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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 ↗)

Diclofenac · DIN 02475065 Manufacturer: Pharma Stulln Inc.; listing date 2019-12-20 Health Canada: Marketed since 2019-03-29 · brand DICLOFENAC · ATC S01BC03 DICLOFENAC · form Solution · route Ophthalmic · ingredients DICLOFENAC SODIUM 0.1 %/W/V · company Pharma stulln inc. · schedule Prescription

DIN 02475065: Diclofenac Raw flags: sec3=Y Item: 523600065; group id 622; item number 1589; lccId None; manufacturer id PHS Source form: Oph Sol; strength: 0.1% Recorded listing: General benefit Source prices (unrounded): $1.2397; ministry $1.2397 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02475065 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=96535 Therapeutic Notes (formulary) The prescriber should be aware that diclofenac sodium 0.1% ophthalmic solution products may be preservative-free or preservative-containing. If applicable, the prescriber should choose the most appropriate formulation (preservative-free or preservative containing) for use in the specific clinical situation in which the product was prescribed. Diclofenac sodium 0.1% ophthalmic solution (DIN 02475065) is in a unit dose container of 0.3mL and it is preservative-free. Its Drug Benefit Price is displayed on a per mL basis. Dispensers must ensure that the unit of reimbursement for this product is accurate in the submitted claims. (For example, when dispensing a package of 10 x 0.3mL containers, a unit of 3 must be selected in the Health Network System claim to reflect that 3mL is being dispensed.)

Interchangeable products

Apo-Diclofenac Ophthalmic · DIN 02441020 · $1.2397 Jamp Diclofenac · DIN 02534525 · $1.2397 Mint-Diclofenac · DIN 02475197 · $1.2397 Sandoz Diclofenac Ophtha · DIN 02454807 · $1.2397 Voltaren Ophtha · DIN 01940414 · $1.2397

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