Product Details

Tivicay

Dolutegravir
50 mg
Tablet


DIN/PIN/NPN

02414945

Manufacturer

ViiV Healthcare ULC

Formulary Listing Date

2015-04-30  

Unit Price

23.9840

Amount MOH Pays

17.6525

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 17.6525
02556782 PMS-Dolutegravir 17.6525 17.6525
 

LU Clinical Criteria

NO  

Requirements


EAP Criteria

  NO

Product Monograph

View Monograph