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Reason for Use code 215 For the treatment of emesis in cancer patients receiving highly emetogenic chemotherapy. Coverage limit: LU Authorization Period: 1 year Reason for Use code 216 For patients receiving intravenous chemotherapy or radiation therapy who have not experienced adequate control with other available anti-emetics. Coverage limit: LU Authorization Period: 1 year Reason for Use code 217 For patients receiving intravenous chemotherapy or radiation therapy who experience intolerable side effects with other anti-emetics. Coverage limit: LU Authorization Period: 1 year Reason for Use code 218 For the treatment of emesis in patients receiving radiation therapy which consists of single fraction treatment to the abdominal cavity, hemi-body irradiation and total body irradiation. Coverage limit: The therapeutic value of Ondansetron Hydrochloride more than 24 hours after the last dose of chemotherapy is unproven. Coverage limit: LU Authorization Period: 1 year Reason for Use code 454 For the treatment of emesis in cancer patients receiving moderately emetogenic chemotherapy (MEC) regimens. Coverage limit: LU Authorization Period: 1 year Reason for Use code 696 For the treatment of emesis in patients receiving palliative care who are refractory to, intolerant to, or have a contraindication to at least two other anti-emetics. Note: Pharmacists and prescribers should be informed of and stay current with a drug product's official indications in accordance with Health Canada's approved product monograph. Some aspects of the above criteria may differ from the official indications as described in the product monograph for the ondansetron product. The Executive Officer's funding of drug products is informed by advice from experts that consider evidence regarding the safety, clinical efficacy, and cost-effectiveness of drug products. Coverage limit: LU Authorization Period: 1 year

Lowest DBP recovery rule under medically necessary no-substitution claims: 6.2 Medically Necessary "No Substitution" Claims The Side Effect Reporting Form will not have to be renewed. However, the pharmacy must maintain a copy of the prescription that contains a direction that there be no substitution and the required Health Canada Side Effect Reporting Form (completed and signed by the prescriber). The prescriber must write “No Substitution” or “No Sub” on renewal or subsequent new written prescriptions, and indicate “No Substitution” on subsequent new oral prescriptions. The dispenser will be reimbursed the DBP plus a mark-up and the lesser of the posted usual and customary fee or the ODB dispensing fee minus the applicable ODB co-payment amount. Where a completed Side Effect Reporting Form is not available at the pharmacy during an inspection, the difference between the cost of the higher-cost product and the lowest DBP listed for the interchangeable category will be recovered. (ontario.ca, Revision #17; 2026-08-03 ↗) 6.2 Medically Necessary "No Substitution" Claims The Ministry will provide reimbursement of a higher-cost interchangeable product in medically necessary circumstances where a patient has experienced a significant adverse reaction with two (2) lower-cost interchangeable drug products, where available. When a prescriber identifies a patient for which it is medically necessary that a higher cost interchangeable product be provided, the prescriber must: • Complete, sign and forward to the pharmacist a copy of the Health Canada side effect reporting form for each lower-cost interchangeable drug product trialed (Side Effect Reporting Form[s]); and • Write “No Substitution” or “No Sub” on a written prescription or indicate “No Substitution” to the pharmacist in the case of a verbal prescription. The prescriber should keep a copy of the completed form in the patient’s record for future use and reference. In the case of a written prescription, when the pharmacist or dispensing physician receives a prescription with the written notation “No Substitution” or “No Sub”, reimbursement will be provided for the higher-cost interchangeable product only if the prescription is accompanied by a completed Health Canada Side Effect Reporting Form for each of the lower-cost interchangeable drug products trialed. This form must be completely filled out noting the details of the adverse reaction and signed by the prescriber. In the case of a verbal prescription, the prescriber must satisfy the operator of the pharmacy or dispensing physician that a completed Health Canada Side Effect Reporting Form for each of the lower-cost interchangeable drug products trialed has been completed and signed by the prescriber. A written record of this verbal prescription and the completed Health Canada Side Effect Reporting Form must be received by the pharmacy prior to claim submission. Upon receipt, the pharmacist must: • Fax, submit online or mail the completed and signed form to Health Canada’s Canada Vigilance Program; and • Retain his or her copy of the completed and signed Side Effect Reporting Form. (ontario.ca, Revision #17; 2026-08-03 ↗)

Jamp-Ondansetron · DIN 02313685 Manufacturer: Jamp Pharma Corporation; listing date 2009-01-30 Health Canada: Marketed since 2008-09-26 · brand JAMP-ONDANSETRON · ATC A04AA01 ONDANSETRON · form Tablet · route Oral · ingredients ONDANSETRON (ONDANSETRON HYDROCHLORIDE) 4 MG · company Jamp pharma corporation · schedule Prescription

DIN 02313685: Jamp-Ondansetron Raw flags: sec12=Y, sec3=Y Item: 562200022; group id 671; item number 1665; lccId 00102; manufacturer id JPC Source form: Tab; strength: 4mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $3.3495; ministry $2.5450 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02313685 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=79919

Interchangeable products

Accel-Ondansetron · DIN 02478927 · $2.5450 Apo-Ondansetron · DIN 02288184 · $2.5450 Mar-Ondansetron · DIN 02371731 · $2.5450 Mint-Ondansetron · DIN 02305259 · $2.5450 Mylan-Ondansetron · DIN 02297868 · $2.5450 Nat-Ondansetron · DIN 02417839 · $2.5450 Ondansetron · DIN 02421402 · $2.5450 Ondansetron · DIN 02541424 · $2.5450 PMS-Ondansetron · DIN 02258188 · $2.5450 Sandoz Ondansetron · DIN 02274310 · $2.5450 Septa-Ondansetron · DIN 02376091 · $2.5450 Teva-Ondansetron · DIN 02296349 · $2.5450 Zofran · DIN 02213567 · not recorded

Shortage status: not checked (no credentials)