Product Details
Xarelto
Rivaroxaban15 mg
Tablet
DIN/PIN/NPN
02378604
Manufacturer
Bayer Inc., Health Care Division
Formulary Listing Date
2012-07-27
Unit Price
2.8700
Amount MOH Pays
0.7175
Coverage Status
General Benefit
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
B01AF01
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02378604 | Xarelto | 2.8700 | 0.7175 |
| 02470500 | Apo-Rivaroxaban | 0.7175 | 0.7175 |
| 02512068 | PMS-Rivaroxaban | 0.7175 | 0.7175 |
| 02472430 | Reddy-Rivaroxaban | 0.7175 | 0.7175 |
| 02482231 | Sandoz Rivaroxaban | 0.7175 | 0.7175 |
| 02483815 | Taro-Rivaroxaban | 0.7175 | 0.7175 |
| 02507218 | Teva-Rivaroxaban | 0.7175 | 0.7175 |
| 02541483 | Rivaroxaban | 0.7175 | 0.7175 |
| 02516306 | Jamp Rivaroxaban | 0.7175 | 0.7175 |
LU Clinical Criteria
NOEAP Criteria
| Therapeutic Class | Reimbursement Criteria |
|---|---|
| Unclassified EAP Drugs | These drugs are not currently listed in the Exceptional Access Program Reimbursement Criteria for Frequently Requested Drugs – August 8, 2023 Edition Physicians may wish to contact the EAP directly by phone at 416-327-8109 or 1-866-811-9893 or by email at EAPFeedback.MOH@ontario.ca to see if an unlisted drug product and/or indication may be considered for EAP funding. |