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Ontario coverage, price, criteria word for word, Health Canada status and shortages for one product

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MODAFINIL

All products: not a benefit

Other products in the same Health Canada class (N06BA) — coverage varies; not interchangeable

  • Dextroamphetamine (Dexedrine Spansules): general benefit
  • Lisdexamfetamine (Vyvanse): general benefit, Not a benefit
  • Methylphenidate (Foquest): general benefit, Not a benefit
  • Mixed salt amphetamine (Adderall XR): general benefit

Mar-Modafinil · DIN 02432560 · 100mg · tablet

Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-02
StatusOff-Formulary Interchangeable, not an ODB benefit
Write on scriptnot a benefit; no Exceptional Access criteria on record; see alternatives
Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.

Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. Current criteria in SADIE

Coverage criteria
Exceptional Access criteria on record are for Brand(s): Alertec; DOSAGE FORM/ STRENGTH: 100 mg tablet — not this product; no criteria on record for this product in this block. Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive): Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange Modafinil Brand(s): Alertec DOSAGE FORM/ STRENGTH: 100 mg tablet For the symptomatic treatment of excessive daytime sleepiness in patients with narcolepsy who have demonstrated a lack of response to or an inability to tolerate dextroamphetamine AND methylphenidate. Note: See also Multiple Sclerosis Drugs Duration of Approval: 2 years (Initials and Renewals) EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 104, record 63, corpus 2025-01-01; name match only, not an eligibility decision Exceptional Access criteria on record are for Brand(s): Alertec; DOSAGE FORM/ STRENGTH: 100 mg tablet — not this product; no criteria on record for this product in this block. Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive): Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange Modafinil Brand(s): Alertec DOSAGE FORM/ STRENGTH: 100 mg tablet For the treatment of fatigue in patients with multiple sclerosis who have demonstrated a lack of response to or an inability to tolerate amantadine. Note: See additional indications and criteria under “CNS” drugs Duration of Approval: Lifetime EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 231, record 136, corpus 2025-01-01; name match only, not an eligibility decision
Brand vs generic price
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 ↗)
1 brand, same coverage
Mar-Modafinil · DIN 02432560 Manufacturer: Marcan Pharmaceuticals Inc.; listing date 2015-01-28 Health Canada: Marketed since 2015-01-09 · brand MAR-MODAFINIL · ATC N06BA07 MODAFINIL · form Tablet · route Oral · ingredients MODAFINIL 100 MG · company Marcan pharmaceuticals inc · schedule Prescription
Check this DIN again · Health Canada product record

Mar-Modafinil: Formulary list price $0.9293/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.9293 per source unit.

Source explanation: The formulary price is what ODB pays; the cash price at the counter is set by the pharmacy.

Formulary data: Ontario extract of Aug 26, 2026 · Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=91701 · Verify on the e-Formulary ↗ (DIN 02432560)

Source record
The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02432560). DIN 02432560: Mar-Modafinil Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y Item: 282000040; group id 518; item number 1405; lccId None; manufacturer id MAR Source form: Tab; strength: 100mg Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed) Source prices (unrounded): $0.9293; ministry $0.9293 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02432560 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=91701
Interchangeable products
Alertec · DIN 02239665 · $0.9293 Apo-Modafinil · DIN 02285398 · $0.9293 Auro-Modafinil · DIN 02430487 · $0.9293 Jamp Modafinil · DIN 02503727 · $0.9293 Modafinil · DIN 02530244 · $0.9293 Teva-Modafinil · DIN 02420260 · $0.9293
Shortage status: resolved shortage (ended 2018-10-18); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02432560
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Other drugs in the same formulary class (28:20 C.N.S. Stimulants) and how they are covered

Matched class: 28:20 C.N.S. Stimulants

Drug-class inventory only. Lists recorded Ontario formulary products, not every Canadian medication; does not recommend treatment. Covered without a code on the Ontario formulary: DEXTROAMPHETAMINE SULFATE, MIXED SALT AMPHETAMINE Some products covered without a code (check the product listing): LISDEXAMFETAMINE DIMESYLATE, METHYLPHENIDATE HCL 28:20 C.N.S. Stimulants

DEXTROAMPHETAMINE SULFATE

· 6 products · General benefit · strengths: 10mg, 15mg, 5mg · SR Cap, Tab

LISDEXAMFETAMINE DIMESYLATE

· 60 products · General benefit (54), Off-Formulary Interchangeable, not an ODB benefit (6) · strengths: 10mg, 20mg, 30mg, 40mg, 50mg, 60mg, 70mg · Cap, Chew Tab

METHYLPHENIDATE HCL

· 47 products · General benefit (43), Listed, not a benefit (1), Off-Formulary Interchangeable, not an ODB benefit (3) · strengths: 25mg, 35mg, 45mg, 55mg, 70mg, 85mg, 100mg, 10mg, 15mg, 20mg, 30mg, 40mg, 50mg, 60mg, 80mg, 18mg, 27mg, 36mg, 54mg · CR Cap, ER Cap, ER Tab, SR Tab, Tab

MIXED SALT AMPHETAMINE

· 24 products · General benefit · strengths: 5mg, 10mg, 15mg, 20mg, 25mg, 30mg · ER Cap Source: formulary-ed43-front-matter.txt Part V; ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26; class 28:20
Full class listing Related classes: 28:08 Analgesics, 28:10 Opiate Antagonists, 28:12 Anticonvulsants, 28:16 Psychotherapeutic Agents, 28:24 Sedatives and Hypnotics, 28:36 Antiparkinsonian Agents, 28:92 Miscellaneous Central Nervous System Drugs Same formulary class, not same indication: class membership alone does not establish equivalent uses.
What the Health Canada label says it is for
1 INDICATIONS ALERTEC (modafinil) is indicated for: • The symptomatic treatment of excessive sleepiness in adult patients with narcolepsy. In narcolepsy, ALERTEC has no significant effect on cataplexy. • The symptomatic treatment of excessive sleepiness in adult patients with obstructive sleep apnea (OSA). In OSA, ALERTEC is indicated as an adjunct to successful standard treatment(s) for the underlying obstruction, when excessive sleepiness persists. If continuous positive airway pressure (CPAP) is the treatment of choice for a patient with OSA, a maximal effort to treat with CPAP for an adequate period of time should be made prior to initiating ALERTEC. If ALERTEC is used adjunctively with CPAP, the encouragement of and periodic assessment of CPAP compliance is necessary. • The symptomatic treatment of excessive sleepiness in adult patients with circadian rhythm sleep disorder, shift work type (shift work disorder) (SWD). In SWD, ALERTEC (modafinil) is indicated for the symptomatic treatment of excessive sleepiness (as confirmed b… https://pdf.hres.ca/dpd_pm/00085569.PDF PM date: JUL 23, 2026 Source product: ALERTEC; DIN 02239665; fetched 2026-09-10 Product monograph posted by Health Canada; excerpt for lookup only.

Prepare an Exceptional Access request

SADIE has its own form for many drugs; this checklist prepares the answers; the ministry decides. Open SADIE

Use this text in SADIE’s free-text fields or read from it on a Telephone Request Service call. Review marks do not indicate eligibility. Evidence stays in this page until you copy it; nothing entered here is sent or saved. Do not enter patient identifiers.

EAP Telephone Request Service: The TRS can be accessed by calling toll-free at 1-866-811-9893 or 416-327-8109 (Toronto area) between 8:30 a.m. and 5:00 p.m. Monday through Friday (except holidays) and selecting the TRS option. Source; updated September 15, 2026

EAP fax: In Ontario: 1-866-811-9908 or 416-327-7526 (Toronto area). Outside Ontario: 1-833-905-4260. Source; updated September 15, 2026

Posted turnaround and Telephone Request Service scope
Turnaround times The Exceptional Access Program receives between 250 and 500 requests a day. Requests are categorized in order of priority based on how quickly a drug is needed, the type of drug, and the condition for which the drug is being used. Turnaround times begin on the business day on which the EAP receives a complete request from a physician or nurse practitioner. You may have to wait longer if the request is missing information or supporting documents required by the EAP criteria, if a request requires external review, or if documents are sent by fax or mail instead of submitted via SADIE. EAP Weekly Progress Report Date: September 15, 2026 Processing categories and examples | Target | Current | Priority 1 — for drugs such as antibiotics, cancer medications, and initial requests for pain medications | 3 business days | 2 business day | Priority 2 — for antiviral drugs to treat HIV, drugs for multiple sclerosis, and pulmonary hypertension | 5 business days | 3 business days | Biologics — for biologic drugs to treat rheumatoid arthritis, psoriatic arthritis, ulcerative colitis and Crohn’s disease | 10 business days | 4 business days | Chronic — for drugs used for chronic conditions such as migraines, chronic pain, Ménière's disease and symptoms of Parkinson’s disease. | 4 to 6 weeks | 11 business days |
For selected drugs, the Telephone Request Service is available to authorized prescribers or their delegates. In most cases, the funding decision is provided by the end of the call and processed within one business day.
Source; updated September 15, 2026

Modafinil (Alertec)

Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. Current criteria in SADIE

Prepare answers: See the ministry wording below; no separate indication heading is held.

Ministry criteria corpus 2025-01-01; page 104

Modafinil Brand(s): Alertec DOSAGE FORM/ STRENGTH: 100 mg tablet
For the symptomatic treatment of excessive daytime sleepiness in patients with narcolepsy who have demonstrated a lack of response to or an inability to tolerate dextroamphetamine AND methylphenidate.
Note: See also Multiple Sclerosis Drugs
Duration of Approval: 2 years (Initials and Renewals)

Prepared from the ministry's published criteria; eligibility is decided by the Exceptional Access Program.

Modafinil (Alertec)

Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. Current criteria in SADIE

Prepare answers: For the treatment of fatigue in patients with multiple sclerosis who have demonstrated a lack of response to or an inability to tolerate amantadine.

Ministry criteria corpus 2025-01-01; page 231

Modafinil Brand(s): Alertec DOSAGE FORM/ STRENGTH: 100 mg tablet
For the treatment of fatigue in patients with multiple sclerosis who have demonstrated a lack of response to or an inability to tolerate amantadine.
Note: See additional indications and criteria under “CNS” drugs
Duration of Approval: Lifetime

Prepared from the ministry's published criteria; eligibility is decided by the Exceptional Access Program.

Other review policies

For Mar-Modafinil: no applicable EAP criteria are held and no ODB benefit is established. These policies do not establish coverage.

For rare, immediately life-, limb- or organ-threatening circumstances, the Compassionate Review Policy may consider an unfunded drug or indication, subject to its criteria and without bypassing the drug review process. Compassionate Review Policy

Compassionate Review Policy: source quote
Where there are rare clinical circumstances in immediately life, limb, or organ-threatening conditions, the Executive Officer will also consider requests for drugs or indications in situations where there has not been a decision by the Executive Officer to provide funding of the drug or indication as part of the Ontario Drug Benefit program (and the EAP), and the drug or indication requested would not circumvent the established review process for new drugs or indications as part of the drug submission process for listing within the Ontario Drug Benefit program. Requests must meet the criteria for the Compassionate Review Policy.

Ontario source; updated September 15, 2026

For cancer drugs, Case-by-Case Review considers rare, immediately life-threatening circumstances when no satisfactory funded treatment exists; its criteria and application process apply. Case-by-Case Review (cancer drugs)

Case-by-Case Review (cancer drugs): source quote
Note: Requests for cancer drugs are considered under the Case-by-Case Review Program (CBCRP) which is administered by Ontario Health (Cancer Care Ontario) on behalf of the Ministry of Health. The CBCRP considers funding requests for drugs (both oral therapies and injectable drugs) for the treatment of cancer in patients who have a rare clinical circumstance that is immediately life-threatening (death is likely within a matter of months) and who require treatment with an unfunded drug, because there is no other satisfactory and funded treatment. Please refer to the Ontario Health website for information on the application process, FAQs, eligibility criteria and program policies.

Ontario source; updated September 15, 2026