Product Details

Lantus-(Vial)

Insulin Glargine
100 U/mL
Solution for Injection
10-mL Vial Pack

DIN/PIN/NPN

02245689

Manufacturer

Sanofi Aventis Pharma

Formulary Listing Date

2008-12-03  

Unit Price

61.6900

Amount MOH Pays

61.6900

Coverage Status

Limited Use Product Insulin or Oral Hypoglycemic Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

A10AE04

Interchangeable Products

NO  

LU Clinical Criteria

LU Code Auth. Period Clinical Criteria
644 1 year

Patient requires insulin therapy and is unable to use the insulin pen.
 

EAP Criteria

NO

Product Monograph

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