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Reason for Use code 290 For patients with urinary frequency, urgency or urge incontinence who have: Failed to respond to behavioral techniques AND an adequate trial of oxybutynin with gradual dose escalation has shown to be either ineffective or resulted in unacceptable side effects. NOTE: If after a trial of 2 weeks patients continue to experience similar side effects and no greater efficacy than oxybutynin, continued therapy with this more costly agent should be reassessed. Antimuscarinic agents should be used with caution in the elderly due to potentially serious adverse effects (e.g. confusion, psychosis, acute urinary retention, constipation). Antimuscarinic agents should be avoided in older adults with pre-existing cognitive impairment (e.g. dementia) and those who are already using other drugs with significant anticholinergic effects (e.g. tricyclic antidepressants) in order to avoid a high overall anticholinergic drug burden. Coverage limit: LU Authorization Period: Indefinite

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 ↗)

Act Solifenacin · DIN 02422247 Manufacturer: Actavis Pharma Company; listing date 2015-11-26 Health Canada: Cancelled post market since 2018-04-30 · brand ACT SOLIFENACIN · ATC G04BD08 SOLIFENACIN · form Tablet · route Oral · ingredients SOLIFENACIN SUCCINATE 10 MG · company Actavis pharma company · schedule Prescription

DIN 02422247: Act Solifenacin Raw flags: sec12=Y, sec3=Y Item: 920000639; group id 960; item number 2280; lccId 00218; manufacturer id ACV Source form: Tab; strength: 10mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.3041; ministry $0.3041 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02422247 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=90697

Interchangeable products

Ach-Solifenacin Succinate · DIN 02439352 · $0.3041 Apo-Solifenacin · DIN 02423383 · $0.3041 Auro-Solifenacin · DIN 02446383 · $0.3041 Jamp Solifenacin Succinate · DIN 02428938 · $0.3041 Jamp-Solifenacin · DIN 02424347 · $0.3041 M-Solifenacin Succinate · DIN 02529718 · $0.3041 PMS-Solifenacin · DIN 02417731 · $0.3041 PRZ-Solifenacin · DIN 02493047 · $0.3041 Ran-Solifenacin · DIN 02437996 · $0.3041 Sandoz Solifenacin · DIN 02399040 · $0.3041 Solifenacin · DIN 02458268 · $0.3041 Solifenacin Succinate Tablets · DIN 02448343 · $0.3041 Teva-Solifenacin · DIN 02397919 · $0.3041 Vesicare · DIN 02277271 · $0.3041

Shortage status: not checked (no credentials)

Health Canada lists this DIN as Cancelled post market since 2018-04-30 — choose a marketed DIN from the same-category list.