All strengths: General benefit; same patient cost rules
Shared coverage and patient cost rules
StatusGeneral benefit
Patient paysPatient pays: program not supplied; amount cannot be determined.
Other products in the same Health Canada class (G03A) — coverage varies; not interchangeable
Desogestrel + ethinyl estradiol (Marvelon 21): general benefit
Drospirenone (Slynd): general benefit
Drospirenone + ethinyl estradiol (Yasmin 21): general benefit
Ethinyl estradiol + norethindrone (Brevicon): general benefit
Ethinyl estradiol + norethindrone (Minestrin 1/20): general benefit
Etonogestrel (Nexplanon): general benefit
5 more in the class list below
Backup Plan Onestep · DIN 02433532 · 1.5mg · tablet-1 tablet Pk
General benefitMarketed · checked 2026-09-02
Write on scriptno code needed
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
Backup Plan Onestep · DIN 02433532
Manufacturer: Apotex Inc.; listing date 2017-06-29
Health Canada: Marketed since 2016-06-07 · brand BACKUP PLAN ONESTEP · ATC G03AD01 LEVONORGESTREL · form Tablet · route Oral · ingredients LEVONORGESTREL 1.5 MG · company Apotex inc · schedule Non-prescription drugs
Backup Plan Onestep: Formulary list price $4.3000/unit (unit not stated in source; not the patient's cost)
Ministry pays: $4.3000 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=91790 · Verify on the e-Formulary ↗ (DIN 02433532)
Source record
DIN 02433532: Backup Plan Onestep
Raw flags: sec3=Y
Item: 683200115; group id 800; item number 1956; lccId None; manufacturer id APX
Source form: Tab-1 Tab Pk; strength: 1.5mg
Recorded listing: General benefit
Source prices (unrounded): $4.3000; ministry $4.3000
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02433532
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=91790Interchangeable products
Contingency One · DIN 02425009 · $4.3000
MyStep · DIN 02548461 · $4.3000
Plan B · DIN 02293854 · $4.3000
Shortage status: resolved shortage (ended 2023-10-19); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02433532
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Contingency One · DIN 02425009 · 1.5mg · tablet-1 tablet Pk
General benefitMarketed · checked 2026-09-02
Write on scriptno code needed
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
Contingency One · DIN 02425009
Manufacturer: Mylan Pharmaceuticals ULC; listing date 2017-02-28
Health Canada: Marketed since 2026-05-29 · brand CONTINGENCY ONE · ATC G03AD01 LEVONORGESTREL · form Tablet · route Oral · ingredients LEVONORGESTREL 1.5 MG · company Senador laboratories private limited · schedule Non-prescription drugs
Contingency One: Formulary list price $4.3000/unit (unit not stated in source; not the patient's cost)
Ministry pays: $4.3000 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=90967 · Verify on the e-Formulary ↗ (DIN 02425009)
Source record
DIN 02425009: Contingency One
Raw flags: sec3=Y
Item: 683200115; group id 800; item number 1956; lccId None; manufacturer id MYL
Source form: Tab-1 Tab Pk; strength: 1.5mg
Recorded listing: General benefit
Source prices (unrounded): $4.3000; ministry $4.3000
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02425009
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=90967Interchangeable products
Backup Plan Onestep · DIN 02433532 · $4.3000
MyStep · DIN 02548461 · $4.3000
Plan B · DIN 02293854 · $4.3000
Shortage status: resolved shortage (ended 2025-01-30); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02425009
Shortage record checked 2026-09-13T08:10:21.292534+00:00
MyStep · DIN 02548461 · 1.5mg · tablet-1 tablet Pk
General benefitMarketed · checked 2026-09-02
Write on scriptno code needed
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
MyStep · DIN 02548461
Manufacturer: Jamp Pharma Corporation; listing date 2025-08-29
Health Canada: Marketed since 2025-06-10 · brand MYSTEP · ATC G03AD01 LEVONORGESTREL · form Tablet · route Oral · ingredients LEVONORGESTREL 1.5 MG · company Jamp pharma corporation · schedule Non-prescription drugs
MyStep: Formulary list price $4.3000/unit (unit not stated in source; not the patient's cost)
Ministry pays: $4.3000 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=103734 · Verify on the e-Formulary ↗ (DIN 02548461)
Source record
DIN 02548461: MyStep
Raw flags: sec3=Y
Item: 683200115; group id 800; item number 1956; lccId None; manufacturer id JPC
Source form: Tab-1 Tab Pk; strength: 1.5mg
Recorded listing: General benefit
Source prices (unrounded): $4.3000; ministry $4.3000
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02548461
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=103734Interchangeable products
Backup Plan Onestep · DIN 02433532 · $4.3000
Contingency One · DIN 02425009 · $4.3000
Plan B · DIN 02293854 · $4.3000
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=02548461
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Plan B · DIN 02293854 · 1.5mg · tablet-1 tablet Pk
General benefitMarketed · checked 2026-09-02
Write on scriptno code needed
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.
1 brand, same coverage
Plan B · DIN 02293854
Manufacturer: Teva Branded Pharmaceutical Products R&D Inc.; listing date 2016-09-29
Health Canada: Marketed since 2018-10-11 · brand PLAN B · ATC G03AD01 LEVONORGESTREL · form Tablet · route Oral · ingredients LEVONORGESTREL 1.5 MG · company Foundation consumer healthcare, llc · schedule Non-prescription drugs
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=77922 · Verify on the e-Formulary ↗ (DIN 02293854)
Source record
DIN 02293854: Plan B
Raw flags: sec3=Y
Item: 683200115; group id 800; item number 1956; lccId None; manufacturer id TBP
Source form: Tab-1 Tab Pk; strength: 1.5mg
Recorded listing: General benefit
Source prices (unrounded): $17.2000; ministry $4.3000
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02293854
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=77922Interchangeable products
Backup Plan Onestep · DIN 02433532 · $4.3000
Contingency One · DIN 02425009 · $4.3000
MyStep · DIN 02548461 · $4.3000
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=02293854
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Kyleena · DIN 02459523 · 19.5mg · Insert
General benefitMarketed · checked 2026-09-02
Write on scriptno code needed
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
Kyleena · DIN 02459523
Manufacturer: Bayer Inc., Consumer Care Division; listing date 2018-05-31
Health Canada: Marketed since 2017-01-10 · brand KYLEENA · ATC G02BA03 PLASTIC IUD WITH PROGESTOGENS · form Insert (extended-release) · route Intrauterine · ingredients LEVONORGESTREL 19.5 MG · company Bayer inc · schedule Prescription
Kyleena: Formulary list price $355.5800/unit (unit not stated in source; not the patient's cost)
Ministry pays: $355.5800 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=94684 · Verify on the e-Formulary ↗ (DIN 02459523)
Source record
DIN 02459523: Kyleena
Raw flags: sec3=Y
Item: 681200002; group id 729; item number 1792; lccId None; manufacturer id BAY
Source form: Insert; strength: 19.5mg
Recorded listing: General benefit
Source prices (unrounded): $355.5800; ministry $355.5800
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02459523
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=94684
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=02459523
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Mirena · DIN 02243005 · 52mg · Insert
General benefitMarketed · checked 2026-09-02
Write on scriptno code needed
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
Mirena · DIN 02243005
Manufacturer: Bayer Inc., Consumer Care Division; listing date 2001-10-11
Health Canada: Marketed since 2007-11-22 · brand MIRENA · ATC G02BA03 PLASTIC IUD WITH PROGESTOGENS · form Insert (extended-release) · route Intrauterine · ingredients LEVONORGESTREL 52 MG · company Bayer inc · schedule Prescription
Mirena: Formulary list price $380.0000/unit (unit not stated in source; not the patient's cost)
Ministry pays: $380.0000 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=66845 · Verify on the e-Formulary ↗ (DIN 02243005)
Source record
DIN 02243005: Mirena
Raw flags: sec3=Y
Item: 681200003; group id 729; item number 1793; lccId None; manufacturer id BAY
Source form: Insert; strength: 52mg
Recorded listing: General benefit
Source prices (unrounded): $380.0000; ministry $380.0000
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02243005
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=66845
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=02243005
Shortage record checked 2026-09-13T08:10:21.292534+00:00
ETHINYL ESTRADIOL & LEVONORGESTREL
16 general benefit · 2 not a benefit
Other products in the same Health Canada class (G03A) — coverage varies; not interchangeable
Desogestrel + ethinyl estradiol (Marvelon 21): general benefit
Drospirenone (Slynd): general benefit
Drospirenone + ethinyl estradiol (Yasmin 21): general benefit
Ethinyl estradiol + norethindrone (Brevicon): general benefit
Ethinyl estradiol + norethindrone (Minestrin 1/20): general benefit
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 ETHINYL ESTRADIOL 30 MCG, LEVONORGESTREL 150 MCG · company Pfizer canada ulc · schedule Prescription
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=18754Interchangeable 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
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=87265Interchangeable 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
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 ETHINYL ESTRADIOL 0.03 MG, LEVONORGESTREL 0.15 MG · company Teva canada limited · schedule Prescription
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=78129Interchangeable 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
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 ETHINYL ESTRADIOL 30 MCG, LEVONORGESTREL 150 MCG · company Pfizer canada ulc · schedule Prescription
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=18755Interchangeable 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
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 ETHINYL ESTRADIOL 30 MCG, LEVONORGESTREL 150 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=87266Interchangeable 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
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
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=78130Interchangeable 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: 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: 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
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
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=60269Interchangeable 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
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=87345Interchangeable 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
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=102123Interchangeable 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
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=78383Interchangeable 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
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=90899Interchangeable 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
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 ETHINYL ESTRADIOL 20 MCG, LEVONORGESTREL 100 MCG · company Pfizer canada ulc · schedule Prescription
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=60270Interchangeable 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
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=87346Interchangeable 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
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 ETHINYL ESTRADIOL 20 MCG, LEVONORGESTREL 100 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=102124Interchangeable 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
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=88378Interchangeable 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: 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=78201Interchangeable 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
Other drugs in the same formulary classes and how they are covered
Other drugs in the same formulary class (68:12 Contraceptives) and how they are covered
Matched class: 68:12 Contraceptives
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: ETONOGESTREL
68:12 Contraceptives
Other drugs in the same formulary class (68:32 Progestogens and Oral Contraceptives) and how they are covered
Matched class: 68:32 Progestogens and Oral Contraceptives
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: DESOGESTREL & ETHINYL ESTRADIOL, DROSPIRENONE, DROSPIRENONE & ETHINYL ESTRADIOL, ETHINYL ESTRADIOL & NORETHINDRONE, ETHINYL ESTRADIOL & NORETHINDRONE ACETATE
Some products covered without a code (check the product listing): MEDROXYPROGESTERONE ACETATE, NORETHINDRONE, NORGESTIMATE & ETHINYL ESTRADIOL
68:32 Progestogens and Oral Contraceptives
· 10 products · Temporary benefit (2), General benefit; DIN status E (meaning unconfirmed); confirm discontinuation/availability with Health Canada (3), General benefit (4), Listed, not a benefit (1) · strengths: 150mg/mL, 2.5mg, 5mg, 10mg, 100mg · Inj Sol-1mL Pref Syr, Tab
· 8 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 100mg · Cap
Source: formulary-ed43-front-matter.txt Part V; ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26; class 68:32
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.
Covered without a code on the Ontario formulary: DESOGESTREL & ETHINYL ESTRADIOL, DROSPIRENONE & ETHINYL ESTRADIOL
DESOGESTREL & ETHINYL ESTRADIOL · General benefit
• Conception control
PM: https://pdf.hres.ca/dpd_pm/00077799.PDF; date NOV 20, 2024; DIN 02042479; fetched 2026-09-10
Product monographDROSPIRENONE & ETHINYL ESTRADIOL · General benefit
• Conception Control
PM: https://pdf.hres.ca/dpd_pm/00080997.PDF; date 2025-07-07; DIN 02261723; fetched 2026-09-10
Product monographETHINYL ESTRADIOL & ETONOGESTREL · Off-Formulary Interchangeable, not an ODB benefit
• Conception control
PM: https://pdf.hres.ca/dpd_pm/00077755.PDF; date DEC 12, 2004; DIN 02253186; fetched 2026-09-10
Product monographNORETHINDRONE · Listed, not a benefit (1), General benefit (2)
INDICATIONS AND CLINICAL USE
MOVISSE Tablets are indicated for conception control.
PM: https://pdf.hres.ca/dpd_pm/00085300.PDF; date JUL 10, 2026; DIN 02410303; fetched 2026-09-10
Product monographNORGESTIMATE & ETHINYL ESTRADIOL · Listed, not a benefit (4), General benefit (6)
Indications
TRI-CIRA LOTM 21 and TRI-CIRA LOTM 28 (Norgestimate and Ethinyl Estradiol Tablets) are indicated for:
Conception control.
1.1.
PM: https://pdf.hres.ca/dpd_pm/00081457.PDF; date 2025-08-21; DIN 02401967; fetched 2026-09-10
Product monograph
Coverage source: ON formulary extract 2026-08-26
What the Health Canada label says it is for
1 Indications
MIRENA (levonorgestrel-releasing intrauterine system) is indicated for:
• conception control for maximum up to 8 years
• treatment of idiopathic menorrhagia following appropriate diagnostic investigation for up to 5 years
in individuals accepting the contraceptive effect of MIRENA
1.1 Pediatrics
Pediatrics (<18 years of age): No data are available to Health Canada; therefore, Health Canada has not
authorized an indication for pediatric use.
1.2 Geriatrics
Geriatrics: MIRENA has not been studied in individuals over the age of 65 years. No data are available to
Health Canada, therefore, Health Canada has not authorized an indication for geriatric use.
https://pdf.hres.ca/dpd_pm/00081240.PDF
PM date: 2025-07-30
Source product: MIRENA; DIN 02243005; fetched 2026-09-10
Product monograph posted by Health Canada; excerpt for lookup only.
What the Health Canada label says it is for
1 Indications
TRIQUILAR (levonorgestrel and ethinyl estradiol) is indicated for:
• Conception control
1.1 Pediatrics
Pediatrics (˂16 years of age): Based on the data submitted and reviewed by Health Canada, Health
Canada has authorized an indication in women of reproductive age. TRIQUILAR is not indicated for use
before menarche (see 7.1.3 Pediatrics).
1.2 Geriatrics
Geriatrics: TRIQUILAR is not indicated for use in postmenopausal women. No data are available to
Health Canada; therefore, Health Canada has not authorized an indication for geriatric use.
https://pdf.hres.ca/dpd_pm/00081001.PDF
PM date: 2025-07-07
Source product: TRIQUILAR 28; DIN 00707503; fetched 2026-09-10
Product monograph posted by Health Canada; excerpt for lookup only.
Availability
Min-Ovral 21 · DIN 02042320
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
Min-Ovral 28 · DIN 02042339
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
Aviane 21 · DIN 02298538
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
Seasonale · DIN 02296659
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
For Indayo, Seasonale: no applicable EAP criteria are held and no ODB benefit is established. These policies do not establish coverage.
For rare, immediately life-, limb- or organ-threatening circumstances, the Compassionate Review Policy may consider an unfunded drug or indication, subject to its criteria and without bypassing the drug review process. Compassionate Review Policy
Compassionate Review Policy: source quote
Where there are rare clinical circumstances in immediately life, limb, or organ-threatening conditions, the Executive Officer will also consider requests for drugs or indications in situations where there has not been a decision by the Executive Officer to provide funding of the drug or indication as part of the Ontario Drug Benefit program (and the EAP), and the drug or indication requested would not circumvent the established review process for new drugs or indications as part of the drug submission process for listing within the Ontario Drug Benefit program. Requests must meet the criteria for the Compassionate Review Policy.
For cancer drugs, Case-by-Case Review considers rare, immediately life-threatening circumstances when no satisfactory funded treatment exists; its criteria and application process apply. Case-by-Case Review (cancer drugs)
Case-by-Case Review (cancer drugs): source quote
Note: Requests for cancer drugs are considered under the Case-by-Case Review Program (CBCRP) which is administered by Ontario Health (Cancer Care Ontario) on behalf of the Ministry of Health. The CBCRP considers funding requests for drugs (both oral therapies and injectable drugs) for the treatment of cancer in patients who have a rare clinical circumstance that is immediately life-threatening (death is likely within a matter of months) and who require treatment with an unfunded drug, because there is no other satisfactory and funded treatment. Please refer to the Ontario Health website for information on the application process, FAQs, eligibility criteria and program policies.