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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 ↗)

Accel-Dapagliflozin · DIN 02543184 Manufacturer: Accel Pharma Inc.; listing date 2026-03-31 Health Canada: Marketed since 2026-01-05 · brand ACCEL-DAPAGLIFLOZIN · ATC A10BK01 DAPAGLIFLOZIN · form Tablet · route Oral · ingredients DAPAGLIFLOZIN 5 MG · company Accel pharma inc · schedule Prescription

DIN 02543184: Accel-Dapagliflozin Raw flags: chronicUseMed=Y, insOH=Y, sec3=Y Item: 682002059; group id 741; item number 1811; lccId None; manufacturer id ACC Source form: Tab; strength: 5mg Recorded listing: General benefit; chronic-use medication (100-day supply rule, dispensing-fee limit); diabetes medication flag Source prices (unrounded): $0.5220; ministry $0.5220 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02543184 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=103167 Therapeutic Notes (formulary) Added on to metformin for patients: - Who have inadequate glycemic control on metformin and - Who have a contraindication or intolerance to a sulfonylurea or - For whom insulin is not an option. Added on to a sulfonylurea for patients: - Who have inadequate glycemic control on a sulfonylurea and - Who have a contraindication or intolerance to metformin or - For whom insulin is not an option. For the treatment of adult patients with New York Heart Association (NYHA) class II and III heart failure, as an adjunct to standard of care therapy, for the treatment of heart failure with reduced ejection fraction (HFrEF) [Left ventricular ejection fraction (LVEF less than or equal to 40%)]. Standard of care therapies include beta-blockers, angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs), plus a mineralocorticoid receptor antagonist.

Interchangeable products

Apo-Dapagliflozin · DIN 02527189 · $0.5220 Auro-Dapagliflozin · DIN 02531402 · $0.5220 Dapagliflozin · DIN 02561328 · $0.5220 Forxiga · DIN 02435462 · $0.5220 GLN-Dapagliflozin · DIN 02519852 · $0.5220 Jamp Dapagliflozin · DIN 02531364 · $0.5220 M-Dapagliflozin · DIN 02535297 · $0.5220 NRA-Dapagliflozin · DIN 02538334 · $0.5220 PMS-Dapagliflozin · DIN 02531550 · $0.5220 Sandoz Dapagliflozin · DIN 02518732 · $0.5220

Shortage status: not checked (no credentials)