Product Details
PMS-Dolutegravir
Dolutegravir50 mg
Tablet
DIN/PIN/NPN
02556782
Manufacturer
Pharmascience Inc.
Formulary Listing Date
2026-06-30
Unit Price
12.9452
Amount MOH Pays
12.9452
Coverage Status
General Benefit
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
J05AJ03
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02414945 | Tivicay | 23.9840 | 12.9452 |
| 02556782 | PMS-Dolutegravir | 12.9452 | 12.9452 |
LU Clinical Criteria
NORequirements