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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 ↗)

Sitagliptin · DIN 02529033 Manufacturer: Sivem Pharmaceuticals ULC; listing date 2023-04-28 Health Canada: Marketed since 2023-01-26 · brand SITAGLIPTIN · ATC A10BH01 SITAGLIPTIN · form Tablet · route Oral · ingredients SITAGLIPTIN (SITAGLIPTIN PHOSPHATE MONOHYDRATE) 25 MG · company Sivem pharmaceuticals ulc · schedule Prescription

DIN 02529033: Sitagliptin Raw flags: chronicUseMed=Y, insOH=Y, sec3=Y Item: 682002046; group id 756; item number 1854; lccId None; manufacturer id SIV Source form: Tab; strength: 25mg Recorded listing: General benefit; chronic-use medication (100-day supply rule, dispensing-fee limit); diabetes medication flag Source prices (unrounded): $0.8197; ministry $0.8197 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02529033 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=101823 Therapeutic Notes (formulary) Treatment of Type 2 diabetes in patients on maximally tolerated doses of metformin who have: . Inadequate glycemic control (defined as HbA1c greater than 0.07) and intolerance or contraindication to a sulfonylurea; OR . Inadequate glycemic control (HbA1c greater than 0.07) and on maximal doses of sulfonylurea and for whom insulin is not an option.

Interchangeable products

Ach-Sitagliptin · DIN 02512475 · $0.8197 Apo-Sitagliptin · DIN 02428261 · $0.8197 Apo-Sitagliptin Malate · DIN 02508656 · $0.8197 Auro-Sitagliptin · DIN 02529866 · $0.8197 Jamp Sitagliptin · DIN 02534134 · $0.8197 Januvia · DIN 02388839 · $0.8197 M-Sitagliptin · DIN 02534983 · $0.8197 Mint-Sitagliptin · DIN 02553910 · $0.8197 NAT-Sitagliptin · DIN 02558157 · $0.8197 PMS-Sitagliptin · DIN 02503840 · $0.8197 PRZ-Sitagliptin · DIN 02545837 · $0.8197 Sandoz Sitagliptin · DIN 02504049 · $0.8197 Sitagliptin · DIN 02548550 · $0.8197 Taro-Sitagliptin Fumarate · DIN 02531631 · $0.8197 Teva-Sitagliptin Malate · DIN 02522705 · $0.8197

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