Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
GENERIC NAME
NOM GÉNÉRIQUE
STRENGTH
DOSAGE
TRADENAME
MARQUE DE COMMERCE
DIN
PIN
MFR
FAB
MLP
PCF
Abacavir Sulfate / Abacavir (sulfate d')
Liq Orl 20mg
Ziagen
02240358
VIV
0.4568
Abacavir Sulfate / Abacavir (sulfate d')
Tab/Co. Orl 300mg
Ziagen
02240357
VIV
6.8693
Abacavir Sulfate/Lamivudine / Abacavir (sulfate d')
/Lamivudine
Tab/Co. Orl 600mg/300mg
Kivexa
02269341
VIV
23.6190
Abacavir Sulfate/Lamivudine/Zidovudine / Abacavir
(sulfate d`) /Lamivudine/Zidovudine
Tab/Co. Orl 300mg
Trizivir
02244757
VIV
17.9388
Abatacept / Abatacept
Liq Inj 125mg
Orencia
02402475
BRI
358.9000
Abatacept / Abatacept
Pws/Pds. Inj 250mg
Orencia
02282097
BRI
480.4100
Abitraterone Acetate / Abitratérone (acétate d')
Tab/Co. Orl 250mg
Zytiga
02371065
JAN
29.1833
0.8000
Acamprostate Calcium / Acamprosate Calcium
Tab/Co. Orl 333mg
Campral
02293269
MYL
Acarbose / Acarbose
Tab/Co. Orl 50mg
Glucobay
02190885
BAY
0.2695
Acarbose / Acarbose
Tab/Co. Orl 100mg
Glucobay
02190893
BAY
0.3733
Acenocoumarol / Acénocoumarol
Tab/Co. Orl 1mg
Sintrom
00010383
PAL
0.5578
Acenocoumarol / Acénocoumarol
Tab/Co. Orl 4mg
Sintrom
00010391
PAL
1.7399
Acetaminophen / Acétaminophène
Sup/Supp. Rt 325mg
Abenol
01919393
PDP
0.6692
Acetaminophen / Acétaminophène
Tab/Co. Orl 325mg
Acetaminophen
01938088
JPC
0.0120
Acetaminophen / Acétaminophène
Tab/Co. Orl 500mg
Apo-Acetaminophen
00544981
APX
0.0326
Novo-Gesic
00389218
TEV
0.0326
Acetaminophen
01939122
JPC
0.0157
Apo-Acetaminophen
00545007
APX
0.0389
Novo-Gesic
00482323
TEV
0.0389
Tylenol w Codeine
02163942
JAN
0.1147
02163934
JAN
0.0975
00653241
RPH
0.0690
0.1150
Acetaminophen/Codeine / Acétaminophène/Codéine
Elx Orl 32mg/1.6mg
Acetaminophen/Caffeine/Codeine /
Tab/Co. Orl 300mg/15mg/15mg Tylenol No.2
Acétaminophène/Codéine/Caféine
ratio-Lenoltec #2
Acetaminophen/Caffeine/Codeine /
Acétaminophène/Codéine/Caféine
Tab/Co. Orl 300mg/30mg/15mg Atasol-15
00293504
CHU
Acetaminophen/Caffeine/Codeine /
Tab/Co. Orl 300mg/30mg/15mg Tylenol No.3
02163926
JAN
0.1182
00653276
RPH
0.0760
CHU
0.1338
Acétaminophène/Codéine/Caféine
ratio-Lenoltec #3
Acetaminophen/Caffeine/Codeine /
Acétaminophène/Codéine/Caféine
Tab/Co. Orl 300mg/30mg/30mg Atasol-30
00293512
Acetaminophen/Codeine / Acétaminophène/Codéine
Tab/Co. Orl 300mg/60mg
Tylenol No.4
02163918
JAN
0.2271
ratio-Lenoltec #4
00621463
RPH
0.1605
ratio-Emtec-30
00608882
RPH
0.1300
Mucomyst
02091526
WLS
0.7200
Parvolex
02181460
BCH
0.9330
Acetaminophen/Codeine / Acétaminophène/Codéine
Tab/Co. Orl 300mg/30mg
Acetylcysteine / Acétylcystéine
Liq Inh 200mg
Acetylsalicylic Acid / Acide Acétylsalicylique
Acetylsalicylic Acid / Acide Acétylsalicylique
Acetylsalicylic Acid / Acide Acétylsalicylique
Effective January 16, 2015
Effectif le 16 janvier 2015
ECT/Co.Ent Orl 81mg
ECT/Co.Ent Orl 325mg
ECT/Co.Ent Orl 650mg
Acetylcysteine
02243098
SDZ
0.7000
ASA ECT
02244993
PMS
0.0423
ASA daily low dose
02243101
PMS
0.0640
Equate daily low-dose EC
02243801
PMS
0.0423
Exact Coated daily low dose ASA
02243896
PMS
0.0640
Praxis ASA
02283700
PDP
0.0530
ASA EC
02426811
SAS
0.0530
Rexall Coated low dose ASA
02243802
PMS
0.0596
ASA Tab EC
02352427
ODN
0.0280
Enteric Coated ASA
02010526
TAN
0.0280
Entrophen
00010332
PDP
0.0503
Novasen
00216666
TEV
0.0304
pms-ASA EC
02284529
PMS
0.0280
0.0705
Entrophen
00010340
PDP
Jamp-ASA EC
00794244
JPC
0.0550
Novasen
00229296
TEV
0.0521
1
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Acitretin / Acitrétine
Cap/Caps Orl 10mg
Soriatane
02070847
TRB
2.1130
Acitretin / Acitrétine
Cap/Caps Orl 25mg
Soriatane
02070863
TRB
3.7113
Aclidinum Bromide / Bromure d'Aclidinum
Pwr/Pds Inh 400mcg/act
Tudorza Genuair
02409720
ALM
0.8850
Acyclovir / Acyclovir
Ont Top 5%
Zovirax
00569771
VLN
13.1800
Acyclovir Sodium / Acyclovir Sodique
Liq Inj 25mg
Acyclovir Sodium
02236916
HOS
4.8620
Acyclovir Sodium / Acyclovir Sodique
Liq Inj 50mg
Acyclovir Sodium
02236926
PPC
12.5840
Adalimumab / Adalimumab
Liq Inj 40mg/0.8mL
Humira Inj (Prefilled Syringe)
02258595
ABV
740.3600
Afatinib Dimaleate / Dimaléate D'Afatinib
Tab/Co. Orl 20mg
Giotrif
02415666
BOE
80.0000
Afatinib Dimaleate / Dimaléate D'Afatinib
Tab/Co. Orl 30mg
Giotrif
02415674
BOE
80.0000
Afatinib Dimaleate / Dimaléate D'Afatinib
Tab/Co. Orl 40mg
Giotrif
02415682
BOE
80.0000
Alfacalcidol / Alfacalcidol
Cap/Caps Orl 0.25mcg
One-Alpha
00474517
LEO
0.4748
Alfacalcidol / Alfacalcidol
Cap/Caps Orl 1mcg
One-Alpha
00474525
LEO
1.4211
Alglucosidase Alfa / Alglucosidase Alpha
Pws/Pds. Inj 50mg
Myozyme
02284863
GZM
840.31
Aluminum/Benzethonium / Aluminum/Benzéthonium
Pwr/Pds. Top 0.35%
Buro Sol
00579947
TCD
0.7360
Aluminum/Magnesium / Aluminum/Magnésium
Sus/Susp Orl 120mg/60mg
Diovol EX
00491217
CHU
0.0189
Aluminum/Magnesium / Aluminum/Magnésium
Sus/Susp Orl 45.6mg/40mg
Diovol
01966529
CHU
0.0148
Aluminum/Benzethonium / Aluminum/Benzéthonium
Liq Ot 0.5%/0.03%
Buro-Sol Otic
00674222
TCD
0.2700
Ambrisentan / Ambrisentan
Tab/Co. Orl 5mg
Volibris
02307065
GSK
122.5200
Ambrisentan / Ambrisentan
Tab/Co. Orl 10mg
Volibris
02307073
GSK
122.5200
Amikacin Sulfate / Amikacine (sulfate d')
Liq Inj 250mg
Amikacin
02242971
SDZ
29.1800
Aminobenzoate Potassium / Potassium
(aminobenzoate de)
Cap/Caps Orl 500mg
Potaba
00611271
GLE
0.3616
Aminobenzoate Potassium / Potassium
(aminobenzoate de)
Tab/Co. Orl 500mg
Potaba
00550175
GLE
0.4711
Amiodarone Hydrochloride / Amiodarone (chlorhydrate d') Tab/Co. Orl 100mg
pms-Amiodarone
02292173
PMS
0.7599
Amitriptyline Hydrochloride / Amitriptyline (chlorhydrate d') Tab/Co. Orl 10mg
Amitriptyline
00370991
PDL
0.0435
Amitriptyline Hydrochloride / Amitriptyline (chlorhydrate d') Tab/Co. Orl 25mg
Amitriptyline
00371009
PDL
0.0829
Amoxicillin/Clavulanic Acid / Amoxicilline/Acide
Clavulanique
Pws/Pds. Orl
200mg/28.5mg/5mL
Clavulin 200
02238831
GSK
0.1440
Amoxicillin/Clavulanic Acid / Amoxicilline/Acide
Clavulanique
Tab/Co. Orl 500mg/125mg
ratio-Aclavulanate
02243771
TEV
0.9340
2.1500
Ampicillin Sodium / Ampicilline Sodique
Pws/Pds. Inj 500mg
Teva-Ampicillin
00872652
TEV
Ampicillin Sodium / Ampicilline Sodique
Pws/Pds. Inj 1g
Teva-Ampicillin
01933345
TEV
3.6000
Amphotericin B / Amphotéricine B
Pws/Pds. Inj 50mg
Fungizone IV
00029149
BRI
79.6500
Ampicillin Sodium / Ampicilline Sodique
Pws/Pds. Inj 2g
Ampicillin Sodium
01933353
TEV
7.2000
Apraclonidine Hydrochloride / Apraclonidine
(chlorhydrate d')
Liq Oph 0.5%
Iopidine
02076306
ALC
4.6380
Aprepitant / Aprépitant
Cap/Caps Orl 80mg
Emend
02298805
FRS
31.5450
Aprepitant / Aprépitant
Cap/Caps Orl 125mg
Emend
02298791
FRS
31.5450
Aprepitant / Aprépitant
Cap/Caps Orl 85mg
Emend-Tri-Pack Cap
02298813
FRS
31.5450
Apixaban / Apixaban
Tab/Co. Orl 2.5mg
Eliquis
02377233
BRI
1.6000
Apixaban / Apixaban
Tab/Co. Orl 5mg
Eliquis
02397714
BRI
1.6000
Aripiprazole / Aripiprazole
Tab/Co. Orl 2mg
Abilify
02322374
BRI
3.0300
Aripiprazole / Aripiprazole
Tab/Co. Orl 5mg
Abilify
02322382
BRI
3.4117
Aripiprazole / Aripiprazole
Tab/Co. Orl 10mg
Abilify
02322390
BRI
3.8933
Aripiprazole / Aripiprazole
Tab/Co. Orl 15mg
Abilify
02322404
BRI
3.9700
Aripiprazole / Aripiprazole
Tab/Co. Orl 20mg
Abilify
02322412
BRI
4.0100
Aripiprazole / Aripiprazole
Tab/Co. Orl 30mg
Abilify
02322455
BRI
4.0100
ASA/Caffeine/Butalbital / AAS/Caféine/Butalbital
Tab/Co. Orl 50mg/330mg/40mg ratio-Tecnal
00608211
RPH
0.5038
ASA/Codeine/Caffeine / AAS/Codéine/Caféine
Tab/Co. Orl 375mg/30mg/30mg 292
02238645
PDP
0.1730
Asenapine Maleate / Asénapine (maléate d')
Slt/Co.S.L. Orl 5mg
02374803
FRS
1.4300
Saphris
Asenapine Maleate / Asénapine (maléate d')
Slt/Co.S.L. Orl 10mg
Saphris
02374811
FRS
1.4300
Atazanavir Sulfate / Atazanavir (sulfate d')
Cap/Caps Orl 150mg
Reyataz
02248610
BRI
11.4132
Effective January 16, 2015
Effectif le 16 janvier 2015
2
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Atazanavir Sulfate / Atazanavir (sulfate d')
Cap/Caps Orl 200mg
Reyataz
02248611
BRI
11.4797
Atazanavir Sulfate / Atazanavir (sulfate d')
Cap/Caps Orl 300mg
Reyataz
Atovaquone / Atovaquone
Sus/Susp. Orl 750mg/5mL
Mepron
02294176
BRI
22.4330
02217422
GSK
Atropine Sulfate / Atropine (sulfate d')
Dps/Gttes Oph 1%
2.6554
Isopto Atropine
00035017
ALC
0.6540
Auranofin / Auranofine
Cap/Caps Orl 3mg
Riduara
01916823
XPI
6.0142
Axitinib / Axitinib
Tab/Co. Orl 1mg
Inlyta
02389630
PFI
18.8604
Axitinib / Axitinib
Tab/Co. Orl 5mg
Inlyta
02389649
PFI
94.3020
Azelaic Acid / Acide Azélaïque
Gel Top 15%
Finacea
02270811
BAY
0.6000
Azithromycin / Azithromycine
Pws/Pds. Orl 20mg
Phl-Azithromycin
02282380
PHL
0.0198
Azithromycin / Azithromycine
Pws/Pds. Orl 40mg
Phl-Azithromycin
02282410
PHL
0.0140
Beclomethasone / Béclométhasone
Aem/Aém Inh 50mcg
Qvar
02242029
VLN
0.1546
Beclomethasone / Béclométhasone
Aem/Aém Inh 100mcg
Qvar
02242030
VLN
0.3083
Belladonna/Ergotamine/Phenobarbital /
Belladone/Ergotamine/Phénobarbital
SRT/Co.L.L. Orl
40mg/0.6mg/0.2mg
Bellergal spaceTabs
00176141
PAL
1.4919
Benzoyl Peroxide / Benzoyle (peroxyde de)
Gel Top 10%/6%
Panoxyl
00263699
GSK
0.1458
Benzoyl Peroxide / Benzoyle (peroxyde de)
Gel Top 20%/6%
Panoxyl
00373036
GSK
0.1900
Benztropine Mesylate / Benztropine (mésylate de)
Liq Inj 1mg
Benztropine Omega
02238903
OMG
9.5000
Benztropine Mesylate / Benztropine (mésylate de)
Tab/Co. Orl 1mg
pms-Benztropine
00706531
PMS
0.0477
Betamethasone Dipropionate/
Crm/Cr. Top 0.05%
Diprosone
00323071
FRS
0.2048
ratio-Topisone
00804991
RPH
0.2048
Crm/Cr. Top 0.05%
Diprolene Glycol
00688622
FRS
0.5186
ratio-Topilene
00849650
RPH
0.5187
Diprosone
00417246
FRS
0.1980
ratio-Topisone
00809187
RPH
0.1980
Diprolene Glycol
00862975
FRS
0.2697
ratio-Topilene Glycol
01927914
RPH
0.4683
Bétaméthasone (Dipropionate de)
Betamethasone Dipropionate/
Bétaméthasone (Dipropionate de)
Betamethasone Dipropionate/
Lot Top 0.05%
Bétaméthasone (Dipropionate de)
Betamethasone Dipropionate/
Lot Top 0.05%
Bétaméthasone (Dipropionate de)
Betamethasone Dipropionate/
Ont Top 0.05%
Diprosone
00344923
FRS
0.2152
ratio-Topisone
00805009
RPH
0.2158
Betnesol
02060884
PAL
0.1035
Betamethasone Sodium Phoshapte/Betamethasone /
Sus/Susp. Ia 3mg/3mg
Bétaméthasone (acétate de)/Bétaméthasone (phosphate
sodique de)
Celestone Soluspan
00028096
FRS
12.9041
Betamethasone Valerate / Bétaméthasone (valérate de)
Crm/Cr. Top 0.05%
ratio-Ectosone Mild
00535427
RPH
0.0611
Betamethasone Valerate / Bétaméthasone (valérate de)
Crm/Cr. Top 0.1%
ratio-Ectosone
00535435
RPH
0.0911
Betamethasone Valerate / Bétaméthasone (valérate de)
Lot Top 0.05%
ratio-Ectosone Mild
00653209
RPH
0.2108
Betamethasone Valerate / Bétaméthasone (valérate de)
Lot Top 0.1%
Betaderm
00716634
TAR
0.0852
Bétaméthasone (Dipropionate de)
Betamethasone Sodium Phosphate / Bétaméthasone
(phosphate sodiuqe de)
Enm/Lav. Rt 0.05mg
Valisone
00027944
VLN
0.0853
ratio-Ectosone
00750050
RPH
0.2588
ratio-Ectosone Scalp
00653217
RPH
0.0853
Betamethasone/Gentamicin /
Bétaméthasone/Gentamicine
Ont Top 0.1%/0.1%
Valisone G
00232351
VLN
0.9967
Betamethasone/Gentamicin /
Bétaméthasone/Gentamicine
Crm/Cr. Top 0.1%/0.1%
Valisone G
00177016
VLN
0.9967
Betamethasone/Salicylic Acid / Bétaméthasone/Acide
Salicylique
Ont Top 30mg/0.5mg
Diprosalic
00578436
FRS
1.1038
Bethanechol Chloride / Béthanéchol (chlorure de)
Tab/Co. Orl 10mg
Duvoid
01947958
PAL
0.3033
Bethanechol Chloride / Béthanéchol (chlorure de)
Tab/Co. Orl 25mg
Duvoid
01947931
PAL
0.4914
Bethanechol Chloride / Béthanéchol (chlorure de)
Tab/Co. Orl 50mg
Duvoid
01947923
PAL
0.6473
Betaxolol Hydrochloride / Bétaxolol (chlorhydrate de)
Sus/Susp. Oph 0.25%
Betoptic S
01908448
ALC
2.3360
Bimatoprost / Bimatoprost
Liq Oph 0.01%
Lumigan RC
02324997
ALL
11.1200
Boceprevir / Bocéprévir
Cap/Caps Orl 200mg
Victrelis
02370816
FRS
12.5000
Boceprevir/Ribavirin/Peginterferon Alfa 2B /
Bocéprévir/Ribavirine/Interféron Alfa 2B Péguylé
Kit/Trousse Inj 80mcg
Victrelis Triple Cap
02371448
FRS
2652.5500
Effective January 16, 2015
Effectif le 16 janvier 2015
3
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Boceprevir/Ribavirin/Peginterferon Alfa 2B /
Bocéprévir/Ribavirine/Interféron Alfa 2B Péguylé
Kit/Trousse Inj 100mcg
Victrelis Triple Cap
02371456
FRS
2652.5500
Boceprevir/Ribavirin/Peginterferon Alfa 2B /
Bocéprévir/Ribavirine/Interféron Alfa 2B Péguylé
Kit/Trousse Inj 120mcg
Victrelis Triple Cap
02371464
FRS
2726.0000
Boceprevir/Ribavirin/Peginterferon Alfa 2B /
Bocéprévir/Ribavirine/Interféron Alfa 2B Péguylé
Kit/Trousse Inj 150mcg
Victrelis Triple Cap
02371472
FRS
2726.0000
Brinzolamide / Brinzolamide
Liq Oph 1%
Azopt
02238873
ALC
3.4120
Brinzolamide/Timolol / Brinzolamide/Timolol
Sus/Susp. Oph 0.5%/1%
Azarga
02331624
ALC
4.4820
Brinzolamide/Timolol / Brinzolamide/Timolol
Liq Oph 0.5%/0.2%
Combigan
02248347
ALL
4.1890
Budesonide / Budésonide
Aem/Aém Nas 100mcg
Rhinocort
02035324
AZE
0.1208
0.1564
Budesonide / Budésonide
Aem/Aém Inh 100mcg
Pulmicort Turbuhaler
00852074
AZE
Budesonide / Budésonide
Aem/Aém Inh 200mcg
Pulmicort Turbuhaler
00851752
AZE
0.3193
Budesonide / Budésonide
Aem/Aém Inh 400mcg
Pulmicort Turbuhaler
00851760
AZE
0.4650
Budesonide / Budésonide
Cap/Caps Orl 3mg
Entocort
02229293
AZE
1.6345
8.5071
Budesonide / Budésonide
Enm/Lav. Rt 2.3mg
Entocort
02052431
AZE
Budesonide / Budésonide
Sus/Susp. Inh 0.125mg
Pulmicort Nebuamp
02229099
AZE
0.2175
Budesonide / Budésonide
Sus/Susp. Inh 0.25mg
Pulmicort Nebuamp
01978918
AZE
0.4350
Budesonide / Budésonide
Sus/Susp. Inh 0.5mg
Pulmicort Nebuamp
01978926
AZE
0.8680
Budesonide/Formoterol / Budésonide/Formotérol
Pwr/Pds. Inh 100mcg/6mcg
Symbicort
02245385
AZE
0.5317
Budesonide/Formoterol / Budésonide/Formotérol
Pwr/Pds. Inh 200mcg/6mcg
Symbicort
02245386
AZE
0.6908
Buprenorphine/Naloxone / Buprénophine/Naloxone
Slt/Co.S.L. Orl 2mg/0.5mg
Suboxone
02295695
RBH
2.6700
Buprenorphine/Naloxone / Buprénophine/Naloxone
Slt/Co.S.L. Orl 8mg/2mg
Suboxone
02295709
RBH
4.7300
Bupropion Hydrochloride / Bupropion (chlorhydrate de)
Tab/Co. Orl 150mg
Zyban
02238441
VLN
0.9619
Buserelin Acetate / Buséréline (acétate de)
Asp Nas 1mg/mL
Suprefact
02225158
SAV
7.9370
Buserelin Acetate / Buséréline (acétate de)
Imp Inj 6.3mg
Suprefact Depot
02228955
SAV
768.1600
Buserelin Acetate / Buséréline (acétate de)
Imp Inj 9.45mg
Suprefact Depot
02240749
SAV
1137.2600
Busulfan / Busulfan
Tab/Co. Orl 2mg
Myleran
00004618
TRI
1.5224
Caffeine/Diphenhydramine/Ergotamine /
Caféine/Diphenhydramine/Ergotamine
Cap/Caps Orl
1mg/100mg/25mg
Ergodryl
00156086
ERF
0.9225
Calcipotriol / Calcipotriol
Crm/Cr. Top 50mcg
Dovonex
02150956
LEO
0.8143
Calcipotriol / Calcipotriol
Liq Top 50mcg
Dovonex Scalp Solution
02194341
LEO
0.8117
Calcipotriol / Calcipotriol
Ont Top 50mcg
Calcipotriol/Betamethasone / Calcipotriol/Bétaméthasone Gel Top 50mcg/0.5mg/g
Dovonex
01976133
LEO
0.7983
Dovobet
02319012
LEO
1.4928
Calcitonin Salmon / Calcitonine Saumon
Liq Ing 100IU
Caltine
02007134
FEI
8.0550
Calcitriol / Calcitriol
Cap/Caps Orl 0.25mcg
Rocaltrol
00481823
HLR
0.9280
Calcitriol / Calcitriol
Cap/Caps Orl 0.5mcg
Rocaltrol
00481815
HLR
1.4758
Calcium Folinate / Calcium (folinate de)
Tab/Co. Orl 5mg
Leucovorin Calcium
02170493
PFI
6.1958
Capsaicin / Capsaïcine
Crm/Cr. Top 0.025%
Capsaicin / Capsaïcine
Crm/Cr. Top 0.075%
Capsaicin
02157101
VLN
0.1917
Zostrix
00740306
MDS
0.2192
Capsaicin Crm
02157128
VLN
0.2250
Zostrix H.P.
02004240
MDS
0.2800
FRS
222.0000
17.2480
Caspofungin Acetate / Caspofongine (Acétate de)
Pws/Pds. Inj 50mg
Cancidas IV
02244265
Cefepime Hydrochloride / Céfépime (chlorhydrate de)
Pws/Pds. Inj 1g
Maxipime
02163632
BRI
Cefixime / Céfixime
Pws/Pds. Orl 20mg
Suprax
00868965
SAV
0.4266
Cefixime / Céfixime
Tab/Co. Orl 400mg
Suprax
00868981
SAV
3.6230
Cefotaxime Sodium / Céfotaxime Sodique
Pws/Pds. Orl 1g
Claforan
02225093
SAV
9.8000
Cefotaxime Sodium / Céfotaxime Sodique
Pws/Pds. Orl 2g
Claforan
02225107
SAV
19.6300
Cefoxitin Sodium / Céfoxitine Sodique
Pws/Pds. Inj 10g
Cefoxitin
02240773
TEV
105.9500
Ceftazidime / Ceftazidime
Pws/Pds. Inj 1g
Fortaz
02212218
GSK
22.9270
Ceftazidime
00886971
PPC
31.9700
Fortaz
02212226
GSK
45.0770
Ceftazidime
00886955
PPC
60.8100
Ceftin
02212307
GSK
0.1748
Ceftazidime / Ceftazidime
Cefuroxime Axetil / Céfuroxime Axétil
Effective January 16, 2015
Effectif le 16 janvier 2015
Pws/Pds. Inj 2g
Liq Orl 25mg
4
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Cephalexin / Céphalexine
Cap/Caps Orl 250mg
Novo-Lexin
00342084
TEV
0.2250
Cephalexin / Céphalexine
Cap/Caps Orl 500mg
Novo-Lexin
00342114
TEV
0.4500
Chlorambucil / Chlorambucil
Tab/Co. Orl 2mg
Leukeran
00004626
TRI
1.4348
Chloral Hydrate / Chloral (hydrate de)
Syr/Sir. Orl 100mg
Chloral Hydrate Syrup Odan
02247621
ODN
0.0433
pms-Chloral Hydrate
00792659
PMS
0.0446
Chloramphenicol / Chloramphénicole
Dps/Gttes Oph 0.25%
Pentamycetin
01980556
SDZ
0.6180
Chloramphenicol / Chloramphénicole
Dps/Gttes Oph 0.5%
Pentamycetin
02164051
SDZ
0.6300
Chloramphenicol / Chloramphénicole
Dps/Gttes Oph 1%
Pentamycetin
01980564
SDZ
2.1600
Chloramphenicol/Hydrochortisone /
Chloramphénicol/Hydrocortisone
Ont Oph 1%/1%
Pentamycetin/HC
01980580
SDZ
2.9714
Chloramphenicol/Hydrochortisone /
Chloramphénicol/Hydrocortisone
Sus/Susp. Oph 0.2%/1%
Pentamycetin/HC
01980572
SDZ
2.4580
Chlordiazepoxide HCl/Clidinium Bromide /
Cap/Caps Orl 5mg/2.5mg
Chlordiazépoxide (chlorhydrate de)/Clidinum
(bromure de)
Chlorpheniramine Maleate / Chlorphéniramine
Tab/Co. Orl 4mg
(maléate de)
Librax
00115630
VLN
0.3176
Chlorax
00618454
AAP
0.2330
Chlor-Tripolon
00738972
SCO
0.2117
Novo-Pheniram
00021288
TEV
0.0645
Chlorpromazine / Chlorpromazine
Tab/Co. Orl 25mg
Teva-Chlorpromazine
00232823
TEV
0.1734
Chlorpromazine / Chlorpromazine
Tab/Co. Orl 50mg
Teva-Chlorpromazine
00232807
TEV
0.1983
Chlorpromazine / Chlorpromazine
Tab/Co. Orl 100mg
Teva-Chlorpromazine
00232831
TEV
0.3313
Ciclesonide / Ciclésonide
Aem/Aém Inh 100mcg
Alvesco
02285606
NYC
0.3795
Ciclesonide / Ciclésonide
Aem/Aém Inh 200mcg
Alvesco
02285614
NYC
0.6273
Ciclopirox Olamine / Ciclopirox Olamine
Crm/Cr. Top 1%
Loprox
02221802
VLN
0.3112
Ciclopirox Olamine / Ciclopirox Olamine
Lot Top 1%
Loprox
02221810
VLN
0.3223
Ciprofloxacin Hydrochloride / Ciprofloxacine (chlorhydrate Ont Oph 0.3%
Ciprofloxacin / Ciprofloxacine
ERT/Co.L.P. Orl 1000mg
Ciloxan
02200864
ALC
3.0200
Cipro XL Tab 1000mg
02251787
BAY
3.1120
Ciprofloxacin / Ciprofloxacine
Liq Orl 100mg
Cipro Oral Suspension
02237514
BAY
0.5756
Ciprofloxacin/Dexamethasone /
Ciprofloxacine/Dexaméthasone
Sus/Susp. Ot 0.3%/0.1%
Ciprodex
02252716
ALC
3.6907
Citalopram Hydrobromide / Citalopram (bromhydrate de) Tab/Co. Orl 30mg
CTP 30
02296152
SNV
0.8750
Clindamycin Palmitate / Clindamycine (palmitate de)
Pws/Pds. Orl 15mg
Dalacin C
00225851
PFI
0.1287
Clioquinol/Hydrocortisone / Clioquinol/Hydrocortisone
Crm/Cr. Top 3%/1%
Vioform HC
00074500
PAL
0.8803
Clobetasone 17-Butyrate / Clobétasone (17-butyrate de)
Crm/Cr. Top 0.05%
Spectro Eczemacare
02214415
GCH
0.3817
Clobetasol Propionate / Clobétasol (propionate de)
Crm/Cr. Top 0.05%
Mylan-Clobetasol
02024187
MYL
0.2280
Novo-Clobetasol
02093162
TEV
0.4068
Clobetasol Propionate / Clobétasol (propionate de)
Lot Top 0.05%
Mylan-Clobetasol Propionate
02216213
MYL
0.1990
Clobetasol Propionate / Clobétasol (propionate de)
Ont Top 0.05%
Mylan-Clobetasol
02026767
MYL
0.2280
Novo-Clobetasol
02126192
TEV
0.4068
Clodronate Disodium / Clodronate Disodique
Cap/Caps Orl 400mg
Bonefos
01984845
BAY
1.9582
Clonazepam / Clonazépam
Tab/Co. Orl 0.25mg
pms-Clonazepam
02179660
PMS
0.0774
Clotrimazole / Clotrimazole
Crm/Cr. Top 1%
Clotrimaderm
00812382
TAR
0.3065
Clotrimazole / Clotrimazole
Crm/Cr. Vag 1%
Canesten
02150891
YNO
0.2438
Clotrimazole / Clotrimazole
Crm/Cr. Vag 2%
Canesten 3
02150905
YNO
0.4876
Clotrimazole / Clotrimazole
Crm/Cr. Vag 500mg/1%
Canesten 1 Comfortab
02264102
YNO
13.3100
Canesten 3 Comfortab Combi-Pak
02264099
YNO
13.3100
Clotrimazole/Betamethasone /
Clotrimazole/Bétaméthasone
Crm/Cr. Top 1%/0.05%
Lotriderm
00611174
FRS
0.9850
Cloxacillin Sodium / Cloxacilline Sodique
Pws/Pds. Inj 500mg
Cloxacillin Sodium
01912429
TEV
4.5600
Cloxacillin Sodium / Cloxacilline Sodique
Pws/Pds. Inj 1g
Cloxacillin Sodium
01975447
TEV
5.6050
Cloxacillin Sodium / Cloxacilline Sodique
Pws/Pds. Inj 2g
Cloxacillin Sodium
01912410
TEV
7.3150
Cloxacillin
02367424
STR
9.1440
Clozapine / Clozapine
Tab/Co. Orl 50mg
Gen-Clozapine
02305003
MYL
1.3188
Clozapine / Clozapine
Tab/Co. Orl 200mg
Gen-Clozapine
02305011
MYL
5.2892
Effective January 16, 2015
Effectif le 16 janvier 2015
5
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Coal Tar / Goudron de Houille
Crm/Cr. Top 1%
Odans LCD
00358495
ODN
0.0710
Codeine Phosphate / Codéine (phosphate de)
Liq Inj 30mg
Codeine Phosphate
00544884
SDZ
3.1420
Codeine Phosphate / Codéine (phosphate de)
Syr/Sir Orl 5mg
Codeine Phosphate
00050024
ATL
0.0541
ratio-Codeine
00779474
RPH
0.0345
Codeine Phosphate / Codéine (phosphate de)
Tab/Co. Orl 15mg
Codeine
00779458
ROG
0.0775
ratio-Codeine
00593435
RPH
0.0700
Codeine Phosphate / Codéine (phosphate de)
Tab/Co. Orl 30mg
ratio-Codeine
00593451
RPH
0.0800
Codeine Monohydrate/Codeine Sulfate / Codéine
(monohydrate de)/Codéine (sulfate de)
SRT/Co.L.L. Orl 50mg
Codeine Contin
02230302
PFR
0.3230
Codeine Monohydrate/Codeine Sulfate / Codéine
(monohydrate de)/Codéine (sulfate de)
SRT/Co.L.L. Orl 100mg
Codeine Contin
02163748
PFR
0.6560
Codeine Monohydrate/Codeine Sulfate / Codéine
(monohydrate de)/Codéine (sulfate de)
SRT/Co.L.L. Orl 150mg
Codeine Contin
02163780
PFR
0.9840
Codeine Monohydrate/Codeine Sulfate / Codéine
(monohydrate de)/Codéine (sulfate de)
SRT/Co.L.L. Orl 200mg
Codeine Contin
02163799
PFR
1.3120
Colchicine / Colchicine
Tab/Co. Orl 0.6mg
Colchicine
00287873
EUR
0.2565
Colchicine
00572349
ODN
0.2565
Jamp-Colchicine
02373823
JPC
0.2565
Colchicine / Colchicine
Tab/Co. Orl 1mg
Colchicine
00621374
ODN
0.5080
Colesevelam hydrochloride / Colésévélam (chlorhydrate
de)
Tab/Co. Orl 625mg
Lodalis
02373955
VLN
1.1000
Colestipol Hydrochloride / Colestipol (chlorhydrate de)
Tab/Co. Orl 1g
Colestid
02132680
PFI
0.2690
Colestipol Hydrochloride / Colestipol (chlorhydrate de)
Pws/Pds. Orl 5g
Colestid
00642975
PFI
0.1919
Colestipol Hydrochloride / Colestipol (chlorhydrate de)
Pws/Pds. Orl 7.5g
Colestid (Orange)
02132699
PFI
0.1279
Combinations of Vitamins / Combinaisons de Vitamines
Liq Orl
Infantol
00558079
CHU
0.0191
Conjugated Estrogens / Estrogènes Conjugués
Crm/Cr. Vag 0.625mg
Premarin
02043440
PFI
9.3840
Conjugated Estrogens / Estrogènes Conjugués
Tab/Co. Orl 0.3mg
Premarin
02414678
PFI
0.3106
Conjugated Estrogens / Estrogènes Conjugués
Tab/Co. Orl 0.625mg
Premarin
02414686
PFI
0.3106
CES
00265470
VLN
0.0929
Conjugated Estrogens / Estrogènes Conjugués
Tab/Co. Orl 1.25mg
Premarin
02414694
PFI
0.3106
Crizotinib / Crizotinib
Cap/Caps Orl 200mg
Xalkori
02384256
PFI
146.6667
Crizotinib / Crizotinib
Cap/Caps Orl 250mg
Xalkori
02384264
PFI
146.6667
Cromolyn Sodium / Cromolyn Sodique
Aem/Aém Nas 2%
Rhinaris-CS Anti-Allergic
01950541
PDP
0.7677
Crotamiton / Crotamiton
Crm/Cr. Top 10%
Eurax
00623377
CLC
0.3584
Cyclopentolate HCl / Cyclopentolate (chlorhydrate de)
Liq Oph 1%
Cyclogyl
00252506
ALC
0.8787
Cyclophosphamide / Cyclophosphamide
Tab/Co. Orl 25mg
Procytox
02241795
BAX
0.5385
Cyclophosphamide / Cyclophosphamide
Tab/Co. Orl 50mg
Procytox
02241796
BAX
0.7225
Cyclosporine / Cyclosporine
Cap/Caps Orl 10mg
Neoral
02237671
NVR
0.6238
Dabigatran Etexilate / Dabigatran Etexilate
Cap/Caps Orl 110mg
Pradaxa
02312441
BOE
1.6000
Dabigatran Etexilate / Dabigatran Etexilate
Cap/Caps Orl 150mg
Pradaxa
02358808
BOE
1.6000
Dabrafenib / Dabrafénib
Cap/Caps Orl 50mg
Tafinlar
02409607
GSK
42.2223
Dabrafenib / Dabrafénib
Cap/Caps Orl 75mg
Tafinlar
02409615
GSK
63.3333
Dalteparin Sodium / Daltéparine Sodique
Liq Inj 5000IU
Fragmin (Prefilled Syringe)
02132648
PFI
52.2200
Dalteparin Sodium / Daltéparine Sodique
Liq Inj 7500IU
Fragmin (Prefilled Syringe)
02352648
PFI
52.2200
Dalteparin Sodium / Daltéparine Sodique
Liq Inj 10000IU
Fragmin (Prefilled Syringe)
02352656
PFI
52.2200
Dalteparin Sodium / Daltéparine Sodique
Liq Inj 10000IU
Fragmin (Ampoule)
02132664
PFI
16.4920
Dalteparin Sodium / Daltéparine Sodique
Liq Inj 12500IU
Fragmin (Prefilled Syringe)
02352664
PFI
52.2200
Dalteparin Sodium / Daltéparine Sodique
Liq Inj 15000IU
Fragmin (Prefilled Syringe)
02352672
PFI
52.2233
Dalteparin Sodium / Daltéparine Sodique
Liq Inj 18000IU
Fragmin (Prefilled Syringe)
02352680
PFI
52.2194
Dalteparin Sodium / Daltéparine Sodique
Liq Inj 25000IU
Fragmin (Multidose Vial)
02231171
PFI
41.2289
Danazol / Danazol
Cap/Caps Orl 100mg
Cyclomen
02018152
SAV
1.3748
Danazol / Danazol
Cap/Caps Orl 200mg
Cyclomen
02018160
SAV
2.1969
Dantrolene Sodium / Dantrolène Sodique
Cap/Caps Orl 25mg
Dantrium
01997602
MTP
0.3780
Effective January 16, 2015
Effectif le 16 janvier 2015
6
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Dantrolene Sodium / Dantrolène Sodique
Cap/Caps Orl 100mg
Dantrium
01997653
MTP
0.7684
Dapsone / Dapsone
Tab/Co. Orl 100mg
Dapsone
02041510
JCB
1.3391
Darbepoetin Alfa / Darbépoétine Alfa
Liq Inj 10mcg/0.4mL
Aranesp (Prefilled Syringe)
02392313
AGA
26.8000
Darbepoetin Alfa / Darbépoétine Alfa
Liq Inj 20mcg/0.5mL
Aranesp (Prefilled Syringe)
02392321
AGA
53.6000
Darbepoetin Alfa / Darbépoétine Alfa
Liq Inj 30mcg/0.3mL
Aranesp (Prefilled Syringe)
02392348
AGA
80.4000
Darbepoetin Alfa / Darbépoétine Alfa
Liq Inj 40mcg/0.4mL
Aranesp (Prefilled Syringe)
02391740
AGA
107.2000
Darbepoetin Alfa / Darbépoétine Alfa
Liq Inj 50mcg/0.5mL
Aranesp (Prefilled Syringe)
02391759
AGA
134.0000
Darbepoetin Alfa / Darbépoétine Alfa
Liq Inj 60mcg/0.3mL
Aranesp (Prefilled Syringe)
02392356
AGA
160.8000
Darbepoetin Alfa / Darbépoétine Alfa
Liq Inj 80mcg/0.5mL
Aranesp (Prefilled Syringe)
02391767
AGA
268.0000
Darbepoetin Alfa / Darbépoétine Alfa
Liq Inj 100mcg/0.5mL
Aranesp (Prefilled Syringe)
02391775
AGA
268.0000
Darbepoetin Alfa / Darbépoétine Alfa
Liq Inj 130mcg/0.65mL
Aranesp (Prefilled Syringe)
02391783
AGA
348.4000
Darbepoetin Alfa / Darbépoétine Alfa
Liq Inj 150mcg/0.3mL
Aranesp (Prefilled Syringe)
02391791
AGA
402.0000
Darbepoetin Alfa / Darbépoétine Alfa
Liq Inj 200mcg/0.4mL
Aranesp (Prefilled Syringe)
02391805
AGA
598.4100
Darbepoetin Alfa / Darbépoétine Alfa
Liq Inj 300mcg/0.6mL
Aranesp (Prefilled Syringe)
02391821
AGA
924.4000
Darbepoetin Alfa / Darbépoétine Alfa
Liq Inj 500mcg/mL
Aranesp (Prefilled Syringe)
02392364
AGA
1540.6800
Darifenacin Hydrobromide / Darifénacine
(bromhydrate de)
ERT/Co.L.P Orl 7.5mg
Enablex
02273217
MRS
1.5600
Darifenacin Hydrobromide / Darifénacine
(bromhydrate de)
ERT/Co.L.P Orl 15mg
Enablex
02273225
MRS
1.5600
Darunavir Ethanolate / Darunavir (éthanolate de)
Tab/Co. Orl 75mg
Prezista
02338432
JAN
1.8930
Darunavir Ethanolate / Darunavir (éthanolate de)
Tab/Co. Orl 150mg
Prezista
02369753
JAN
3.7860
Darunavir Ethanolate / Darunavir (éthanolate de)
Tab/Co. Orl 300mg
Prezista
02284057
JAN
7.2622
Darunavir Ethanolate / Darunavir (éthanolate de)
Tab/Co. Orl 400mg
Prezista
02324016
JAN
10.8580
Darunavir Ethanolate / Darunavir (éthanolate de)
Tab/Co. Orl 600mg
Prezista
02324024
JAN
15.4390
Darunavir Ethanolate / Darunavir (éthanolate de)
Tab/Co. Orl 800mg
Prezista
02393050
JAN
21.7160
Dasatinib / Dasatinib
Tab/Co. Orl 20mg
Sprycel
02293129
BRI
38.0008
Dasatinib / Dasatinib
Tab/Co. Orl 50mg
Sprycel
02293137
BRI
76.4798
Dasatinib / Dasatinib
Tab/Co. Orl 70mg
Sprycel
02293145
BRI
84.2867
Dasatinib / Dasatinib
Tab/Co. Orl 80mg
Sprycel
02360810
BRI
138.0300
Dasatinib / Dasatinib
Tab/Co. Orl 100mg
Sprycel
02320193
BRI
152.8567
Dasatinib / Dasatinib
Tab/Co. Orl 140mg
Sprycel
02360829
BRI
166.9183
Deferasirox / Déférasirox
Tab/Co. Orl 125mg
Exjade
02287420
NVR
10.5432
Deferasirox / Déférasirox
Tab/Co. Orl 250mg
Exjade
02287439
NVR
21.0861
Deferasirox / Déférasirox
Tab/Co. Orl 500mg
Exjade
02287447
NVR
42.1725
Degarelix Acetate / Degarelix (acétate de)
Pws/Pds. Inj 80mg/vial
Firmagon
02337029
FEI
255.0000
Degarelix Acetate / Degarelix (acétate de)
Pws/Pds. Inj 120mg/vial
Firmagon
02337037
FEI
345.0000
Denosumab / Denosumab
Liq Inj 60mg/mL
Prolia (Prefilled Syringe)
02343541
AGA
357.9000
Denosumab / Denosumab
Liq Inj 120mg/1.7mL
Xgeva (Single Use Vial)
02368153
AGA
558.7900
Desiccated Thyroid / Extrait Thyroïdien Lyophilisé
Tab/Co. Orl 30mg
Thyroid
00023949
ERF
0.1350
Desiccated Thyroid / Extrait Thyroïdien Lyophilisé
Tab/Co. Orl 60mg
Thyroid
00023957
ERF
0.2765
Desiccated Thyroid / Extrait Thyroïdien Lyophilisé
Tab/Co. Orl 125mg
Thyroid
00023965
ERF
0.4325
Desmopressin Acetate / Desmopressine (acétate de)
Liq Inj 4mg
DDAVP*
00873993
FEI
10.3620
Desmopressin Acetate / Desmopressine (acétate de)
Liq Nas 0.1mg
DDAVP
00402516
FEI
19.4480
Desmopressin Acetate / Desmopressine (acétate de)
ODT/Co.D.O. Slg 60mg
DDAVP Melt
02284995
FEI
0.9910
Desmopressin Acetate / Desmopressine (acétate de)
ODT/Co.D.O. Slg 120mg
DDAVP Melt
02285002
FEI
1.9823
Desmopressin Acetate / Desmopressine (acétate de)
ODT/Co.D.O. Slg 240mg
DDAVP Melt
02285010
FEI
3.5683
Desogestrel/Ethinyl Estradiol /
Tab/Co. Orl 0.15mg/0.03mg
Linessa 21
02272903
FRS
0.7429
Linessa 28
02257238
FRS
0.5571
Désogestrel/Éthinyloestradiol
Desogestrel/Ethinyl Estradiol /
Désogestrel/Éthinyloestradiol
Tab/Co. Orl 0.15mg/0.03mg
Ortho-Cept
02042533
JAN
0.7850
Dexamethasone / Dexaméthasone
Tab/Co. Orl 2mg
pms-Dexamethasone
02279363
PMS
0.4589
Dexamethasone / Dexaméthasone
Tab/Co. Orl 4mg
Dexasone
00489158
VLN
0.8140
Effective January 16, 2015
Effectif le 16 janvier 2015
7
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Dexamethasone / Dexaméthasone
Dps/Gttes Oph 0.1%
Maxidex
00042560
ALC
1.6780
Dexamethasone / Dexaméthasone
Ont Oph 0.1%
Maxidex
00042579
ALC
2.6000
Desoximetasone / Désoximétasone
Dexamethasone Soidum / Dexaméthasone (sodique de)
Ont Top 0.25%
Liq Inj 4mg
Topicort
Dexamethasone-Omega
02221934
0.6310
02204266
VLN
OMG
1.6900
Dextroamphetamine Sulfate / Dexamphétamine
(sulfate de)
Tab/Co. Orl 5mg
Dexedrine
01924516
PAL
0.6909
Dextroamphetamine Sulfate / Dexamphétamine
(sulfate de)
SRC/Caps.L.L. Orl 10mg
Dexedrine
01924559
PAL
0.9911
Dextroamphetamine Sulfate / Dexamphétamine
(sulfate de)
SRC/Caps.L.L. Orl 15mg
Dexedrine
01924567
PAL
1.2117
Dextromethorphan / Dextrométhorphane
Syr/Sir Orl 3mg
Balminil DM
00436895
ROG
0.0332
Benylin DM
01944738
JNJ
0.0494
Koffex DM
01928783
ROG
0.0190
Koffex Sugar Free Clear
01928791
ROG
0.0190
Dextromethorphan / Dextrométhorphane
Syr/Sir. Orl 3mg
Dextromethorphan / Dextrométhorphane
Syr/Sir Orl 20mg
Balminil
00608920
ROG
0.0450
Balminil Expect Sans Sucrose
00609951
ROG
0.0450
Robitussin
01931032
WCH
0.0495
Dextromethorphan Polistirex / Dextrométhorphane
Polistirex
Sus/Susp Orl 0.6mg
Delsym
02018403
NNC
0.0656
Dextromethorphan/Guaifenesin /
Dextrométhorphane/Guaifénésine
Liq Orl 20mg/3mg
Robitussin DM Exp
01931024
WCH
0.0495
Dexamethasone/Neomycin/Polymixin B /
Dexaméthasone/Néomycine/Polymyxine B
Sus/Susp. Oph
6000IU/3.5mg/1mg
Maxitrol
00042676
ALC
2.0740
Dextromethorphan/Pseudoephedrine/Guaifenesin /
Dextrométhorphan/Pseudoéphédrine/Guaifénésine
Syr/Sir. Orl 100mg/50mg/30mg Benylin DM-D-E
01944673
JNJ
0.0494
Diazepam / Diazépam
Liq Inj 5mg
Diazepam (vial)
00399728
SDZ
1.1285
Diazepam (amp)
02386143
SDZ
1.2415
Diclofenac Sodium / Diclofénac Sodique
Liq Oph 0.1%
Voltaren
01940414
ALC
3.4560
Dicyclomine HCl / Dicyclomine (chlorhydrate de)
Cap/Caps Orl 10mg
Protylol
00287709
PDL
0.0609
Dicyclomine HCl / Dicyclomine (chlorhydrate de)
Syr/Sir Orl 2mg
Bentylol
02102978
AXC
0.0644
Dicyclomine HCl / Dicyclomine (chlorhydrate de)
Tab/Co. Orl 10mg
Bentylol
02103087
AXC
0.1240
Jamp-Dicyclomine
02391619
JPC
0.1128
Dicyclomine HCl / Dicyclomine (chlorhydrate de)
Tab/Co. Orl 20mg
Bentylol
02103095
AXC
0.2341
Protylol-20
00513059
PDL
0.1690
Jamp-Dicyclomine
02366088
JPC
0.2207
Didanosine / Didanosine
ECC/Caps.Ent. Orl 125mg
Videx EC
02244596
BRI
3.8550
Didanosine / Didanosine
ECC/Caps.Ent. Orl 200mg
Videx EC
02244597
BRI
6.1683
Didanosine / Didanosine
ECC/Caps.Ent. Orl 250mg
Videx EC
02244598
BRI
7.6417
Didanosine / Didanosine
ECC/Caps.Ent. Orl 400mg
Videx EC
02244599
BRI
12.3617
Dienogest / Diénogest
Tab/Co. Orl 2mg
Visanne
02374900
BAY
1.9643
Diflucortolone Valerate / Diflucortolone (valérate de)
Crm/Cr. Top 0.1%
Nerisone
00587826
GSK
0.3943
Nerisone Oily
00587818
GSK
0.3947
Diflucortolone Valerate / Diflucortolone (valérate de)
Ont Top 0.1%
Nerisone
00587834
GSK
0.3853
Digoxin / Digoxine
Tab/Co. Orl 0.05mg
Toloxin
02335700
PDP
0.2541
0.2541
Digoxin / Digoxine
Tab/Co. Orl 0.0625mg
Toloxin
02335719
PDP
Digoxin / Digoxine
Tab/Co. Orl 0.125mg
Toloxin
02335727
PDP
0.2541
Digoxin / Digoxine
Tab/Co. Orl 0.25mg
Toloxin
02242320
PDP
1.1045
Dihydroergotamine / Dihydroergotamine
Liq Nas 4mg
Migranal
02228947
STR
9.9167
Diltiazem Hydrochloride / Diltiazem (chlorhydrate de)
ERT/Co.L.P. Orl 120mg
Tiazac XC
02256738
VLN
0.8348
Diltiazem Hydrochloride / Diltiazem (chlorhydrate de)
ERT/Co.L.P. Orl 180mg
Tiazac XC
02256746
VLN
1.1096
Diltiazem Hydrochloride / Diltiazem (chlorhydrate de)
ERT/Co.L.P. Orl 240mg
Tiazac XC
02256754
VLN
1.4733
Diltiazem Hydrochloride / Diltiazem (chlorhydrate de)
ERT/Co.L.P. Orl 300mg
Tiazac XC
02256762
VLN
1.4690
Diltiazem Hydrochloride / Diltiazem (chlorhydrate de)
ERT/Co.L.P. Orl 360mg
Tiazac XC
02256770
VLN
1.4732
Effective January 16, 2015
Effectif le 16 janvier 2015
8
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Dimenhydrinate / Dimenhydrinate
Liq Inj 50mg
Gravol
00013579
CHU
1.1510
Dimenhydrinate / Dimenhydrinate
Syr Orl 3mg
Gravol
00230197
CHU
0.0708
Dimenhydrinate / Dimenhydrinate
Tab/Co. Orl 15mg
Gravol
00511196
CHU
0.2433
Dimenhydrinate / Dimenhydrinate
Liq Inj 50mg
Dimenhydrinate IM
00392537
SDZ
1.3800
Dimethyl Fumarate / Fumarate de Diméthyle
CDR/Caps.L.R. Orl 120mg
Tecfidera
02404508
BIG
16.1925
Dimethyl Fumarate / Fumarate de Diméthyle
CDR/Caps.L.R. Orl 240mg
Tecfidera
02420201
BIG
32.3850
Diphenhydramine HCl / Diphenhydramine
(chlorhydrate de)
Tab/Co. Orl 25mg
Diphenhydramine
02257548
JPC
0.1379
Diphenhydramine HCl / Diphenhydramine
(chlorhydrate de)
Tab/Co. Orl 50mg
Diphenhydramine
02257556
JPC
0.1659
Diphenhydramine HCl / Diphenhydramine
(chlorhydrate de)
Elx Orl 2.5mg
Benadryl
02019736
JNJ
0.0540
Diphenhydramine HCl / Diphenhydramine
(chlorhydrate de)
Tab/Co. Orl 25mg
Benadryl
02017849
JNJ
0.3883
Diphenoxylate/Atropine / Diphénoxylate/Atropine
Tab/Co. Orl 2.5mg/0.025mg
Lomotil
00036323
PFI
0.4607
Dipyridamole/ASA / Dipyridamole AAS
Cap/Caps Orl 200mg/25mg
Aggrenox
02242119
BOE
0.8492
Disopyramide / Disopyramide
Cap/Caps Orl 100mg
Rythmodan
02224801
SAV
0.2738
Dornase Alfa Recombinant / Dornase Alfa Recombinant
Liq Inh 1mg/mL
Pulmozyme
02046733
HLR
15.3091
Doxylamine/Pyridoxine / Doxylamine/Pyridoxine
SRT/Co.L.L. Orl 10mg/10mg
Diclectin
00609129
DUI
1.2721
Duloxetine Hydrochloride / Duloxétine (chlorhydrate de)
Cap/Caps Orl 30mg
Cymbalta
02301482
LIL
1.9254
Duloxetine Hydrochloride / Duloxétine (chlorhydrate de)
Cap/Caps Orl 60mg
Cymbalta
02301490
LIL
3.8575
Eculizumab / Éculizumab
Liq Inj 10mg/mL
Soliris
02322285
ALX
224.7333
Efavirenz / Éfavirenz
Cap/Caps Orl 20mg
Sustiva
02239886
BRI
1.2680
Efavirenz / Éfavirenz
Cap/Caps Orl 200mg
Sustiva
02239888
BRI
5.0708
Efavirenz/Emtricitabine/Tenofovir /
Éfavirenz/Emtricitabine/Ténofovir
Tab/Co. Orl
600mg/300mg/200mg
Atripla
02300699
GIL
43.2477
Elvitegravir/Cobicistat/Emtricitabine/Tenofovir /
Elvitégravir/Cobicistat/Emtricitabine/Ténofovir
Tab/Co. Orl
150mg/150mg/200mg/300mg
Stribild
02397137
GIL
45.5200
Emtricitabine/Rilpivirine/Tenofovir /
Emtricitabine/Rilpivirine/Ténofovir
Tab/Co. Orl
25mg/200mg/300mg
Complera
02374129
GIL
42.5303
Emtricitabine/Tenofovir Disoproxil /
Emtricitabine/Ténofovir Disoproxil
Tab/Co. Orl 300mg/200mg
Truvada
02274906
GIL
28.0353
Enoxaparin Sodium / Énoxaparine Sodique
Liq Inj 30mg/0.3mL
Lovenox (Prefilled Syringe)
02012472
SAV
6.3600
Enoxaparin Sodium / Énoxaparine Sodique
Liq Inj 40mg/0.4mL
Lovenox (Prefilled Syringe)
02236883
SAV
8.4800
Enoxaparin Sodium / Énoxaparine Sodique
Liq Inj 60mg/0.6mL
Lovenox (Prefilled Syringe)
02378426
SAV
12.7200
Enoxaparin Sodium / Énoxaparine Sodique
Liq Inj 80mg/0.8mL
Lovenox (Prefilled Syringe)
02378434
SAV
16.9600
Enoxaparin Sodium / Énoxaparine Sodique
Liq Inj 100mg/mL
Lovenox (Prefilled Syringe)
02378442
SAV
21.2000
Enoxaparin Sodium / Énoxaparine Sodique
Liq Inj 100mg/mL
Lovenox (Multidose Vial)
02236564
SAV
21.2000
Enoxaparin Sodium / Énoxaparine Sodique
Liq Inj 120mg/0.8mL
Lovenox HP (Prefilled Syringe)
02242692
SAV
25.4400
Enoxaparin Sodium / Énoxaparine Sodique
Liq Inj 150mg/mL
Lovenox HP (Prefilled Syringe)
02378469
SAV
31.8000
Enzalutamide / Enzalutamide
Tab/Co. Orl 40mg
Xtandi
02407329
ASL
28.3450
Epinephrine / Épinéprhrine
Liq Inj 0.15mg
Twinject
02268205
PAL
76.0000
Allerject
02382059
SAV
82.6200
Twinject
02247310
PAL
76.0000
Allerject
02382067
SAV
82.6200
Epinephrine / Épinéprhrine
Liq Inj 0.3mg
Epinephrine / Épinéprhrine
Liq Inj 0.5mg
Epi Pen Jr
00578657
KNG
86.8224
Epinephrine / Épinéprhrine
Liq Inj 1mg
Epi Pen
00509558
KNG
86.8224
Epineprhine Hydrochloride / Épinéprine (chlorhydrate d')
Liq Inj 1mg
Adrenalin
00155357
ERF
0.7193
Epoetin Alfa / Époétine Alfa
Liq Inj 1000IU/0.5mL
Eprex
02231583
JAN
14.2500
Epoetin Alfa / Époétine Alfa
Liq Inj 2000IU/0.5mL
Eprex
02231584
JAN
28.5000
Epoetin Alfa / Époétine Alfa
Liq Inj 3000IU/0.3mL
Eprex
02231585
JAN
42.7500
Epoetin Alfa / Époétine Alfa
Liq Inj 4000IU0.4mL
Eprex
02231586
JAN
57.0000
Epoetin Alfa / Époétine Alfa
Liq Inj 5000IU/0.5mL
Eprex
02243400
JAN
71.2500
Epoetin Alfa / Époétine Alfa
Liq Inj 6000IU/0.6mL
Eprex
02243401
JAN
85.5000
Effective January 16, 2015
Effectif le 16 janvier 2015
9
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Epoetin Alfa / Époétine Alfa
Liq Inj 8000IU/0.8mL
Eprex
02243403
JAN
114.0000
Epoetin Alfa / Époétine Alfa
Liq Inj 10000IU/mL
Eprex
02231587
JAN
142.5000
Epoetin Alfa / Époétine Alfa
Liq Inj 20000IU/mL
Eprex
02243239
JAN
292.4900
Epoetin Alfa / Époétine Alfa
Liq Inj 30000IU/0.75mL
Eprex
02288680
JAN
438.7300
Epoetin Alfa / Époétine Alfa
Liq Inj 40000IU/mL
Eprex
02240722
JAN
438.7300
Epoprostenol Sodium / Époprosténol Sodique
Pws/Pds Inj 0.5mg
Caripul
02397447
ACT
17.1800
Epoprostenol Sodium / Époprosténol Sodique
Pws/Pds Inj 1.5mg
Caripul
02397455
ACT
34.4500
Epoprostenol Sodium / Époprosténol Sodique
Pws/Pds Inj 0.5mg
Flolan
02230845
GSK
18.6400
Epoprostenol Sodium / Époprosténol Sodique
Pws/Pds Inj 1.5mg
Flolan
02230848
GSK
37.2700
Eprosartan Mesylate / Éprosartan (mésylate d')
Tab/Co. Orl 400mg
Teveten
02240432
ABB
0.7246
Eprosartan Mesylate / Éprosartan (mésylate d')
Tab/Co. Orl 600mg
Teveten
02243942
ABB
1.1079
Eprosartan/Hydrochlorothiazide /
Éprosartan/Hydrochlorothiazide
Tab/Co. Orl 600mg/12.5mg
Teveten Plus
02253631
ABB
1.1079
Ergocalciferol / Ergocalciferol
Cap/Caps Orl 50000IU
D-Forte
02237450
EUR
0.1986
Osto-D2
02301911
PAL
0.2067
0.0419
Ergocalciferol / Ergocalciferol
Tab/Co. Orl 1000IU
Vitamin D
80000436
JAM
Ergotamine/Caffeine / Ergotamine/Caféine
Tab/Co. Orl 1mg/100mg
Cafergot
00176095
NVR
0.8930
Erlotinib Hydrochlordie / Erlotinib (chlorhydrate de)
Tab/Co. Orl 100mg
Tarceva
02269015
HLR
53.3333
Erlotinib Hydrochlordie / Erlotinib (chlorhydrate de)
Tab/Co. Orl 150mg
Tarceva
02269023
HLR
80.0000
Ertapenem Sodium / Ertapénem Sodique
Pws/Pds. Inj 1g
Invanz
02247437
FRS
52.2210
Erythromycin / Érythromycine
Tab/Co. Orl 500mg
Erythro-S
00688568
AAP
0.5425
Erythromycin/Tretinoin / Érythromycine/Trétinoïne
Gel Top 4%/0.025%
Stievamycin
01905112
GSK
0.8427
Estradiol-17β / Estradiol-17β
Tab/Co. Vag 10mcg
Vagifem 10
02325462
NNO
3.5422
Estradiol-17β / Estradiol-17β
Ins Vag 2mg
Estring
02168898
PAL
71.1200
Estradiol-17β / Estradiol-17β
Pth Trd 25mcg
Climara 25
02247499
BAY
4.9667
Estradiol-17β / Estradiol-17β
Pth Trd 50mcg
Climara 50
02231509
BAY
5.3050
Estradiol-17β / Estradiol-17β
Pth Trd 75mcg
Climara 75
02247500
BAY
5.6558
Estradiol-17β / Estradiol-17β
Pth Trd 100mcg
Climara 100
02231510
BAY
5.9817
Estradiol-17β / Estradiol-17β
Srd Trd 25mcg
Estraderm-25
00756849
NVR
3.3238
Estradiol-17β / Estradiol-17β
Srd Trd 100mcg
Estraderm-100
00756792
NVR
4.0113
Estradiol-17β / Estradiol-17β
Pth Trd 25mcg
Estradot
02245676
NVR
2.6650
Estradiol-17β / Estradiol-17β
Pth Trd 37.5mcg
Estradot
02243999
NVR
2.6825
Estradiol-17β Hemihydrate / Estradiol-17β Hémihydraté
Gel Trd 0.06%
Estrogel
02238704
FRS
0.4395
Estradiol-17β (micronized) / Estradiol-17β (micronisé)
Tab/Co. Orl 0.5mg
Estrace
02225190
SHI
0.1356
Estradiol-17β (micronized) / Estradiol-17β (micronisé)
Tab/Co. Orl 1mg
Estrace
02148587
SHI
0.2616
Estradiol-17β (micronized) / Estradiol-17β (micronisé)
Tab/Co. Orl 2mg
Estrace
02148595
SHI
0.4619
Estramustine Sodium / Estramustine (sodique d')
Cap/Caps Orl 140mg
Emcyt
02063794
PFI
3.6471
Etanercept / Étanercept
Pws/Pds. Inj 25mg/mL
Enbrel
02242903
AGA
197.6350
Etanercept / Étanercept
Liq Inj 50mg/mL
Enbrel
02274728
AGA
395.3900
Ethacrynic Acid / Acide Éthacrynique
Tab/Co. Orl 25mg
Edecrin
02258528
VLN
0.8751
Etonogestrel/Ethinyl Estradiol /
Étonogestrel/Éthinyloestradiol
Ins Vag 11.4mg/2.6mg
Nuvaring
02253186
FRS
15.1500
Ethopropazine Hydrochloride / Éthoprppazine
(chlorhydrate d')
Tab/Co. Orl 50mg
Parsitan
01927744
ERF
0.2277
Ethosiximide / Éthosuximide
Cap/Caps Orl 250mg
Zarontin
00022799
ERF
0.3416
Ethosiximide / Éthosuximide
Syr/Sir Orl 50mg
Zarontin
00023485
ERF
0.0683
Ethynodiol/Ethinyl Estradiol / Éthynodiol/Éthinyloestradiol Tab/Co. Orl 0.03mg/2mg
Demulen 30 (21)
00469327
PFI
0.6529
Demulen 30 (28)
00471526
PFI
0.5235
Etoposide / Étoposide
Cap/Caps Orl 50mg
Vepesid
00616192
BRI
37.3325
Etravirine / Étraviring
Tab/Co. Orl 100mg
Intelence
02306778
JAN
5.8055
Etravirine / Étraviring
Tab/Co. Orl 200mg
Intelence
02375931
JAN
11.3730
Everolimus / Évérolimus
Tab/Co. Orl 2.5mg
Afinitor
02369257
NVR
195.2200
Effective January 16, 2015
Effectif le 16 janvier 2015
10
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Everolimus / Évérolimus
Tab/Co. Orl 5mg
Afinitor
02339501
NVR
195.2200
Everolimus / Évérolimus
Tab/Co. Orl 10mg
Afinitor
02339528
NVR
195.2200
Febuxostat / Fébuxostat
Tab/Co. Orl 80mg
Uloric
02357380
TAK
1.5900
Fentanyl / Fentanyl
Pth Trd 37mcg
Sandoz Fentanyl
02327139
SDZ
8.5000
Ferrous Fumarate / Fumarate Ferreux
Cap/Caps Orl 300mg
Neo-Fer
00482064
NEO
0.2033
Palafer
01923420
MVL
0.2293
Ferrous Fumarate / Fumarate Ferreux
Sus/Susp. Orl 60mg
Palafer
01923439
MVL
0.0900
Ferrous Fumarate / Fumarate Ferreux
Tab/Co. Orl 300mg
Ferrous Fumarate
00031089
JPC
0.1172
Ferrous Gluconate / Gluconate Ferreux
Tab/Co. Orl 300mg
Apo-ferrous Gluconate
00545031
APX
0.0404
Ferrous Gluconate
00031097
JPC
0.0575
Ferrous Gluconate
00582727
VTH
0.0246
Novo-Ferrogluc
80000435
TEV
0.0254
0.1900
Ferrous Sulphate / Sulfate Ferreux
Dps/Gttes Orl 75mg
pms-Ferrous Sulfate
02222574
PMS
Ferrous Sulphate / Sulfate Ferreux
Dps/Gttes Orl 125mg
pms-Ferrous Sulfate
00816035
PMS
0.2966
Ferrous Sulphate / Sulfate Ferreux
ECT/Co.Ent. Orl 300mg
Apo-Ferrous Sulfate-FC
01912518
APX
0.0334
Ferrous Sulphate / Sulfate Ferreux
Liq Orl 15mg
Jamp Ferrous Sulfate
80008309
JPC
0.1952
Ferrous Sulphate / Sulfate Ferreux
Liq Orl 30mg
Jamp Ferrous Sulfate
80008295
JPC
0.0375
Ferrous Sulphate / Sulfate Ferreux
SRT/Co.L.L. Orl 160mg
Slow-Fe
00623520
NNC
0.2520
Ferrous Sulphate / Sulfate Ferreux
Syr/Sir. Orl 30mg
Fer-In-Sol
00017884
MJO
0.0519
Ferodan
00758469
ODN
0.0350
0.0396
Ferrous Sulphate / Sulfate Ferreux
Tab/Co. Orl 300mg
pms-Ferrous Sulfate
00792675
PMS
Ferrous Sulfate
00031100
JPC
0.0575
Ferrous Sulfate
00346918
PMT
0.0339
pms-Ferrous Sulfate
00586323
PMS
0.0296
Fesoterodine Fumarate / Fésotérodine (fumarate de)
ERT/Co.L.P Orl 4mg
Toviaz
02380021
PFI
1.5000
Fesoterodine Fumarate / Fésotérodine (fumarate de)
ERT/Co.L.P Orl 8mg
Toviaz
02380048
PFI
1.5000
Fidaxomicin / Fidaxomicin
Tab/Co. Orl 200mg
Dificid
02387174
CBP
110.0000
Filgrastim / Filgrastim
Liq Inj 0.3mg
Neupogen
00999001
AGA
188.7536
Neupogen
01968017
AGA
188.7538
Fingolimod Hydrochloride / Fingolimod (chlorhydrate de)
Cap/Caps Orl 0.5mg
Gilenya
02365480
NVR
85.1650
Fludarabine Phosphate / Fludarabine (phosphate de)
Tab/Co. Orl 10mg
Fludara
02246226
SAV
40.0760
Fludrocortisone Acetate / Fludrocortisone (acétate de)
Tab/Co. Orl 0.1mg
Florinef
02086026
PAL
0.2685
Flumethasone/Cloquinol / Fluméthasone/Clioquinol
Crm/Cr. Top 3%/0.02%
Locacorten-Vioform
00074462
PAL
0.9140
Fluocinonide / Fluocinonide
Crm/Cr. Top 0.05%
Lidemol
02163152
VLN
0.1980
Fluorometholone / Fluorométholone
Dps/Gttes Oph 0.1%
FML
00247855
ALL
3.2120
Fluorometholone / Fluorométholone
Sus/Susp. Oph 0.25%
FML Forte
00707511
ALL
2.7580
Fluorometholone Acetate / Fluorométholone (acétate de) Sus/Susp. Oph 0.1%
Flarex
00756784
ALC
1.8960
Flumethasone/Clioquinol / Fluméthasone/Clioquinol
Locacorten-Vioform
00074454
PAL
1.6091
Dps/Gttes Ot 1%/0.02%
Fluorouracil / Fluorouracile
Crm/Cr. Top 5%
Efudex
00330582
VLN
0.8378
Flupentixol Dihydrochloride / Flupentixol
(dichlorhydrate de)
Tab/Co. Orl 0.5mg
Fluanxol
02156008
VLH
0.2557
Flupentixol Dihydrochloride / Flupentixol
(dichlorhydrate de)
Tab/Co. Orl 3mg
Fluanxol
02156016
VLH
0.5523
Flupentixol Decanoate / Flupentixol (décanoate de)
Liq Inj 20mg
Fluanxol Depot
02156032
VLH
7.4020
Fluphenazine Hydrochloride / Fluphénazine
(chlorhydrate de)
Tab/Co. Orl 1mg
Fluphenazine
00405345
AAP
0.1739
Fluphenazine Hydrochloride / Fluphénazine
(chlorhydrate de)
Tab/Co. Orl 2mg
Fluphenazine
00410632
AAP
0.2252
Fluphenazine Hydrochloride / Fluphénazine
(chlorhydrate de)
Tab/Co. Orl 5mg
Fluphenazine
00405361
AAP
0.1720
Fluticasone Propionate / Fluticasone (propionate de)
Aem/Aém Inh 50mcg
Flovent HFA
02244291
GSK
0.1994
Fluticasone Propionate / Fluticasone (propionate de)
Aem/Aém Inh 125mcg
Flovent HFA
02244292
GSK
0.3440
Fluticasone Propionate / Fluticasone (propionate de)
Aem/Aém Inh 250mcg
Flovent HFA
02244293
GSK
0.6878
Effective January 16, 2015
Effectif le 16 janvier 2015
11
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Fluticasone Propionate / Fluticasone (propionate de)
Pwr/Pd. Inh 50mcg
Flovent Diskus
02237244
GSK
0.2522
Fluticasone Propionate / Fluticasone (propionate de)
Pwr/Pd. Inh 100mcg
Flovent Diskus
02237245
GSK
0.3988
Fluticasone Propionate / Fluticasone (propionate de)
Pwr/Pd. Inh 250mcg
Flovent Diskus
02237246
GSK
0.6880
Fluticasone Propionate / Fluticasone (propionate de)
Pwr/Pd. Inh 500mcg
Flovent Diskus
02237247
GSK
1.1720
Fluvastatin Sodium / Fluvastatine Sodique
SRT/Co.L.L. Orl 80mg
Lescol XL
02250527
NVR
1.5393
Folic Acid / Acide Folique
Tab/Co. Orl 5mg
Formoterol Fumarate/ Formotérol (fumarate de)
Aem/Aém Inh 6mcg
Formoterol Fumarate/ Formotérol (fumarate de)
Aem/Aém Inh 12mcg
Fosamprenavir Calcium / Fosamprénavir Calcique
Sus/Susp. Orl 50mg
Fosamprenavir Calcium / Fosamprénavir Calcique
Tab/Co. Orl 700mg
Fosfomycin Tromethamine / Fosfomycine Trométhamine Pws/Pds. Orl 3gm
Framycetin Sulfate / Framycétine (sulfate de)
Dre Top 1%
Apo-Folic Acid
00426849
APX
0.0404
Euro-Folic
02285673
EUR
0.0198
Jamp-Folic
02366061
JPC
0.0363
Oxeze
02237225
AZE
0.5608
Foradil
02230898
NVR
0.8422
Oxeze
02237224
AZE
0.7467
Telzir
02261553
VIV
0.6000
Telzir
02261545
VIV
8.2077
Monurol Sachet
02240335
TRI
5.6667
Sofra-Tulle (10cm x 10cm)
01988840
ERF
1.5500
Sofra-Tulle (10cm x 30cm)
01987682
ERF
3.6000
Furosemide / Furosémide
Liq Inj 10mg
Furosemide
00527033
SDZ
0.8650
Furosemide / Furosémide
Liq Orl 10mg
Lasix
02224720
SAV
0.2822
Furosemide / Furosémide
Tab/Co. Orl 500mg
Lasix Special
02224755
SAV
3.0875
Fusidic Acid / Acide Fusidique
Ont Top 2%
Fucidin
00586676
LEO
0.6633
Fusidic Acid / Acide Fusidique
Crm/Cr. Top 2%
Fucidin
00586668
LEO
0.6633
Fusidic Acid/Hydrocortisone / Acide
Fusidique/Hydrocortisone
Crm/Cr. Top 2%/1%
Fucidin H
02238578
LEO
1.1843
Ganciclovir Sodium / Ganciclovir Sodique
Pws/Pds. Inj 500mg
Cytovene
02162695
HLR
42.6880
Gentamicin Sulfate / Gentamicine (sulfate de)
Crm/Cr. Top 0.1%
ratio-Gentamicin Sulfate
00805386
RPH
0.3560
Gentamicin Sulfate / Gentamicine (sulfate de)
Ont Top 0.1%
ratio-Gentamicin Sulfate
00805025
RPH
0.3560
Gentamicin Sulfate / Gentamicine (sulfate de)
Ont Oph 0.3%
Sandoz Gentamicin
02230888
SDZ
1.5000
Glatiramer Acetate / Glatiramère (acétate de)
Liq Inj 20mg
Copaxone
02245619
SAV
45.2080
Gliclazide / Gliclazide
ECT/Co.Ent. Orl 60mg
Diamicron MR
02356422
SEV
0.2528
Glucagon / Glucagon
Pws/Pds. Inj 1mg
Glucagon
02243297
LIL
86.3500
Glucagen
02333619
NNO
79.2700
Glucagen Hypokit
02333627
NNO
79.2700
Glycopyrrolate / Glycopyrrolate
Liq Inj 0.2mg
Glycopyrrolate
02039508
SDZ
3.9775
Glycopyrrolate / Glycopyrrolate
Cap/Caps. Inh 50mcg
Seebri Breezhaler
02394936
NVR
1.7700
Golimumab / Golimumab
Liq Inj 50mg/0.5mL
Simponi (Prefilled Syringe)
02324776
JAN
1520.2100
Golimumab / Golimumab
Liq Inj 50mg/0.5mL
Simponi (Autoinjector)
02324784
JAN
1520.2100
Gosereline Acetate / Goséréline (acétate de)
Imp Inj 3.6mg
Zoladex Depot
02049325
AZE
398.3000
Gosereline Acetate / Goséréline (acétate de)
Imp Inj 10.8mg
Zoladex LA
02225905
AZE
1135.2500
Haloperidol / Halopéridol
Liq Inj 5mg
Haloperidol
00808652
SDZ
4.8300
Heparin Sodium / Héparine Sodique
Liq Inj 100IU
Heparin
00727520
LEO
0.4654
Heparin Sodium / Héparine Sodique
Liq Inj 10000IU
Heparin
00579718
LEO
1.1000
Homatropine Hydrobromide / Homatropine
(bromhydrate d')
Liq Oph 2%
Isopto Homatropine
00000779
ALC
0.6647
Homatropine Hydrobromide / Homatropine
(bromhydrate d')
Liq Oph 5%
Isopto Homatropine
00000787
ALC
0.7920
Hydrochlorothiazide / Hydrochlorothiazide
Tab/Co. Orl 100mg
Apo-Hydro
00644552
APX
0.1232
Hydrocortisone Acetate / Hydrocortisone (acétate d')
Aer/Aér Rt 10%
Cortifoam
00579335
PAL
6.6740
Hydrocortisone / Hydrocortisone
Crm/Cr. Top 0.5%
Hydrocortisone / Hydrocortisone
Effective January 16, 2015
Effectif le 16 janvier 2015
Crm/Cr. Top 1%
Cortate
80021088
SCO
0.1333
Hyderm
00716820
TAR
0.1893
Hydrosone
00564281
ROG
0.1267
Emo-Cort
00192597
GSK
0.1718
Hyderm
00716839
TAR
0.2133
12
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Prevex HC
00804533
GSK
0.2703
0.2347
Hydrocortisone / Hydrocortisone
Crm/Cr. Top 2.5%
Emo-Cort
00595799
GSK
Hydrocortisone / Hydrocortisone
Lot Top 1%
Emo-Cort
00192600
GSK
0.1587
Sarna HC
00578541
GSK
0.0938
00595802
GSK
0.2100
Hydrocortisone / Hydrocortisone
Lot Top 2.5%
Emo-Cort
Sarna HC
00856711
GSK
0.1813
Hydrocortisone / Hydrocortisone
Ont Top 1%
Cortoderm
00716693
TAR
0.0442
Hydrocortisone / Hydrocortisone
Enm/Lav. Rt 1.66666mg
Cortenema
02112736
AXC
0.1188
Hycort
00230316
VLN
0.0909
Hydrocortisone / Hydrocortisone
Tab/Co. Orl 10mg
Cortef
00030910
PFI
0.1581
Hydrocortisone / Hydrocortisone
Tab/Co. Orl 20mg
Cortef
00030929
PFI
0.2853
Hydrocortisone / Hydrocortisone
Pws/Pds. Inj 100mg
Solu-Cortef
00030600
PFI
3.7372
Hydrocortisone/Paramoxine / Hydrocortisone/Parmoxine Aer/Aér Rt 1%/1%
Proctofoam HC
00363014
DUI
1.7056
Hydrocortisone/Pramoxine / Hydrocortisone/Pramoxine
Pramox HC
00770957
DPT
0.4444
Crm/Cr. Top 1%/1%
Hydrocortisone/Urea / Hydrocortiosne/Urée
Crm/Cr. Top 10%/1%
Uremol HC
00503134
GSK
0.1746
Hydrocortisone/Urea / Hydrocortiosne/Urée
Lot Top 10%/1%
Uremol HC
00560022
GSK
0.0982
Hydrocortisone/Zinc Sulfate / Hydrocortisone/Zinc
Ont Rt 0.5%/0.5%
0.4160
(sulfate de)
Hydrocortisone/Zinc Sulfate / Hydrocortisone/Zinc
(sulfate de)
Sup/Supp. Rt 0.5%/0.5%
Ratio-Hemcort HC
00607789
RPH
Jamp-Zinc-HC
02387239
JPC
0.4130
Ratio-Hemcort HC
00607797
RPH
0.6075
Hydromorphone / Hydromorphone
Cap/Caps. Orl 4.5mg
Hydromorph Contin
02359502
PFR
0.8320
Hydromorphone / Hydromorphone
Cap/Caps. Orl 9mg
Hydromorph Contin
02359510
PFR
1.3640
Hydromorphone / Hydromorphone
SRC/Caps.L.L. 3mg
Hydromorph Contin SR
02125323
PFR
0.6890
Hydromorphone / Hydromorphone
SRC/Caps.L.L. 6mg
Hydromorph Contin SR
02125331
PFR
1.0330
Hydromorphone / Hydromorphone
SRC/Caps.L.L. 12mg
Hydromorph Contin SR
02125366
PFR
1.7900
Hydromorphone / Hydromorphone
SRC/Caps.L.L. 18mg
Hydromorph Contin SR
02243562
PFR
2.5830
Hydromorphone / Hydromorphone
SRC/Caps.L.L. 24mg
Hydromorph Contin SR
02125382
PFR
3.3060
Hydromorphone / Hydromorphone
SRC/Caps.L.L. 30mg
Hydromorph Contin SR
02125390
PFR
3.9600
Hydroxyzine Hydrochloride / Hydroxyzine (chlorhydrate d') Syr/Sir. Orl 2mg
Atarax
00024694
ERF
0.0563
pms-Hydroxyzine
00741817
PMS
0.0462
Hyoscince Butylbromyide / Hyoscine (butylbromure d')
Buscopan
00363839
BOE
4.6050
Hyoscine Butylbromide
02229868
SDZ
4.5150
Liq Inj 20mg
Hyoscince Butylbromyide / Hyoscine (butylbromure d')
Tab/Co. 10mg
Buscopan
00363812
BOE
0.3383
Hypertonic Sodium Chloride / Hypertonique (chlorure de
sodium)
Liq Inh 7%
Hyper-Sal
80029414
KEG
0.2458
Imipenem/Cilastatin Sodium /
Pws/Pds. Inj 250mg
Ran-Imipenem-Cilastatin
02351692
RAN
11.7400
Imipénem/Cilastatine Sodique
Imipenem/Cilastatin Sodium /
Pws/Pds. Inj 500mg
Imipénem/Cilastatine Sodique
Primaxin
00717282
FRS
28.5628
Ran-Imipenem-Cilastatin
02351706
RAN
21.9400
Imipramine Hydrochloride / Imipramine (chlorhydrate d')
Tab/Co. Orl 75mg
Imipramine
00644579
AAP
0.6308
Incobotulinumtoxin A / Incoboulinumtoxin A
Pws/Pds. Inj 50units
Xeomin
02371081
MRZ
165.0000
Incobotulinumtoxin A / Incoboulinumtoxin A
Pws/Pds. Inj 100units
Xeomin
02324032
MRZ
330.0000
Indacaterol Maleate / Indacatérol (maléate d')
Cap/Caps. Inh 75mcg
Onbrez Breezhaler
02376938
NVR
1.5500
1.3467
Indinavir Sulfate / Indinavir (sulfate d')
Cap/Caps Orl 200mg
Crixivan
02229161
FRS
Indinavir Sulfate / Indinavir (sulfate d')
Cap.Caps Orl 400mg
Crixivan
02229196
FRS
2.6933
Infliximab / Infliximab
Pws/Pds. Inj 100mg
Remicade
02244016
JAN
987.5600
Insulin Aspart / Insuline Asparte
Liq Inj 100IU
Novorapid
02245397
NNO
2.9000
Novorapid Penfill (3mL)
02244353
NNO
3.9207
Insulin Determir / Insuline Détémir
Liq Inj 100units
Levemir Penfill Cartridge
02271842
NNO
6.7787
Insulin Glargine / Insuline Glargine
Liq Inj 100units
Lantus 10mL Vial
02245689
SAV
6.1060
Lantus Cartridge
02251930
SAV
6.1467
Lantus SoloSTAR (Prefilled Pen)
02294338
SAV
6.1467
Effective January 16, 2015
Effectif le 16 janvier 2015
13
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Insulin Glulisine / Insuline Glulisine
Liq Inj 3mL
Apidra (cartridge)
02279479
SAV
Apidra Solostar
02294346
SAV
3.3400
Insulin Glulisine / Insuline Glulisine
Liq Inj 10mL
Apidra
02279460
SAV
2.5050
Insulin Isophane / Insuline Isophane
Sus/Susp. Inj 100IU
Insulin Injection/Insulin Isophane / D'insulin
Sus/Susp. Inj 30IU/70IU
injectable/D'insuline humaine
3.3033
Humulin N
00587737
LIL
2.2540
Humulin N (Cartridge)
01959239
LIL
2.9493
Humulin N (Kwikpen)
02403447
LIL
2.9493
Novolin GE NPH
02024225
NNO
2.1490
Novolin GE NPH (Penfill) (3ml)
02024268
NNO
2.8153
Humulin 30/70
00795879
LIL
2.2540
Humulin 30/70 (Cartridge)
01959212
LIL
2.9493
Novolin GE 30/70
02024217
NNO
2.1600
Novolin GE 30/70 (Penfill) (3ml)
02025248
NNO
2.7827
Insulin Injection/Insulin Isophane / D'insulin
injectable/D'insuline humaine
Sus/Susp. Inj 40IU/60IU
Novolin GE 40/60 (Penfill)
02024314
NNO
2.8027
Insulin Injection/Insulin Isophane / D'insulin
injectable/D'insuline humaine
Sus/Susp. Inj 50IU/50IU
Novolin GE 50/50 (Penfill)
02024322
NNO
2.8027
Insulin Lispro / Insuline Lispro
Liq Inj 100IU
Insulin Regular / Insuline Régulière
Liq Inj 100IU
Humalog
02229704
LIL
2.7610
Humalog (Cartridge)
02229705
LIL
3.6847
3.6847
Humalog Kwikpen
02403412
LIL
Humulin R
00586714
LIL
2.2540
Humulin R (Cartridge)
01959220
LIL
2.9493
Novolin GE Toronto
02024233
NNO
2.1010
Novolin GE Toronto (Penfill) (3ml)
02024284
NNO
2.7493
Interferon Alfa-2b / Interféron Alfa-2b
Liq Inj 6000000IU
Intron A
02238674
SCH
72.9200
Interferon Alfa-2b / Interféron Alfa-2b
Liq Inj 10000000IU
Intron A
02223406
SCH
125.8200
Intron A
02238675
SCH
121.5320
Interferon Alfa-2b / Interféron Alfa-2b
Liq Inj 15000000IU
Intron A
02240693
SCH
182.3000
Interferon Alfa-2b / Interféron Alfa-2b
Liq Inj 25000000IU
Intron A
02240694
FRS
303.8333
Interferon Alfa-2b / Interféron Alfa-2b
Liq Inj 50000000IU
Intron A
02240695
SCH
607.6583
Interferon Beta-1a / Interféron Bêta-1a
Liq Inj 22mcg
Interferon Beta-1a / Interféron Bêta-1a
Liq Inj 44mcg
Interferon Beta-1a / Interféron Bêta-1a
Liq Inj 30mcg
Interferon Beta-1b / Interféron Bêta-1b
Liq Inj 0.3mg
Rebif
02237319
EMD
257.6867
Rebif Cartridge
02318253
EMD
257.6817
Rebif Initiation Pack
02281708
EMD
1501.0600
Rebif
02237320
EMD
313.7067
Rebif Cartridge
02318261
EMD
313.7000
Avonex PS
02269201
BIG
811.5150
Betaseron
02169649
BAY
114.4000
Extavia
02337819
NVR
99.3593
1.0202
Iodoquinol / Iodoquinol
Tab/Co. Orl 650mg
Diodoquin
01997750
GLE
Ipratropium Bromide / Ipratropium (bromure d')
Aem/Aém Inh 20mcg
Atrovent HFA
02247686
BOE
0.0946
Iron Dextran / Fer-dextran
Liq Inj 50mg
Dexiron
02205963
MYL
13.7500
Infufer
02221780
SDZ
13.7500
Isopropyl Myristate / Isopropyle (myristate d')
Liq Top 50%
Resultz
02279592
MDF
0.1094
Isotretinoin / Isotrétinoïne
Tab/Co. Orl 10mg
Epuris
02396971
CIP
1.0710
Isotretinoin / Isotrétinoïne
Tab/Co. Orl 20mg
Epuris
02396998
CIP
1.4423
Isotretinoin / Isotrétinoïne
Tab/Co. Orl 30mg
Epuris
02397005
CIP
1.8140
Isotretinoin / Isotrétinoïne
Tab/Co. Orl 40mg
Epuris
02397013
CIP
2.1853
Itraconazole / Itraconazole
Cap/Caps Orl 100mg
Sporanox
02047454
JAN
4.2000
Ivacaftor / Ivacaftor
Tab/Co. Orl 150mg
Kalydeco
02397412
VTX
420.0000
Ketoprofen / Kétoprofène
Sup/Supp. Rt 100mg
pms-Ketoprofen
02015951
PMS
1.2150
Ketoprofen / Kétoprofène
ECT/Co.Ent. Orl 50mg
Keto-E
00790435
AAP
0.3373
Ketoprofen / Kétoprofène
ECT/Co.Ent. Orl 100mg
Keto-E
00842664
AAP
0.6823
Ketorolac Tromethamine / Kétorolac Trométhamine
Liq Inj 10mg
Toradol
02162644
HLR
1.2340
Effective January 16, 2015
Effectif le 16 janvier 2015
14
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Ketorolac Tromethamine / Kétorolac Trométhamine
Liq Oph 0.45%
Acuvail
02369362
ALL
0.6042
Lacosamide / Lacosamide
Tab/Co. Orl 50mg
Vimpat
02357615
UCB
2.4787
Lacosamide / Lacosamide
Tab/Co. Orl 100mg
Vimpat
02357623
UCB
3.4793
Lacosamide / Lacosamide
Tab/Co. Orl 150mg
Vimpat
02357631
UCB
4.6155
Lacosamide / Lacosamide
Tab/Co. Orl 200mg
Vimpat
02357658
UCB
5.6938
Lactobacillus Rhamnosus / Lactobacillus Rhamnosus
Cap/Caps Orl 1b
Bacid
80017987
ERF
0.9300
Lactulose / Lactulose
Syr/Sir. Orl 667mg
pms-Lactulose
00703486
PMS
0.0145
Jamp-Lactulose
02295881
JPC
0.0145
Lactulose
02142268
SAS
0.0145
Lamivudine / Lamivudine
Liq Orl 5mg
Heptovir
02239194
GSK
0.2300
Lamivudine / Lamivudine
Liq Orl 10mg
3TC
02192691
VIV
0.3139
Lamotrigine / Lamotrigine
TabC/Co.C Orl 2mg
Lamictal Chewtabs
02243803
GSK
0.1700
Lamotrigine / Lamotrigine
TabC/Co.C Orl 5mg
Lamictal Chewtabs
02240115
GSK
0.1654
Lanreotide Acetate / Lanréotide (acétate de)
Liq Inj 60mg/0.3mL
Somatuline Autogel
02283395
EMD
1146.4100
Lanreotide Acetate / Lanréotide (acétate de)
Liq Inj 90mg/0.3mL
Somatuline Autogel
02283409
EMD
1514.1000
Lanreotide Acetate / Lanréotide (acétate de)
Liq Inj 120mg/0.5mL
Somatuline Autogel
02283417
EMD
1914.1500
Lansoprazole / Lansoprazole
SRT/Co.L.L. Orl 15mg
Prevacid FasTab
02249464
ABB
2.0000
Lansoprazole / Lansoprazole
SRT/Co.L.L. Orl 30mg
Prevacid FasTab
02249472
ABB
2.0000
Lansoprazole/Clarithromycin/Amoxicillin /
Lansoprazole/Clarithromycine/Amoxicilline
Kit/Trousse Orl
30mg/500mg/500mg
Hp-Pac Kit 7 blister cards
02238525
ABB
85.0300
Lapatinib Ditosylate / Lapatinib (ditosylate de)
Tab/Co. Orl 250mg
Tykerb
02326442
GSK
23.5000
Lenalidomide / Lénalidomide
Cap/Caps Orl 5mg
Revlimid
02304899
CEL
340.0000
Lenalidomide / Lénalidomide
Cap/Caps Orl 10mg
Revlimid
02304902
CEL
361.0000
Lenalidomide / Lénalidomide
Cap/Caps Orl 15mg
Revlimid
02317699
CEL
382.0000
Lenalidomide / Lénalidomide
Cap/Caps Orl 25mg
Revlimid
02317710
CEL
424.0000
Leuprolide Acetate / Leuprolide (acétate de)
Liq Inj 5mg
Lupron
00727695
ABV
189.4100
Leuprolide Acetate / Leuprolide (acétate de)
Liq Inj 11.25mg
Lupron Depot
02239834
ABV
1034.4100
Leuprolide Acetate / Leuprolide (acétate de)
Pws/Pds. Inj 3.75mg
Lupron Depot
00884502
ABV
347.1800
Leuprolide Acetate / Leuprolide (acétate de)
Pws/Pds. Inj 7.5mg
Lupron Depot
00836273
ABV
387.9700
Leuprolide Acetate / Leuprolide (acétate de)
Pws/Pds. Inj 22.5mg
Lupron Depot
02230248
ABB
1071.0000
Leuprolide Acetate / Leuprolide (acétate de)
Pws/Pds. Inj 30mg
Lupron Depot
02239833
ABB
1428.0000
Leuprolide Acetate / Leuprolide (acétate de)
Sus/Susp. Inj 22.5mg
Eligard
02248240
SAV
891.0000
Leuprolide Acetate / Leuprolide (acétate de)
Sus/Susp. Inj 45mg
Eligard
02268892
SAV
1450.0000
Levocarnitine / Lévocarnitine
Liq Orl 100mg
Carnitor
02144336
QGT
0.3961
Levocarnitine / Lévocarnitine
Tab/Co. Orl 330mg
Carnitor
02144328
QGT
1.3078
Levodopa/Benserazide / Lévodopa/Bensérazide
Cap/Caps Orl 50mg/12.5mg
Prolopa
00522597
HLR
0.2830
Levodopa/Benserazide / Lévodopa/Bensérazide
Cap/Caps Orl 100mg/25mg
Prolopa
00386464
HLR
0.4659
Levodopa/Benserazide / Lévodopa/Bensérazide
Cap/Caps Orl 200mg/50mg
Prolopa
00386472
HLR
0.7821
Levodopa/Carbidopa/Entacapone /
Lévodopa/Carbidopa/Entacapone
Tab/Co. Orl 50mg
Stalevo
02305933
NVR
1.6810
Levodopa/Carbidopa/Entacapone /
Lévodopa/Carbidopa/Entacapone
Tab/Co. Orl 75mg
Stalevo
02337827
NVR
1.6810
Levodopa/Carbidopa/Entacapone /
Lévodopa/Carbidopa/Entacapone
Tab/Co. Orl 100mg
Stalevo
02305941
NVR
1.6810
Levodopa/Carbidopa/Entacapone /
Lévodopa/Carbidopa/Entacapone
Tab/Co. Orl 125mg
Stalevo
02337835
NVR
1.6810
Levodopa/Carbidopa/Entacapone /
Lévodopa/Carbidopa/Entacapone
Tab/Co. Orl 150mg
Stalevo
02305968
NVR
1.6810
Levofloxacin / Lévofloxacine
Liq Inj 5mg
Levaquin
02236839
JAN
0.3052
Levonorgestrel / Lévonorgestrel
Ins Vag 52mg
Mirena
02243005
BAY
336.2200
Levonorgestrel/Ethinyl Estradiol / Lévonorgestrel/
Tab/Co. Orl 0.050mg/0.075mg/ Triquilar (21)
00707600
BAY
0.7157
Éthinyloestradiol
0.125mg/0.030mg/0.040mg/0.03 Triquilar (28)
00707503
BAY
0.5368
Levothyroxine Sodium / Lévothyroxine Sodique
Tab/Co. Orl 0.025mg
02172062
ABB
0.0886
Effective January 16, 2015
Effectif le 16 janvier 2015
Synthroid
15
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Levothyroxine Sodium / Lévothyroxine Sodique
Tab/Co. Orl 0.05mg
Eltroxin
02213192
TRI
0.0295
Synthroid
02172070
ABB
0.0609
Levothyroxine Sodium / Lévothyroxine Sodique
Tab/Co. Orl 0.075mg
Synthroid
02172089
ABB
0.0958
Levothyroxine Sodium / Lévothyroxine Sodique
Tab/Co. Orl 0.088mg
Synthroid
02172097
ABB
0.0958
Levothyroxine Sodium / Lévothyroxine Sodique
Tab/Co. Orl 0.1mg
Eltroxin
02213206
TRI
0.0362
Synthroid
02172100
ABB
0.0750
Levothyroxine Sodium / Lévothyroxine Sodique
Tab/Co. Orl 0.112
Synthroid
02171228
ABB
0.1010
Levothyroxine Sodium / Lévothyroxine Sodique
Tab/Co. Orl 0.125mg
Synthroid
02172119
ABB
0.1022
Levothyroxine Sodium / Lévothyroxine Sodique
Tab/Co. Orl 0.137mg
Synthroid
02233852
ABB
0.1728
Levothyroxine Sodium / Lévothyroxine Sodique
Tab/Co. Orl 0.15mg
Levothyroxine Sodium / Lévothyroxine Sodique
Tab/Co. Orl 0.175mg
Levothyroxine Sodium / Lévothyroxine Sodique
Tab/Co. Orl 0.2mg
Levothyroxine Sodium / Lévothyroxine Sodique
Tab/Co. Orl 0.3mg
Eltroxin
02213214
TRI
0.0402
Synthroid
02172127
ABB
0.0803
Synthroid
02172135
ABB
0.1097
Eltroxin
02213222
TRI
0.0425
Synthroid
02172143
ABB
0.0857
Eltroxin
02213230
TRI
0.0645
Synthroid
02172151
ABB
0.1182
Lindane / Lindane
Lot Top 1%
pms-Lindane
00703591
PDP
0.1170
Lindane / Lindane
Shp Top 1%
pms-Lindane
00703605
PDP
0.1170
Linagliptin / Lingliptine
Tab/Co. Orl 5mg
Trajenta
02370921
BOE
2.2500
Liothyronine Sodium / Liothyronine Sodique
Tab/Co. Orl 5mcg
Cytomel
01919458
PFI
1.0317
Liothyronine Sodium / Liothyronine Sodique
Tab/Co. Orl 25mcg
Cytomel
01919466
PFI
1.1215
Lithium Carbonate / Lithium (carbonate de)
Cap/Caps Orl 600mg
Carbolith
02011239
VLN
0.1832
Lithium Citrate / Lithium (citrate de)
Liq Orl 8mmol/5mL
pms-Lithium Citrate
02074834
PMS
0.0708
Loperamide Hydrochloride / Lopéramide (chlorhydrate de) Tab/Co. Orl 2mg
Loperamide
02256452
JPC
0.2508
Lopinavir/Ritonavir / Lopinavir/Ritonavir
Kaletra Oral Solution
02243644
ABV
2.2084
Liq Orl 80mg
Lopinavir/Ritonavir / Lopinavir/Ritonavir
Tab/Co. Orl 100mg/5mg
Kaletra
02312301
ABV
2.7598
Lopinavir/Ritonavir / Lopinavir/Ritonavir
Tab/Co. Orl 200mg/50mg
Kaletra Tab
02285533
ABB
5.5197
Lorazepam / Lorazépam
Liq Inj 4mg
Lorazepam
02243278
SDZ
12.4240
Loxapine Succinate / Loxapine (succinate de)
Tab/Co. Orl 2.5mg
Xylac
02242868
PDP
0.1812
Lurasidone / Lurasidone
Tab/Co. Orl 40mg
Latuda
02387751
SNV
4.0800
Lurasidone / Lurasidone
Tab/Co. Orl 80mg
Latuda
02387778
SNV
4.0800
Lurasidone / Lurasidone
Tab/Co. Orl 120mg
Latuda
02387786
SNV
4.0800
Maraviroc / Maraviroc
Tab/Co. Orl 150mg
Celsentri
02299844
VIV
16.5000
Maraviroc / Maraviroc
Tab/Co. Orl 300mg
Celsentri
02299852
VIV
16.5000
Mebendazole / Mébendazole
Tab/Co. Orl 100mg
Vermox
00556734
JAN
4.7350
Medroxyprogesterone Acetate / Médroxyprogestérone
(acétate de)
Sus/Susp. Inj 50mg
Depo-Provera
00030848
PFI
5.4180
Melphalan / Melphalan
Tab/Co. Orl 2mg
Alkeran
00004715
TRI
1.6468
Meropenem / Méropénem
Pws/Pds. Inj 500mg
Merrem
02218488
AZE
26.0000
Meropenem / Méropénem
Pws/Pds. Inj 1g
Merrem
02218496
AZE
52.0000
Mesalazine / Mésalazine
ECT/Co.Ent Orl 500mg
Mesasal
01914030
GSK
0.6368
Salofalk
02112787
AXC
0.5703
Mesalazine / Mésalazine
SRT/Co.L.L. Orl 500mg
Pentasa
02099683
FEI
0.5716
Mesalazine / Mésalazine
ERT/Co.L.P. Orl 1000mg
Pentasa
02399466
FEI
1.1138
Mesalazine / Mésalazine
Sup/Supp. Rt 1gm
Pentasa
02153564
FEI
1.6480
Salofalk
02242146
AXC
1.8517
Mesalazine / Mésalazine
Sup/Supp. Rt 500mg
Salofalk
02112760
AXC
1.2603
Mesalazine / Mésalazine
Sus/Susp. Rt 1gm
Pentasa
02153521
FEI
0.0381
Mesalazine / Mésalazine
Sus/Susp. Rt 2gm
Salofalk
02112795
AXC
0.0677
Mesalazine / Mésalazine
Sus/Susp. Rt 4gm
Pentasa
02153556
FEI
0.0459
Mesalazine / Mésalazine
Sus/Susp. Rt 66.66666mg
Salofalk
02112809
AXC
0.1150
Mesalazine / Mésalazine
ECT/Co.Ent. Orl 400mg
Asacol
01997580
WNC
0.5520
Effective January 16, 2015
Effectif le 16 janvier 2015
16
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Mesalazine / Mésalazine
ECT/Co.Ent. Orl 800mg
Mesalazine / Mésalazine
Tab/Co. Orl 1.2gm
Asacol
02267217
WNC
1.0787
Mezavant
02297558
SHI
1.6253
Methadone Hydrochloride / Méthadone (chlorhydrate de) Tab/Co. Orl 1mg
Metadol
02247698
PAL
0.1800
Methadone Hydrochloride / Méthadone (chlorhydrate de) Tab/Co. Orl 5mg
Metadol
02247699
PAL
0.6148
Methadone Hydrochloride / Méthadone (chlorhydrate de) Tab/Co. Orl 10mg
Metadol
02247700
PAL
0.9836
Methadone Hydrochloride / Méthadone (chlorhydrate de) Tab/Co. Orl 25mg
Metadol
02247701
PAL
1.7300
Methenamine Mandelate / Méthénamine (mandélate de)
Tab/Co. Orl 500mg
Mandelamine
00499013
ERF
0.3800
Methimazole / Méthimazole
Tab/Co. Orl 5mg
Tapazole
00015741
PAL
0.2722
Methimazole / Méthimazole
Tab/Co. Orl 10mg
Tapazole
02296039
PAL
0.5446
Methocarbamol / Méthocarbamol
Tab/Co. Orl 500mg
Robaxin
01930990
WCH
0.4708
Methocarbamol / Méthocarbamol
Tab/Co. Orl 750mg
Robaxin
01932187
WCH
0.7772
Methocarbamol/ASA/Codeine /
Méthocarbamol/AAS/Codéine
Tab/Co. Orl
400mg/325mg/16.2mg
Robaxisal C-1/4
01934783
WCH
0.9625
Methocarbamol/ASA/Codeine /
Méthocarbamol/AAS/Codéine
Tab/Co. Orl
400mg/325mg/32.4mg
Robaxisal C-1/2
01934791
WCH
1.1500
Methotrexate Sodium / Méthotrexate Sodique
Liq Inj 10mg
Methotrexate Inj USP
02182947
HOS
8.2650
Methotrexate Sodium / Méthotrexate Sodique
Liq Inj 25mg
Methotrexate Inj USP
02182955
HOS
8.8200
Methotrexate Inj USP
02182777
HOS
9.7250
Methotrexate Inj USP
02099705
TEV
6.2500
Methotrexate Sodium / Méthotrexate Sodique
Liq IM 7.5mg/0.75mL
Metoject
02320029
MDX
46.8000
Methotrexate Sodium / Méthotrexate Sodique
Liq IM 10mg/mL
Metoject
02320037
MDX
49.4000
Methotrexate Sodium / Méthotrexate Sodique
Liq IM 15mg/1.5mL
Metoject
02320045
MDX
54.9000
Methotrexate Sodium / Méthotrexate Sodique
Liq IM 20mg/2mL
Metoject
02304767
MDX
59.8000
Methotrexate Sodium / Méthotrexate Sodique
Liq IM 25mg/2.5mL
Metoject
02320053
MDX
65.0000
Methotrexate / Méthotrexate
Tab/Co. Orl 2.5mg
Methotrexate
02182963
APX
0.6325
Methotrexate / Méthotrexate
Tab/Co. Orl 10mg
Methotrexate
02182750
HOS
2.7067
3.4170
Methotrimeprazine / Méthotriméprazine
Liq Inj 25mg
Nozinan
01927698
SAV
Methoxsalen / Méthoxsalen
Cap/Caps Orl 10mg
Oxsoralen
01946374
VLN
0.5773
Methsuximide / Mésuximide
Cap/Caps Orl 300mg
Celontin
00022802
ERF
1.0763
Methylphenidate / Méthylphénidate
Tab/Co. Orl 5mg
pms-Methylphenidate
02234749
PMS
0.0947
Methylphenidate / Méthylphénidate
ERC/Caps.L.P. Orl 10mg
Biphentin
02277166
PFR
0.6950
Methylphenidate / Méthylphénidate
ERC/Caps.L.P. Orl 15mg
Biphentin
02277131
PFR
0.9940
Methylphenidate / Méthylphénidate
ERC/Caps.L.P. Orl 20mg
Biphentin
02277158
PFR
1.2850
Methylphenidate / Méthylphénidate
ERC/Caps.L.P. Orl 30mg
Biphentin
02277174
PFR
1.7630
Methylphenidate / Méthylphénidate
ERC/Caps.L.P. Orl 40mg
Biphentin
02277182
PFR
2.2460
Methylphenidate / Méthylphénidate
ERC/Caps.L.P. Orl 50mg
Biphentin
02277190
PFR
2.7240
Methylphenidate / Méthylphénidate
ERC/Caps.L.P. Orl 60mg
Biphentin
02277204
PFR
3.1700
Methylphenidate / Méthylphénidate
ERC/Caps.L.P. Orl 80mg
Biphentin
02277212
PFR
4.1840
Methylprednisolone / Méthylprednisolone
Tab/Co. Orl 4mg
Medrol
00030988
PFI
0.3576
Methylprednisolone / Méthylprednisolone
Tab/Co. Orl 16mg
Medrol
00036129
PFI
1.0305
Methylprednisolone Acetate / Méthylprednisolone
(acétate de)
Sus/Susp. Ia 20mg
Depo-Medrol
01934325
PFI
2.5010
Methylprednisolone Acetate / Méthylprednisolone
Sus/Susp. IM 40mg
Depo-Medrol
00030759
PFI
5.6110
Depo-Medrol
01934333
PFI
5.3170
Depo-Medrol
00030767
PFI
10.8466
(acétate de)
Methylprednisolone Acetate / Méthylprednisolone
Sus/Susp. Ia 80mg
(acétate de)
Depo-Medrol
01934341
PFI
8.2966
Methylprednisolone Acetate/Lidocaine /
Méthylprednisolone (acétate de)/Lidocaïne
Sus/Susp Ia 40mg/10mg
Depo-Medrol
00260428
PFI
6.1300
Methylprednisolone/Neomycin/Aluminum/Sulfur /
Méthylprednisolone/Néomycine/Aluminum/Soufre
Lot Top
100mg/50mg/2.5mg/2.5mg
Neo-Medrol Acne
00195057
PFI
0.2604
Methylprednisolone Sodium Succinate /
Méthylprednisolone (succinate sodique de)
Pws/Pds. Inj 125mg
Solu-Medrol
02367955
PFI
14.9216
Effective January 16, 2015
Effectif le 16 janvier 2015
17
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Methylprednisolone Sodium Succinate /
Méthylprednisolone (succinate sodique de)
Pws/Pds. Inj 500mg
Solu-Medrol
02367963
PFI
37.3972
Metoclopramide HCl / Métoclopramide (chlorhydrate de)
Liq Inj 5mg
Metoclopramide HCl
02185431
SDZ
2.9500
Metolazone / Métolazone
Tab/Co. Orl 2.5mg
Zaroxolyn
00888400
SAV
0.1983
Metronidazole / Métronidazole
Crm/Cr. Top 0.75%
Metrocream
02226839
GAC
0.6600
Metronidazole / Métronidazole
Crm/Cr. Top 1%
Noritate
02156091
VLN
0.5738
Rosasol cream
02242919
GSK
0.5257
Metronidazole / Métronidazole
Gel Top 1%
Metrogel
02297809
GAC
0.6287
Metronidazole / Métronidazole
Lot Top 0.75%
Metrolotion
02248206
GAC
0.6600
Metronidazole / Métronidazole
Crm/Cr. Vag 10%
Flagyl
01926861
AVE
0.2375
Metronidazole / Métronidazole
Liq Inj 0.50%
Metronidazole
00649074
HOS
0.1739
Metronidazole
00870420
BAX
0.0282
Metronidazole/Nystatin / Métronidazole/Nystatine
Sup/Supp. Vag 100000IU/500mgFlagystatin
01926829
SAV
3.1970
Metronidazole/Nystatin / Métronidazole/Nystatine
Crm/Cr. Vag 100000IU
Flagystatin
01926845
SAV
0.5813
Miconazole Nitrate / Miconazole (nitrate de)
Crm/Cr. Top 2%
Micatin
02085852
WLS
0.2973
Monistat Derm
02126567
JNJ
0.3933
Miconazole Nitrate / Miconazole (nitrate de)
Sup/Supp. Vag 400mg
Monistat-3
02126605
JNJ
4.0067
Miconazole Nitrate / Miconazole (nitrate de)
Crm/Cr. Vag 1200mg/2%
Monistat 3 Dual Pak
02126249
JNJ
13.7600
Midazolam / Midazolam
Liq Inj 1mg
Midazolam
02240285
SDZ
0.7800
Midazolam
02242904
PPC
1.1450
Midazolam Injection
02382873
SDZ
0.7800
Midazolam / Midazolam
Liq Inj 5mg
Midazolam
02240286
SDZ
4.1000
Midazolam
02242905
PPC
4.1000
Midazolam Injection
02382903
SDZ
4.1000
Midodrine / Midodrine
Tab/Co. Orl 2.5mg
Midodrine
02278677
AAP
0.3378
Midodrine / Midodrine
Tab/Co. Orl 5mg
Midodrine
02278685
AAP
0.5630
Minoxidil / Minoxidil
Tab/Co. Orl 2.5mg
Loniten
00514497
PFI
0.3553
Minoxidil / Minoxidil
Tab/Co. Orl 10mg
Loniten
00514500
PFI
0.7832
Mometasone Furoate / Mométasone (furoate de)
Pwr/Pd. Inh 200mcg
Asmanex Twisthaler
02243595
MSD
0.5833
Mometasone Furoate / Mométasone (furoate de)
Pwr/Pd. Inh 400mcg
Asmanex Twisthaler
02243596
MSD
1.1667
Mometasone/Formoterol / Mométasone/Formotérol
Aem/Aém Inh 5mcg/50mcg
Zenhale
02361744
FRS
0.5828
Mometasone/Formoterol / Mométasone/Formotérol
Aem/Aém Inh 5mcg/100mcg
Zenhale
02361752
FRS
0.7396
Mometasone/Formoterol / Mométasone/Formotérol
Aem/Aém Inh 5mcg/50mcg
Zenhale
02361760
FRS
0.8964
Morphine Sulfate / Morphine (sulfate de)
Dps/Gtts Orl 20mg
Statex
00621935
PAL
0.5080
Morphine Sulfate / Morphine (sulfate de)
Dps/Gtts Orl 50mg
Statex
00705799
PAL
0.9654
Morphine Sulfate / Morphine (sulfate de)
Liq Inj 10mg
Morphine Sulfate
00392588
SDZ
2.0650
Morphine Sulfate / Morphine (sulfate de)
Liq Inj 15mg
Morphine Sulfate
00392561
SDZ
2.0940
Morphine Sulfate / Morphine (sulfate de)
Liq Inj 25mg
Morphine HP 25
00676411
SDZ
3.6130
Morphine Sulfate / Morphine (sulfate de)
Liq Inj 50mg
Morphine HP 50
00617288
SDZ
5.9302
Morphine Sulfate / Morphine (sulfate de)
SRC/Caps/L.L. Orl 10mg
M-Eslon
02019930
SAV
0.3030
Kadian
02242163
ABB
0.3769
0.3500
Morphine Sulfate / Morphine (sulfate de)
SRC/Caps/L.L. Orl 15mg
M-Eslon 15
02177749
SAV
Morphine Sulfate / Morphine (sulfate de)
SRC/Caps/L.L. Orl 20mg
Kadian
02184435
ABB
0.7323
Morphine Sulfate / Morphine (sulfate de)
SRC/Caps/L.L. Orl 30mg
M-Eslon
02019949
SAV
0.5222
Morphine Sulfate / Morphine (sulfate de)
SRC/Caps/L.L. Orl 50mg
Kadian
02184443
ABB
1.3462
0.9270
Morphine Sulfate / Morphine (sulfate de)
SRC/Caps/L.L. Orl 60mg
M-Eslon
02019957
SAV
Morphine Sulfate / Morphine (sulfate de)
SRC/Caps/L.L. Orl 100mg
M-Eslon
02019965
SAV
1.9950
Kadian
02184451
ABB
2.3480
Morphine Sulfate / Morphine (sulfate de)
SRC/Caps/L.L. Orl 200mg
Kadian
02177757
ABB
3.9896
Morphine Sulfate / Morphine (sulfate de)
SRT/Co.L.L. Orl 30mg
M.O.S.SR
00776181
VLN
0.4768
Morphine Sulfate / Morphine (sulfate de)
SRT/Co.L.L. Orl 60mg
M.O.S.SR
00776203
VLN
0.8404
Morphine Sulfate / Morphine (sulfate de)
Sup/Supp. Rt 5mg
Statex
00632228
PAL
1.7360
Effective January 16, 2015
Effectif le 16 janvier 2015
18
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Morphine Sulfate / Morphine (sulfate de)
Sup/Supp. Rt 10mg
Statex
00632201
PAL
1.9310
Morphine Sulfate / Morphine (sulfate de)
Sup/Supp. Rt 20mg
Statex
00596965
PAL
2.3080
Morphine Sulfate / Morphine (sulfate de)
Sup/Supp. Rt 30mg
Statex
00639389
PAL
2.5330
Morphine Sulfate / Morphine (sulfate de)
Syr/Sir. Orl 1mg
Statex
00591467
PAL
0.0200
Morphine Sulfate / Morphine (sulfate de)
Syr/Sir. Orl 1mg
ratio-Morphine
00607762
RPH
0.0245
Morphine Sulfate / Morphine (sulfate de)
Syr/Sir. Orl 5mg
Statex
00591475
PAL
0.0803
Morphine Sulfate / Morphine (sulfate de)
Syr/Sir. Orl 5mg
ratio-Morphine
00607770
RPH
0.0851
Morphine Sulfate / Morphine (sulfate de)
Syr/Sir. Orl 10mg
ratio-Morphine
00690783
RPH
0.2008
Morphine Sulfate / Morphine (sulfate de)
Syr/Sir. Orl 20mg
ratio-Morphine
00690791
RPH
0.5240
Morphine Sulfate / Morphine (sulfate de)
Tab/Co. Orl 5mg
Statex
00594652
PAL
0.1420
MS IR
02014203
PFR
0.1240
00594644
PAL
0.1860
Morphine Sulfate / Morphine (sulfate de)
Tab/Co. Orl 10mg
Statex
MS IR
02014211
PFR
0.1930
Morphine Sulfate / Morphine (sulfate de)
Tab/Co. Orl 20mg
MS IR
02014238
PFR
0.3440
Morphine Sulfate / Morphine (sulfate de)
Tab/Co. Orl 25mg
Statex
00594636
PAL
0.2250
Morphine Sulfate / Morphine (sulfate de)
Tab/Co. Orl 30mg
MS IR
02014254
PFR
0.4410
Morphine Sulfate / Morphine (sulfate de)
Tab/Co. Orl 50mg
Statex
00675962
PAL
0.3450
Moxifloxacin Hydrochloride / Moxifloxacine
(chlorhydrate de)
Liq Inj 400mg
Avelox I.V.
02246414
BAY
0.1401
Moxifloxacin Hydrochloride / Moxifloxacine
(chlorhydrate de)
Tab/Co. Orl 400mg
Avelox
02242965
BAY
6.0920
Multiple Vitamins and Minterals / Multivitamines et
Minéraux
Tab/Co. Orl
Centrum Junior
02246236
WCH
0.1208
Nadroparin Calcium / Nadroparine Calcique
Liq Inj 19000IU
Fraxiparin Forte (Prefilled Syringe)
02240114
GSK
30.4300
Nadroparin Calcium / Nadroparine Calcique
Liq Inj 9500IU
Fraxiparine
02236913
GSK
30.4300
Nafarelin Acetate / Nafaréline (acetate de)
Liq Nas 2mg
Synarel
02188783
PFI
4.8365
Naltrexone Hydrochloride / Naltrexone (chlorhydrate de)
Tab/Co. Orl 50mg
Revia
02213826
TEV
5.6150
Naproxen / Naproxène
Sus/Susp. Orl 25mg
Pediapharm Naproxen
02162431
PED
0.0635
Natalizumab / Natalizumab
Liq Inj 20mg/mL
Tysabri
02286386
BIG
205.4387
Nelfinavir Mesylate / Nelfinavir (mésylate de)
Tab/Co. Orl 250mg
Viracept
02238617
VIV
1.8861
Nelfinavir Mesylate / Nelfinavir (mésylate de)
Tab/Co. Orl 625mg
Viracept
02248761
VIV
4.7153
Neomycin/Polymyxin B/Bactracin/Hydrocortisone /
Néomycine/Polymyxine B/Bacitracine/Hydrocotisone
Ont Top 5000IU/400IU/10mg/5m Cortisporin
00666246
GSK
0.7880
Nevirapine / Névirapine
ERT/Co.L.P. Orl 400mg
Viramune XR
02367289
BOE
2.4690
Nifedipine / Nifédipine
ERT/Co.L.P. Orl 20mg
Adalat XL
02237618
BAY
1.2726
Nilotinib Hydrochloride / Nilotinib (chlorhydrate de)
Cap/Caps Orl 150mg
Tasigna
02368250
NVR
28.7161
Nilotinib Hydrochloride / Nilotinib (chlorhydrate de)
Cap/Caps Orl 200mg
Tasigna
02315874
NVR
39.7213
Nilutamide / Nilutamide
Tab/Co. Orl 50mg
Anandron
02221861
SAV
2.2383
Nitrofurantonin / Nitrofurantoïne
Tab/Co. Orl 50mg
Nitrofurantoin
00319511
AAP
0.1670
Nitrofurantonin / Nitrofurantoïne
Tab/Co. Orl 100mg
Nitrofurantoin
00312738
AAP
0.2227
Nitrofurantonin/Macrocrystals /
Nitrofurantoïne/Macrocristaux
Cap/Caps Orl 100mg
Macrobid
02063662
WNC
0.7146
Nitroglycerin / Nitroglycérine
Ont Top 2%
Nitrol
01926454
PAL
0.6950
Nitroglycerin / Nitroglycérine
Pth Trd 0.2mg/hr
Minitran
02162806
VLN
0.6207
Trinipatch
02230732
PAL
0.6070
Nitroglycerin / Nitroglycérine
Nitroglycerin / Nitroglycérine
Pth Trd 0.4mg/hr
Pth Trd 0.6mg/hr
Minitran
02163527
VLN
0.7013
Trinipatch
02230733
PAL
0.6989
Minitran
02163535
VLN
0.7017
Trinipatch
02230734
PAL
0.6989
Nitroglycerin / Nitroglycérine
Slt/Co.S.L. Slg 0.3mg
Nitrostat
00037613
PFI
0.1211
Nitroglycerin / Nitroglycérine
Slt/Co.S.L. Slg 0.6mg
Nitrostat
00037621
PFI
0.1211
Nitroglycerin / Nitroglycérine
Srd Trd 0.2mg
Transderm-Nitro
00584223
NVR
0.7713
Nitroglycerin / Nitroglycérine
Srd Trd 0.4mg
Transderm-Nitro
00852384
NVR
0.8710
Effective January 16, 2015
Effectif le 16 janvier 2015
19
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Nitroglycerin / Nitroglycérine
Srd Trd 0.6mg
Transderm-Nitro
02046156
Norethindrone / Noréthindrone
Tab/Co. Orl 0.35mg
Micronor (28)
00037605
JAN
0.7850
Norethidrone/Ethinyl Estradiol /
Tab/Co. Orl 0.020mg/1mg
Minestrin 1/20 (21)
00315966
WNC
0.6614
Minestrin 1/20 (28)
00343838
WNC
0.4961
Tab/Co. Orl 1.5mg/0.03mg
Loestrin 1.5/30 (21)
00297143
WNC
0.6614
Loestrin 1.5/30 (28)
00353027
WNC
0.4961
Tab/Co. Orl 0.5mg/0.035mg
Brevicon (21)
02187086
PFI
0.5980
Noréthindron/Éthinyloestradiol
Norethidrone/Ethinyl Estradiol /
Noréthindron/Éthinyloestradiol
Norethidrone/Ethinyl Estradiol /
Noréthindron/Éthinyloestradiol
Norethidrone/Ethinyl Estradiol /
Tab/Co. Orl 1mg/0.035mg
Noréthindron/Éthinyloestradiol
NVR
0.8710
Brevicon (28)
02187094
PFI
0.4485
Ortho 0.5/35 (21)
00317047
JAN
1.0467
Ortho 0.5/35 (28)
00340731
JAN
0.7850
Brevicon 1/35 (21)
02189054
PFI
0.5980
Brevicon 1/35 (28)
02189062
PFI
0.4485
Ortho 1/35 (21)
00372846
JAN
1.0467
Ortho 1/35 (28)
00372838
JAN
0.7850
Select 1/35 (21)
02197502
PFI
0.3980
Select 1/35 (28)
02199297
PFI
0.2985
Norethidrone/Ethinyl Estradiol /
Tab/Co. Orl 1mg/0.5mg/
Synphasic (21)
02187108
PFI
0.5495
Noréthindron/Éthinyloestradiol
0.035mg
Synphasic (28)
02187116
PFI
0.4122
Norethidrone/Ethinyl Estradiol /
Tab/Co. Orl 1mg/0.75mg/
Ortho 7/7/7 (21)
00602957
JAN
1.0467
Noréthindron/Éthinyloestradiol
0.5mg/0.035mg
Ortho 7/7/7 (28)
00602965
JAN
0.7850
Norethindrone/Estradiol-17β /
Noréthindrone/Estradiol-17β
Pth Trd 140/0.050mg
Estalis
02241835
NVR
3.2325
Norethindrone/Estradiol-17β /
Noréthindrone/Estradiol-17β
Pth Trd 250/0.050mg
Estalis
02241837
NVR
3.2325
Norgestimate/Ethinyl Estradiol / Norgestimate/
Tab/Co. Orl 0.25mg/0.035mg
Éthinyloestradiol
Cyclen 21
01968440
JAN
1.0167
Cyclen 28
01992872
JAN
0.7850
1.0467
Norgestimate/Ethinyl Estradiol / Norgestimate/
Tab/Co. Orl 0.25mg/0.215mg/
Tri-Cyclen (21)
02028700
JAN
Éthinyloestradiol
0.18mg/0.035mg
Tri-Cyclen (28)
02029421
JAN
0.7850
Nylidrin Hydrochloride / Nylidrine (chlorhydrate de)
Tab/Co. Orl 6mg
Arlidin
01926713
ERF
0.6079
Nystatin / Nystatine
Crm/Cr. Top 100000IU
Nyaderm
00716871
TAR
0.0667
Ratio-Nystatin
02194236
RPH
0.0700
Nystatin / Nystatine
Ont Top 100000IU
Ratio-Nystatin
02194228
RPH
0.0903
Nystatin / Nystatine
Susp/Susp. Orl 100000IU
pms-Nystatin Oral
00792667
PMS
0.0592
Ratio-Nystatin
02194201
RPH
0.0521
Nystatin / Nystatine
Tab/Co. Orl 500000IU
ratio-Nystatin
02194198
RPH
0.2400
Nystatin / Nystatine
Crm/Cr. Vag 25000IU
Nyaderm
00716901
TAR
0.1250
Nystatin / Nystatine
Crm/Cr. Vag 100000IU
Ratio-Nystatin
02194163
RPH
0.2553
Octreotide Acetate / Octréotide (acétate de)
Pws/Pds. Inj 10mg
Sandostatin LAR
02239323
NVR
1320.9300
Octreotide Acetate / Octréotide (acétate de)
Pws/Pds. Inj 20mg
Sandostatin LAR
02239324
NVR
1706.5800
Octreotide Acetate / Octréotide (acétate de)
Pws/Pds. Inj 30mg
Sandostatin LAR
02239325
NVR
2189.5200
Olmesartan Medoxomil / Olmésartan Médoxomil
Tab/Co. Orl 20mg
Olmetec
02318660
FRS
1.1165
Olmesartan Medoxomil / Olmésartan Médoxomil
Tab/Co. Orl 40mg
Olmetec
02318679
FRS
1.1165
Olmesartan/Hydrochlorothiazide /
Olmésartan/Hydrochlorothiazide
Tab/Co. Orl 20mg/12.5mg
Olmetec Plus
02319616
FRS
1.1165
Olmesartan/Hydrochlorothiazide /
Olmésartan/Hydrochlorothiazide
Tab/Co. Orl 40mg/12.5mg
Olmetec Plus
02319624
FRS
1.1165
Olmesartan/Hydrochlorothiazide /
Olmésartan/Hydrochlorothiazide
Tab/Co. Orl 40mg/25mg
Olmetec Plus
02319632
FRS
1.1165
Olopatadine Hydrochloride / Olopatadine (chlorhydrate d') Liq Oph 0.2%
Pataday
02362171
ALC
11.9080
Olsalazine Sodium / Olsalazine sodique
Cap/Caps Orl 250mg
Dipentum
02063808
UCB
0.5585
Onabotulinumtoxin A / Onabotulinumtoxin A
Pws/Pds. Inj 50units
Botox
00903741
ALL
178.5000
Onabotulinumtoxin A / Onabotulinumtoxin A
Pws/Pds. Inj 100units
Botox
01981501
ALL
357.0000
Onabotulinumtoxin A / Onabotulinumtoxin A
Pws/Pds. Inj 200units
Botox
00999505
ALL
714.0000
Effective January 16, 2015
Effectif le 16 janvier 2015
20
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Oseltamivir Phosphate / Oseltamivir (phosphate d')
Cap/Caps Orl 30mg
Tamiflu
02304848
HLR
2.0190
Oseltamivir Phosphate / Oseltamivir (phosphate d')
Cap/Caps Orl 45mg
Tamiflu
02304856
HLR
3.1070
Oseltamivir Phosphate / Oseltamivir (phosphate d')
Cap/Caps Orl 75mg
Tamiflu
02241472
HLR
4.0390
Oxcarbazepine / Oxcarbazépine
Sus/Susp Orl 60mg
Trileptal
02244673
NVR
0.3310
Oxtriphylline / Oxtriphylline
Elx Orl 20mg
Choledyl
00476366
ERF
0.0387
Oxybutynin Chloride / Oxybutynine (chlorure d')
Tab/Co. Orl 2.5mg
pms-Oxybutynin
02240549
PMS
0.1515
Oxybutynin Chloride / Oxybutynine (chlorure d')
ERT/Co.L.P. Orl 5mg
Ditropan XL
02243960
JAN
2.2780
Oxybutynin Chloride / Oxybutynine (chlorure d')
ERT/Co.L.P. Orl 10mg
Ditropan XL
02243961
JAN
2.2780
Oxybutynin Chloride / Oxybutynine (chlorure d')
ERT/Co.L.P. Orl 10mg
Uromax
02273578
PFR
1.3655
Oxybutynin Chloride / Oxybutynine (chlorure d')
ERT/Co.L.P. Orl 15mg
Uromax
02273586
PFR
1.4710
Oxycodone Hydrochloride / Oxycodone (chlorhydrate d')
ERT/Co.L.P. Orl 10mg
Oxyneo
02372525
PFR
0.8780
Oxycodone Hydrochloride / Oxycodone (chlorhydrate d')
ERT/Co.L.P. Orl 15mg
Oxyneo
02372533
PFR
1.0600
Oxycodone Hydrochloride / Oxycodone (chlorhydrate d')
ERT/Co.L.P. Orl 20mg
Oxyneo
02372797
PFR
1.3170
Oxycodone Hydrochloride / Oxycodone (chlorhydrate d')
ERT/Co.L.P. Orl 30mg
Oxyneo
02372541
PFR
1.7400
Oxycodone Hydrochloride / Oxycodone (chlorhydrate d')
ERT/Co.L.P. Orl 40mg
Oxyneo
02372568
PFR
2.2825
Oxycodone Hydrochloride / Oxycodone (chlorhydrate d')
ERT/Co.L.P. Orl 60mg
Oxyneo
02372576
PFR
3.1500
Oxycodone Hydrochloride / Oxycodone (chlorhydrate d')
ERT/Co.L.P. Orl 80mg
Oxyneo
02372584
PFR
4.2160
Oxycodone Hydrochloride / Oxycodone (chlorhydrate d')
Sup/Supp. Rt 10mg
Supeudol
00392480
SDZ
2.8583
Oxycodone Hydrochloride / Oxycodone (chlorhydrate d')
Tab/Co. Orl 5mg
Supeudol
00789739
SDZ
0.1776
Oxycodone/Acetaminophen /
Oxycodone/Acétaminophène
Tab/Co. Orl 325mg/2.5mg
Percocet Demi
01916491
BRI
0.6915
Oxycodone/ASA / Oxycodone/AAS
Tab/Co. Orl 325mg/5mg
ratio-Oxycodan
00608157
RPH
0.3220
Paliperidone Palmitate / Palipéridone (palmitate de)
Sus/Susp. Inj 50mg/0.5mL
Invega Sustenna
02354217
JAN
317.9100
Paliperidone Palmitate / Palipéridone (palmitate de)
Sus/Susp. Inj 75mg/0.75mL
Invega Sustenna
02354225
JAN
476.8700
Paliperidone Palmitate / Palipéridone (palmitate de)
Sus/Susp. Inj 100mg/mL
Invega Sustenna
02354233
JAN
476.8700
Paliperidone Palmitate / Palipéridone (palmitate de)
Sus/Susp. Inj 150mg/1.5mL
Invega Sustenna
02354241
JAN
635.8300
Pancreatic Enzymes / Enzymes Pancréatiques
ECC/Caps.Ent. Orl
5000U/16600U/18750U
Creon 5 Minimicrospheres
02239007
ABB
0.1703
Pancreatic Enzymes / Enzymes Pancréatiques
ECC/Caps.Ent. Orl
6000U/30000U/19000U
Creon 6 Minimicrospheres
02415194
ABB
0.1703
Pancreatic Enzymes / Enzymes Pancréatiques
ECC/Caps.Ent. Orl
10000U/33200U/37500U
Creon10 Minimicrospheres
02200104
ABB
0.2723
Pancreatic Enzymes / Enzymes Pancréatiques
Ecc/Caps.Ent. Orl
25000U/74000U/62500U
Creon 25 Minimicrospheres
01985205
ABB
0.8507
Pancrelipase / Pancrélipase
Cap/Caps Orl
4500U/20000U/20000U
Ultrase MS 4
02203324
AXC
0.2334
Pancrelipase / Pancrélipase
Cap/Caps Orl
8000U/20000U/30000U
Cotazym
00263818
FRS
0.2079
Pancrelipase / Pancrélipase
Cap/Caps Orl
12000U/39000U/39000U
Ultrase MT 12
02045834
AXC
0.4565
Pancrelipase / Pancrélipase
Cap/Caps Orl
20000U/65000U/65000U
Ultrase MT 20
02045869
AXC
0.7909
Pancrelipase / Pancrélipase
ECC/Caps.Ent. Orl
4000U/12000U/12000U
Pancrease MT 4
00789445
JAN
0.5430
Pancrelipase / Pancrélipase
ECC/Caps.Ent. Orl
8000U/30000U/30000U
Cotazym ECS 8
00502790
SCH
0.3751
Pancrelipase / Pancrélipase
ECC/Caps.Ent. Orl
1000U/30000U/30000U
Pancrease MT 10
00789437
JAN
1.3571
Pancrelipase / Pancrélipase
ECC/Caps.Ent. Orl
16000U/48000U/48000U
Pancrease MT 16
00789429
JAN
2.2800
Pancrelipase / Pancrélipase
ECC/Caps.Ent. Orl
20000U/55000U/55000U
Cotazym ECS 20
00821373
SCH
0.9837
Pancrelipase / Pancrélipase
Tab/Co. Orl
8000U/30000U/30000U
Viokase 8
02230019
AXC
0.2383
Pancrelipase / Pancrélipase
Tab/Co. Orl
16000U/60000U/60000U
Viokase 16
02241933
AXC
0.3658
Effective January 16, 2015
Effectif le 16 janvier 2015
21
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Pantoprazole Magnesium / Pantoprazole magnésien
Tab/Co. Orl 40mg
Tecta
02267233
TAK
0.7500
Pazopanib Hydrochloride / Pazopanib (chlorhydrate de)
Tab/Co. Orl 200mg
Votrient
02352303
GSK
34.4100
Penicillamine / Pénicillamine
Cap/Caps Orl 250mg
Cuprimine
00016055
VLN
3.4971
Penicillin G Sodium / Pénicilline G Sodique
Liq Inj 1000000IU
Penicillin G Sodium
01930672
TEV
2.4000
Penicillin G Sodium / Pénicilline G Sodique
Liq Inj 5000000IU
Penicillin G Sodium
00883751
TEV
5.1000
Penicillin G Sodium / Pénicilline G Sodique
Liq Inj 10000000IU
Penicillin G Sodium
01930680
TEV
8.9000
Penicillin G Sodium / Pénicilline G Sodique
Pws/Pds. Inj 1000000IU
Crystapen
02060086
BCH
2.4000
Penicillin G Sodium / Pénicilline G Sodique
Pws/Pds. Inj 10000000IU
Crystapen
02060108
BCH
8.9000
Penicillin V Potassium / Pénicilline V Potassique
Pws/Pds. Orl 25mg
Apo-Pen VK
00642223
APX
0.0535
Penicillin G Benzathine / Pénicilline G Benzathine
Sus/Susp. Inj 6000000IU
Bicillin L-A
02291924
KNG
21.3825
Penicillin V Potassium / Pénicilline V Potassique
Pws/Pds. Orl 60mg
Novo-Pen-VK
00391603
TEV
0.0618
Apo-Pen VK
00642231
APX
0.0618
Pentamidine Isetionate / Pentamidine Isétionate
Pws/Pds. Inj 300mg
Pentamidine Isetionate
02183080
HOS
127.1200
Pentazocine Hydrochloride / Pentazocine
(chlorhydrate de)
Tab/Co. Orl 50mg
Talwin
02137984
SAV
0.4441
Pentoxifylline / Pentoxifylline
SRT/Co.L.L.
Pentoxifylline SR
02230090
AAP
0.5846
Paroxetine Hydrochloride / Paroxétine (chlorhydrate de)
Tab/Co. Orl 40mg
pms-Paroxetine
02293749
PMS
2.3475
Pegfilgrastim / Pegfilgrastim
Liq Inj 6mg/0.6mL
Neulasta
02249790
AGA
2454.4100
Peginterferon Alfa-2a / Peginterféron Alfa-2a
Liq Inj 180mcg/0.5mL
Pegasys
02248077
HLR
395.8400
Peginterferon Alfa-2a/Ribavirin / Peginterféron Alfa-2a/
Ribavirine
Kit/Trousse/Trousse Inj
180mcg/mL
Pegasys RBV
02253410
HLR
395.8400
Pentosan Polysulfate Sodium / Plysulfate de Pentosane
Cap/Caps Orl 100mg
Elmiron
02029448
JAN
2.1695
Perampanel / Pérampanel
Tab/Co Orl 2mg
Fycompa
02404516
EIS
9.4500
Perampanel / Pérampanel
Tab/Co Orl 4mg
Fycompa
02404524
EIS
9.4500
Perampanel / Pérampanel
Tab/Co Orl 6mg
Fycompa
02404532
EIS
9.4500
Perampanel / Pérampanel
Tab/Co Orl 8mg
Fycompa
02404540
EIS
9.4500
Perampanel / Pérampanel
Tab/Co Orl 10mg
Fycompa
02404559
EIS
9.4500
Perampanel / Pérampanel
Tab/Co Orl 12mg
Fycompa
02404567
EIS
9.4500
Periciazine / Péricyazine
Cap/Caps Orl 5mg
Neuleptil
01926780
ERF
0.2307
Periciazine / Péricyazine
Cap/Caps Orl 10mg
Neuleptil
01926772
ERF
0.4091
Periciazine / Péricyazine
Cap/Caps Orl 20mg
Neuleptil
01926764
ERF
0.5830
Periciazine / Péricyazine
Dps/Gttes Orl 10mg
Neuleptil
01926756
ERF
0.4111
Perindopril Erbumine / Perindopril Erbumine
Tab/Co. Orl 2mg
Coversyl
02123274
SEV
0.6940
Perindopril Erbumine / Perindopril Erbumine
Tab/Co. Orl 4mg
Coversyl
02123282
SEV
0.8690
Perindopril Erbumine/Indapamide / Perindopril
Erbumine/Indapamide
Tab/Co. Orl 4mg/1.25mg
Coversyl Plus
02246569
SEV
1.0613
Perindopril Erbumine/Indapamide / Perindopril
Erbumine/Indapamide
Tab/Co. Orl 8mg/2.5mg
Coversyl Plus HD
02321653
SEV
1.1873
Permethrin / Perméthrine
Crm/Cr. Top 1%
Kwellada-P Creme Rinse 1%
02231480
MDI
0.1238
Nix Creme
00771368
INP
0.1196
Permethrin / Perméthrine
Crm/Cr. Top 5%
Nix Dermal
02219905
GCH
0.4977
Permethrin / Perméthrine
Lot Top 5%
Kwellada-P
02231348
MDI
0.2688
Perphenazine / Perphénazine
Tab/Co. Orl 2mg
Perphenazine
00335134
AAP
0.0626
Perphenazine / Perphénazine
Tab/Co. Orl 4mg
Perphenazine
00335126
AAP
0.0758
Perphenazine / Perphénazine
Tab/Co. Orl 8mg
Perphenazine
00335118
AAP
0.0832
Perphenazine / Perphénazine
Tab/Co. Orl 16mg
Perphenazine
00335096
AAP
0.1274
Pethidine Hydrochloride / Péthidine (chlorhydrate de)
Tab/Co. Orl 50mg
Demerol
02138018
SAV
0.1538
Phenelzine Sulfate / Phénelzine (sulfate de)
Tab/Co. Orl 15mg
Nardil
00476552
ERF
0.3795
Phenobarbital / Phénobarbital
Elx Orl 5mg
Phenobarbital
00645575
PMS
0.1238
Phenobarbital / Phénobarbital
Tab/Co. Orl 15mg
Phenobarbital
00178799
PDP
0.0927
0.1103
Phenobarbital / Phénobarbital
Tab/Co. Orl 30mg
Phenobarbital
00178802
PDP
Phenobarbital / Phénobarbital
Tab/Co. Orl 60mg
Phenobarbital
00178810
PDP
0.1496
Phenobarbital / Phénobarbital
Tab/Co. Orl 100mg
Phenobarbital
00178829
PDP
0.2048
Effective January 16, 2015
Effectif le 16 janvier 2015
22
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Phenytoin / Phénytoïne
Sus/Susp. Orl 6mg
Dilantin 30
00023442
PFI
0.0419
Phenytoin / Phénytoïne
Tab/Co. Orl 50mg
Dilantin infatabs
00023698
PFI
0.0761
Phenytoin / Phénytoïne
Cap/Caps Orl 30mg
Dilantin
00022772
PFI
0.0544
Phenytoin / Phénytoïne
Cap/Caps Orl 100mg
Dilantin
00022780
PFI
0.0756
Phenytoin / Phénytoïne
Liq Orl 50mg
Phenytoin Sodium
00780626
SDZ
5.2855
Pinaverium Bromide / Pinavérium (bromure de)
Tab/Co. Orl 50mg
Dicetel
01950592
ABB
0.3533
Pinaverium Bromide / Pinavérium (bromure de)
Tab/Co. 100mg
Dicetel
02230684
ABB
0.6160
Pindolol/Hydrochlorothiazide /
Pindolol/Hydrochlorothiazide
Tab/Co. Orl 10mg/25mg
Viskazide
00568627
NVR
1.0006
Pindolol/Hydrochlorothiazide /
Pindolol/Hydrochlorothiazide
Tab/Co. Orl 10mg/50mg
Viskazide
00568635
NVR
1.0006
Pipercillin/Tazobactam / Pipéracilline/Tazobactam
Pws/Pds. Inj 2g/0.25g
Piperacillin & Tazobactam
02299623
SDZ
10.1300
Pipercillin/Tazobactam / Pipéracilline/Tazobactam
Pws/Pds. Inj 3g/0.375g
Piperacillin & Tazobactam
02299631
SDZ
15.2000
Pipercillin/Tazobactam / Pipéracilline/Tazobactam
Pws/Pds. Inj 4g/0.5g
Piperacillin & Tazobactam
02299658
SDZ
20.2700
Pipotiazine Palmitate / Pipotiazine (palmitate de)
Liq Inj 25mg
Piportil L4
01926667
SAV
16.3000
Pipotiazine Palmitate / Pipotiazine (palmitate de)
Liq Inj 50mg
Piportil L4
01926675
SAV
27.6400
Pirfenidone / Pirfénidone
Cap/Caps Orl 267mg
Esbriet
02393751
ITM
13.0302
Pizotifen Malate / Pizotifène (malate de)
Tab/Co. Orl 0.5mg
Sandomigran
00329320
PAL
0.3894
Pizotifen Malate / Pizotifène (malate de)
Tab/Co. Orl 1mg
Sandomigran DS
00511552
PAL
0.6998
Placebo / Placebo
Cap/Caps Orl 100mg
Placebo
00501190
ODN
0.0721
Plerixafor / Plérixafor
Liq/Liq Inj 20mg
Mozobil
02377225
SAV
6295.8333
Plymyxin B/Bacitracin / Polymyxine B/Bacitracine
Ont Oph 10000IU/500IU
Polysporin
02239157
JNJ
1.6886
Podophyllum Resin / Podophyllum (résine de)
Liq Top 250mg
Podofilm
00598208
PAL
1.3804
Polymyxin B/Neomycin / Polymyxine B/Néomycine
Liq Urh 200000IU/40mg
Neosporin Irrigating Sol.
00666157
GSK
1.6860
Potassium Chloride / Potassium (chlorure de)
Liq Orl 100mg
K-10
80024360
GSK
0.0159
Potassium Chloride / Potassium (chlorure de)
SRC/Caps.L.L. Orl 600mg
Micro-K
02042304
PAL
0.0930
Potassium Chloride / Potassium (chlorure de)
SRT/Co.L.L. Orl 600mg
0.0899
Potassium Chloride / Potassium (chlorure de)
SRT/Co.L.L. Orl 1500mg
Apo-K
00602884
APX
Jamp-K8
80013005
JPC
0.0899
Slow-K
80040226
NVR
0.1668
Jamp-K20
80013007
JPC
0.1995
Odan K-20
80004415
ODN
0.2050
Prasugrel Hydrochloride / Prasugrel (chlorhydrate de)
Tab/Co. Orl 10mg
Effient
02349124
LIL
2.7133
Prednisone / Prednisone
Tab/Co. Orl 1mg
Winpred
00271373
AAP
0.1072
Apo-Prednisone
00598194
APX
0.1072
Prednisolone Acetate / Prednisolone (acétate de)
Liq Oph 0.12%
Pred Mild
00299405
ALL
1.8320
Prednisolone Acetate / Prednisolone (acétate de)
Sus/Susp. Oph 1%
Diopred
02023768
SDZ
1.9400
Primidone / Primidone
Tab/Co. Orl 125mg
Primidone
00399310
AAP
0.0553
Primidone / Primidone
Tab/Co. Orl 250mg
Primidone
00396761
AAP
0.0870
Procainamide Hydrochloride / Procaïnamide
(chlorhydrate de)
SRT/Co.L.L. Orl 250mg
Procan SR
00638692
ERF
0.4705
Procainamide Hydrochloride / Procaïnamide
(chlorhydrate de)
SRT/Co.L.L. Orl 500mg
Procan SR
00638676
ERF
0.6536
Procainamide Hydrochloride / Procaïnamide
(chlorhydrate de)
SRT/Co.L.L. Orl 750mg
Procan SR
00638684
ERF
1.0506
Procarbazine Hydrochloride / Procarbazine
(chlorhydrate de)
Cap/Caps Orl 50mg
Matulane
00012750
QGT
56.6000
Prochlorperazine Maleate / Prochlorpérazine (maléate de) Sup/Supp Rt 10mg
pms-Prochlorperazine
00753688
PMS
0.8300
Sandoz Prochlorperazine
00789720
SDZ
1.5180
Prochlorperazine Maleate / Prochlorpérazine (maléate de) Tab/Co Orl 5mg
Prochlorazine
00886440
AAP
0.1659
Prochlorperazine Maleate / Prochlorpérazine (maléate de) Tab/Co Orl 10mg
Prochlorazine
00886432
AAP
0.2025
Procyclidine Hydrochloride / Procyclidine
(chlorhydrate de)
Elx Orl 0.5mg
pms-Procyclidine
00587362
PMS
0.2669
Procyclidine Hydrochloride / Procyclidine
(chlorhydrate de)
Tab/Co. Orl 2.5mg
pms-Procyclidine
00649392
PMS
0.0715
Effective January 16, 2015
Effectif le 16 janvier 2015
23
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Procyclidine Hydrochloride / Procyclidine
(chlorhydrate de)
Tab/Co. Orl 5mg
pms-Procyclidine
00587354
PMS
0.1326
Propranolol Hydrochloride / Propranolol (chlorhydrate de) SRC/Caps.L.L. Orl 60mg
Interal LA
02042231
PFI
0.5758
Propranolol Hydrochloride / Propranolol (chlorhydrate de) SRC/Caps.L.L. Orl 80mg
Interal LA
02042258
PFI
0.6493
Propranolol Hydrochloride / Propranolol (chlorhydrate de) SRC/Caps.L.L. Orl 120mg
Interal LA
02042266
PFI
0.9997
Propranolol Hydrochloride / Propranolol (chlorhydrate de) SRC/Caps.L.L. Orl 160mg
Interal LA
02042274
PFI
1.1823
Propylthiouracil / Proplthiouracile
Tab/Co. Orl 50mg
Propyl-Thyracil
00010200
PAL
0.2350
Propylthiouracil / Proplthiouracile
Tab/Co. Orl 100mg
Propyl-Thyracil
00010219
PAL
0.3676
Pyrantel Pamoate / Pyrantel (pamoate de)
Tab/Co. Orl 125mg
Combantrin
01944363
JNJ
1.1083
Pyrethrins/Piperonyl / Pyréthrines/Pipéronyle
Shp top 3%
R & C Shampoo and Conditioner
02125447
MDI
0.1208
Pyridostigmine Bromide / Pyridostigmine (bromure de)
SRT/Co.L.L. Orl 180mg
Mestinon SR
00869953
VLN
1.0130
Pyridostigmine Bromide / Pyridostigmine (bromure de)
Tab/Co. Orl 60mg
Mestinon
00869961
VLN
0.4633
Pyrimethamine / Pyriméthamine
Tab/Co. Orl 25mg
Daraprim
00004774
TRB
1.3276
Quinagolide Hydrochloride / Quinagolide (chlorhydrate de) Tab/Co. Orl 0.075mg
Norprolac
02223767
FEI
1.1227
Quinagolide Hydrochloride / Quinagolide (chlorhydrate de) Tab/Co. Orl 0.15mg
Norprolac
02223775
FEI
1.6790
Quinine Sulfate / Quinine (sulfate de)
Quinine Sulfate / Quinine (sulfate de)
Cap/Caps Orl 200mg
Cap/Caps Orl 300mg
Novo-Quinine
00021008
TEV
0.2390
Quinine Sulfate
00695440
ODN
0.2390
Novo-Quinine
00021016
TEV
0.3750
Quinine Sulfate
00695459
ODN
0.3750
Quinine Sulfate / Quinine (sulfate de)
Tab/Co. Orl 300mg
Quinine Sulfate
00695432
ODN
0.3750
Raltegravir Potassium / Raltégravir Potassique
Tab/Co. Orl 400mg
Isentress
02301881
FRS
11.5000
Ramipril / Ramipril
Tab/Co. Orl 1.25mg
Sandoz Ramipril
02291398
SDZ
0.4550
Ramipril / Ramipril
Tab/Co. Orl 2.5mg
Sandoz Ramipril
02291401
SDZ
0.5250
Ramipril / Ramipril
Tab/Co. Orl 5mg
Sandoz Ramipril
02291428
SDZ
0.5250
Ramipril / Ramipril
Tab/Co. Orl 10mg
Sandoz Ramipril
02291436
SDZ
0.6650
Ranibizumab / Ranibizumab
Liq Inj 10mg/mL
Lucentis
02296810
NVO
1575.0000
Ranitidine Hydrochloride / Ranitidine (chlorhydrate de)
Liq Inj 25mg
Zantac
02212366
GSK
1.4210
Regorafenib / Regorafenib
Tab/Co. Orl 150mg
Stivarga
02403390
BAY
74.2500
Ribavirin/Peginterferon Alfa-2b / Ribavirine/Interféron Alfa- Kit/Trousse Inj 100mcg/mL
2b Péguylé
Pegetron Kit
02246026
SCH
786.3900
Ribavirin/Peginterferon Alfa-2b / Ribavirine/Interféron Alfa- Kit/Trousse Inj 150mcg/0.5mL
2b Péguylé
Pegetron Kit
02246030
SCH
868.9600
Ribavirin/Peginterferon Alfa-2b / Ribavirine/Interféron Alfa- Kit/Trousse Inj 80mcg/0.5mL
2b Péguylé
Pegetron Redipen
02254581
SCH
786.3900
Ribavirin/Peginterferon Alfa-2b / Ribavirine/Interféron Alfa- Kit/Trousse Inj 100mcg/0.5mL
2b Péguylé
Pegetron Redipen
02254603
SCH
786.3900
Ribavirin/Peginterferon Alfa-2b / Ribavirine/Interféron Alfa- Kit/Trousse Inj 100mcg/mL
2b Péguylé
Pegetron Redipen
02254573
SCH
786.3900
Ribavirin/Peginterferon Alfa-2b / Ribavirine/Interféron Alfa- Kit/Trousse Inj 120mcg/0.5mL
2b Péguylé
Pegetron Redipen
02254638
SCH
868.9600
Ribavirin/Peginterferon Alfa-2b / Ribavirine/Interféron Alfa- Kit/Trousse Inj 150mcg/0.5mL
2b Péguylé
Pegetron Redipen
02254646
SCH
868.9600
Rifabutin / Rifabutine
Cap/Caps. Orl 150mg
Mycobutin
02063786
PFI
4.1844
Rifampin / Rifampine
Cap/Caps Orl 150mg
Rifampin / Rifampine
Cap/Caps Orl 300mg
Rofact
00393444
VLN
0.6405
Rifadin
02091887
SAV
0.8395
Rofact
00343617
VLN
1.0081
Rifadin
02092808
SAV
1.3211
14.4950
Rilpivirine Hydrochloride / Rilpivirine (chlorhydrate de)
Tab/Co. Orl 25mg
Edurant
02370603
JAN
Risperidone / Rispéridone
Pws/Pds. Inj 12.5mg
Risperdal Consta
02298465
JAN
78.5900
Risperidone / Rispéridone
Pws/Pds. Inj 25mg
Risperdal Consta
02255707
JAN
163.1700
Risperidone / Rispéridone
Pws/Pds. Inj 37.5mg
Risperdal Consta
02255723
JAN
244.7500
Risperidone / Rispéridone
Pws/Pds. Inj 50mg
Risperdal Consta
02255758
JAN
326.3400
Ritonavir / Ritonavir
Tab/Co. Orl 100mg
Norvir
02357593
ABV
1.4670
Rituximab / Rituximab
Liq Inj 10mg/mL
Rituxan
02241927
HLR
45.3100
Effective January 16, 2015
Effectif le 16 janvier 2015
24
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Rivaroxaban / Rivaroxaban
Tab/Co. Orl 10mg
Xarelto
02316986
BAY
2.8400
Rivaroxaban / Rivaroxaban
Tab/Co. Orl 15mg
Xarelto
02378604
BAY
2.8400
Rivaroxaban / Rivaroxaban
Tab/Co. Orl 20mg
Xarelto
02378612
BAY
2.8400
Rivastigmine / Rivastigmine
Liq Orl 2mg/mL
Exelon
02245240
NVR
1.3700
Rufinamide / Rufinamide
Tab/Co. Orl 100mg
Banzel
02369613
EIS
0.7183
Rufinamide / Rufinamide
Tab/Co. Orl 200mg
Banzel
02369621
EIS
1.4364
Rufinamide / Rufinamide
Tab/Co. Orl 400mg
Banzel
02369648
EIS
3.1298
Ruxolitinib Phosphate / Ruxolitinib (phosphate de)
Tab/Co. Orl 5mg
Jakavi
02388006
NVR
82.1918
Ruxolitinib Phosphate / Ruxolitinib (phosphate de)
Tab/Co. Orl 15mg
Jakavi
02388014
NVR
82.1918
Ruxolitinib Phosphate / Ruxolitinib (phosphate de)
Tab/Co. Orl 20mg
Jakavi
02388022
NVR
82.1918
Salbutamol Sulfate / Salbutamol (sulfate de)
Liq Inh 1mg
Med-Salbutamol
02237414
MED
0.4622
Salbutamol Sulfate / Salbutamol (sulfate de)
Pwr. Pd. Inh 200mcg
Ventolin Diskus
02243115
GSK
0.1928
Salmeterol/Fluticasone / Salmétérol/Fluticasone
Pwr/Pd. Inh 25mcg/125mcg
Advair 125
02245126
GSK
0.7999
Salmeterol/Fluticasone / Salmétérol/Fluticasone
Pwr/Pd. Inh 25mcg/250mcg
Advair 250
02245127
GSK
1.1356
Salmeterol/Fluticasone / Salmétérol/Fluticasone
Pwr/Pd. Inh 50mcg/100mcg
Advair Diskus
02240835
GSK
1.3365
Salmeterol/Fluticasone / Salmétérol/Fluticasone
Pwr/Pd. Inh 50mcg/250mcg
Advair Diskus
02240836
GSK
1.5998
Salmeterol/Fluticasone / Salmétérol/Fluticasone
Pwr/Pd. Inh 50mcg/500mcg
Advair Diskus
02240837
GSK
2.2712
Salmeterol Xinafoate / Salmétérol (xinofoate de)
Pwr. Pd. Inh 50mcg
Serevent Diskus
02231129
GSK
0.9350
Salmeterol Xinofoate / Salmétérol (xinafoate de)
Pwr/Pds. Inh 50mcg
Serevent
02214261
GSK
0.9350
Saquinavir Mesylate / Saquinavir (mésylate de)
Cap/Caps Orl 200mg
Invirase
02216965
HLR
1.8851
Saquinavir Mesylate / Saquinavir (mésylate de)
Tab/Co. Orl 300mg
Invirase
02279320
HLR
4.3503
Scopolamine Hydrobromide / Scopolamine
(bromhydrate de)
Liq Inj 0.4mg
Scopolamine Hydrobromide
00541869
HOS
4.8900
Scopolamine Hydrobromide / Scopolamine
(bromhydrate de)
Liq Inj 0.6mg
Scopolamine Hydrobromide
00541877
HOS
5.3600
Scopolamine / Scopolamine
Srd Trd 1.5mg
Transderm-V
80024336
NVR
3.9250
Sevelamer Hydrochloride / Sevelamer (chlorhydrate de)
Tab/Co. Orl 800mg
Renagel
02244310
SAV
1.6426
Silver Sulfadiazine / Argent (sulfadiazine d')
Crm/Cr. Top 1%
Flamazine
00323098
SNE
0.2430
Simeprevir / Simeprévir
Cap/Caps Orl 150mg
Galexos
02416441
JAN
434.5500
Sirolimus / Sirolimus
Liq Orl 1mg
Rapamune
02243237
PFI
7.9610
Sirolimus / Sirolimus
Tab/Co. Orl 1mg
Rapamune
02247111
PFI
7.9611
Sitagliptin / Sitagliptine
Tab/Co. Orl 25mg
Januvia
02388839
FRS
2.6177
Sitagliptin / Sitagliptine
Tab/Co. Orl 50mg
Januvia
02388847
FRS
2.6177
Sitagliptin / Sitagliptine
Tab/Co. Orl 100mg
Januvia
02303922
FRS
2.6178
Sitagliptin/Metformin / Sitagliptine/Metformine
Tab/Co. Orl 50mg/500mg
Janumet
02333856
FRS
1.3700
Sitagliptin/Metformin / Sitagliptine/Metformine
Tab/Co. Orl 50mg/850mg
Janumet
02333864
FRS
1.3700
Sitagliptin/Metformin / Sitagliptine/Metformine
Tab/Co. Orl 50mg/1000mg
Janumet
02333872
FRS
1.3700
Sodium Cromoglycate / Cromoglycate di sodique
Cap/Caps Orl 100mg
Nalcrom
00500895
SAV
1.4620
Sodium Fluoride / Sodium (fluorure de)
Liq Den 0.2%
Fluorinse
00782882
MLA
0.0162
Sodium Fluoride / Sodium (fluorure de)
Dps/Gttes Orl 5.56mg
Fluor-a-Day
00610100
PDP
0.1698
Sodium Fluoride / Sodium (fluorure de)
Tab/Co. Orl 2.21mg
Fluor-a-Day
00575569
PDP
0.0849
Sodium Acid Phosphate / Phosphate Acide de Sodium
Evt/Co.Eff. Orl
356mg/350mg/315mg
Phosphate Novartis
80027202
NVR
0.7765
Sodium Chloride / Sodium (chlorure de)
Ont Oph 5%
Muro 128
00750816
BSH
2.8086
Sodium Polystyrene / Polystyrène Sodique
Sus/Susp. Orl 250mg
Solystat
00769541
PDP
0.1504
Solifenacin Succinate / Solifénacine (succinate de)
Tab/Co. Orl 5mg
Vesicare
02277263
ASL
1.5450
Solifenacin Succinate / Solifénacine (succinate de)
Tab/Co. Orl 10mg
Vesicare
02277271
ASL
1.5450
Somatropin / Somatotrophine
Pwd./pws. SC 0.6mg
Genotropin MiniQuick
02401762
PFI
16.7400
Somatropin / Somatotrophine
Pwd./pws. SC 0.8mg
Genotropin MiniQuick
02401770
PFI
22.3200
Somatropin / Somatotrophine
Pwd./pws. SC 1mg
Genotropin MiniQuick
02401789
PFI
27.9000
Somatropin / Somatotrophine
Pwd./pws. SC 1.2mg
Genotropin MiniQuick
02401797
PFI
33.4800
Somatropin / Somatotrophine
Pwd./pws. SC 1.4mg
Genotropin MiniQuick
02401800
PFI
39.0600
Effective January 16, 2015
Effectif le 16 janvier 2015
25
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Somatropin / Somatotrophine
Pwd./pws. SC 1.6mg
Genotropin MiniQuick
02401819
PFI
44.6400
Somatropin / Somatotrophine
Pwd./pws. SC 1.8mg
Genotropin MiniQuick
02401827
PFI
50.2200
Somatropin / Somatotrophine
Pwd./pws. SC 2mg
Genotropin MiniQuick
02401835
PFI
55.8000
Somatropin / Somatotrophine
Pwd./pws. SC 5.3mg
Genotropin GoQuick
02401703
PFI
147.8700
Somatropin / Somatotrophine
Pwd./pws. SC 12mg
Genotropin GoQuick
02401711
PFI
334.8000
Somatropin / Somatotrophine
Ctg/Cart Inj 6mg
Humatrope
02243077
LIL
280.0200
Somatropin / Somatotrophine
Ctg/Cart Inj 12mg
Humatrope
02243078
LIL
560.0400
Somatropin / Somatotrophine
Ctg/Cart Inj 24mg
Humatrope
02243079
LIL
1120.0800
Somatropin / Somatotrophine
Liq Inj 3.33mg
Omnitrope
02325063
SDZ
103.8667
Somatropin / Somatotrophine
Liq Inj 6.70mg
Omnitrope
02325071
SDZ
207.7333
Somatropin / Somatotrophine
Liq Inj 5mg/mL
Nutropin AQ
02229722
HLR
194.7200
Somatropin / Somatotrophine
Liq Inj 5mg/mL
Nutropin AQ NuSpin
02376393
HLR
197.7350
Somatropin / Somatotrophine
Liq Inj 10mg/2mL
Nutropin AQ Pen
02249002
HLR
197.7350
Somatropin / Somatotrophine
Liq Inj 6mg
Saizen
02350122
EMD
268.8300
Somatropin / Somatotrophine
Liq Inj 12mg
Saizen
02350130
EMD
537.6600
Somatropin / Somatotrophine
Liq Inj 20mg
Saizen
02350149
EMD
896.1000
Somatropin / Somatotrophine
Pws/Pds Inj 1mg
Humatrope
00745626
LIL
233.3500
Nutropin
02216191
HLR
389.4400
Somatropin / Somatotrophine
Pws/Pds Inj 3.33mg
Saizen
02215136
EMD
149.2500
Somatropin / Somatotrophine
Pws/Pds Inj 5mg
Saizen
02237971
EMD
224.0500
Somatropin / Somatotrophine
Pws/Pds Inj 8.8mg
Saizen
02272083
EMD
358.4700
Sorafenib Tosylate / Sorafenib Tosylate
Tab/Co. Orl 200mg
Nexavar
02284227
BAY
46.4689
Spiramycin / Spiramycine
Cap/Caps Orl 750000IU
Rovamycine 250
01927825
ODN
1.3640
Spiramycin / Spiramycine
Cap/Caps Orl 1500000IU
Rovamycine 500
01927817
ODN
2.7240
Stavudine / Stavudine
Cap/Caps Orl 15mg
Zerit
02216086
BRI
4.7000
Stavudine / Stavudine
Cap/Caps Orl 20mg
Zerit
02216094
BRI
4.8875
Stavudine / Stavudine
Cap/Caps Orl 30mg
Zerit
02216108
BRI
5.0983
Stavudine / Stavudine
Cap/Caps Orl 40mg
Zerit
02216116
BRI
5.2850
Sucralfate / Sucralfate
Sus/Susp. Orl 200mg
Sulcrate Plus
02103567
AXC
0.1100
Sulfacetamide Sodium/Sulfur / Sulfacétamide
Sodique/Soufre
Lot Top 10%/5%
Sulfacet R
02220407
VLN
1.0212
Sulfacetamide Sodium / Slfacétamide Sodique
Dps/Gttes Oph 10%
Sodium Sulamyd
00028053
SDZ
0.4933
Sulfacetamide/Prednisolone /
S lf ét id /P d i l
Sulfacetamide/Prednisolone
/
Dps/Gttes Oph 10%/0.2%
Blephamide
00807788
ALL
2.7980
Ont Oph 10%/0.2%
Blephamide S.O.P.
00307246
ALL
3.5714
S
lf ét id /P d i l
Sulfamethoxazole/Trimethoprim
/
S
lf éth
l /T i éth i
Sulfasalazine
/ Sulfasalazine
Tab/Co. Orl 20mg/100mg
Apo-Sulfatrim
00445266
APX
0.0911
ECT/Co.Ent Orl 500mg
pms-Sulfasalazine EC
00598488
PMS
0.3483
Sulfasalazine / Sulfasalazine
Tab/Co. Orl 500mg
pms-Sulfasalazine
00598461
PMS
0.2288
Sumatriptan Hemisulfate / Sumatriptan (hémisulfate de)
Spr Nas 5mg
Imitrex
02230418
GSK
14.6000
Sumatriptan Hemisulfate / Sumatriptan (hémisulfate de)
Spr Nas 20mg
Imitrex
02230420
GSK
15.0250
Sunitinib Malate / Sunitinib (malate de)
Cap/Caps Orl 12.5mg
Sutent
02280795
PFI
64.4157
Sunitinib Malate / Sunitinib (malate de)
Cap/Caps Orl 25mg
Sutent
02280809
PFI
128.8304
Sunitinib Malate / Sunitinib (malate de)
Cap/Caps Orl 50mg
Sutent
02280817
PFI
257.6611
Tacrolimus / Tacrolimus
Cap/Caps Orl 0.5mg
Prograf
02243144
ASL
1.9700
Tacrolimus / Tacrolimus
ERC/Caps.L.P. Orl 0.5mg
Advagraf
02296462
ASL
1.9700
Tacrolimus / Tacrolimus
ERC/Caps.L.P. Orl 1mg
Advagraf
02296470
ASL
2.5200
Tacrolimus / Tacrolimus
ERC/Caps.L.P. Orl 3mg
Advagraf
02331667
ASL
7.5600
Tacrolimus / Tacrolimus
ERC/Caps.L.P. Orl 5mg
Advagraf
02296489
ASL
12.6200
Tacrolimus / Tacrolimus
Ont Top 0.03%
Protopic
02244149
ASL
2.2147
Tacrolimus / Tacrolimus
Ont Top 0.1%
Protopic
02244148
ASL
2.3690
Telaprevir / Télaprévir
Tab/Co. Orl 375mg
Incivek
02371553
VTX
69.3810
Telmisartan/Amlodipine/ Telmisartan/Amlodipine
Tab/Co. Orl 40mg/5mg
Twynsta
02371030
BOE
0.6818
Telmisartan/Amlodipine/ Telmisartan/Amlodipine
Tab/Co. Orl 40mg/10mg
Twynsta
02371022
BOE
0.6818
Effective January 16, 2015
Effectif le 16 janvier 2015
26
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Telmisartan/Amlodipine/ Telmisartan/Amlodipine
Tab/Co. Orl 80mg/5mg
Twynsta
02371057
BOE
0.6818
Telmisartan/Amlodipine/ Telmisartan/Amlodipine
Tab/Co. Orl 80mg/10mg
Twynsta
02371049
BOE
0.6818
Temozolomide / Témozolomide
Cap/Caps Orl 5mg
Temodal
02241093
FRS
7.8000
Temozolomide / Témozolomide
Cap/Caps Orl 180mg
Temodal
02312816
FRS
267.0240
Tenofovir Disoproxil / Ténofovir Disoproxil
Tab/Co. Orl 300mg
Viread
02247128
GIL
18.3640
Terbinafine Hydrochloride / Terbinafine (chlorhydrate de) Crm/Cr. Top 1%
Lamisil
02031094
NVR
0.5283
Terbutaline Sulfate / Terbutaline (sulfate de)
Aem/Aém Inh 0.5mg
Bricanyl Turbuhaler
00786616
AZE
0.0764
Testosterone Cypionate / Testostérone (cypionate de)
Liq Inj 100mg
Depo-Testosterone
00030783
PFI
2.8345
Sandoz Testosterone
02246063
SDZ
2.3580
Testosterone Enanthate / Testostérone (énanthate de)
Liq Inj 200mg
Delatestryl
00029246
VLN
10.1300
Testosterone / Testostérone
Pth Trd 2.5mg
Androderm
02239653
WTS
2.1347
Testosterone / Testostérone
Pth Trd 5mg
Androderm
02245972
WTS
4.2693
Testosterone / Testostérone
Gel Top 50mg
Androgel Packets
02245346
ABB
0.7887
Testosterone / Testostérone
Gel Top 25mg
Androgel Packets
02245345
ABB
0.8920
Testosterone / Testostérone
Gel Top 1%
Testim
02280248
PAL
0.7307
Theophylline / Théophylline
Liq Orl 5.33333mg
Theolair
01966219
VLN
0.0252
Theophylline / Théophylline
SRT/Co.L.L. 100mg
Apo-Theo LA
00692689
APX
0.1300
Theophylline / Théophylline
SRT/Co.L.L. 200mg
Apo-Theo LA
00692697
APX
0.1350
Theophylline / Théophylline
SRT/Co.L.L. 300mg
Apo-Theo LA
00692700
APX
0.1817
Thioguanine / Thioguanine
Tab/Co. Orl 40mg
Lanvis
00282081
TRI
4.3964
Thiothixene / Thiothixène
Cap/Caps Orl 2mg
Navane
00024430
ERF
0.3178
Thiothixene / Thiothixène
Cap/Caps Orl 5mg
Navane
00024449
ERF
0.4600
Thiothixene / Thiothixène
Cap/Caps Orl 10mg
Navane
00024457
ERF
0.5638
818.2300
Thyrotropin Alfa / thyrotropine Alfa
Pws/Pds. Inj 0.9mg
Thyrogen
02246016
GZM
Ticagrelor / Ticagrélor
Tab/Co. Orl 90mg
Brilinta
02368544
AZE
1.4800
Ticarcillin/Potassium Clavulanate / Ticarcilline/Potassium Pws/Pds. Inj 3g
(Clavulanate de)
Timentin
01916939
GSK
3.4684
Tinzaparin Sodium / Tinzaparine Sodique
Innohep (Multidose Vial)
02167840
LEO
18.5490
Innohep (Prefilled Syringe)
02229755
LEO
18.7200
Innohep (Multidose Vial)
02229515
LEO
37.6800
Liq Inj 10000IU/mL
Tinzaparin Sodium / Tinzaparine Sodique
Liq Inj 20000IU/mL
Innohep (Prefilled Syringe)
02231478
LEO
37.1160
Tiotropium / Tiotropium
Cap/Caps Inh 18mcg
Spiriva
02246793
BOE
2.1667
Tipranavir / Tipranavir
Cap/Caps Orl 250mg
Aptivus
02273322
BOE
8.2500
Tobramycin / Tobramycine
Ont Oph 0.3%
Tobrex
00614254
ALC
2.5743
Tobramycin Sulfate / Tobramycine (sulfate de)
Liq Inh 60mg
Tobi
02239630
NVR
10.8981
Tobramycin/Dexamethasone /
Tobramycine/Dexaméthasone
Ont Oph 0.3%/0.1%
Tobradex
00778915
ALC
3.1314
Tobramycin/Dexamethasone /
Tobramycine/Dexaméthasone
Sus/Susp. Oph 0.3%/0.1%
Tobradex
00778907
ALC
2.1240
Tocilizumab / Tocilizumab
Liq Inj 80mg/4mL
Actemra
02350092
HLR
44.8000
Tocilizumab / Tocilizumab
Liq Inj 200mg/10mL
Actemra
02350106
HLR
44.8000
Tocilizumab / Tocilizumab
Liq Inj 400mg/20mL
Actemra
02350114
HLR
44.8000
Tocopherol (Vit E) / Tocophérol (Vit E)
Dps/Gttes Orl 50IU
Aquasol E
02162075
CLC
0.8116
Tocopherol (Vit E) / Tocophérol (Vit E)
Cap/Caps Orl 100IU
Tocopherol (Vit E) / Tocophérol (Vit E)
Tocopherol (Vit E) / Tocophérol (Vit E)
Effective January 16, 2015
Effectif le 16 janvier 2015
Cap/Caps Orl 200IU
Cap/Caps Orl 400IU
Vitamin E Natural
00122823
JAM
0.0523
Vitamin E
00189227
JAM
0.0587
Vitamin E Natural
00122831
JAM
0.0672
Vitamin E
00189235
SWS
0.0854
Vitamin E Natural
00122858
JAM
0.1344
Vitamin E
00266108
PMT
0.2567
Vitamin E
02040816
PMT
0.1620
Vitamin E
02247190
HHC
0.0808
Vitamin E Natural
00201995
JPC
0.0792
27
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Vitamin E Synthetic
00274259
WAM
0.0667
Tolterodine L-Tartrate / Toltérodine (L-tartrate de)
SRC/Caps.L.L. Orl 2mg
Detrol LA
02244612
PFI
1.9877
Tolterodine L-Tartrate / Toltérodine (L-tartrate de)
SRC/Caps.L.L. Orl 4mg
Detrol LA
02244613
PFI
1.9877
Tolterodine L-Tartrate / Toltérodine (L-tartrate de)
Tab/Co. Orl 1mg
Detrol
02239064
PFI
0.9938
Tolterodine L-Tartrate / Toltérodine (L-tartrate de)
Tab/Co. Orl 2mg
Detrol
02239065
PFI
0.9938
Topiramate / Topiramate
Cap/Caps Orl 15mg
Topamax
02239907
JAN
1.2025
Topiramate / Topiramate
Cap/Caps Orl 25mg
Topamax
02239908
JAN
1.2620
Topiramate / Topiramate
Tab/Co. Orl 50mg
pms-Topiramate
02312085
PMS
1.1494
Trametinib / Tramétinib
Tab/Co. Orl 0.5mg
Mekinist
02409623
GSK
72.5000
Trametinib / Tramétinib
Tab/Co. Orl 2mg
Mekinist
02409658
GSK
290.0000
Trandolapril / Trandolapril
Cap/Caps Orl 1mg
Mavik
02231459
ABB
0.6901
Trandolapril / Trandolapril
Cap/Caps Orl 2mg
Mavik
02231460
ABB
0.7931
Trandolapril / Trandolapril
Cap/Caps Orl 4mg
Mavik
02239267
ABB
0.9785
Tranylcypromine Sulfate / Tranylcypromine (sulfate de)
Tab/Co. Orl 10mg
Parnate
01919598
GSK
0.3816
Travoprost/Timolol / Travoprost/Timolol
Liq Oph 0.5%/0.004%
Duo Trav
02278251
ALC
13.6040
Treprostinil Sodium / Treprostinil (sodium de)
Liq Inj 1mg
Remodulin
02246552
UTC
45.0000
Treprostinil Sodium / Treprostinil (sodium de)
Liq Inj 2.5mg
Remodulin
02246553
UTC
112.5000
Treprostinil Sodium / Treprostinil (sodium de)
Liq Inj 5mg
Remodulin
02246554
UTC
225.0000
Treprostinil Sodium / Treprostinil (sodium de)
Liq Inj 10mg/mL
Remodulin
02246555
UTC
450.0000
Tretinoin / Trétinoïne
Cap/Caps Orl 10mg
Vesanoid
02145839
XPI
16.3863
0.3022
Tretinon / Trétinoïne
Crm/Cr. Top 0.01%
Stieva-A
00657204
GSK
Tretinon / Trétinoïne
Crm/Cr. Top 0.025%
Stieva-A
00578576
GSK
0.3022
Tretinon / Trétinoïne
Crm/Cr. Top 0.05%
Retin-A
00443794
VLN
0.3960
Stieva-A
00518182
GSK
0.3022
Tretinon / Trétinoïne
Crm/Cr. Top 0.1%
Stieva-A Forte
00662348
GSK
0.3022
Tretinon / Trétinoïne
Gel Top 0.01%
Vitamin A Acid
01926462
VLN
0.3140
Tretinon / Trétinoïne
Gel Top 0.025%
Vitamin A Acid
01926470
VLN
0.3140
Tretinon / Trétinoïne
Gel Top 0.05%
Vitamin A Acid
01926489
VLN
0.3140
Triamcinolone Acetonide / Triamcinolone (acétonide de)
Crm/Cr. Top 0.1%
Aristocort R
02194058
VLN
0.1300
Triamcinolone Acetonide / Triamcinolone (acétonide de)
Crm/Cr. Top 0.5%
Aristocort C
02194066
VLN
1.1520
Triamcinolone Acetonide / Triamcinolone (acétonide de)
Ont Top 0.1%
Aristocort R
02194031
VLN
0.1300
Triamcinolone Acetonide / Triamcinolone (acétonide de)
Pst Den 0.1%
Oracort
01964054
TAR
1.2267
Triamcinolone/Neomycin/Nystatin/Gramicidin /
Triamcinolone/Néomycine/Nystatine/Gramicidine
Crm/Cr.Top
100000IU/2.5mg/1mg/0.25mg
Viaderm K-C
00717002
TAR
0.4233
Triamcinolone/Neomycin/Nystatin/Gramicidin /
Triamcinolone/Néomycine/Nystatine/Gramicidine
Ont Top
100000IU/2.5mg/1mg/0.25mg
Viaderm K-C
00717029
TAR
0.5053
Triptorelin Pamoate / Triptoréline (pamoate de)
Pws/Pds. Inj 3.75mg
Trelstar
02240000
ATV
340.5200
Triptorelin Pamoate / Triptoréline (pamoate de)
Pws/Pds. Inj 11.25
Trelstar
02243856
ATV
1021.6000
Triptorelin Pamoate / Triptoréline (pamoate de)
Pws/Pds. Inj 22.5mg
Trelstar
02412322
ATV
1650.0000
Trospium Chloride / Trospium (chlorure de)
Tab/Co. Orl 20mg
Trosec
02275066
SNV
0.7635
Topiramate / Topiramate
Cap/Caps Orl 15mg
Topamax
02239907
JAN
1.2025
Topiramate / Topiramate
Cap/Caps Orl 25mg
Topamax
02239908
JAN
1.2620
L-Tryptophan / L-Tryptophane
Tab/Co. Orl 250mg
Tryptan
02239326
VLN
0.3842
L-Tryptophan / L-Tryptophane
Tab/Co. Orl 750mg
Tryptan
02239327
VLN
1.1531
Ustekinumab / Ustekinumab
Ustekinumab / Ustekinumab
Liq Inj 45mg/0.5mL
Liq Inj 90mg/1mL
Stelara
Stelara
02320673
02320681
JAN
JAN
4593.1400
4593.1400
Valganciclovir Hydrochloride / Valganciclovir
(chlorhydrate de)
Pws/Pds. Orl 50mg/mL
Valcyte
02306085
HLR
2.5791
Vancomycin Hydrochloride /
Pws/Pds. Inj 500mg
Vancomycine (chlorhydrate de)
Vancomycin Hydrochloride /
Vancomycine (chlorhydrate de)
Effective January 16, 2015
Effectif le 16 janvier 2015
Pws/Pds. Inj 1g
Sterile Vancomycin
02230191
HOS
41.5200
Sterile Vancomycin HCL
02139375
PPC
47.7040
Val-Vancomycin
02342855
VLN
31.0500
Vancomycin HCL
02139383
PPC
95.1660
Val-Vancomycin
02342863
VLN
58.9900
28
Liste des prix catalogues du fabricant (PCF) pour
régimes médicaments du N.-B.
Manufacturer List Price (MLP)
List for NB Drug Plans
Varenicline tartrate / Varénicline (tartrate de)
Tab/Co. Orl 0.5mg
Champix
02291177
PFI
1.7975
Varenicline tartrate / Varénicline (tartrate de)
Tab/Co. Orl 1mg
Champix
02291185
PFI
1.7969
Varenicline tartrate / Varénicline (tartrate de)
Tab/Co. Orl 0.5mg/1mg
Champix Starter Kit
02298309
PFI
1.7980
Vemurafenib / Vémurafénib
Tab/Co. Orl 240mg
Zelboraf
02380242
HLR
46.5420
Verapamil Hydrochloride / Vérapamil (chlorhydrate de)
SRT/Co.L.L. Orl 240mg
Novo-Veramil SR
02211920
TEV
0.8720
Vigabatrin / Vigabatrin
Tab/Co. Orl 500mg
Sabril
02065819
LBK
0.9110
Vigabatrin / Vigabatrin
Pwr/Pds. Orl 0.5gm
Sabril
02068036
LBK
0.9110
Vismodegib / Vismodegib
Cap/Caps Orl 150mg
Erivedge
02409267
HLR
294.2238
Zarfirlukast / Zafirlukast
Tab/Co. Orl 20mg
Accolate
02236606
AZE
0.7675
Zanamivir / Zanamivir
Pwr/Pds. Inh 5mg
Relenza
02240863
GSK
7.3080
Zidovudine / Zidovudine
Liq Inj 100mg
Retrovir
01902644
VIV
0.8675
Zidovudine / Zidovudine
Syr/Sir. Orl 10mg
Retrovir
01902652
VIV
0.1975
Ziprasidone Hydrochloride / Ziprasidone (chlorhydrate de) Cap/Caps Orl 20mg
Zeldox
02298597
PFI
1.7492
Ziprasidone Hydrochloride / Ziprasidone (chlorhydrate de) Cap/Caps Orl 40mg
Zeldox
02298600
PFI
2.0037
Ziprasidone Hydrochloride / Ziprasidone (chlorhydrate de) Cap/Caps Orl 60mg
Zeldox
02298619
PFI
2.0037
Ziprasidone Hydrochloride / Ziprasidone (chlorhydrate de) Cap/Caps Orl 80mg
Zeldox
02298627
PFI
2.0037
Zolmitriptan / Zolmitriptan
Spr Nas 2.5mg
Zomig Nasal Spray
02248992
AZE
14.1500
Zolmitriptan / Zolmitriptan
Spr Nas 5mg
Zomig Nasal Spray
02248993
AZE
14.1500
Effective January 16, 2015
Effectif le 16 janvier 2015
29