Product Details
GLN-Ursodiol
Ursodiol250 mg
Tablet
DIN/PIN/NPN
02426900
Manufacturer
Glenmark Pharmaceuticals Canada Inc.
Formulary Listing Date
2016-06-29
Unit Price
0.3818
Amount MOH Pays
0.3818
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 |
|---|---|---|---|
| 02238984 | Urso | NA | NA |
| 02273497 | PMS-Ursodiol C | 0.3818 | 0.3818 |
| 02472392 | Jamp-Ursodiol | 0.3818 | 0.3818 |
| 02426900 | GLN-Ursodiol | 0.3818 | 0.3818 |
| 02505363 | AG-Ursodiol | 0.3818 | 0.3818 |
| 02515520 | Ursodiol C | 0.3818 | 0.3818 |
| 02544032 | NRA-Ursodiol | 0.3818 | 0.3818 |
LU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 273 | Indefinite | For the treatment of primary biliary cirrhosis. |
| 534 | 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. |