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

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GLUCAGON

All products: Limited Use (codes 625)

Other products in the same Health Canada class (H04AA) — coverage varies; not interchangeable

  • Glucagon rdna origin (GlucaGen HypoKit): general benefit

Baqsimi · DIN 02492415 · 3mg · Nas Pd Device

Limited Use — Reason for Use code 625 requiredMarketed · checked 2026-09-19
StatusLimited Use — Reason for Use code 625 required
Write on scriptLU code 625 (patient must meet the criteria below)
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.
Ontario Limited Use criteria — code 625
Reason for Use code 625 For the treatment of severe hypoglycemia (SH) reactions in patients with diabetes mellitus who are receiving insulin therapy and are at high risk for SH, when impaired consciousness precludes oral carbohydrate. Coverage limit: LU Authorization Period: 1 year
No interchangeable product listed in the Ontario extract
Baqsimi · DIN 02492415 Manufacturer: Amphastar Pharmaceuticals Inc.; listing date 2022-01-31 Health Canada: Marketed since 2024-09-23 · brand BAQSIMI · ATC H04AA01 GLUCAGON · form Powder · route Nasal · ingredients GLUCAGON 3 MG/CONTAINER · company Amphastar pharmaceuticals, inc. · schedule Ethical
Check this DIN again · Health Canada product record

Baqsimi: Formulary list price $160.5200/unit (unit not stated in source; not the patient's cost)

Ministry pays: $160.5200 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=98243 · Verify on the e-Formulary ↗ (DIN 02492415)

Source record
DIN 02492415: Baqsimi Raw flags: sec12=Y, sec3=Y Item: 920000739; group id 920; item number 2193; lccId 00351; manufacturer id AMP Source form: Nas Pd Device; strength: 3mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $160.5200; ministry $160.5200 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02492415 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=98243
Shortage status: not checked (no credentials)
Other drugs in the same formulary class (92:00 UNCLASSIFIED THERAPEUTIC AGENTS) and how they are covered

Matched class: 92:00 UNCLASSIFIED THERAPEUTIC AGENTS

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: ALENDRONATE & CHOLECALCIFEROL, AZATHIOPRINE, CYCLOSPORINE, GLUCAGON RDNA ORIGIN, LANREOTIDE ACETATE, LEFLUNOMIDE, LEVODOPA & BENSERAZIDE, MYCOPHENOLATE SODIUM Some products covered without a code (check the product listing): ALENDRONATE, ALLOPURINOL, AMANTADINE HCL, BROMOCRIPTINE, CLOPIDOGREL BISULFATE, LEVODOPA & CARBIDOPA, MYCOPHENOLATE MOFETIL, OCTREOTIDE, RISEDRONATE SODIUM, ROPINIROLE, SELEGILINE HCL, TAMSULOSIN HCL 92:00 UNCLASSIFIED THERAPEUTIC AGENTS

GLUCAGON RDNA ORIGIN

· 2 products · General benefit · strengths: 1mg/Vial · Inj Pd-Syr Pk, Inj Pd-Vial Pk

ALENDRONATE

· 28 products · Off-Formulary Interchangeable, not an ODB benefit (4), Listed, not a benefit (1), General benefit (23) · strengths: 5mg, 10mg, 70mg · Tab

ALENDRONATE & CHOLECALCIFEROL

· 6 products · General benefit · strengths: 70mg & 70mcg, 70mg & 140mcg · Tab

ALLOPURINOL

· 10 products · General benefit (6), Listed, not a benefit (4) · strengths: 100mg, 200mg, 300mg · Tab

AMANTADINE HCL

· 5 products · Listed, not a benefit (2), General benefit (3) · strengths: 100mg, 10mg/mL · Cap, O/L

AZATHIOPRINE

· 3 products · General benefit · strengths: 50mg · Tab

BROMOCRIPTINE

· 4 products · Listed, not a benefit (2), General benefit (2) · strengths: 5mg, 2.5mg · Cap, Tab

CLOPIDOGREL BISULFATE

· 19 products · General benefit (16), Off-Formulary Interchangeable, not an ODB benefit (3) · strengths: 75mg, 300mg · Tab

CYCLOSPORINE

· 8 products · General benefit · strengths: 10mg, 25mg, 50mg, 100mg, 100mg/mL · Cap, O/L

LANREOTIDE ACETATE

· 6 products · General benefit · strengths: 60mg/Syr, 90mg/Syr, 120mg/Syr · ER Pref Syr Pk

LEFLUNOMIDE

· 16 products · General benefit · strengths: 10mg, 20mg · Tab

LEVODOPA & BENSERAZIDE

· 3 products · General benefit · strengths: 50mg & 12.5mg, 100mg & 25mg, 200mg & 50mg · Cap Source: formulary-ed43-front-matter.txt Part V; ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26; class 92:00 and 75 more
Full class listing Related classes: 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 BAQSIMI is indicated for the treatment of severe hypoglycemic reactions which may occur in the management of insulin treated patients with diabetes mellitus, when impaired consciousness precludes oral carbohydrates. 1.1 Pediatrics Pediatrics (<18 years of age): BAQSIMI is indicated in children 4 years and above. BAQSIMI has not been studied in pediatric patients less than 4 years of age. The number of pediatric patients (4 to <18 years) included in the clinical trials is limited (n=48) (see WARNINGS AND PRECAUTIONS, Special Populations, DOSAGE AND ADMINISTRATION, ACTION AND CLINICAL PHARMACOLOGY, and CLINICAL TRIALS). 1.2 Geriatrics Geriatrics (≥65 years of age): Clinical studies of BAQSIMI did not include sufficient numbers of subjects aged 65 and over. Limited clinical trial experience with BAQSIMI has not identified differences in responses between the elderly and younger patients (see WARNINGS AND PRECAUTIONS, Special Populations; DOSAGE AND ADMINISTRATION; and ACTION AND CLINICAL PHARMACOLOGY). https://pdf.hres.ca/dpd_pm/00074561.PDF PM date: not printed or not captured Source product: BAQSIMI; DIN 02492415; fetched 2026-09-10 Product monograph posted by Health Canada; excerpt for lookup only.