Product Details
Humatrope
Somatropin12 mg/Cartridge
Powder for Solution for Injection
12-mg Cartridge Pack + 3.15-mL Diluent (With Preservative)
DIN/PIN/NPN
02243078
Manufacturer
Eli Lilly Canada Inc.
Formulary Listing Date
2023-04-28
Unit Price
630.5000
Amount MOH Pays
630.5000
Coverage Status
Exceptional Access Program Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
H01AC01
Interchangeable Products
NOLU 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. |