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

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TRAVOPROST

All products: Limited Use (codes 171, 172, 387)

Travatan Z · PIN 09857332 · 0.004% · Oph Sol-5mL Pk

Limited Use — Reason for Use code 171, 172, 387 requiredOntario PIN; no Health Canada record under this code
StatusLimited Use — Reason for Use code 171, 172, 387 required
Write on scriptLU code 171, 172, 387 (patient must meet the criteria below)
Patient paysPatient pays: program not supplied; amount cannot be determined.

No Health Canada record under this code: Ontario lists it under a product identification number (PIN), not a DIN. Look up the brand's own DIN on Health Canada: https://health-products.canada.ca/dpd-bdpp/index-eng.jsp

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Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.
Ontario Limited Use criteria — code 171, 172, 387
Reason for Use code 171 As first line treatment of elevated intraocular pressure in patients who cannot tolerate an ophthalmic beta-blocking agent or where beta-blocking agents are contraindicated. Coverage limit: LU Authorization Period: Indefinite Reason for Use code 172 As second line monotherapy or combination therapy in patients who do not have an adequate intraocular pressure lowering response to ophthalmic beta-blocking agents. Coverage limit: LU Authorization Period: Indefinite Reason for Use code 387 For use as adjunctive therapy with an ophthalmic beta-blocking agent in an urgent situation (e.g. patients with a high baseline intraocular pressure) where monotherapy is unlikely to be effective. Coverage limit: LU Authorization Period: Indefinite
1 brand, same coverage
Travatan Z · DIN 09857332 Manufacturer: Novartis Pharma Canada Inc.; listing date 2009-08-18 No Health Canada record under this code: Ontario lists it under a product identification number (PIN), not a DIN. Look up the brand's own DIN on Health Canada: https://health-products.canada.ca/dpd-bdpp/index-eng.jsp
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Ministry pays: $28.7600 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 · Ontario PIN; see Health Canada brand lookup · Verify on the e-Formulary ↗ (DIN 09857332)

Source record
DIN 09857332: Travatan Z Raw flags: sec12=Y, sec3=Y Item: 523600119; group id 644; item number 1621; lccId 00094; manufacturer id NOV Source form: Oph Sol-5mL Pk; strength: 0.004% Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $58.9600; ministry $28.7600 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=09857332 Look up the brand's own DIN on Health Canada: https://health-products.canada.ca/dpd-bdpp/index-eng.jsp
Interchangeable products
Jamp Travoprost Z · DIN 02548089 · $28.7600 Sandoz Travoprost · DIN 02413167 · $28.7600
Shortage status: not checked (no credentials)
Other drugs in the same formulary class (52:36 Other Eye, Ear, Nose and Throat Agents) and how they are covered

Matched class: 52:36 Other Eye, Ear, Nose and Throat 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: BETAXOLOL HCL, DICLOFENAC SODIUM, LEVOBUNOLOL HCL Some products covered without a code (check the product listing): ACETAZOLAMIDE, METHAZOLAMIDE, SODIUM CROMOGLYCATE, TIMOLOL MALEATE 52:36 Other Eye, Ear, Nose and Throat Agents

ACETAZOLAMIDE

· 2 products · General benefit (1), Listed, not a benefit (1) · strengths: 250mg · Tab

BETAXOLOL HCL

· 1 products · General benefit · strengths: 0.25% · Oph Susp

DICLOFENAC SODIUM

· 6 products · General benefit · strengths: 0.1% · Oph Sol

LEVOBUNOLOL HCL

· 1 products · General benefit · strengths: 0.5% · Oph Sol

METHAZOLAMIDE

· 2 products · Listed, not a benefit (1), General benefit (1) · strengths: 50mg · Tab

SODIUM CROMOGLYCATE

· 2 products · General benefit (1), Listed, not a benefit (1) · strengths: 2% · Oph Sol

TIMOLOL MALEATE

· 10 products · Listed, not a benefit (2), General benefit (8) · strengths: 0.25%, 0.5% · Oph Gellan Sol, Oph Sol

AFLIBERCEPT

· 6 products · Limited Use, codes 729, 730, 731 (4), Limited Use, codes 694, 695 (2) · strengths: 2mg/0.05mL, 8mg/0.07mL · Inj Sol-0.05mL Pref Syr (Preservative-Free), Inj Sol-0.07mL Pref Syr, Inj Sol-0.07mL Vial Pk, Sol for Intravitreal Inj-0.05mL Vial Pk

BIMATOPROST

· 8 products · Listed, not a benefit (1), Limited Use, codes 171, 172, 387 (7) · strengths: 0.03%, 0.01% · Oph Sol, Oph Sol-5mL Pk, Oph Sol-7.5mL Pk

BRIMONIDINE

· 7 products · Limited Use, codes 171, 172, 387 · strengths: 0.15%, 0.2% · Oph Sol

BRIMONIDINE TARTRATE & TIMOLOL MALEATE

· 3 products · Limited Use, codes 310, 393 · strengths: 0.2% & 0.5% · Oph Sol-10mL Pk

BRINZOLAMIDE

· 1 products · Limited Use, codes 171, 172, 387 · strengths: 1% · Oph Susp Source: formulary-ed43-front-matter.txt Part V; ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26; class 52:36 and 20 more
Full class listing Related classes: 52:04 Anti-Infectives, 52:08 Anti-Inflammatory Agents, 52:16 Local Anesthetics, 52:20 Miotics, 52:24 Mydriatics, 52:32 Vasoconstrictors Same formulary class, not same indication: class membership alone does not establish equivalent uses.
Other drugs whose Health Canada label lists a similar indication: intraocular pressure
From Health Canada product monographs; label wording only, not a treatment recommendation. Matching is lexical and uses one held product label per generic; formulations and qualifying criteria may differ. No displayed matched alternative is a general benefit. BRINZOLAMIDE & BRIMONIDINE TARTRATE · Limited Use, codes 466, 393 • the reduction of intraocular pressure (IOP) in adult patients with open-angle glaucoma or ocular hypertension for whom monotherapy provides insufficient IOP reduction AND when the use of SIMBRINZA is considered appropriate. PM: https://pdf.hres.ca/dpd_pm/00068869.PDF; date DEC 23, 2022; DIN 02435411; fetched 2026-09-10 Product monograph Coverage source: ON formulary extract 2026-08-26
What the Health Canada label says it is for
INDICATIONS AND CLINICAL USE Sandoz Travoprost is indicated for the reduction of intraocular pressure in adult patients with open-angle glaucoma or ocular hypertension. Pediatrics (< 18 years of age): The safety and effectiveness of Sandoz Travoprost have not been established in pediatric patients, and its use is not recommended in these patients. https://pdf.hres.ca/dpd_pm/00051001.PDF PM date: May 7, 2019 Source product: SANDOZ TRAVOPROST; DIN 02413167; fetched 2026-09-10 Product monograph posted by Health Canada; excerpt for lookup only.