Product Details
Mycamine
Micafungin Sodium100 mg/Vial
Powder for Injection
10-mL Vial Pack
DIN/PIN/NPN
02311054
Manufacturer
Astellas Pharma Canada Inc.
Formulary Listing Date
2023-09-28
Unit Price
NA
Amount MOH Pays
NA
Coverage Status
Off-Formulary Interchangeable Exceptional Access Program Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
J02AX05
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02311054 | Mycamine | NA | NA |
| 02524961 | Micafungin Sodium for Injection | 186.2000 | 186.2000 |
LU Clinical Criteria
NOEAP Criteria
| Therapeutic Class | Reimbursement Criteria |
|---|---|
| Unclassified EAP Drugs | These drugs are not currently listed in the Exceptional Access Program Reimbursement Criteria for Frequently Requested Drugs – August 8, 2023 Edition Physicians may wish to contact the EAP directly by phone at 416-327-8109 or 1-866-811-9893 or by email at EAPFeedback.MOH@ontario.ca to see if an unlisted drug product and/or indication may be considered for EAP funding. |