Product Details

NRA-Varenicline

Varenicline Tartrate
1 mg
Tablet

DIN/PIN/NPN

02542978

Manufacturer

Nora Pharma

Formulary Listing Date

2024-08-30

Unit Price

0.4618

Amount MOH Pays

0.4618

Coverage Status

Limited Use Product

ODB Formulary Therapeutic Classification

92:00:00 Unclassified Therapeutic Agents

Therapeutic Note

NO

ATC Code

N07BA03

Interchangeable Products

DIN/ PIN/ NPN	Brand name	Unit Price	Amount MOH pays
02426234	Teva-Varenicline	0.4618	0.4618
02291185	Champix	1.8470	0.4618
02419890	Apo-Varenicline	0.4618	0.4618
02542978	NRA-Varenicline	0.4618	0.4618

LU Clinical Criteria

LU Code	Auth. Period	Clinical Criteria
423	12 weeks	For smoking-cessation treatment in adults, in conjunction with smoking-cessation counseling. Network Note: Limited to 12 weeks (168 tablets) of reimbursement per 365 days per patient

EAP Criteria

NO

Product Monograph