Product Details
Delatestryl
Testosterone Enanthate1000 mg/5 mL
Oily Solution for Injection
5-mL Vial Pack
DIN/PIN/NPN
00029246
Manufacturer
Valeant Canada Ltd.
Formulary Listing Date
1996-10-01
Unit Price
NA
Amount MOH Pays
NA
Coverage Status
Not a Benefit
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
G03BA03
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 00029246 | Delatestryl | NA | NA |
| 02536315 | Testosterone Enanthate Injection, USP | 35.5943 | 35.5943 |
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. |