Product Details
pH 12 Sterile Diluent for Flolan
Glycine + Sodium Chloride + Water94 mg + 73.3 mg + 50 mL/Vial
Solution for Injection
50-mL Plastic Vial
DIN/PIN/NPN
02443651
Manufacturer
GlaxoSmithKline Inc., GlaxoSmithKline Consumer Health Care
Formulary Listing Date
2023-04-28
Unit Price
11.9150
Amount MOH Pays
11.9150
Coverage Status
Exceptional Access Program Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
V07AB
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. |