C1 cda approximate cost reference list for antihyperglycemic agents 2016

Appendix 5 (March 2016)Approximate Cost Reference Listi for Antihyperglycemic Agents

ANTIHYPERGLYCEMIC AGENTS

AVAILABLE STRENGTHS

USUAL MAINTENANCE DOSE OR USUAL DOSAGE RANGE

APPROXIMATE WHOLESALE COST*/UNIT

Alpha Glucosidase Inhibitor

Acarbose (Glucobay™)100 mg 50 - 100 mg three times a day $ 0.41/Tab

50 mg 50 - 100 mg three times a day $ 0.29/Tab

Biguanides

Metformin(Glucophage®, generic)

500 mg 500 - 2000 mg per day in divided doses $ 0.05/Tab

850 mg 850 - 2550 mg per day in divided doses $ 0.06/Tab

Metformin ER (Glumetza®)

500 mg 500 - 2000 mg per day $ 0.63/Tab

1000 mg 500 - 2000 mg per day $ 1.27/Tab

Incretin Agents – DPP-4 Inhibitors

Alogliptin (Nesina™)

6.25 mg 6.25 mg once daily (depending on renal function) $ 2.84/Tab

12.5 mg 12.5 mg once daily (depending on renal function) $ 2.84/Tab

25 mg 25 mg once daily (depending on renal function) $ 2.84/Tab

Linagliptin (Trajenta®) 5 mg 5 mg once daily $ 2.43/Tab

Saxagliptin (Onglyza®)2.5 mg 2.5 - 5 mg once daily $ 2.57/Tab

5 mg 2.5 - 5 mg once daily $ 3.09/Tab

Sitagliptin (Januvia®)



100 mg 100 mg once daily $ 3.21/Tab

Incretin Agents – GLP-1 Receptor Agonists

Albiglutide (Eperzan™) N/A N/A N/A

Dulaglutide(Trulicity™)

0.75 mg & 1.5 mg prefilled pen

Available in packages of 2 or 4 pens

Initial dose of 0.75 mg once weekly, increasing to 1.5 mg once weekly

$ 52.03 per week = an average of $ 7.43/per day(supplied as prefilled pen)

Exenatide (Byetta®)

5 mcg prefilled pen (250 µg/mL)

10 mcg twice a day

$ 2.60/5 mcg dose = an average cost of $5.20/day or $ 36.38/week (supplied as prefilled pen)

10 mcg prefilled pen (250 µg/mL)

10 mcg twice a day

$ 2.60/10 mcg dose) = an average cost of $5.20/day or $ 36.38/week (supplied as prefilled pen

guidelines.diabetes.cadiabetes.ca | 1-800-BANTING (226-8464)Updated March 2016. Copyright © 2016 Canadian Diabetes Association.


AVAILABLE STRENGTHS



Exenatide Extended Release (Bydureon®)

2 mg prefilled pen (Sold in

packages of 4 pens)Single dose of 2 mg injected once weekly

$ 52.01 per week = an average of $ 7.43/per day(Supplied as prefilled pen)

Liraglutide (Victoza®)6 mg/mL

prefilled pen1.2 - 1.8 mg once daily

$ 2.98/0.6 mg dose = an average cost of $ 20.86 per week$ 5.96/1.2 mg dose = an average cost of $ 41.77 per week$ 8.95/1.8 mg dose = an average cost of $ 62.65 per week (supplied as prefilled pen)

Insulin Secretagogues – Sulfonylureas

Gliclazide(Diamicron®, generic)

80 mg80 - 320 mg per day (doses > 160 mg should be twice a day)

$ 0.09/Tab

Gliclazide (Diamicron MR®, generic)

30 mg 30 - 120 mg once daily $ 0.09/Tab


Glimepiride (Amaryl®, generic)

1 mg1 - 4 mg once daily (may increase to a maximum dose of 8 mg/day)

$ 0.44/Tab


$ 0.44/Tab


$ 0.44/Tab

Glyburide (Diabeta®, generic)

2.5 mg 1.25 - 20 mg daily, taken usually twice per day $ 0.04/Tab

5 mg 1.25 - 20 mg daily, taken usually twice per day $ 0.06/Tab

Note: chlorpropamide and tolbutamide are still available in Canada, but rarely used

Insulin Secretagogues – Meglitinides

Nateglinide (Starlix) (Discontinued)

60 mg 120 mg three times a day $ 0.60/Tab

120 mg 120 mg three times a day $ 0.63/Tab

Repaglinide(Gluconorm®, generic)

0.5 mg0.5 - 4 mg taken with meals (max daily dose: 16 mg/day)

$ 0.15/Tab

1 mg0.5 - 4 mg taken with meals (max daily dose: 16 mg/day)

$ 0.16/Tab

2 mg0.5 - 4 mg taken with meals (max daily dose: 16 mg/day)

$ 0.18/Tab



AVAILABLE STRENGTHS



Sodium Glucose co-transporter 2 inhibitors (SGLT2)

Canagliflozin (Invokana™)100 mg 100 - 300 mg once daily $ 2.84/Tab


Dapagliflozin (Forxiga®)5 mg 5 - 10 mg once daily $ 2.84/Tab


Empagliflozin (Jardiance™)



Thiazolidinediones

Pioglitazone (Actos) generic



45 mg Maximum daily dose $ 2.72/Tab

Rosiglitazone (Avandia®)

2 mg 4 - 8 mg daily as a single or as a divided dose $ 1.49/Tab



Weight Loss Agent

Xenical® 120 mg tab 120 mg three times a day $ 1.78/Tab

Combination Products

Alogliptin/Metformin (Kazano™)

12.5 mg/ 500 mg

Usual dose 1 tablet twice per day $ 1.49/Tab

12.5 mg/ 850 mg


12.5 mg/ 1000 mg


Dapagliflozin/Metformin (Xigduo® )

5 mg/850 mg Usual dose 1 tablet twice per day (taken with food) $ 1.42/Tab

5 mg/1000 mg Usual dose 1 tablet twice per day (taken with food) $ 1.42/Tab

Linagliptin/Metformin (Jentadueto™)

2.5 mg/500 mg Usual dose 1 tablet twice per day $ 1.37/Tab

2.5 mg/ 850 mg


2.5 mg/ 1000 mg




AVAILABLE STRENGTHS



Rosiglitazone/Metformin (AvandaMet®)

2 mg/500 mgStarting dose of 2 mg/500 mg may increase to a maximum dose of 8 mg/2000 mg per day

$ 1.26/Tab


$ 1.38/Tab


$ 1.73/Tab


$ 1.83/Tab

Saxagliptin/Metformin (Komboglyze®)

2.5 mg/ 500 mg


2.5 mg/ 850 mg


2.5 mg/ 1000 mg


Sitagliptin/Metformin (Janumet®)

50 mg/ 500 mg


50 mg/ 850 mg


50 mg/ 1000 mg


Sitagliptan/Metformin Extended Release Formula (Janumet XR®)

50 mg/ 500 mg

Usual dose 2 tablets once daily $ 1.61/Tab

50 mg/ 1000 mg

Usual dose 2 tablets once daily $ 1.61/Tab

100 mg/1000 mg (currently only

available in Quebec)Usual dose 1 tablets once daily $ 1.61/Tab


Approximate Cost Reference for Insulinsii


AVAILABLE STRENGTHSUSUAL MAINTENANCE DOSE

OR USUAL DOSAGE RANGE

UNIT COST FOR PEN

CARTRIDGE

UNIT COST FOR PRE-

FILLED PEN

PRANDIAL (BOLUS) INSULINS

Rapid-Acting Insulin Analogues

Aspart (NovoRapid®)

100 units/mL(300 units/cartridge)

N/A as dose is determined by response by patient

$ 0.043/unit $ 0.044/unit

Glulisine (Apidra®)100 units/mL

(300 units/cartridge)N/A as dose is determined by response by patient

$ 0.036/unit $ 0.036/unit

Lispro (Humalog®)100 units/mL


$ 0.041/unit $ 0.040/unit

Lispro 200 units/mL (Humalog®)

200 units/mL (600 units/prefilled pen)


N/A $ 0.037/unit

Short-Acting

Insulin regular (Humulin®-R)



$ 0.033/unit N/A

Insulin regular (Novolin®ge Toronto)



$ 0.031/unit N/A

Note: Pork regular insulin (Hypurin® Regular Insulin Pork) and pork isophane insulin (Hypurin® NPH Insulin Isophane) are available but rarely used.

BASAL INSULINS

Intermediate-acting

Insulin NPH (Humulin®-N)



$ 0.033/unit $ 0.033/unit

Insulin NPH (Novolin®ge NPH)



$ 0.031/unit N/A

Long-acting Basal Insulin Analogues

Determir (Levemir®)100 units/mL


$ 0.075/unit $ 0.078/unit

Glargine 100 units/mL (Lantus®)



$ 0.067/unit $ 0.067/unit

Glargine 300 units/mL(Toujeo™)

300 units/mL(450 units/prefilled pen)


N/A $ 0.064/unit

Note: Pork regular insulin (Hypurin® Regular Insulin Pork) and pork isophane insulin (Hypurin® NPH Insulin Isophane) are available but rarely used.

SUBSEQUENT ENTRY BIOLOGICS (SEB)

Long-acting Basal Insulin Analogues

Glargine (rDNA origin) 100 units/mL (Basaglar™)

100 units/mL (300 units/ cartridge)


$ 0.057/unit $ 0.057/unit


* Approximate unit drug cost not including dispensing/professional fee and pharmacy mark-up. Approximate Canadian Cost average is the weighted wholesale cost (including a wholesale mark-up charge) to the pharmacy before dispensing.

i The listed medications represent both the classes and the agents that are most commonly used in primary care practices. It is not meant to be an exhaustive list, and is intended only as a guide for the family physician.

ii Insulin prices are based on the pen cartridge price and corresponding vial price would be marginally less


AVAILABLE STRENGTHSUSUAL MAINTENANCE DOSE

OR USUAL DOSAGE RANGE

UNIT COST FOR PEN

CARTRIDGE

UNIT COST FOR PRE-

FILLED PEN

PREMIXED INSULINS

Premixed Regular Insulin – NPH

Insulin regular/NPH (Humulin® 30/70)



$ 0.028/unit N/A

Insulin regular/NPH (Novolin®ge 30/70, 40/60, 50/50)



$ 0.031/unit N/A

Premixed Insulin Analogues

Aspart 30%/aspart protamine 70% (NovoMix®30)



$ 0.040/unit N/A

Lispro 25%/lispro protamine 75% (Humalog Mix25™)

100 units/mL (300 units/cartridge)


$ 0.041/unit $ 0.040/unit

Lispro 50%/lispro protamine 50% (Humalog Mix50™)



$ 0.040/unit $ 0.040/unit


C1 cda approximate cost reference list for antihyperglycemic agents 2016

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Transcript of C1 cda approximate cost reference list for antihyperglycemic agents 2016