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
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