Product Details

GLN-Ursodiol

Ursodiol
500 mg
Tablet


DIN/PIN/NPN

02426919

Manufacturer

Glenmark Pharmaceuticals Canada Inc.

Formulary Listing Date

2016-06-29  

Unit Price

0.7242

Amount MOH Pays

0.7242

Coverage Status

Limited Use Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

A05AA02

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02245894 Urso DS 3.1751 0.7242
02273500 PMS-Ursodiol C 0.7242 0.7242
02472406 Jamp-Ursodiol 0.7242 0.7242
02426919 GLN-Ursodiol 0.7242 0.7242
02505371 AG-Ursodiol 0.7242 0.7242
02515539 Ursodiol C 0.7242 0.7242
02544024 NRA-Ursodiol 0.7242 0.7242
 

LU Clinical Criteria

LU Code Auth. Period Clinical Criteria
273 Indefinite

For the treatment of primary biliary cirrhosis.

386 Indefinite

For the treatment of primary sclerosing cholangitis.

 

EAP 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.

Product Monograph

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