Product Details
Salagen
Pilocarpine HCl5 mg
Tablet
DIN/PIN/NPN
02216345
Manufacturer
Amdipharm Limited
Formulary Listing Date
2013-05-31
Unit Price
NA
Amount MOH Pays
NA
Coverage Status
Off-Formulary Interchangeable Exceptional Access Program Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
N07AX01
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02216345 | Salagen | NA | NA |
| 02496119 | M-Pilocarpine | 1.1708 | 1.1708 |
| 02509571 | Jamp Pilocarpine | 1.1708 | 1.1708 |
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. |