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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 ↗)

Diltiazem CD · DIN 02400448 Manufacturer: Sanis Health Inc.; listing date 2022-07-29 Daily cost (source): $0.4824 Health Canada: Marketed since 2022-04-20 · brand DILTIAZEM CD · ATC C08DB01 DILTIAZEM · form Capsule (controlled-delivery) · route Oral · ingredients DILTIAZEM HYDROCHLORIDE 180 MG · company Sanis health inc · schedule Prescription

DIN 02400448: Diltiazem CD Raw flags: chronicUseMed=Y, sec3=Y Item: 240400123; group id 280; item number 0589; lccId None; manufacturer id SAI Source form: LA Cap; strength: 180mg Recorded listing: General benefit; chronic-use medication (100-day supply rule, dispensing-fee limit) Source prices (unrounded): $0.4824; ministry $0.4824 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02400448 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=88524

Interchangeable products

Apo-Diltiaz CD · DIN 02230998 · $0.4824 Cardizem CD · DIN 02097257 · $0.4824 Co Diltiazem CD · DIN 02370638 · $0.4824 Diltiazem CD · DIN 02446006 · $0.4824 Jamp Diltiazem CD · DIN 02528045 · $0.4824 M-Diltiazem CD · DIN 02546094 · $0.4824 Mar-Diltiazem CD · DIN 02484072 · $0.4824 Sandoz Diltiazem CD · DIN 02243339 · $0.4824 Teva-Diltazem CD · DIN 02242539 · $0.4824

Shortage status: resolved shortage (ended 2017-08-03); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02400448

Shortage record checked 2026-09-13T08:10:21.292534+00:00