Product Details
Rybelsus
Semaglutide3 mg
Tablet
DIN/PIN/NPN
02497581
Manufacturer
Novo Nordisk Canada Inc.
Formulary Listing Date
2023-12-29
Unit Price
7.2030
Amount MOH Pays
7.2030
Coverage Status
Limited Use Product Insulin or Oral Hypoglycemic Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
A10BJ06
Interchangeable Products
NOLU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 662 | Indefinite | For the treatment of adult patients with type 2 diabetes when adequate glycemic control is not achieved on the maximum tolerated dose of metformin or where metformin is contraindicated or inappropriate. Semaglutide is not funded in combination with another glucagon-like peptide-1 receptor agonist (GLP-1 RA) or dipeptidyl peptidase-4 (DPP-4) inhibitor. Oral semaglutide is not funded in combination with injectable semaglutide. Coverage is only provided for one dosage format. Maximum reimbursed dose: 3mg once daily |