Product Details
Zavesca
Miglustat100 mg
Capsule
DIN/PIN/NPN
02250519
Manufacturer
Actelion Pharmaceutiques Canada Inc.
Formulary Listing Date
2020-06-30
Unit Price
128.9600
Amount MOH Pays
81.4125
Coverage Status
Off-Formulary Interchangeable Exceptional Access Program Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
A16AX06
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02250519 | Zavesca | 128.9600 | 81.4125 |
| 02456257 | Sandoz Miglustat | 81.4125 | 81.4125 |
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. |