ETHINYL ESTRADIOL & LEVONORGESTREL
18 general benefit · 2 not a benefit
Other products in the same Health Canada class (G03A, G03AA, G03AB) — coverage varies; not interchangeable
- Desogestrel + ethinyl estradiol (Marvelon 21): general benefit
- Drospirenone + ethinyl estradiol (Yasmin 21): general benefit
- Ethinyl estradiol + norethindrone (Brevicon): general benefit
- Ethinyl estradiol + norethindrone (Minestrin 1/20): general benefit
- Ethinyl estradiol + norgestimate (Tri-Cyclen): general benefit, Not a benefit
- Drospirenone (Slynd): general benefit
3 more in the class list below
Min-Ovral 21 · DIN 02042320 · 0.03mg & 0.15mg · tablets, 21-pack
General benefitMarketed · checked 2026-09-19
StatusGeneral benefit
Write on scriptno code needed
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.
Brand vs generic price
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 ↗)1 brand, same coverage
Min-Ovral 21 · DIN 02042320
Manufacturer: Pfizer Canada Inc.; listing date 1996-10-01
Health Canada: Marketed since 2011-12-05 · brand MIN-OVRAL 21 · ATC G03AA07 LEVONORGESTREL AND ESTROGEN · form Tablet · route Oral · ingredients LEVONORGESTREL 150 MCG, ETHINYL ESTRADIOL 30 MCG · company Pfizer canada ulc · schedule Prescription
Ministry pays: $7.2800 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=18754 · Verify on the e-Formulary ↗ (DIN 02042320)
Source record
DIN 02042320: Min-Ovral 21
Raw flags: sec3=Y
Item: 683200064; group id 797; item number 1940; lccId None; manufacturer id PFI
Source form: Tab-21 Pk; strength: 0.03mg & 0.15mg
Recorded listing: General benefit
Source prices (unrounded): $19.2900; ministry $7.2800
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02042320
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=18754
Interchangeable products
Ovima 21 · DIN 02387085 · $7.2800
Portia 21 · DIN 02295946 · $7.2800
Shortage status: active shortage (reported 2026-08-13, last updated 2026-08-18); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02042320
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Ovima 21 · DIN 02387085 · 0.03mg & 0.15mg · tablets, 21-pack
General benefitMarketed · checked 2026-09-19
StatusGeneral benefit
Write on scriptno code needed
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.
Brand vs generic price
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 ↗)1 brand, same coverage
Ovima 21 · DIN 02387085
Manufacturer: Apotex Inc.; listing date 2014-01-03
Health Canada: Marketed since 2013-08-27 · brand OVIMA 21 · ATC G03AA07 LEVONORGESTREL AND ESTROGEN · form Tablet · route Oral · ingredients LEVONORGESTREL 150 MCG, ETHINYL ESTRADIOL 30 MCG · company Apotex inc · schedule Prescription
Ovima 21: Formulary list price $7.2800/unit (unit not stated in source; not the patient's cost)
Ministry pays: $7.2800 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=87265 · Verify on the e-Formulary ↗ (DIN 02387085)
Source record
DIN 02387085: Ovima 21
Raw flags: sec3=Y
Item: 683200064; group id 797; item number 1940; lccId None; manufacturer id APX
Source form: Tab-21 Pk; strength: 0.03mg & 0.15mg
Recorded listing: General benefit
Source prices (unrounded): $7.2800; ministry $7.2800
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02387085
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=87265
Interchangeable products
Min-Ovral 21 · DIN 02042320 · $7.2800
Portia 21 · DIN 02295946 · $7.2800
Shortage status: resolved shortage (ended 2023-05-05); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02387085
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Portia 21 · DIN 02295946 · 0.03mg & 0.15mg · tablets, 21-pack
General benefitMarketed · checked 2026-09-19
StatusGeneral benefit
Write on scriptno code needed
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.
Brand vs generic price
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 ↗)1 brand, same coverage
Portia 21 · DIN 02295946
Manufacturer: Barr Laboratories Inc.; listing date 2007-10-03
Health Canada: Marketed since 2015-05-28 · brand PORTIA 21 · ATC G03AA07 LEVONORGESTREL AND ESTROGEN · form Tablet · route Oral · ingredients LEVONORGESTREL 0.15 MG, ETHINYL ESTRADIOL 0.03 MG · company Teva canada limited · schedule Prescription
Ministry pays: $7.2800 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=78129 · Verify on the e-Formulary ↗ (DIN 02295946)
Source record
DIN 02295946: Portia 21
Raw flags: sec3=Y
Item: 683200064; group id 797; item number 1940; lccId None; manufacturer id BAR
Source form: Tab-21 Pk; strength: 0.03mg & 0.15mg
Recorded listing: General benefit
Source prices (unrounded): $10.6600; ministry $7.2800
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02295946
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=78129
Interchangeable products
Min-Ovral 21 · DIN 02042320 · $7.2800
Ovima 21 · DIN 02387085 · $7.2800
Shortage status: resolved shortage (ended 2022-12-21); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02295946
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Min-Ovral 28 · DIN 02042339 · 0.03mg & 0.15mg · tablets, 28-pack
General benefitMarketed · checked 2026-09-19
StatusGeneral benefit
Write on scriptno code needed
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.
Brand vs generic price
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 ↗)1 brand, same coverage
Min-Ovral 28 · DIN 02042339
Manufacturer: Pfizer Canada Inc.; listing date 1996-10-01
Health Canada: Marketed since 2011-11-25 · brand MIN-OVRAL 28 · ATC G03AA07 LEVONORGESTREL AND ESTROGEN · form Tablet · route Oral · ingredients LEVONORGESTREL 150 MCG, ETHINYL ESTRADIOL 30 MCG · company Pfizer canada ulc · schedule Prescription
Ministry pays: $7.2800 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=18755 · Verify on the e-Formulary ↗ (DIN 02042339)
Source record
DIN 02042339: Min-Ovral 28
Raw flags: sec3=Y
Item: 683200065; group id 797; item number 1943; lccId None; manufacturer id PFI
Source form: Tab-28 Pk; strength: 0.03mg & 0.15mg
Recorded listing: General benefit
Source prices (unrounded): $19.2900; ministry $7.2800
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02042339
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=18755
Interchangeable products
Ovima 28 · DIN 02387093 · $7.2800
Portia 28 · DIN 02295954 · $7.2800
Shortage status: active shortage (reported 2026-08-13, last updated 2026-08-18); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02042339
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Ovima 28 · DIN 02387093 · 0.03mg & 0.15mg · tablets, 28-pack
General benefitMarketed · checked 2026-09-19
StatusGeneral benefit
Write on scriptno code needed
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.
Brand vs generic price
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 ↗)1 brand, same coverage
Ovima 28 · DIN 02387093
Manufacturer: Apotex Inc.; listing date 2014-01-03
Health Canada: Marketed since 2013-08-27 · brand OVIMA 28 · ATC G03AA07 LEVONORGESTREL AND ESTROGEN · form Tablet · route Oral · ingredients LEVONORGESTREL 150 MCG, ETHINYL ESTRADIOL 30 MCG · company Apotex inc · schedule Prescription
Ovima 28: Formulary list price $7.2800/unit (unit not stated in source; not the patient's cost)
Ministry pays: $7.2800 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=87266 · Verify on the e-Formulary ↗ (DIN 02387093)
Source record
DIN 02387093: Ovima 28
Raw flags: sec3=Y
Item: 683200065; group id 797; item number 1943; lccId None; manufacturer id APX
Source form: Tab-28 Pk; strength: 0.03mg & 0.15mg
Recorded listing: General benefit
Source prices (unrounded): $7.2800; ministry $7.2800
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02387093
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=87266
Interchangeable products
Min-Ovral 28 · DIN 02042339 · $7.2800
Portia 28 · DIN 02295954 · $7.2800
Shortage status: resolved shortage (ended 2023-03-22); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02387093
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Portia 28 · DIN 02295954 · 0.03mg & 0.15mg · tablets, 28-pack
General benefitMarketed · checked 2026-09-19
StatusGeneral benefit
Write on scriptno code needed
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.
Brand vs generic price
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 ↗)1 brand, same coverage
Portia 28 · DIN 02295954
Manufacturer: Barr Laboratories Inc.; listing date 2007-10-03
Health Canada: Marketed since 2015-05-28 · brand PORTIA 28 · ATC G03AA07 LEVONORGESTREL AND ESTROGEN · form Tablet · route Oral · ingredients LEVONORGESTREL 0.15 MG, ETHINYL ESTRADIOL 0.03 MG · company Teva canada limited · schedule Prescription
Ministry pays: $7.2800 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=78130 · Verify on the e-Formulary ↗ (DIN 02295954)
Source record
DIN 02295954: Portia 28
Raw flags: sec3=Y
Item: 683200065; group id 797; item number 1943; lccId None; manufacturer id BAR
Source form: Tab-28 Pk; strength: 0.03mg & 0.15mg
Recorded listing: General benefit
Source prices (unrounded): $10.6600; ministry $7.2800
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02295954
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=78130
Interchangeable products
Min-Ovral 28 · DIN 02042339 · $7.2800
Ovima 28 · DIN 02387093 · $7.2800
Shortage status: resolved shortage (ended 2022-12-21); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02295954
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Triquilar 21 · DIN 00707600 · 3 Phase · tablets, 21-pack
General benefitMarketed · checked 2026-09-19
StatusGeneral benefit
Write on scriptno code needed
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.
No interchangeable product listed in the Ontario extract
Triquilar 21 · DIN 00707600
Manufacturer: Bayer Inc., Consumer Care Division; listing date 1996-10-01
Health Canada: Marketed since 2008-07-03 · brand TRIQUILAR 21 · ATC G03AB03 LEVONORGESTREL AND ESTROGEN · form Tablet · route Oral · ingredients LEVONORGESTREL 50 MCG, ETHINYL ESTRADIOL 30 MCG, LEVONORGESTREL 75 MCG, ETHINYL ESTRADIOL 40 MCG, LEVONORGESTREL 125 MCG, ETHINYL ESTRADIOL 30 MCG · company Chanel · schedule Prescription
Triquilar 21: Formulary list price $16.0700/unit (unit not stated in source; not the patient's cost)
Ministry pays: $16.0700 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=8124 · Verify on the e-Formulary ↗ (DIN 00707600)
Source record
DIN 00707600: Triquilar 21
Raw flags: sec3=Y
Item: 683200066; group id 797; item number 1941; lccId None; manufacturer id BAY
Source form: Tab-21 Pk; strength: 3 Phase
Recorded listing: General benefit
Source prices (unrounded): $16.0700; ministry $16.0700
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=00707600
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=8124
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=00707600
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Triquilar 28 · DIN 00707503 · 3 Phase · tablets, 28-pack
General benefitMarketed · checked 2026-09-02
StatusGeneral benefit
Write on scriptno code needed
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.
No interchangeable product listed in the Ontario extract
Triquilar 28 · DIN 00707503
Manufacturer: Bayer Inc., Consumer Care Division; listing date 1996-10-01
Health Canada: Marketed since 2008-05-21 · brand TRIQUILAR 28 · ATC G03AB03 LEVONORGESTREL AND ESTROGEN · form Tablet · route Oral · ingredients LEVONORGESTREL 50 MCG, ETHINYL ESTRADIOL 30 MCG, LEVONORGESTREL 125 MCG, ETHINYL ESTRADIOL 40 MCG, LEVONORGESTREL 75 MCG, ETHINYL ESTRADIOL 30 MCG · company Bayer inc · schedule Prescription
Triquilar 28: Formulary list price $16.0700/unit (unit not stated in source; not the patient's cost)
Ministry pays: $16.0700 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=8123 · Verify on the e-Formulary ↗ (DIN 00707503)
Source record
DIN 00707503: Triquilar 28
Raw flags: sec3=Y
Item: 683200067; group id 797; item number 1944; lccId None; manufacturer id BAY
Source form: Tab-28 Pk; strength: 3 Phase
Recorded listing: General benefit
Source prices (unrounded): $16.0700; ministry $16.0700
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=00707503
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=8123
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=00707503
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Alesse 21 · DIN 02236974 · 20mcg & 100mcg · tablets, 21-pack
General benefitMarketed · checked 2026-09-19
StatusGeneral benefit
Write on scriptno code needed
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.
Savings card: RxHelp ONE lists Alesse (read 2026-09-10) — brand-name savings card, free; cannot be combined with another card on the same claim.
(rxhelp.ca ↗)1 brand, same coverage
Alesse 21 · DIN 02236974
Manufacturer: Pfizer Canada Inc.; listing date 1998-12-31
Health Canada: Marketed since 2012-04-10 · brand ALESSE 21 · ATC G03AA07 LEVONORGESTREL AND ESTROGEN · form Tablet · route Oral · ingredients LEVONORGESTREL 100 MCG, ETHINYL ESTRADIOL 20 MCG · company Pfizer canada ulc · schedule Prescription
Ministry pays: $3.9425 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=60269 · Verify on the e-Formulary ↗ (DIN 02236974)
Source record
DIN 02236974: Alesse 21
Raw flags: sec3=Y
Item: 683200102; group id 797; item number 1939; lccId None; manufacturer id PFI
Source form: Tab-21 Pk; strength: 20mcg & 100mcg
Recorded listing: General benefit
Source prices (unrounded): $16.0696; ministry $3.9425
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02236974
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=60269
Interchangeable products
Alysena 21 · DIN 02387875 · $3.9425
Audrina 21 · DIN 02532174 · $3.9425
Aviane 21 · DIN 02298538 · $3.9425
Laylaa 21 · DIN 02424282 · $3.9425
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02236974
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Alysena 21 · DIN 02387875 · 20mcg & 100mcg · tablets, 21-pack
General benefitMarketed · checked 2026-09-02
StatusGeneral benefit
Write on scriptno code needed
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.
Brand vs generic price
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 ↗)1 brand, same coverage
Alysena 21 · DIN 02387875
Manufacturer: Apotex Inc.; listing date 2012-11-27
Health Canada: Marketed since 2012-11-19 · brand ALYSENA 21 · ATC G03AA07 LEVONORGESTREL AND ESTROGEN · form Tablet · route Oral · ingredients ETHINYL ESTRADIOL 20 MCG, LEVONORGESTREL 100 MCG · company Apotex inc · schedule Prescription
Alysena 21: Formulary list price $3.9425/unit (unit not stated in source; not the patient's cost)
Ministry pays: $3.9425 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=87345 · Verify on the e-Formulary ↗ (DIN 02387875)
Source record
DIN 02387875: Alysena 21
Raw flags: sec3=Y
Item: 683200102; group id 797; item number 1939; lccId None; manufacturer id APX
Source form: Tab-21 Pk; strength: 20mcg & 100mcg
Recorded listing: General benefit
Source prices (unrounded): $3.9425; ministry $3.9425
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02387875
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=87345
Interchangeable products
Alesse 21 · DIN 02236974 · $3.9425
Audrina 21 · DIN 02532174 · $3.9425
Aviane 21 · DIN 02298538 · $3.9425
Laylaa 21 · DIN 02424282 · $3.9425
Shortage status: resolved shortage (ended 2026-04-16); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02387875
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Audrina 21 · DIN 02532174 · 20mcg & 100mcg · tablets, 21-pack
General benefitMarketed · checked 2026-09-19
StatusGeneral benefit
Write on scriptno code needed
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.
Brand vs generic price
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 ↗)1 brand, same coverage
Audrina 21 · DIN 02532174
Manufacturer: Jamp Pharma Corporation; listing date 2023-08-31
Health Canada: Marketed since 2023-06-09 · brand AUDRINA 21 · ATC G03AA07 LEVONORGESTREL AND ESTROGEN · form Tablet · route Oral · ingredients LEVONORGESTREL 100 MCG, ETHINYL ESTRADIOL 20 MCG · company Jamp pharma corporation · schedule Prescription
Audrina 21: Formulary list price $3.9425/unit (unit not stated in source; not the patient's cost)
Ministry pays: $3.9425 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=102123 · Verify on the e-Formulary ↗ (DIN 02532174)
Source record
DIN 02532174: Audrina 21
Raw flags: sec3=Y
Item: 683200102; group id 797; item number 1939; lccId None; manufacturer id JPC
Source form: Tab-21 Pk; strength: 20mcg & 100mcg
Recorded listing: General benefit
Source prices (unrounded): $3.9425; ministry $3.9425
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02532174
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=102123
Interchangeable products
Alesse 21 · DIN 02236974 · $3.9425
Alysena 21 · DIN 02387875 · $3.9425
Aviane 21 · DIN 02298538 · $3.9425
Laylaa 21 · DIN 02424282 · $3.9425
Shortage status: resolved shortage (ended 2026-02-04); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02532174
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Aviane 21 · DIN 02298538 · 20mcg & 100mcg · tablets, 21-pack
General benefitMarketed · checked 2026-09-19
StatusGeneral benefit
Write on scriptno code needed
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.
Brand vs generic price
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 ↗)1 brand, same coverage
Aviane 21 · DIN 02298538
Manufacturer: Teva Canada Limited; listing date 2008-01-15
Health Canada: Marketed since 2015-05-20 · brand AVIANE 21 · ATC G03AA07 LEVONORGESTREL AND ESTROGEN · form Tablet · route Oral · ingredients LEVONORGESTREL 100 MCG, ETHINYL ESTRADIOL 20 MCG · company Teva canada limited · schedule Prescription
Aviane 21: Formulary list price $3.9425/unit (unit not stated in source; not the patient's cost)
Ministry pays: $3.9425 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=78383 · Verify on the e-Formulary ↗ (DIN 02298538)
Source record
DIN 02298538: Aviane 21
Raw flags: sec3=Y
Item: 683200102; group id 797; item number 1939; lccId None; manufacturer id TEV
Source form: Tab-21 Pk; strength: 20mcg & 100mcg
Recorded listing: General benefit
Source prices (unrounded): $3.9425; ministry $3.9425
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02298538
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=78383
Interchangeable products
Alesse 21 · DIN 02236974 · $3.9425
Alysena 21 · DIN 02387875 · $3.9425
Audrina 21 · DIN 02532174 · $3.9425
Laylaa 21 · DIN 02424282 · $3.9425
Shortage status: shortage reported ended 2026-05-05 (report last updated 2026-05-05); confirm supply with the pharmacy; reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02298538
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Laylaa 21 · DIN 02424282 · 20mcg & 100mcg · tablets, 21-pack
General benefitMarketed · checked 2026-09-19
StatusGeneral benefit
Write on scriptno code needed
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.
Brand vs generic price
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 ↗)1 brand, same coverage
Laylaa 21 · DIN 02424282
Manufacturer: Lupin Pharma Canada Limited; listing date 2025-11-28
Health Canada: Marketed since 2023-11-10 · brand LAYLAA 21 · ATC G03AA07 LEVONORGESTREL AND ESTROGEN · form Tablet · route Oral · ingredients LEVONORGESTREL 100 MCG, ETHINYL ESTRADIOL 20 MCG · company Lupin pharma canada limited · schedule Prescription
Laylaa 21: Formulary list price $3.9425/unit (unit not stated in source; not the patient's cost)
Ministry pays: $3.9425 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=90899 · Verify on the e-Formulary ↗ (DIN 02424282)
Source record
DIN 02424282: Laylaa 21
Raw flags: sec3=Y
Item: 683200102; group id 797; item number 1939; lccId None; manufacturer id LUP
Source form: Tab-21 Pk; strength: 20mcg & 100mcg
Recorded listing: General benefit
Source prices (unrounded): $3.9425; ministry $3.9425
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02424282
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=90899
Interchangeable products
Alesse 21 · DIN 02236974 · $3.9425
Alysena 21 · DIN 02387875 · $3.9425
Audrina 21 · DIN 02532174 · $3.9425
Aviane 21 · DIN 02298538 · $3.9425
Shortage status: resolved shortage (ended 2025-09-29); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02424282
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Alesse 28 · DIN 02236975 · 20mcg & 100mcg · tablets, 28-pack
General benefitMarketed · checked 2026-09-19
StatusGeneral benefit
Write on scriptno code needed
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.
Savings card: RxHelp ONE lists Alesse (read 2026-09-10) — brand-name savings card, free; cannot be combined with another card on the same claim.
(rxhelp.ca ↗)1 brand, same coverage
Alesse 28 · DIN 02236975
Manufacturer: Pfizer Canada Inc.; listing date 1998-12-31
Health Canada: Marketed since 2012-03-16 · brand ALESSE 28 · ATC G03AA07 LEVONORGESTREL AND ESTROGEN · form Tablet · route Oral · ingredients LEVONORGESTREL 100 MCG, ETHINYL ESTRADIOL 20 MCG · company Pfizer canada ulc · schedule Prescription
Ministry pays: $3.9425 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=60270 · Verify on the e-Formulary ↗ (DIN 02236975)
Source record
DIN 02236975: Alesse 28
Raw flags: sec3=Y
Item: 683200103; group id 797; item number 1942; lccId None; manufacturer id PFI
Source form: Tab-28 Pk; strength: 20mcg & 100mcg
Recorded listing: General benefit
Source prices (unrounded): $16.0696; ministry $3.9425
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02236975
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=60270
Interchangeable products
Alysena 28 · DIN 02387883 · $3.9425
Audrina 28 · DIN 02532182 · $3.9425
Aviane 28 · DIN 02298546 · $3.9425
Laylaa 28 · DIN 02424290 · $3.9425
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02236975
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Alysena 28 · DIN 02387883 · 20mcg & 100mcg · tablets, 28-pack
General benefitMarketed · checked 2026-09-19
StatusGeneral benefit
Write on scriptno code needed
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.
Brand vs generic price
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 ↗)1 brand, same coverage
Alysena 28 · DIN 02387883
Manufacturer: Apotex Inc.; listing date 2012-11-27
Health Canada: Marketed since 2012-11-19 · brand ALYSENA 28 · ATC G03AA07 LEVONORGESTREL AND ESTROGEN · form Tablet · route Oral · ingredients LEVONORGESTREL 100 MCG, ETHINYL ESTRADIOL 20 MCG · company Apotex inc · schedule Prescription
Alysena 28: Formulary list price $3.9425/unit (unit not stated in source; not the patient's cost)
Ministry pays: $3.9425 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=87346 · Verify on the e-Formulary ↗ (DIN 02387883)
Source record
DIN 02387883: Alysena 28
Raw flags: sec3=Y
Item: 683200103; group id 797; item number 1942; lccId None; manufacturer id APX
Source form: Tab-28 Pk; strength: 20mcg & 100mcg
Recorded listing: General benefit
Source prices (unrounded): $3.9425; ministry $3.9425
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02387883
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=87346
Interchangeable products
Alesse 28 · DIN 02236975 · $3.9425
Audrina 28 · DIN 02532182 · $3.9425
Aviane 28 · DIN 02298546 · $3.9425
Laylaa 28 · DIN 02424290 · $3.9425
Shortage status: resolved shortage (ended 2025-01-09); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02387883
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Audrina 28 · DIN 02532182 · 20mcg & 100mcg · tablets, 28-pack
General benefitMarketed · checked 2026-09-19
StatusGeneral benefit
Write on scriptno code needed
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.
Brand vs generic price
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 ↗)1 brand, same coverage
Audrina 28 · DIN 02532182
Manufacturer: Jamp Pharma Corporation; listing date 2023-08-31
Health Canada: Marketed since 2023-06-08 · brand AUDRINA 28 · ATC G03AA07 LEVONORGESTREL AND ESTROGEN · form Tablet · route Oral · ingredients LEVONORGESTREL 100 MCG, ETHINYL ESTRADIOL 20 MCG · company Jamp pharma corporation · schedule Prescription
Audrina 28: Formulary list price $3.9425/unit (unit not stated in source; not the patient's cost)
Ministry pays: $3.9425 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=102124 · Verify on the e-Formulary ↗ (DIN 02532182)
Source record
DIN 02532182: Audrina 28
Raw flags: sec3=Y
Item: 683200103; group id 797; item number 1942; lccId None; manufacturer id JPC
Source form: Tab-28 Pk; strength: 20mcg & 100mcg
Recorded listing: General benefit
Source prices (unrounded): $3.9425; ministry $3.9425
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02532182
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=102124
Interchangeable products
Alesse 28 · DIN 02236975 · $3.9425
Alysena 28 · DIN 02387883 · $3.9425
Aviane 28 · DIN 02298546 · $3.9425
Laylaa 28 · DIN 02424290 · $3.9425
Shortage status: resolved shortage (ended 2026-02-04); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02532182
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Aviane 28 · DIN 02298546 · 20mcg & 100mcg · tablets, 28-pack
General benefitMarketed · checked 2026-09-19
StatusGeneral benefit
Write on scriptno code needed
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.
Brand vs generic price
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 ↗)1 brand, same coverage
Aviane 28 · DIN 02298546
Manufacturer: Teva Canada Limited; listing date 2008-01-15
Health Canada: Marketed since 2015-05-20 · brand AVIANE 28 · ATC G03AA07 LEVONORGESTREL AND ESTROGEN · form Tablet · route Oral · ingredients LEVONORGESTREL 100 MCG, ETHINYL ESTRADIOL 20 MCG · company Teva canada limited · schedule Prescription
Aviane 28: Formulary list price $3.9425/unit (unit not stated in source; not the patient's cost)
Ministry pays: $3.9425 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=78384 · Verify on the e-Formulary ↗ (DIN 02298546)
Source record
DIN 02298546: Aviane 28
Raw flags: sec3=Y
Item: 683200103; group id 797; item number 1942; lccId None; manufacturer id TEV
Source form: Tab-28 Pk; strength: 20mcg & 100mcg
Recorded listing: General benefit
Source prices (unrounded): $3.9425; ministry $3.9425
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02298546
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=78384
Interchangeable products
Alesse 28 · DIN 02236975 · $3.9425
Alysena 28 · DIN 02387883 · $3.9425
Audrina 28 · DIN 02532182 · $3.9425
Laylaa 28 · DIN 02424290 · $3.9425
Shortage status: shortage reported ended 2026-05-05 (report last updated 2026-05-05); confirm supply with the pharmacy; reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02298546
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Laylaa 28 · DIN 02424290 · 20mcg & 100mcg · tablets, 28-pack
General benefitMarketed · checked 2026-09-02
StatusGeneral benefit
Write on scriptno code needed
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.
Brand vs generic price
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 ↗)1 brand, same coverage
Laylaa 28 · DIN 02424290
Manufacturer: Lupin Pharma Canada Limited; listing date 2025-11-28
Health Canada: Marketed since 2023-11-10 · brand LAYLAA 28 · ATC G03AA07 LEVONORGESTREL AND ESTROGEN · form Tablet · route Oral · ingredients ETHINYL ESTRADIOL 20 MCG, LEVONORGESTREL 100 MCG · company Lupin pharma canada limited · schedule Prescription
Laylaa 28: Formulary list price $3.9425/unit (unit not stated in source; not the patient's cost)
Ministry pays: $3.9425 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=90900 · Verify on the e-Formulary ↗ (DIN 02424290)
Source record
DIN 02424290: Laylaa 28
Raw flags: sec3=Y
Item: 683200103; group id 797; item number 1942; lccId None; manufacturer id LUP
Source form: Tab-28 Pk; strength: 20mcg & 100mcg
Recorded listing: General benefit
Source prices (unrounded): $3.9425; ministry $3.9425
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02424290
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=90900
Interchangeable products
Alesse 28 · DIN 02236975 · $3.9425
Alysena 28 · DIN 02387883 · $3.9425
Audrina 28 · DIN 02532182 · $3.9425
Aviane 28 · DIN 02298546 · $3.9425
Shortage status: resolved shortage (ended 2026-05-25); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02424290
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Indayo · DIN 02398869 · 0.03mg & 0.15mg · tablets, 91-pack
Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-19
StatusOff-Formulary Interchangeable, not an ODB benefit
Write on scriptnot a benefit; no Exceptional Access criteria on record; see alternatives
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.
1 brand, same coverage
Indayo · DIN 02398869
Manufacturer: Mylan Pharmaceuticals ULC; listing date 2016-11-30
Health Canada: Marketed since 2026-07-08 · brand INDAYO · ATC G03AA07 LEVONORGESTREL AND ESTROGEN · form Tablet · route Oral · ingredients LEVONORGESTREL 0.15 MG, ETHINYL ESTRADIOL 0.03 MG · company Senador laboratories private limited · schedule Prescription
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=88378 · Verify on the e-Formulary ↗ (DIN 02398869)
Source record
DIN 02398869: Indayo
Raw flags: notABenefit=Y, sec3=Y, sec3b=Y
Item: 683200116; group id 797; item number 1945; lccId None; manufacturer id MYL
Source form: Tab-91 Pk; strength: 0.03mg & 0.15mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit
Source prices (unrounded): $45.9550; ministry not recorded
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02398869
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=88378
Interchangeable products
Seasonale · DIN 02296659 · not recorded
Shortage status: resolved shortage (ended 2023-02-01); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02398869
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Seasonale · DIN 02296659 · 0.03mg & 0.15mg · tablets, 91-pack
Off-Formulary Interchangeable, not an ODB benefitMarketed · checked 2026-09-19
StatusOff-Formulary Interchangeable, not an ODB benefit
Write on scriptnot a benefit; no Exceptional Access criteria on record; see alternatives
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.
1 brand, same coverage
Seasonale · DIN 02296659
Manufacturer: Teva Women's Health Inc.; listing date 2016-11-30
Health Canada: Marketed since 2022-09-26 · brand SEASONALE · ATC G03AA07 LEVONORGESTREL AND ESTROGEN · form Tablet · route Oral · ingredients LEVONORGESTREL 0.15 MG, ETHINYL ESTRADIOL 0.03 MG · company Teva canada limited · schedule Prescription
Seasonale: Formulary list price not recorded/unit (unit not stated in source; not the patient's cost)
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=78201 · Verify on the e-Formulary ↗ (DIN 02296659)
Source record
DIN 02296659: Seasonale
Raw flags: notABenefit=Y, sec3=Y, sec3b=Y
Item: 683200116; group id 797; item number 1945; lccId None; manufacturer id TEW
Source form: Tab-91 Pk; strength: 0.03mg & 0.15mg
Recorded listing: Off-Formulary Interchangeable, not an ODB benefit
Source prices (unrounded): not recorded; ministry not recorded
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02296659
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=78201
Interchangeable products
Indayo · DIN 02398869 · not recorded
Shortage status: active shortage (reported 2026-02-11, last updated 2026-06-25); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02296659
Shortage record checked 2026-09-13T08:10:21.292534+00:00