB 50mg TAB/CAP $12.33CAPTOPRIL-APT TAB 12.5mg TAB/CAP $3.08CAPTOPRIL-APT TAB 25mg TAB/CAP $6.17CAPTOPRIL-APT TAB 50mg TAB/CAP $12.33CAPTOPRIL-DENK TAB 25mg TAB/CAP $6.17CAPTOPRIL-H2K TAB 25mg TAB/CAP $6.17CAPTOPRIL-H2K TAB 50mg TAB/CAP $12.33CAPTOPRIL-LAS TAB 25mg TAB/CAP $6.17NOVO-CAPTORIL TAB 25mg TAB/CAP $6.17NOVO-CAPTORIL TAB 50mg TAB/CAP $12.33TENSIOMIN TAB 50mg TAB/CAP $12.33

BISOPROLOL & HYDROCHLOROTHIAZIDE

ZIAC TAB 10mg/6.25mg TAB/CAP $78.04ZIAC TAB 2.5mg/6.25mg TAB/CAP $51.79ZIAC TAB 5mg/6.25mg TAB/CAP $64.81

CARVEDILOLAKRIDOL TAB 6.25mg TAB/CAP $9.20AKRIDOL TAB 12.5mg TAB/CAP $18.39APO-CARVEDILOL TAB 12.5mg TAB/CAP $18.39APO-CARVEDILOL TAB 25mg TAB/CAP $36.77APO-CARVEDILOL TAB 6.25mg TAB/CAP $9.20CARCA TAB 12.5mg TAB/CAP $18.39CARCA TAB 6.25mg TAB/CAP $9.20CARLOC TABLETS 6.25mg TAB/CAP $9.20CARLOC TABLETS 12.5mg TAB/CAP $18.39CARLOC TABLETS 25mg TAB/CAP $36.77CARVEDI-DENK TAB 6.25mg TAB/CAP $9.20CARVEDI-DENK TAB 25mg TAB/CAP $36.77CARVEDILOL-H2K TAB 12.5mg TAB/CAP $18.39CARVEDILOL H2K TAB 6.25mg TAB/CAP $9.20CARVEDILOL-PMS TAB 3.125mg TAB/CAP $4.60CARVEDILOL-PMS TAB 6.25mg TAB/CAP $9.20CARVEDILOL-PMS TAB 12.5mg TAB/CAP $18.39CARVEDILOL-PMS TAB 25mg TAB/CAP $36.77CARVIDEX TAB 12.5mg TAB/CAP $18.39CARVIDEX TAB 25mg TAB/CAP $36.77CARVIDEX TAB 6.25mg TAB/CAP $9.20



CLOPIDOGRELAURIX TAB 75mg TAB/CAP $47.49CADIGREL TAB 75mg TAB/CAP $47.49CLOPACT -75 TAB TAB/CAP $47.49CLOPI-DENK 75 TAB 75mg TAB/CAP $47.49CLOPIDOGREL(Sandoz) TAB 75mg TAB/CAP $47.49CLOPIDOGREL-H2K TAB 75mg TAB/CAP $47.49CLOPIDOGREL-LAS TAB 75mg TAB/CAP $47.49CLOPIVAS TAB 75mg TAB/CAP $47.49CLOPREZ TAB 75mg TAB/CAP $47.49DE PLATT TAB 75mg TAB/CAP $47.49FLOGREL TAB 75mg TAB/CAP $47.49LODIGREL TAB 75mg TAB/CAP $47.49PLAGRIL TAB 75mg TAB/CAP $47.49PLASEP TAB 75mg TAB/CAP $47.49PLAVIX TAB 75mg TAB/CAP $47.49PREVA TAB 75mg TAB/CAP $47.49TROMBLATT TAB 75mg TAB/CAP $47.49ZYLLT TAB 75mg TAB/CAP $47.49

CARVEDILOL cont’d

COREG TAB 12.5mg TAB/CAP $18.39COREG TAB 25mg TAB/CAP $36.77COREG TAB 6.25mg TAB/CAP $9.20TALLITON TAB 12.5mg TAB/CAP $18.39TALLITON TAB 25mg TAB/CAP $36.77TALLITON TAB 6.25mg TAB/CAP $9.20

CLOPIDOGREL & ASPIRIN PLAGRIL A TAB 75mg/75mg TAB/CAP $46.03TROMBLATT-AS TAB 75mg/75mg TAB/CAP $46.03

DIGOXINDIGOXIN-NA TAB 0.25mg TAB/CAP $9.83LANOXIN PED ELX 0.05/ml - 60ml LIQUID $657.21LANOXIN TAB 0.125mg TAB/CAP $4.91LANOXIN TAB 0.25mg TAB/CAP $9.83



DILTIAZEM HCL

APO-DILTIAZ TAB 30mg TAB/CAP $13.55APO-DILTIAZ TAB 60mg TAB/CAP $27.07DILZEM RETARD TAB 180mg TAB/CAP $81.25DILZEM RETARD TAB 90mg TAB/CAP $40.62DILZEM TAB 60mg TAB/CAP $27.07

DIPYRIDAMOLEAPO-DIPYRIDAMOLE TAB 25mg TAB/CAP $1.39APO-DIPYRIDAMOLE TAB 75mg TAB/CAP $4.18PERSANTINE TAB 25mg TAB/CAP $1.39PERSANTINE TAB 75mg TAB/CAP $4.18

ENALAPRIL & HYDROCHLOROTHIAZIDEENA +HCTZ- DENK TAB 20mg/12.5mg TAB/CAP $67.45VASERETIC TAB 10-25mg TAB/CAP $33.75VASERETIC TAB 20-12.5mg TAB/CAP $67.45

ENALAPRIL MALEATEAPO-ENALAPRIL TAB 10mg TAB/CAP $8.66APO-ENALAPRIL TAB 20mg TAB/CAP $17.38APO-ENALAPRIL TAB 5mg TAB/CAP $4.33BQL 10 TAB TAB/CAP $8.66BQL 5 TAB TAB/CAP $4.33EDNYT TAB 10mg TAB/CAP $8.66EDNYT TAB 20mg TAB/CAP $17.38EDNYT TAB 5mg TAB/CAP $4.33ENA-DENK TAB 10mg TAB/CAP $8.66ENA-DENK TAB 20mg TAB/CAP $17.38ENALAPRIL-H2K TAB 10mg TAB/CAP $8.66ENALAPRIL-H2K TAB 20mg TAB/CAP $17.38ENALAPRIL-H2K TAB 5mg TAB/CAP $4.33ENALAPRIL-LAS TAB 10mg TAB/CAP $8.66ENALAPRIL-LAS TAB 5mg TAB/CAP $4.33ENAM TAB 10mg TAB/CAP $8.66ENAM TAB 2.5mg TAB/CAP $2.19ENAM TAB 5mg TAB/CAP $4.33ENATEC TAB 10mg TAB/CAP $8.66ENATEC TAB 5mg TAB/CAP $4.33ENVAS TAB 10mg TAB/CAP $8.66ENVAS TAB 5mg TAB/CAP $4.33INVORIL TAB 10mg TAB/CAP $8.66INVORIL TAB 20mg TAB/CAP $17.38


FELODIPINE


PLENDIL TAB 10mg TAB/CAP $45.62PLENDIL TAB 5mg TAB/CAP $22.81

FUROSEMIDEAPO-FUROSEMIDE TAB 40mg TAB/CAP $7.15FEDFRUSEMIDE TAB 40mg TAB/CAP $7.15FRUSEMIDE-ALP TAB 40mg TAB/CAP $7.15FRUSIX-40 TAB 40mg TAB/CAP $7.15FURO-DENK TAB 40mg TAB/CAP $7.15LASIX TAB 40mg TAB/CAP $7.15

ENALAPRIL MALEATE cont’d

INVORIL TAB 5mg TAB/CAP $4.33REDOPRIL TAB 5mg TAB/CAP $4.33VASOTEC TAB 10mg TAB/CAP $8.66VASOTEC TAB 20mg TAB/CAP $17.38VASOTEC TAB 5mg TAB/CAP $4.33

ISOSORBIDE DINITRATEAPO-ISDN TAB 10mg TAB/CAP $2.07ISORDIL SUBLINGUAL TAB 5mg TAB/CAP $1.04ISORDIL TAB 10mg TAB/CAP $2.07

IVABRADINEPROCORALAN TAB 5mg TAB/CAP $72.25PROCORALAN TAB 7.5mg TAB/CAP $108.37

LACIDIPINELACIPIL TAB 4mg TAB/CAP $46.08

LISINOPRILAPO-LISINOPRIL TAB 10mg TAB/CAP $12.82APO-LISINOPRIL TAB 20mg TAB/CAP $25.64APO-LISINOPRIL TAB 5mg TAB/CAP $6.41LINOTEN TAB 10mg TAB/CAP $12.82LISDENE TAB 20mg TAB/CAP $25.64LISDENE TAB 10mg TAB/CAP $12.82LISDENE TAB 5mg TAB/CAP $6.41LISINOPRIL -H2K TAB 2.5mg TAB/CAP $3.21LISINOPRIL- H2K TAB 5mg TAB/CAP $6.41LISINOPRIL- H2K TAB 10mg TAB/CAP $12.82LISOPRESS TAB 10mg TAB/CAP $12.82LISOPRESS TAB 20mg TAB/CAP $25.64


LISINOPRIL & HYDROCHLOROTHIAZIDE


LISOPRESS HCT TAB 10mg/12.5mg TAB/CAP $15.48LISOPRESS HCT TAB 20mg/12.5mg TAB/CAP $29.80ZESTORETIC TAB 20-12.5mg TAB/CAP $29.80

LISINOPRIL

LISOPRESS TAB 5mg TAB/CAP $6.41LISORIL TAB 10mg TAB/CAP $12.82LISORIL TAB 20mg TAB/CAP $25.64LISORIL TAB 5mg TAB/CAP $6.41LISTRIL TAB 10mg TAB/CAP $12.82LISTRIL TAB 5mg TAB/CAP $6.41ZESTRIL TAB 10mg TAB/CAP $12.82ZESTRIL TAB 20mg TAB/CAP $25.64ZESTRIL TAB 5mg TAB/CAP $6.41

METOPROLOL TARTRATELOPRESSOR DIVITAB 200mg TAB/CAP $59.05LOPRESSOR TAB 100mg TAB/CAP $29.53LOPRESSOR TAB 50mg TAB/CAP $14.77

NEBIVOLOLNEBICARD TAB 5mg TAB/CAP $31.70NEBIEM TAB 5mg TAB/CAP $31.70NEBIEM TAB 10mg TAB/CAP $63.40

NIFEDIPINEADALAT CAP 10mg TAB/CAP $5.49ADALAT OROS TAB 30mg TAB/CAP $22.09ADALAT OROS TAB 60mg TAB/CAP $44.19ADALAT RETARD TAB 20mg TAB/CAP $11.05APO-NIFED CAP 10mg TAB/CAP $5.49APO-NIFED PA TAB 10mg TAB/CAP $5.49APO-NIFED PA TAB 20mg TAB/CAP $11.05CALCIGARD RET. TAB 20mg TAB/CAP $11.05CALNIF RETARD TAB 20mg TAB/CAP $11.05CORDAFLEX RETD TAB 20mg TAB/CAP $11.05EPILAT RETARD TAB 20mg TAB/CAP $11.05NIFEDI-DENK GEL CAP 10mg TAB/CAP $5.49NIFEDI-DENK RETD TAB 10mg TAB/CAP $5.49NIFEDI-DENK RETD TAB 20mg TAB/CAP $11.05NIFEDIPINE SR-H2K TAB 20mg TAB/CAP $11.05NIFEDIPINE-LAS CAP 10mg TAB/CAP $5.49NIFEDIPINE-LAS SR TAB 20mg TAB/CAP $11.05NIFELAT R TAB 20mg TAB/CAP $11.05NIFICARD-30 ER TAB 30mg TAB/CAP $22.09



NITROGLYCERIN

NITRODERM TTS PATCH 10 mg PATCH $1,963.04NITRODERM TTS PATCH 5 mg PATCH $981.53NITROMINT 0.4MG AEROSOL AER $419.08NITROMINT RET. TAB 2.6mg TAB/CAP $6.56NITROSTAT SUBLINGUAL TAB 0.6mg TAB/CAP $10.51

PERINDOPRIL ARGININE & AMLODIPINECOVERAM TAB 5mg/5mg TAB/CAP $47.65COVERAM TAB 10mg/5mg TAB/CAP $86.45COVERAM TAB 5mg/10mg TAB/CAP $56.50COVERAM TAB 10mg/10mg TAB/CAP $95.30

PERINDOPRIL ARGININECOVERSYL TAB 10mg TAB/CAP $77.60COVERSYL TAB 5mg TAB/CAP $38.80

PERINDOPRIL ARGININE & INDAPAMIDEPRETERAX TAB 10mg/2.5mg TAB/CAP $61.02PRETERAX TAB 2.5mg/0.625mg TAB/CAP $26.18PRETERAX TAB 5mg/1.25mg TAB/CAP $61.02

PERINDOPRIL ERBUMINE & INDAPAMIDEPERINDAX TAB 2.5mg/0.625mg TAB/CAP $26.18PERINDAX PLUS TAB 4mg/1.25mg TAB/CAP $52.36


PROPRANOLOL HCLAPO-PROPRANOLOL TAB 10mg TAB/CAP $0.57APO-PROPRANOLOL TAB 20mg TAB/CAP $1.13APO-PROPRANOLOL TAB 40mg TAB/CAP $2.26APO-PROPRANOLOL TAB 80mg TAB/CAP $4.53PROPRANOLOL-ALP TAB 40mg TAB/CAP $2.26PROPRANOLOL-COX TAB 10mg TAB/CAP $0.57PROPRANOLOL-COX TAB 40mg TAB/CAP $2.26PROPRANOLOL-COX TAB 80mg TAB/CAP $4.53PROPRANOLOL-SPM TAB 40mg TAB/CAP $2.26


TRIMETAZIDINE DI-HCLIRLARA MR TAB 35mg TAB/CAP $15.92METACARD MR TAB 35mg TAB/CAP $15.92MYOGARD CR-35 TABLETS 35mg TAB/CAP $15.92TRIMETAZIDINE- H2K TAB 20mg TAB/CAP $10.61VASTAREL MR TAB 35mg TAB/CAP $15.92VASTAREL TAB 20mg TAB/CAP $10.61

RAMIPRIL

LABEL PRSNTN SUBSIDY APO-RAMIPRIL CAP 10mg TAB/CAP $74.88APO-RAMIPRIL CAP 2.5mg TAB/CAP $18.72APO-RAMIPRIL CAP 5mg TAB/CAP $37.44RAMCOR TAB 10mg TAB/CAP $74.88RAMCOR TAB 5mg TAB/CAP $37.44RAMIPRES-5 TABS TAB/CAP $37.44RAMIPRES TABS 10mg TAB/CAP $74.88TRITACE PREVENT CAP 10mg TAB/CAP $74.88TRITACE TAB 10mg TAB/CAP $74.88TRITACE TAB 2.5mg TAB/CAP $18.72TRITACE TAB 5mg TAB/CAP $37.44

RAMIPRIL & HYDROCHLOROTHIAZIDERAMIPRIL-HCTZ-PMS TAB 2.5mg/12.5mg TAB/CAP $22.25RAMIPRIL-HCTZ-PMS TAB 5mg/12.5mg TAB/CAP $20.78RAMIPRIL-HCTZ-PMS TAB 5mg/25mg TAB/CAP $44.50RAMIPRIL-HCTZ-PMS TAB 10mg/12.5mg TAB/CAP $32.06RAMIPRIL-HCTZ-PMS TAB 10mg/25mg TAB/CAP $41.55TRITACE HCT TAB 2.5/12.5mg TAB/CAP $22.25

RANOLAZINE CRRAN CV ER TAB 500mg TAB/CAP $91.00

TICAGRELORBRILINTA TAB 90mg TAB/CAP $118.80

VERAPAMIL HCLAPO-VERAP TAB 80mg TAB/CAP $12.85VERAPAMIL-CHN TAB 80mg TAB/CAP $12.85

VERAPAMIL HCL CRISOPTIN SR TAB 120mg TAB/CAP $19.25ISOPTIN SR TAB 240mg TAB/CAP $38.50VERAPAMIL-PMS SR TAB 240mg TAB/CAP $38.50



WARFARIN

WARFARIN-BPS TAB 5mg TAB/CAP $5.46

ATORVASTATIN CALCIUMAPO- ATORVASTATIN TAB 10mg TAB/CAP $69.88APO- ATORVASTATIN TAB 20mg TAB/CAP $139.77APO- ATORVASTATIN TAB 40mg TAB/CAP $139.77ATOR TAB 10mg TAB/CAP $69.88ATOR TAB 20mg TAB/CAP $139.77ATOREM TAB 10mg TAB/CAP $69.88ATOREM TAB 20mg TAB/CAP $139.77ATOREM TAB 40mg TAB/CAP $139.77ATORIS TAB 10mg TAB/CAP $69.88ATORIS TAB 20mg TAB/CAP $139.77ATORIS TAB 40mg TAB/CAP $139.77ATORVASTATIN-H2K TAB 10mg TAB/CAP $69.88ATORVASTATIN-H2K TAB 20mg TAB/CAP $139.77CADITOR TAB 10mg TAB/CAP $69.88CADITOR TAB 20mg TAB/CAP $139.77CADITOR TAB 40mg TAB/CAP $139.77LIPIREST TAB 10mg TAB/CAP $69.88LIPIREST TAB 20mg TAB/CAP $139.77LIPIREST TAB 40mg TAB/CAP $139.77LIPITOR TAB 10mg TAB/CAP $69.88LIPITOR TAB 20mg TAB/CAP $139.77LIPITOR TAB 40mg TAB/CAP $139.77LIPITOR TAB 80mg TAB/CAP $139.77X’TOR TAB 20mg TAB/CAP $139.77

ISCHAEMIC HEART DISEASE - ADJUNCT




PRAVASTATIN SODIUMAPO-PRAVASTATIN TAB 10mg TAB/CAP $21.29APO-PRAVASTATIN TAB 20mg TAB/CAP $42.59APO-PRAVASTATIN TAB 40mg TAB/CAP $85.18PRAVACHOL TAB 10mg TAB/CAP $21.29PRAVACHOL TAB 20mg TAB/CAP $42.59PRAVACHOL TAB 40mg TAB/CAP $85.18PRAVASTATIN-PMS TAB 10mg TAB/CAP $21.29PRAVASTATIN-PMS TAB 20mg TAB/CAP $42.59PRAVASTATIN-PMS TAB 40mg TAB/CAP $85.18PRAVATOR TAB 20mg TAB/CAP $42.59

LOVASTATIN

APO-LOVASTATIN TAB 20mg TAB/CAP $42.31LOSTATIN TAB 20mg TAB/CAP $42.31LOVASTATIN-PMS TAB 20mg TAB/CAP $42.31LOVASTATIN-PMS TAB 40mg TAB/CAP $84.61MEVACOR TAB 20mg TAB/CAP $42.31


ROSUVASTATINAPO-ROSUVASTATIN TAB 5mg TAB/CAP $24.13APO-ROSUVASTATIN TAB 10mg TAB/CAP $48.26APO-ROSUVASTATIN TAB 20mg TAB/CAP $96.51CRESTOR TAB 10mg TAB/CAP $48.26CRESTOR TAB 20mg TAB/CAP $96.51CRESTOR TAB 40mg TAB/CAP $163.20CRESTOR TAB 5mg TAB/CAP $24.13LDNIL TAB 10mg TAB/CAP $48.26LDNIL TAB 20mg TAB/CAP $96.51ROSUVASTATIN SANDOZ TAB 10mg TAB/CAP $48.26ROSUVASTATIN SANDOZ TAB 20mg TAB/CAP $96.51ROSUVASTATIN SANDOZ TAB 40mg TAB/CAP $163.20ROSWERA TAB 5mg TAB/CAP $24.13ROSWERA TAB 10mg TAB/CAP $48.26ROSWERA TAB 20mg TAB/CAP $96.51ROVAS 20 TAB 20mg TAB/CAP $96.51ROZAT 10 TAB 10mg TAB/CAP $48.26ROZAT 20 TAB 20mg TAB/CAP $96.51XOLSTAT TABLETS 10mg TAB/CAP $48.26XOLSTAT TABLETS 20mg TAB/CAP $96.51



SIMVASTATIN

APO-SIMVASTATIN TAB 10mg TAB/CAP $24.87APO-SIMVASTATIN TAB 20mg TAB/CAP $49.74APO-SIMVASTATIN TAB 40mg TAB/CAP $99.47SIMLO TAB 10mg TAB/CAP $24.87SIMLO TAB 20mg TAB/CAP $49.74SIMLO TAB 40mg TAB/CAP $99.47SIMPLAQOR TAB 10mg TAB/CAP $24.87SIMPLAQOR TAB 20mg TAB/CAP $49.74SIMPLAQOR TAB 40mg TAB/CAP $99.47SIMSTATIN TAB 20mg TAB/CAP $49.74SIMSTATIN TAB 40mg TAB/CAP $99.47SIMTAS TAB 20mg TAB/CAP $49.74SIMVA TAB 10mg TAB/CAP $24.87SIMVA TAB 20mg TAB/CAP $49.74SIMVA TAB 40mg TAB/CAP $99.47SIMVA-DENK TAB 20mg TAB/CAP $49.74SIMVA-DENK TAB 40mg TAB/CAP $99.47SIMVASTATIN-BPS TABS 10mg TAB/CAP $24.87SIMVASTATIN-BPS TABS 20mg TAB/CAP $49.74SIMVASTATIN-BPS TABS 40mg TAB/CAP $99.47SIMVASTATIN-H2K TAB 20mg TAB/CAP $49.74SIMVASTATIN-H2K TAB 40mg TAB/CAP $99.47SIMVASTATIN-LAS TAB 10mg TAB/CAP $24.87SIMVASTATIN-LAS TAB 20mg TAB/CAP $49.74SIMVASTATIN-PMS TAB 20mg TAB/CAP $49.74SIMVASTATIN-PMS TAB 40mg TAB/CAP $99.47SIMVOR TAB 10mg TAB/CAP $24.87SIMVOR TAB 20mg TAB/CAP $49.74SIMVOR TAB 40mg TAB/CAP $99.47VASILIP TAB 10mg TAB/CAP $24.87VASILIP TAB 20mg TAB/CAP $49.74VASILIP TAB 40mg TAB/CAP $99.47ZOCOR TAB 10mg TAB/CAP $24.87ZOCOR TAB 20mg TAB/CAP $49.74ZOCOR TAB 40mg TAB/CAP $99.47

Major Depression - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 1

INDIVIDUAL BENEFITS MAJOR DEPRESSIONFOR PRESCRIPTION DRUGS

AGOMELATINELABEL PRSNTN SUBSIDYVALDOXAN TAB 25mg TAB/CAP $172.00

AMITRIPTYLINE HCLAPO-AMITRIPTYLIN TAB 25mg TAB/CAP $2.66

DULOXETINE CR

ESCITALOPRAM OXALATEESCITALOPRAM SANDOZ TAB 10mg TAB/CAP $102.60LEXAPRO TAB 10mg TAB/CAP $102.60LEXAPRO TAB 20mg TAB/CAP $205.20

CYMBALTA CAP 30mg TAB/CAP $62.10CYMBALTA CAP 60mg TAB/CAP $124.20

FLUOXETINEAPO-FLUOXETINE CAP 20mg TAB/CAP $34.20DEPREXIN CAP 20mg TAB/CAP $34.20FLUNIL 20 CAP TAB/CAP $34.20FLUOXETINE-H2K CAP 20mg TAB/CAP $34.20FLUOXETINE-LAS CAP 20mg TAB/CAP $34.20FLURAN CAP 20mg TAB/CAP $34.20HAPILUX CAP 20mg TAB/CAP $34.20PROZAC CAP 20mg TAB/CAP $34.20


IMIPRAMINE HCLAPO-IMIPRAMINE TAB 10mg TAB/CAP $1.50APO-IMIPRAMINE TAB 25mg TAB/CAP $3.77IMIPRAMINE-ALP TAB 10mg TAB/CAP $1.50IMIPRAMINE-ALP TAB 25mg TAB/CAP $3.77TOFRANIL TAB 10mg TAB/CAP $1.50TOFRANIL TAB 25mg TAB/CAP $3.77

BUPROPIONWELLBUTRIN SR TAB 150mg TAB/CAP $74.92WELLBUTRIN XL TAB 150mg TAB/CAP $74.92WELLBUTRIN XL TAB 300mg TAB/CAP $126.46

CARBAMAZEPINEAPO-CARBAMAZEP TAB 200mg TAB/CAP $12.63CARBATOL TAB 200mg TAB/CAP $12.63CARZATOL 200mg TAB TAB/CAP $12.63STORILAT 200mg TAB TAB/CAP $12.63TEGRETOL SUSP. 100mg/5ml -100ml LIQUID $240.00TEGRETOL TAB 100mg TAB/CAP $6.32TEGRETOL TAB 200mg TAB/CAP $12.63TERIL TAB 200mg TAB/CAP $12.63

CARBAMAZEPINE CRTEGRETOL CR TAB 200mg TAB/CAP $12.63TEGRETOL CR TAB 400mg TAB/CAP $25.27TERIL CR TAB 200mg TAB/CAP $12.63TERIL CR TAB 400mg TAB/CAP $25.27CARBATOL CR TAB 200mg TAB/CAP $12.63CARBATOL CR TAB 400mg TAB/CAP $25.27ZEN RETARD ER TAB 400mg TAB/CAP $25.27

CITALOPRAM HYDROBROMIDECIPRAMIL TAB 20mg TAB/CAP $111.63DALSAN TAB 20mg TAB/CAP $111.63

DESVENLAXAFINEPRISTIQ ER TAB 50mg TAB/CAP $118.61

DIVALPROEX SODIUMDEPAKOTE ER TAB 500mg TAB/CAP $30.86DEPAKOTE ER TAB 250mg TAB/CAP $15.43DEPAKOTE TAB 250mg TAB/CAP $15.43DEPAKOTE TAB 500mg TAB/CAP $30.86

LAMOTRIGINELAMICTAL CHW. DISP. TAB 100 mg TAB/CAP $72.38LAMICTAL CHW. DISP. TAB 25mg TAB/CAP $18.09LAMICTAL CHW. DISP. TAB 50mg TAB/CAP $36.19LAMOTRIGINE -PMS TAB 100mg TAB/CAP $72.38LAMOTRIGINE -PMS TAB 25mg TAB/CAP $18.09LAMOTRIGINE -PMS TAB 150mg TAB/CAP $108.57

LITHIUM CARBONATECAMCOLIT TAB 250mg TAB/CAP $7.61


OLANZAPINELABEL PRSNTN SUBSIDY

QUETIAPINE cont’dLABEL PRSNTN SUBSIDY

ZYPREXA 10mg IM Injection INJECTION $998.00ZYPREXA TAB 5mg TAB/CAP $293.02ZYPREXA TAB 10mg TAB/CAP $586.05

RISPERIDONEAPO-RISPERIDONE TAB 1mg TAB/CAP $33.13APO-RISPERIDONE TAB 2mg TAB/CAP $66.26APO-RISPERIDONE TAB 3mg TAB/CAP $99.39RESPIDON -2mg TAB TAB/CAP $66.26RISDAL TAB 2mg TAB/CAP $66.26RISDONE TAB 2mg TAB/CAP $66.26RISPERDAL CONSTA 25mg DEPO INJ INJECTION $8,447.41RISPERDAL CONSTA 37.5mg DEPO INJ INJECTION $12,671.12RISPERDAL CONSTA 50mg DEPO INJ INJECTION $16,894.82RISPERDAL QUICKLET DISP.TAB 1mg TAB/CAP $33.13RISPERDAL QUICKLET TAB 2mg TAB/CAP $66.26RISPERDAL SOLUTION 1mg/ml - 100ml LIQUID $6,991.57RISPERDAL SOLUTION 1mg/ml - 60ml LIQUID $4,194.94RISPERDAL TAB 1mg TAB/CAP $33.13RISPERDAL TAB 2mg TAB/CAP $66.26RISPERDAL TAB 3mg TAB/CAP $99.39RISPERIDONE- PMS (ODT) ORALLY DISINTIGRATING TAB 1mg TAB/CAP $33.13RISPERIDONE- PMS (ODT) ORALLYDISINTIGRATING TAB 2mg TAB/CAP $66.26RISPERIDONE- PMS TAB 1mg TAB/CAP $33.13RISPERIDONE- PMS TAB 2mg TAB/CAP $66.26RISPERIDONE-CPL TAB 2mg TAB/CAP $66.26RISPOLUX TAB 3mg TAB/CAP $99.39RISPOLUX TAB 1mg TAB/CAP $33.13RISPOLUX TAB 2mg TAB/CAP $66.26

OLANZAPINE ORODISPERSABLEZYPREXA VELOTAB TAB 5mg TAB/CAP $293.02ZYPREXA VELOTAB TAB 10mg TAB/CAP $586.05

OXCARBAZEPINETRILEPTAL SUSP 300mg/5ML -100ml LIQUID. $754.76TRILEPTAL TAB 300mg TAB/CAP $56.81TRILEPTAL TAB 600mg TAB/CAP $113.62

PALIPERIDONEINVEGA ER TAB 3mg TAB/CAP $258.77INVEGA ER TAB 6mg TAB/CAP $517.54INVEGA ER TAB 9mg TAB/CAP $776.34

PALIPERIDONE PALMITATEINVEGA SUSTENNA INJECTION 50mg INJECTION $13,098.50INVEGA SUSTENNA INJECTION 75mg INJECTION $19,647.75INVEGA SUSTENNA INJECTION 100mg INJECTION $26,197.00INVEGA SUSTENNA INJECTION 150mg INJECTION $39,295.50

PAROXETINE HCLAPO-PAROXETINE TAB 20mg TAB/CAP $80.27PAROXETINE (PMS) TAB 20mg TAB/CAP $80.27PAROXETINE (Sandoz) TAB 20mg TAB/CAP $80.27PAXIL TAB 20mg TAB/CAP $80.27REXETIN TAB 20mg TAB/CAP $80.27PAXIL CR TAB 12.5mg TAB/CAP $40.14PAXIL CR TAB 25mg TAB/CAP $80.27

QUETIAPINE APO-QUETIAPINE TAB 200mg TAB/CAP $186.56APO-QUETIAPINE TAB 25mg TAB/CAP $23.33KETILEPT TAB 25mg TAB/CAP $23.33KETILEPT TAB 100mg TAB/CAP $93.28KETILEPT TAB 300mg TAB/CAP $279.85APO-QUETIAPINE TAB 100mg TAB/CAP $93.28APO-QUETIAPINE 300mg TAB/CAP $279.85QUETIAPINE-PMS TAB 25mg TAB/CAP $23.33QUETIAPINE-PMS TAB 100mg TAB/CAP $93.28QUETIAPINE-PMS TAB 200mg TAB/CAP $186.56

QUETIAPINE-PMS TAB 300mg TAB/CAP $279.85QUETIAPINE-SDZ TAB 200mg TAB/CAP $186.56QUETIAPINE-SDZ TAB 300mg TAB/CAP $279.85SEROQUEL TAB 100mg TAB/CAP $93.28SEROQUEL TAB 200mg TAB/CAP $186.56SEROQUEL TAB 25mg TAB/CAP $23.33SEROQUEL TAB 300mg TAB/CAP $279.85SEROQUEL XR TAB 200mg TAB/CAP $186.56SEROQUEL XR TAB 300mg TAB/CAP $279.85SEROQUEL XR TAB 400mg TAB/CAP $373.13SEROQUEL XR TAB 50mg TAB/CAP $46.66

Major Depression - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 3

QUETIAPINE cont’dLABEL PRSNTN SUBSIDY

RISPERIDONE

LABEL PRSNTN SUBSIDYSERTRALINE HCL

SODIUM VALPROATEEPILIM CHRONO TAB 200mg TAB/CAP $13.27EPILIM CHRONO TAB 300mg TAB/CAP $19.91EPILIM CHRONO TAB 500mg TAB/CAP $33.18EPILIM SYRUP 200mg/5ml LIQUID $1,459.76EPILIM TAB 200mg TAB/CAP $13.27

VALPROIC ACIDDEPAKENE CAP 250mg TAB/CAP $17.30DEPAKENE SYRUP 250/5ml - 1ml LIQUID $3.36DEPAKENE SOLN. 250mg/5ml - 240ml LIQUID $807.83DEPAKENE SYRUP 250/5ml - 480ml LIQUID $1,615.66

VENLAFAXINE HCL XR

BONILUX P. R. CAP 75mg TAB/CAP $110.71BONILUX P. R. CAP 150mg TAB/CAP $221.41EFFEXOR XR CAP 150mg TAB/CAP $221.41EFFEXOR XR CAP 37.5mg TAB/CAP $55.37EFFEXOR XR CAP 75mg TAB/CAP $110.71VENLAFAXINE (Sandoz) XR CAP 150mg TAB/CAP $221.41VENLAFAXINE (Sandoz) XR CAP 75mg TAB/CAP $110.71VENLIFT OD CAP 37.5mg TAB/CAP $55.37VENLIFT OD CAP 75mg TAB/CAP $110.71


ZIPRASIDONEGEODON TAB 40mg TAB/CAP $126.46GEODON TAB 60mg TAB/CAP $189.68GEODON TAB 80mg TAB/CAP $252.91

CONTACT INFORMATION:OFFICE6th Floor, the Towers25 Dominica Drive, Kingston 5Tel: 1-888-NHFCARE (643-2273) or 906-1106Fax: 906-1105Business Hours: Monday- Thursday 7:00am to 4:30pm | Fridays 7:00am to 3:30pmCall Cantre Hours: Monday – Friday 7:00am – 7:00pm


Business Hours: Monday- Thursday 8:30am to 5:00pm | Friday 8:30am to 4:30pm


APO-SERTRALINE CAP 100mg TAB/CAP $88.25APO-SERTRALINE CAP 50mg TAB/CAP $44.14SERENATA TAB 50mg TAB/CAP $44.14SEROLUX TAB 50mg TAB/CAP $44.14SERTIMA TAB 50mg TAB/CAP $44.14SERTRALINE-LAS TAB 100mg TAB/CAP $88.25SERTRALINE-PMS TAB 100mg TAB/CAP $88.25SERTRALINE-PMS TAB 25mg TAB/CAP $22.08SERTRALINE-PMS TAB 50mg TAB/CAP $44.14STIMULOTON TAB 50mg TAB/CAP $44.14ZOLOFT CAP 100mg TAB/CAP $88.25ZOLOFT CAP 50mg TAB/CAP $44.14

TOPIRAMATETOPAMAX TAB 100mg TAB/CAP $102.83TOPAMAX TAB 25mg TAB/CAP $25.71TOPAMAX TAB 50mg TAB/CAP $51.42TOPAZ TAB 100mg TAB/CAP $102.83TOPAZ TAB 25mg TAB/CAP $25.71TOPAZ TAB 50mg TAB/CAP $51.42TOPIRAMATE -PMS TAB 25mg TAB/CAP $25.71TOPIRAMATE -PMS TAB 100mg TAB/CAP $102.83TOPIRAMATE (Sandoz) TAB 100mg TAB/CAP $102.83TOPIRAMATE (Sandoz) TAB 25mg TAB/CAP $25.71TOPIRAMATE (Sandoz) TAB 50mg TAB/CAP $51.42

Prostate Cancer - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 1



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- PROSTATE CANCERINDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS


BICALUTAMIDELABEL PRSNTN SUBSIDYAPO-BICALUTAMIDE TAB 50mg TAB/CAP 568.03BICAL 50 TAB TAB/CAP $568.03CALUTIDE 50 TAB 50mg TAB/CAP $568.03CASODEX TAB 150mg TAB/CAP $1,022.45CASODEX TAB 50mg TAB/CAP $568.03BICALUTAMIDE-PMS TAB 50mg TAB/CAP $568.03

CONJUGATED OESTROGENPREMARIN TAB 0.3mg TAB/CAP $10.37PREMARIN TAB 0.625mg TAB/CAP $20.73PREMARIN TAB 1.25mg TAB/CAP $41.44

CYPROTERONE ACETATEANDROCUR TAB 100mg TAB/CAP $129.73ANDROCUR TAB 10mg TAB/CAP $12.98ANDROCUR TAB 50mg TAB/CAP $64.86APO-CYPROTERONE TAB 50mg TAB/CAP $64.86

DEGARELIX ACETATEFIRMAGON INJ. 80mg - 4ml INJECTION $17,698.40FIRMAGON INJ. 120mg - 3ml INJECTION $26,547.60

DOCETAXELDAXOTEL INJ. 20mg/0.5ml INJECTION $5,267.47DAXOTEL INJ. 80mg/2ml INJECTION $21,069.89DOCETAX INJ. 20mg/0.5ml INJECTION $5,267.47DOCETAX INJ. 80mg/2ml INJECTION $21,069.89DOCETAXEL-EBWE INJ. 20mg/2ml INJECTION $5,267.47

2 | INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS - Prostate Cancer

FLUTAMIDECYTOMID-250 TAB 250mg TAB/CAP $60.82EULEXIN TAB 125mg TAB/CAP $30.41FLUTAMIDE-LAS TAB 250mg TAB/CAP $60.82

LEUPROLIDELECTRUM DEPOT INJ. 11.25mg-1 vial INJECTION $23,715.83LECTRUM DEPOT INJ. 3.75mg-1 vial INJECTION $7,905.28LECTRUM DEPOT INJ. 7.5mg-1 vial INJECTION $15,810.55LUCRIN DEPOT INJ. 11.25mg- 1vial INJECTION $23,715.83LUCRIN DEPOT INJ. 3.75mg- 1vial INJECTION $7,905.28

GOSERELINZOLADEX DEPOT INJ. 10.8mg- 1vial INJECTION $47,539.18ZOLADEX DEPOT INJ. 3.6mg- 1vial INJECTION $15,846.40

PACLITAXEL

CYTAX Inj. 100mg /16.7ml INJECTION $10,608.00CYTAX Inj. 300mg /50ml INJECTION $31,824.00EBETAXEL (EBWE) Inj. 30mg /5ml INJECTION $3,182.40EBETAXEL (EBWE) Inj. 100mg /16.7ml INJECTION $10,608.00EBETAXEL (EBWE) Inj. 150mg /25ml INJECTION $15,912.00EBETAXEL (EBWE) Inj. 300mg /50ml INJECTION $31,824.00INTAXEL INJ.100mg /17ml INJECTION $10,608.00INTAXEL INJ.300mg /50ml INJECTION $31,824.00INTAXEL INJ.250mg /41.7ml INJECTION $26,520.00MITOTAX INJ.30mg/5ml INJECTION $3,182.40MITOTAX INJ.100mg/16.7ml INJECTION $10,608.00MITOTAX INJ.300mg/50ml INJECTION $31.824.00PACLITAXEL-LAS Inj. 30mg/5ml INJECTION $3,182.40PACLITAXEL-LAS Inj. 100mg/16.7ml INJECTION $10,608.00PACLIWEL INJ. 30mg/5ml INJECTION $3,182.40PACLIWEL INJ. 300mg/50ml INJECTION $31,824.00TAXOL Inj. 30mg/5ml INJECTION $3,182.40

DOCETAXELLABEL PRSNTN SUBSIDYDOCETAXEL-EBWE INJ. 80mg/8ml INJECTION $21,069.89DOCETAXEL-DRS INJ. 20mg/1ml INJECTION $5,267.47DOCETAXEL-DRS INJ. 80mg/4ml INJECTION $21,069.89DOCETERE INJ. 120mg /3ml INJECTION $31,604.82DOCETERE INJ. 20mg /0.5ml INJECTION $5,267.47DOCETERE INJ. 80mg /2ml INJECTION $21,069.89TAXEWELL INJ. 120mg/3ml INJECTION $31,604.82TAXOTERE INJ. 20mg/0.5ml INJECTION $5,267.47TAXOTERE INJ. 80mg/2ml INJECTION $21,069.89

Prostate Cancer - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 3

TRAMADOL

ADAMON CAP 50mg TAB/CAP $36.40ADAMON DROPS 100mg/ml -10ml TAB/CAP $650.00TRAMAL CAP 50mg TAB/CAP $36.40TRAMADOL DENK 50 EFFERVESCENT TAB 50mg - 10s TAB/CAP $36.40TRAMAL DROPS 100mg/ml -10ml TAB/CAP $650.00TRAMAL L.A. TAB 100mg TAB/CAP $72.80TRAMDOL-BM CAPS 50mg TAB/CAP $36.40

PROSTATE CANCER - ADJUNCT



Psychosis - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 1



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- PSYCHOSISINDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS


BENZTROPINE MESYLATELABEL PRSNTN SUBSIDYAPO-BENZTROPINE TAB 2mg TAB/CAP $4.01BENZTROPINE-PMS TAB 2mg TAB/CAP $4.01

CHLORPROMAZINE HCLNOVO-PROMAZINE TAB 100mg TAB/CAP $11.40NOVO-PROMAZINE TAB 25mg TAB/CAP $2.84TAROCTYL TAB 100mg TAB/CAP $11.40TAROCTYL TAB 25mg TAB/CAP $2.84

CLOZAPINELEPONEX TAB 100mg TAB/CAP $90.91LEPONEX TAB 25mg TAB/CAP $22.73

FLUPHENAZINE DECANOATEFLUPHEN DEC-RM INJ 25mg/ml INJECTION $544.50

HALOPERIDOLAPO-HALOPERIDOL TAB 1.5mg TAB/CAP $1.27APO-HALOPERIDOL TAB 2mg TAB/CAP $1.65APO-HALOPERIDOL TAB 5mg TAB/CAP $4.20HALDOL TAB 5 mg TAB/CAP $4.20

OLANZAPINEZYPREXA 10mg IM Injection INJECTION $998.00ZYPREXA TAB 5mg TAB/CAP $293.02ZYPREXA TAB 10mg TAB/CAP $586.05

2 | INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS - Psychosis

OLANZAPINE ORODISPERSABLELABEL PRSNTN SUBSIDYZYPREXA VELOTAB TAB 5mg TAB/CAP $293.02ZYPREXA VELOTAB TAB 10mg TAB/CAP $586.05

PALIPERIDONE PALMITATEINVEGA SUSTENNA INJECTION 50MG INJECTION $13,098.50INVEGA SUSTENNA INJECTION 75mg INJECTION $19,647.75INVEGA SUSTENNA INJECTION 100mg INJECTION $26,197.00INVEGA SUSTENNA INJECTION 150mg INJECTION $39,295.50INVEGA TRINZA INJECTION 350mg INJECTION $91,689.50

PALIPERIDONEINVEGA ER TAB 3mg TAB/CAP $258.77INVEGA ER TAB 6mg TAB/CAP $517.54INVEGA ER TAB 9mg TAB/CAP $776.34

QUETIAPINE KETILEPT TAB 25mg TAB/CAP $23.33KETILEPT TAB 100mg TAB/CAP $93.28KETILEPT TAB 300mg TAB/CAP $279.85

QUETIAPINE FUMARATEAPO-QUETIAPINE TAB 100mg TAB/CAP $93.28APO-QUETIAPINE TAB 300mg TAB/CAP $279.85APO-QUETIAPINE TAB 200mg TAB/CAP $186.56APO-QUETIAPINE TAB 25mg TAB/CAP $23.33 QUETIAPINE-PMS TAB 25mg TAB/CAP $23.33QUETIAPINE-PMS TAB 100mg TAB/CAP $93.28QUETIAPINE-PMS TAB 200mg TAB/CAP $186.56QUETIAPINE-PMS TAB 300mg TAB/CAP $279.85QUETIAPINE-SDZ TAB 200mg TAB/CAP $186.56QUETIAPINE-SDZ TAB 300mg TAB/CAP $279.85SEROQUEL TAB 100mg TAB/CAP $93.28SEROQUEL TAB 200mg TAB/CAP $186.56SEROQUEL TAB 25mg TAB/CAP $23.33SEROQUEL TAB 300mg TAB/CAP $279.85SEROQUEL XR TAB 200mg TAB/CAP $186.56SEROQUEL XR TAB 300mg TAB/CAP $279.85SEROQUEL XR TAB 400mg TAB/CAP $373.13SEROQUEL XR TAB 50mg TAB/CAP $46.66

RISPERIDONEAPO-RISPERIDONE TAB 1mg TAB/CAP $33.13APO-RISPERIDONE TAB 2mg TAB/CAP $66.26APO-RISPERIDONE TAB 3mg TAB/CAP $99.39RESPIDON -2mg TAB TAB/CAP $66.26 RISDAL TAB 2mg TAB/CAP $66.26RISDONE TAB 2mg TAB/CAP $66.26RISPERDAL CONSTA 25mg DEPO INJ INJECTION $8,447.41RISPERDAL CONSTA 37.5mg DEPO INJ INJECTION $12,671.12RISPERDAL CONSTA 50mg DEPO INJ INJECTION $16,894.82RISPERDAL QUICKLET DISP. TAB 1mg TAB/CAP $33.13RISPERDAL QUICKLET TAB 2mg TAB/CAP $66.26RISPERDAL SOLUTION 1mg/ml - 100ml LIQUID $6,991.57RISPERDAL SOLUTION 1mg/ml - 60ml LIQUID $4,194.94

Psychosis - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 3

RISPERIDONE cont’dLABEL PRSNTN SUBSIDY

TRIFLUOPERAZINE HCLAPO-TRIFLUOPERAZ TAB 5mg TAB/CAP $4.15STELAZINE TAB 5mg TAB/CAP $4.15

TRIHEXYPHENIDYL HCL

APO-TRIHEX TAB 2mg TAB/CAP $1.58APO-TRIHEX TAB 5mg TAB/CAP $4.06ARTANE TAB 2mg TAB/CAP $1.58ARTANE TAB 5mg TAB/CAP $4.06

RISPERDAL TAB 1mg TAB/CAP $33.13RISPERDAL TAB 2mg TAB/CAP $66.26RISPERDAL TAB 3mg TAB/CAP $99.39RISPERIDONE- PMS (ODT) ORALLY DISINTIGRATING TAB 1mg TAB/CAP $33.13RISPERIDONE- PMS (ODT) ORALLY DISINTIGRATING TAB 2mg TAB/CAP $66.26RISPERIDONE- PMS TAB 1mg TAB/CAP $33.13 RISPERIDONE- PMS TAB 2mg TAB/CAP $66.26RISPERIDONE-CPL TAB 2mg TAB/CAP $66.26RISPOLUX TAB 3mg TAB/CAP $99.39RISPOLUX TAB 1mg TAB/CAP $33.13RISPOLUX TAB 2mg TAB/CAP $66.26

ZIPRASIDONEGEODON TAB 40mg TAB/CAP $126.46GEODON TAB 60mg TAB/CAP $189.68GEODON TAB 80mg TAB/CAP $252.91GEODON INJ 20mg INJECTION $2,671.29

ZUCLOPENTHIXOL DIHCLCLOPIXOL DROPS 20mg/ml LIQUID $1,202.72CLOPIXOL TAB 10mg TAB/CAP $15.57CLOPIXOL TAB 25mg TAB/CAP $38.93

Rheumatic Fever/Heart Disease - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 1



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- RHEUMATIC FEVER/HEART DISEASEINDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS


BENZATHINE BENZYL PENICILLIN

LABEL PRSNTN SUBSIDYRETARPEN 2.4MU INJ. INJECTION $74.88

DIGOXINDIGOXIN-NA TAB 0.25mg TAB/CAP $7.61LANOXIN PED. ELX 0.05mg/ml - 60ml LIQUID $508.74LANOXIN TAB 0.125mg TAB/CAP $3.80LANOXIN TAB 0.25mg TAB/CAP $7.61

DIPYRIDAMOLE

APO-DIPYRIDAMOLE TAB 25mg TAB/CAP $2.06APO-DIPYRIDAMOLE TAB 75mg TAB/CAP $6.19PERSANTINE TAB 25mg TAB/CAP $2.06PERSANTINE TAB 75mg TAB/CAP $6.19

ERYTHROMYCIN ETHYL SUCCINATEE.E.S.TAB 400mg TAB/CAP $17.52ERYTHROMYCIN-SPM SUSP 200mg-100ml LIQUID $111.15ERYTHROMYCIN-SPM SUSP 400mg -100ml LIQUID $222.30ERYTHROCIN TAB 250mg TAB/CAP $10.95

2 | INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS - Rheumatic Fever/Heart Disease

PREDNISOLONEPREDCORT DS SYRUP 10mg/5ml - 125ml LIQUID $652.76PREDCORT DS SYRUP 10mg/5ml - 30ml LIQUID $156.67PREDNISOLONE-PMS 5mg/5ml LIQUID $313.46PRELONE SYP 15mg/5ml 120ml LIQUID $941.58PRELONE SYP 15mg/5ml 60ml LIQUID $470.78PREDNISOLONE-FP TAB 5mg TAB/CAP $3.18

PENICILLIN V POTASSIUMAPO-PEN VK TAB 300mg TAB/CAP $3.78


ERYTHROMYCIN STEARATE

LABEL PRSNTN SUBSIDYERYTHROCIN TAB 500mg TAB/CAP $21.91ETOCIN TAB 250mg TAB/CAP $10.95ETOCIN TAB 500mg TAB/CAP $21.91

Sickle Cell Disease- INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 1

INDIVIDUAL BENEFITS SICKLE CELL DISEASEFOR PRESCRIPTION DRUGS

ACECLOFENACLABEL PRSNTN SUBSIDYALGIC TAB 100mg TAB/CAP $31.00 ZERODOL TAB 100mg TAB/CAP $31.00

ACECLOFENAC CONTROLLED RELEASE ZERODOL CR TAB 200mg TAB/CAP $62.00

BECLOMETHASONE DIPROPIONATE cont’d

DICLOFENAC POTASSIUM DICLOFENAC -Las Disp. Tab 50mg TAB/CAP $13.99 APO-DICLO TAB RAPIDE 50mg TAB/CAP $13.99 CATAFLAM TAB 50mg TAB/CAP $13.99 DICLO-K 50mg TABS TAB/CAP $13.99 CATAFLAM LIQUID CAP 50mg TAB/CA $13.99DICLOFENAC-H2K TAB 50mg TAB/CAP $13.99 DICLOFENAC-P TAB 50mg TAB/CAP $13.99 DICLOTAS TAB 50mg TAB/CAP $13.99 CATAFLAM DISP. TAB 46.5mg TAB/CAP $12.97 CATAFLAM DROPS SOLUTION $510.80 CATAFLAM SUS 9mg/5ml SOLUTION $490.36 CATAFLAM TAB 25 MG TAB/CAP $7.01 DICLOFENAC -P TAB 25mg TAB/CAP $7.01


ACECLOFENAC & PARACETAMOL ACICROP-P TAB 100mg/500mg TAB/CAP $43.77 ALGIC-P TAB 100mg/500mg TAB/CAP $43.77 ZERODOL-P 100mg/500mg TAB/CAP $43.77

AMOXICILLIN TRIHYDRATE AMOXIL CAPSULES 500mg TAB/CAP $7.50 MOXFLAG CAPSULES 500mg TAB/CAP $7.50 WINPEN CAPSULES 500MG TAB/CAP $7.50 AMOXIL SUSP 125mg/5ml - 100ml Liquid $115.00 AMOXIL SUSP 250mg/5ml - 100ml Liquid $230.00

AMITRIPTYLINE APO-AMITRIPTYLIN TAB 25mg TAB/CAP $2.66

BECLOMETHASONE DIPROPIONATE BECLATE 50 INHALER INHALER $289.13 BECLAZONE INH AER 50mcg INHALER $289.13 BECLAZONE-IVAX INH AER 250mcg INHALER $1,445.66 BECLAZONE- IVAX INH AER 50mcg INHALER $289.13 BECLOCIP HFA AER 100mcg INHALER $578.27 BECLOFORTE AER 250mcg INHALER $1,445.66 BECLOMETHAS-LAS AER 50mcg INHALER $289.13 BECLOMETHAS-LAS AER 200mcg INHALER $1,156.52 BECLOMETHAS-LAS AER 250mcg INHALER $1,445.66 BECLOMETHASONE-H2K AER 50mcg INHALER $289.13 BECLOVAIRE 50 HFA AER INHALER $289.13 BECLOVAIRE 100 HFA AER INHALER $578.27 BECOTIDE AER 50mcg INHALER $289.13 CORTIFLOW INHALER 50 INHALER $289.13 IBICAR 50 AEROSOL INHALER $289.13

DICLOFENAC SODIUM ACTERIC TAB 150mg ER TAB/CAP $41.99 APO-DICLO EC TAB 25mg TAB/CAP $7.01 APO-DICLO EC TAB 50mg TAB/CAP $13.99 APO-DICLO TAB SR 100mg TAB/CAP $27.97 APO-DICLO TAB SR 75mg TAB/CAP $20.99 DICLO DENK RETD TAB 100mg TAB/CAP $27.97 DICLO DENK TAB 25mg TAB/CAP $7.01 DICLO DENK 50mg TAB/CAP $13.99 DICLOFEN SR TAB 100mg TAB/CAP $27.97 DICLOFENAC-MK DROPS 1.5% SOLUTION $510.80 DICLOFENAC-H2K SR TAB 75mg TAB/CAP $20.99 DICLOFENAC-H2K SR TAB 100mg TAB/CAP $27.97 DICLOFENAC-LAS SR TAB 100mg TAB/CAP $27.97 DICLOFENAC-S EC-MAC TAB 25mg TAB/CAP $7.01

IBICAR 100 AEROSOL INHALER $578.27 IBICAR 200 AEROSOL INHALER $1,156.52 RETARPEN 2.4mu INJECTION $74.88

2 | INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS - Sickle Cell Disease

DICLOFENAC SODIUM cont’dLABEL PRSNTN SUBSIDY

ENALAPRIL MALEATE cont’dLABEL PRSNTN SUBSIDY

ERYTHROMYCIN ETHYL SUCCINATE

E.E.S TAB 400mg TAB/CAP $17.52 ERYTHROMYCIN-SPM SUSP 200mg SOLUTION $116.83 ERYTHROMYCIN-SPM SUSP 400mg SOLUTION $233.66

ERYTHROMYCIN STEARATE ERYTHROCIN TAB 250mg TAB/CAP $10.95 ERYTHROCYIN TAB 500mg TAB/CAP $21.91 ETOCIN TAB 250mg TAB/CAP $10.95 ETOCIN TAB 500mg TAB/CAP $21.91

CYTODROX CAP 500mg TAB/CAP $32.18 HYDROXYUREA (MEDAC) CAP 500mg TAB/CAP $32.18

DICLOFENAC-S EC-MAC TAB 50mg (BOTTLE)-100S TAB/CAP $13.99 DICLOFENAC-S EC-MAC TAB 50mg (BOX) TAB/CAP $13.99 DICLOFENAC-S EC-MAC TAB 50mg TAB/CAP $13.99 REMETHAN TAB 50mg TAB/CAP $13.99 DICLOFENAC-S EC-MAC SR TAB 75mg TAB/CAP $20.99 DICLOMAX-50 EC TAB TAB/CAP $13.99 NAKLOFEN DUO CAP 75mg TAB/CAP $20.99 NOVO-DIFENAC TAB 75mg TAB/CAP $20.99 VOLTAREN RETARD TAB 100mg TAB/CAP $27.97 VOLTAREN SR TAB 75mg TAB/CAP $20.99 VOLTAREN TAB 25mg EC TAB/CAP $7.01 VOLTAREN TAB 50mg EC TAB/CAP $13.99

ENALAPRIL MALEATE APO-ENALAPRIL TAB 10mg TAB/CAP $8.66 APO-ENALAPRIL TAB 20mg TAB/CAP $17.38 APO-ENALAPRIL TAB 5mg TAB/CAP $4.33 BQL 10 TAB 10mg TAB/CAP $8.66 BQL 5 TAB 5mg TAB/CAP $4.33 EDNYT TAB 10mg TAB/CAP $8.66 EDNYT TAB 20mg TAB/CAP $17.38 EDNYT 5mg TAB/CAP $4.33 ENA-DENK TABLETS 10mg TAB/CAP $8.66 ENA-DENK TABLETS 20mg TAB/CAP $17.38ENALAPRIL-H2K TAB 20mg TAB/CAP $17.38 ENALAPRIL-LAS TAB 10mg TAB/CAP $8.66 ENALAPRIL-LAS TAB 5mg TAB/CAP $4.33 ENAM TAB 10mg TAB/CAP $8.66 ENAM TAB 2.5mg TAB/CAP $2.19 ENAM TAB 5mg TAB/CAP $4.33 ENAM TAB 20mg TAB/CAP $17.38 ENALAPRIL-H2K TAB 5mg TAB/CAP $4.33 ENALAPRIL-H2K TAB 10mg TAB/CAP $8.66 ENATEC TAB 5mg TAB/CAP $4.33 ENATEC TAB 10mg TAB/CAP $8.66 ENVAS TAB 5mg TAB/CAP $4.33 ENVAS TAB 10mg TAB/CAP $8.66 INVORIL TAB 10mg TAB/CAP $8.66 INVORIL TAB 20mg TAB/CAP $17.38

INVORIL TAB 5mg TAB/CAP $4.33 REDOPRIL TAB 5mg TAB/CAP $4.33 VASOTEC TAB 10mg TAB/CAP $8.66 VASOTEC TAB 20mg TAB/CAP $17.38 VASOTEC TAB 5mg TAB/CAP $4.33

ETORICOXIB ARCOXIA TAB 120mg TAB/CAP $122.30 ARCOXIA TAB 60mg TAB/CAP $61.15 ARCOXIA TAB 90mg TAB/CAP $91.73 HYDROXYUREA

IBUPROFEN APO-IBUPROFEN TAB 400mg TAB/CAP $3.23 APO-IBUPROFEN TAB 600mg TAB/CAP $4.84 BRUFEN TAB 400mg TAB/CAP $3.23 BRUFEN TAB 600mg TAB/CAP $4.84 IBUPROFEN-ALP TAB 400mg TAB/CAP $3.23 IBUPROFEN-H2K TAB 400mg TAB/CAP $3.23 IBUPROFEN -H2K TAB 600mg TAB/CAP $4.84 IBUPROFEN-LAS TAB 400mg TAB/CAP $43.23 IBUPROFEN-LAS TAB 600mg TAB/CAP $4.84

Sickle Cell Disease- INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 3

ENALAPRIL MALEATE cont’dLABEL PRSNTN SUBSIDY LABEL PRSNTN SUBSIDY LABEL PRSNTN SUBSIDY

LISINOPRIL LOSARTAN POTASSIUM

MELOXICAM MELFLAM TAB 15mg TAB/CAP $26.06 MELFLAM TAB 7.5mg TAB/CAP $13.03 MELOFLAM TAB 15mg TAB/CAP $26.06 MELOXICAM-H2K TAB 7.5mg TAB/CAP $13.03 MELOXICAM-H2K TAB 15mg TAB/CAP $26.06 MELOXICAM-MAC TAB 15mg TAB/CAP $26.06 MELOXICAM-MAC TAB 7.5mg TAB/CAP $13.03 MELOXICAM-PMS TAB 7.5mg TAB/CAP $13.03MELOXICAM-PMS TAB 15mg TAB/CAP $26.06 MOBIC TAB 15mg TAB/CAP $26.06 MOBIC TAB 7.5mg TAB/CAP $13.03 MUVERA TAB 7.5mg TAB/CAP $13.03 MUVERA TAB 15mg TAB/CAP $26.06

ETORICOXIB

APO-LISINOPRIL TAB 10mg TAB/CAP $12.82 APO-LISINOPRIL TAB 20mg TAB/CAP $25.64 APO-LISINOPRIL TAB 5mg TAB/CAP $6.41 LINOTEN TAB 10mg TAB/CAP $12.82 LISDENE TAB 20mg TAB/CAP $25.64 LISDENE TAB 5mg TAB/CAP $6.41 LISDENE TAB 10mg TAB/CAP $12.82 LISINOPRIL-H2K TAB 2.5mg TAB/CAP $3.21 LISINOPRIL-H2K TAB 5mg TAB/CAP $6.41 LISINOPRIL-H2K TAB 10mg TAB/CAP $12.82 LISOPRESS TAB 10mg TAB/CAP $12.82 LISOPRESS TAB 20mg TAB/CAP $25.64 LISOPRESS TAB 5mg TAB/CAP $6.41 LISORIL TAB 5mg TAB/CAP $6.41 LISORIL TAB 10mg TAB/CAP $12.82 LISORIL TAB 20mg TAB/CAP $25.64 LISTRIL TAB 10mg TAB/CAP $12.82 LISTRIL TAB 5mg TAB/CAP $6.41 PRINIVIL TAB 20mg TAB/CAP $25.64 ZESTRIL TAB 10mg TAB/CAP $12.82 ZESTRIL TAB 10mg TAB/CAP $12.82 ZESTRIL TAB 20mg TAB/CAP $25.64 ZESTRIL TAB 5mg TAB/CAP $6.41 ZESTRIL TAB 5mg TAB/CAP $6.41

MORPHINE STATEX TABLETS 10mg TAB/CAP $18.87

HYDROXYUREA

LOSARTAN POTASSIUM COVANCE TAB 50mg TAB/CAP $24.76 COZAAR TAB 100mg TAB/CAP $49.52 COZAAR TAB 50mg TAB/CAP $24.76 LOSAR-DENK TAB 50mg TAB/CAP $24.76LOSAR-DENK TAB 100mg TAB/CAP $49.52 LOSARTAS TAB 50mg TAB/CAP $24.76 LOSARTAN-H2K TAB 25mg TAB/CAP $12.38 LOSARTAN-H2K TAB 50mg TAB/CAP $24.76 LOSARTO TAB 25mg TAB/CAP $12.38 LOSARTO TAB 50mg TAB/CAP $24.76 LOSARTO TAB 100mg TAB/CAP $49.52 LOSATENSIL TAB 50mg TAB/CAP $24.76 LOSIUM TAB 25mg TAB/CAP $12.38 LOSIUM TAB 50mg TAB/CAP $24.76

LOSIUM TAB 100mg TAB/CAP $49.52 PRESARTAN-25mg TABS TAB/CAP $12.38 PRESARTAN-50mg TABS TAB/CAP $24.76 RESILO TAB 25mg TAB/CAP $12.38 RESILO TAB 50mg TAB/CAP $24.76 TOZAAR TAB 25mg TAB/CAP $12.38 TOZAAR TAB 50mg TAB/CAP $24.76

PARACETAMOL & CODEINE PARACO-DENK TAB 500mg/30mg TAB/CAP $12.05

PENICILLIN V POTASSIUM APO-PEN VK TAB 300mg INJECTION $3.78

SALBUTAMOL AIR-O-VENT INHALER INHALER $296.36 BUTAHALE AER 100mcg INHALER $296.36 SALBULIN AER 100mcg INHALER $370.44 SALBUTAMOL-LAS AER 100mcg INHALER $296.36 SALOMOL AER 100mcg INHALER $296.36 VENTOLIN AER 100mcg INHALER $296.36

4 | INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS - Sickle Cell Disease

SALBUTAMOL SULFATE LABEL PRSNTN SUBSIDY LABEL PRSNTN SUBSIDYAPO-SALBUTAMOL NEBULISING SOLN. NEB.SOLN $316.14 APO-SALVENT TAB 4mg TAB/CAP $2.29 BRONCLAIR LIQUID SOLUTION $234.94 FEDBUTAMOL SYP 2mg/5ml - 120ML SOLUTION $225.47 FEDBUTAMOL SYP 2mg/5ml - 150ML SOLUTION $281.82 FEDBUTAMOL TAB 2mg TAB/CAP $1.15FEDBUTAMOL TAB 4mg TAB/CAP $2.29 SALAMOL-IVAX AER 100mcg INHALER $296.36 SALAMOL-IVAX NEB. SOLN 0.1% NEB.SOLN $316.14 SALAMOL-IVAX NEB. SOLN 0.2% NEB.SOLN $632.28 SALBUTAMOL-H2K AER 100mcg INHALER $296.36 SALBUTAMOL-H2K AER 100mcg CFC FREE INHALER $296.36 SALBUTAMOL-LAS NEB.SOLN NEB.SOLN $474.22 SALBUTAMOL-LAS SYP 2mg/5ml - 100ml SOLUTION $187.95 SALBUTAMOL-LAS TAB 4mg TAB/CAP $2.29 SALBUTAMOL-SANDOZ AER 100mcg INHALER $296.36 SALBUTAMOL-PMS SYP 2mg/5ml - 100ml SOLUTION $187.95 SALBUTAMOL-PMS TAB 4mg TAB/CAP $2.29 SALBUTAVENT HFA AER 100mcg INHALER $296.36 SALVENT HFA AER 100mcg INHALER $296.36 VENTOLIN NEB 0.5% NEB.SOLN $632.27 VENTOLIN NEB. SOLN. 0.1% - PACK OF 20 NEB.SOLN $316.14 VENTOLIN SYP 2mg/5ml - 150ml SOLUTION $281.82 VENTOLIN ORAL SOL. 2mg/ml - 200ml SOLUTION $375.76

TRAMADOL ADAMON CAP 50mg TAB/CAP $36.40 ADAMON DROPS 100mg/ml SOLUTION $650.00 TRAMAL CAP 50mg TAB/CAP $36.40 TRAMADOL DENK 50 EFFERVESCENT TAB 50mg TAB/CAP $36.40 TRAMAL DROPS 100MG/ML SOLUTION $650.00 TRAMAL L.A. TAB 100mg TAB/CAP $72.80 TRAMDOL-BM CAP 50mg TAB/CAP $36.40






SALBUTAMOL-BECLOMETHASONE cont’d

SALBUTAMOL-BECLOMETHASONE AERODAY INHALER (100/50mcg) INHALER $450.42 BECLOSAL HFA AER 100/50mcg INHALER $450.52 IBICAR S AEROSOL (100/50mcg) INHALER $450.52 LAS-SALBUTAMOL &BECLOMETHAS. AER 100/50mcg INHALER $450.52 SALBUTAMOL & BECLOMETHAS.-H2K AER 100/50mcg INHALER $450.52 COMBIWAVE SF AEROSOL 50 (25/50 mcg) INHALER $3,162.00 COMBIWAVE SF AEROSOL 125 (25/125 mcg) INHALER $3,295.50 COMBIWAVE SF AEROSOL 250 (25/250mcg) INHALER $3,672.00 SALMETIDE HFA AER. 25mcg/125mcg INHALER $2,636.00 SALMETIDE HFA AER. 25mcg/250mcg INHALER $2,937.23 SERETIDE AER 25/125mcg (GLAXO WELL.) INHALER $2,636.00 SERETIDE DISKUS AER 50/100mcg (GLAXO WELL) INHALER $2,529.30

SERETIDE DISKUS AER 50/250mcg (GLAXO WELL) INHALER $2,636.00 SERETIDE DISKUS AER 50/500mcg (Gsk) INHALER $2,937.23 SERETIDE EVOHALER 25/50mcg (GLAXO WELL) INHALER $2,529.30 SERETIDE EVOHALER 25/125mcg (Gsk) INHALER $2,636.00 SERETIDE EVOHALER 25/250mcg (Gsk) INHALER $2,937.23 SERETIDE EVOHALER-Gsk 25mcg/50mcg INHALER $2,529.30 SEROFLO-LAS AER INHALER 25/125mcg INHALER $2,636.00 SEROFLO-LAS AER INHALER 25/250mcg INHALER $2,937.23 SEROFLO 500 MULTIHALER INHALER $1,468.62

Vascular Disease - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 1



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- VASCULAR DISEASEINDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS


APIXABAN

LABEL PRSNTN SUBSIDYELIQUIS TAB 2.5mg TAB/CAP $72.48ELIQUIS TAB 5mg TAB/CAP $144.95

CALCIUM DOBESILATEDOXIUM CAP 500mg TAB/CAP $81.84

ASPIRINASPIRIN-MAC EC TAB 81mg TAB/CAP $4.69BAYER ASPIRIN EC TAB 81mg TAB/CAP $4.69ENTROPHEN EC TAB 81mg TAB/CAP $4.69

CLOPIDOGRELAURIX TAB 75mg TAB/CAP $47.49CADIGREL TAB 75mg TAB/CAP $47.49CLOPACT -75 TAB TAB/CAP $47.49CLOPI-DENK 75 TAB 75mg TAB/CAP $47.49CLOPIDOGREL(Sandoz) TAB 75mg TAB/CAP $47.49

2 | INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS - Vascular Disease

CLOPIDOGREL cont’d


CLOPIDOGREL & ASPIRINPLAGRIL A TAB 75mg/75mg TAB/CAP $46.03TROMBLATT-AS TAB 75mg/75mg TAB/CAP $46.03

DABIGATRANPRADAX CAPSULES 75mg TAB/CAP $87.00PRADAX CAPSULES 110mg TAB/CAP $127.60PRADAX CAPSULES 150mg TAB/CAP $174.00PRADAXA CAPSULES 75mg TAB/CAP $87.00PRADAXA CAPSULES 110mg TAB/CAP $127.60PRADAXA CAPSULES 150mg TAB/CAP $174.00

DIOSMINVENEX TAB 300mg TAB/CAP $13.02VENEX TAB 500mg TAB/CAP $21.70

CLOPIDOGREL-H2K TAB 75mg TAB/CAP $47.49CLOPIDOGREL-LAS TAB 75mg TAB/CAP $47.49CLOPIVAS TAB 75mg TAB/CAP $47.49CLOPREZ TAB 75mg TAB/CAP $47.49DE PLATT TAB 75mg TAB/CAP $47.49FLOGREL TAB 75mg TAB/CAP $47.49LODIGREL TAB 75mg TAB/CAP $47.49PLAGRIL TAB 75mg TAB/CAP $47.49PLASEP TAB 75mg TAB/CAP $47.49PLAVIX TAB 75mg TAB/CAP $47.49PREVA TAB 75mg TAB/CAP $47.49TROMBLATT TAB 75mg TAB/CAP $47.49ZYLLT TAB 75mg TAB/CAP $47.49

DIOSMIN & HESPERIDINDAFLON TAB 500mg TAB/CAP $18.93VENALON 500 TAB 450mg/50mg TAB/CAP $18.93

DIPYRIDAMOLEAPO-DIPYRIDAMOLE TAB 25mg TAB/CAP $2.06APO-DIPYRIDAMOLE TAB 75mg TAB/CAP $6.19PERSANTINE TAB 25mg TAB/CAP $2.06PERSANTINE TAB 75mg TAB/CAP $6.19

DIPYRIDAMOLE & ASPIRINAGGRENOX CAP 200mg/25mg TAB/CAP $62.19

Vascular Disease - INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS | 3

KETANSERIN

LABEL PRSNTN SUBSIDYSUFREXAL GEL -78Gm GEL $2,026.26

PENTOXIFYLLINEAPO-PENTOX SR TAB 400mg TAB/CAP $12.09PENTOX-H2K SR TAB 400mg TAB/CAP $12.09PENTOX-LAS SR TAB 400mg TAB/CAP $12.09PENTOXY TAB 400mg TAB/CAP $12.09TRENTAL TAB 400mg CR TAB/CAP $12.09

PENTOXIFYLLINE & OXPENTIFYLLINEFLEXITAL CR TAB 400mg TAB/CAP $12.09

RIVAROXABANXARELTO TAB 15mg TAB/CAP $244.95XARELTO TAB 20mg TAB/CAP $326.60

VINPOCETINECAVINTON FORTE TAB 10mg TAB/CAP $26.54

ZINC HYALURONATECURIOSIN GEL -15Gm GEL $847.60

WARFARINWARFARIN-BPS TAB 5mg TAB/CAP $5.46

4 | INDIVIDUAL BENEFITS FOR PRESCRIPTION DRUGS - Vascular Disease

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