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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 ↗)

Sandoz Apixaban SDZ · DIN 02489228 Manufacturer: Sandoz Canada Inc.; listing date 2022-11-30 Health Canada: Marketed since 2022-09-22 · brand SANDOZ APIXABAN SDZ · ATC B01AF02 APIXABAN · form Tablet · route Oral · ingredients APIXABAN 2.5 MG · company Sandoz canada incorporated · schedule Prescription

DIN 02489228: Sandoz Apixaban SDZ Raw flags: sec3=Y Item: 201200089; group id 251; item number 0443; lccId None; manufacturer id SDZ Source form: Tab; strength: 2.5mg Recorded listing: General benefit Source prices (unrounded): $0.4084; ministry $0.4084 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02489228 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=97930

Interchangeable products

Ach-Apixaban · DIN 02487713 · $0.4084 Apixaban · DIN 02530708 · $0.4084 Apixaban · DIN 02548879 · $0.4084 Apo-Apixaban · DIN 02487381 · $0.4084 Auro-Apixaban · DIN 02486806 · $0.4084 Bio-Apixaban · DIN 02527979 · $0.4084 Eliquis · DIN 02377233 · $0.4084 Jamp Apixaban · DIN 02528924 · $0.4084 M-Apixaban · DIN 02529009 · $0.4084 Mar-Apixaban · DIN 02492369 · $0.4084 Mint-Apixaban · DIN 02495430 · $0.4084 NRA-Apixaban · DIN 02526050 · $0.4084 NRA-Apixaban Tablets · DIN 02546884 · $0.4084 Nat-Apixaban · DIN 02492814 · $0.4084 Riva-Apixaban · DIN 02525518 · $0.4084 Sandoz Apixaban Tablet · DIN 02487519 · $0.4084 Taro-Apixaban · DIN 02510464 · $0.4084 Teva-Apixaban · DIN 02484994 · $0.4084

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