New Brunswick Drug Plans Formulary - Government of New ...
New Brunswick Drug Plans Formulary
December 2022
Administered by Medavie Blue Cross on Behalf of the Government of New Brunswick
TABLE OF CONTENTS
Page Introduction.............................................................................................................................................I New Brunswick Drug Plans.....................................................................................................................I Exclusions.............................................................................................................................................II Legend..................................................................................................................................................III
Anatomical Therapeutic Chemical (ATC) Classification of Drugs
A
Alimentary Tract and Metabolism
1
B
Blood and Blood Forming Organs
23
C
Cardiovascular System
33
D
Dermatologicals
84
G
Genito Urinary System and Sex Hormones
92
H
Systemic Hormonal Preparations excluding Sex Hormones
104
J
Antiinfectives for Systemic Use
111
L
Antineoplastic and Immunomodulating Agents
136
M
Musculo-Skeletal System
161
N
Nervous System
171
P
Antiparasitic Products, Insecticides and Repellants
240
R
Respiratory System
241
S
Sensory Organs
252
V
Various
259
Appendices
I-A I-B I-C I-D II III IV
Abbreviations of Dosage forms.....................................................................A - 1 Abbreviations of Routes................................................................................A - 4 Abbreviations of Units...................................................................................A - 6 Abbreviations of Manufacturers' Names.......................................................A - 8 Extemporaneous Preparations...................................................................A - 10 Special Authorization Criteria.....................................................................A - 12 Provisional Benefits..................................................................................A - 115
New Brunswick Drug Plans Formulary
Introduction
The Government of New Brunswick provides prescription drug coverage to eligible New Brunswick residents through the New Brunswick Prescription Drug Program, the New Brunswick Drug Plan and other government sponsored plans (collectively known as the New Brunswick Drug Plans). See below for a complete list of plans.
The New Brunswick Drug Plans Formulary is a list of the drugs which are eligible benefits under the NB Drug Plans. The Formulary is updated monthly and all drugs considered for listing as benefits must be reviewed according to the Drug Review Process.
Most drugs listed in the Formulary are "regular" benefits which are reimbursed with no criteria or prior approval requirements. Some drugs are special authorization benefits and have specific criteria that must be met before they are approved for reimbursement (see Formulary Appendix III). The process and forms for submitting special authorization requests is posted on the NB Drug Plans website. Certain drug products are not eligible benefits and are identified on the exclusion list.
The New Brunswick Drug Plans
Plan
The New Brunswick Prescription Drug Program (NBPDP) Seniors Correctional Services Social Development Clients Adults in Licensed Residential Facilities (Special Care Homes) Children in Care of the Minister of Social Development and Special Needs Children Nursing Home Residents Cystic Fibrosis Growth Hormone Deficiency HIV/AIDS Multiple Sclerosis Organ Transplant
The New Brunswick Drug Plan
Other Government Sponsored Plans Pharmacy Administered Publicly Funded Vaccines, Testing, and Drug Therapies Program Tuberculosis Extra-Mural Program Clients Medical Abortion Program
Group Code
A C F E G V B T U H R
D
I P W J
Details regarding the New Brunswick Drug Plans are available on the Government of New Brunswick's website.
December 8, 2022
I
Exclusions
The following classes of products, except those specifically listed on the Formulary, are excluded as benefits under the New Brunswick Drug Plans.
- Drugs not authorized for sale and use in Canada (e.g. drugs obtained through Health Canada's Special Access Program, experimental or investigational drugs)
- Non-prescription drugs - Natural health products (e.g. vitamins and minerals, herbal remedies, probiotics, homeopathic
medicines, traditional medicines) - Cannabis or cannabis products - Nutritional supplements and food products - Weight loss products - Products for the treatment of erectile/sexual dysfunction, or infertility - Drugs for the prevention of travel acquired diseases - Products for esthetic or cosmetic purposes - Soaps, cleansers, shampoos, antiseptics, or disinfectants - Diagnostic agents and point-of-care testing kits - Medical supplies, devices and equipment (e.g. prostheses, first aid supplies, ostomy supplies,
diabetes test strips and syringes, etc.) - Vaccines
December 8, 2022
II
Legend
M011
ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS
M01A2 ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS, NON-STEROIDS
M01AE 3 PROPIONIC ACID DERIVATIVES
M01AE02 4 NAPROXEN ECT 5 Orl 5 250mg 5
6
Naproxen EC
7
02350785
8
SAS
Teva-Naprox EC 02243312 TEV
9
ADEFGVW ADEFGVW
ECT Orl 375mg
Naprosyn E
Apo-Naproxen EC
Naproxen EC
Mylan-Naproxen EC
10 pms-Naproxen EC (Disc/non disp Mar 4/19)
Teva-Naprox EC
02162415 02246700 02350793 02243432 02294702 02243313
MTP APX SAS MYL PMS TEV
ADEFGVW ADEFGVW ADEFGVW ADEFGVW ADEFGVW ADEFGVW
1 Second level ATC, therapeutic subgroup 2 Third level ATC, pharmacological subgroup 3 Fourth level ATC, chemical subgroup 4 Fifth level ATC, chemical substance 5 Dosage form, route and strength. Strength represents the amount of ingredients present in a solid dosage
form (tablet) or in one gram or one millilitre of a product (cream, liquid, etc.) 6 Brand or manufacturers' product name approved by Health Canada. 7 Drug Identification Number (DIN) 8 Manufacturers' identification code. See Appendix I-D for details. 9 Drug plans for which the product is a benefit. See page II for details. Please note that products marked (SA)
are only eligible for coverage under NB Drug Plans through special authorization. 10 Manufacturer has discontinued this product. It will be deleted from the Formulary on the date indicated.
December 8, 2022
III
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