Product Details

Apo-Varenicline

Varenicline Tartrate
1 mg
Tablet


DIN/PIN/NPN

02419890

Manufacturer

Apotex Inc.

Formulary Listing Date

2018-10-31  

Unit Price

0.4618

Amount MOH Pays

0.4618

Coverage Status

Limited Use Product

ODB Formulary Therapeutic Classification

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

View Monograph