Information for Vermont Prescribers of Prescription Drugs (Long Form)

Transcription

1 Information for Vermont Prescribers of Prescription Drugs (Long Form) Beyaz (Drospirenone-Ethinyl Estradiol-Levomefolate Calcium) This list does not imply that the products on this chart are interchangeable or have the same efficacy or safety. Please refer to each product s FDA-approved label and indication for further information. The prices listed below are Average Wholesale s ("AWP") as established and made available to the public by a third party publisher or as calculated from data made available to the public by a third party publisher. The price paid by consumers may be higher or lower than the prices listed below. Information about AWP of these drugs is being provided to Vermont prescribers pursuant to Vermont law, to give you information about the relative prices of marketed drugs and other drugs in the same therapeutic class. The prices listed here do not necessarily reflect price per dosage, price per course of treatment, or the cost effectiveness of all the products listed. For simplicity, only the smallest package sizes available for each product are included. Marketed Product: Product Name Manufacturer NDC Beyaz Oral Tablet Pkg Size PHARMA $6.45 Other Products: Product Name Manufacturer NDC Size Aftera Oral Tablet 1.5 TEVA/WOMENS HEALTH $16.20 $16.20 Altavera Oral Tablet SANDOZ $92.76 $1.10 Alyacen 1/35 Oral Tablet 1-35 Alyacen 7/7/7 Oral Tablet 0.5/0.75/1-35 PHARMACEUTICALS $93.10 $1.11 PHARMACEUTICALS $ $1.21 Amethia Lo Oral Tablet & 0.01 ACTAVIS PHARMA $ $2.95 Amethia Oral Tablet &0.01 ACTAVIS PHARMA $ $2.95 Amethyst Oral Tablet ACTAVIS PHARMA $59.40 $2.12 Apri Oral Tablet Aranelle Oral Tablet 0.5/1/ Ashlyna Oral Tablet &0.01 USA $ $1.09 USA $ $1.41 PHARMACEUTICALS $ $3.35 Aubra Oral Tablet AFAXYS $35.16 $1.26 Aviane Oral Tablet USA $ $1.26 1

2 Azurette Oral Tablet /0.01 (21/5) ACTAVIS PHARMA $ $2.14 Balziva Oral Tablet USA $ $1.60 Bekyree Oral Tablet /0.01 (21/5) LUPIN PHARMACEUTICALS $59.98 $2.14 Beyaz Oral Tablet PHARMA $ $6.45 Blisovi 24 Fe Oral Tablet 1-20 (24) LUPIN PHARMACEUTICALS $89.54 $3.20 Blisovi Fe 1.5/30 Oral Tablet LUPIN PHARMACEUTICALS $28.94 $1.03 Blisovi FE 1/20 Oral Tablet 1-20 LUPIN PHARMACEUTICALS $28.66 $1.02 Brevicon (28) Oral Tablet ACTAVIS PHARMA $ $2.66 Briellyn Oral Tablet Camila Oral Tablet 0.35 Camrese Lo Oral Tablet & 0.01 Camrese Oral Tablet &0.01 PHARMACEUTICALS $ $1.60 USA $ $1.32 USA $ $2.95 USA $ $2.95 Caziant Oral Tablet 0.1/0.125/ ACTAVIS PHARMA $ $1.20 Chateal Oral Tablet AFAXYS $30.93 $1.10 Cryselle-28 Oral Tablet USA $ $1.09 Cyclafem 1/35 Oral Tablet 1-35 PAR PHARMACEUTICALS $93.11 $1.11 Cyclafem 7/7/7 Oral Tablet 0.5/0.75/1-35 PAR PHARMACEUTICALS $ $1.21 Cyclessa Oral Tablet 0.1/0.125/ PRASCO LABORATORIES $69.19 $2.47 Cyred Oral Tablet AFAXYS $35.22 $1.26 Dasetta 1/35 Oral Tablet 1-35 NORTHSTAR RX $29.49 $1.05 Dasetta 7/7/7 Oral Tablet 0.5/0.75/1-35 NORTHSTAR RX $32.22 $1.15 Daysee Oral Tablet &0.01 LUPIN PHARMACEUTICALS $ $2.95 2

3 Deblitane Oral Tablet 0.35 NORTHSTAR RX $49.47 $1.77 Delyla Oral Tablet OHM LABS $35.16 $1.26 Desogen Oral Tablet ORGANON $57.18 $2.04 Desogestrel-Ethinyl Estradiol Oral Tablet /0.01 (21/5) MYLAN $ $2.14 Desogestrel-Ethinyl Estradiol Oral Tablet NORTHSTAR RX $36.39 $1.30 Drospirenone-Ethinyl Estradiol Oral Tablet Drospirenone-Ethinyl Estradiol Oral Tablet PHARMACEUTICALS $ $3.62 PHARMACEUTICALS $ $2.74 Drospirenone-Ethinyl Estradiol Oral Tablet LUPIN PHARMACEUTICALS $76.68 $2.74 Drospirenone-Ethinyl Estradiol Oral Tablet MYLAN $ $2.74 EContra EZ Oral Tablet 1.5 AFAXYS $36.56 $36.56 Elinest Oral Tablet NORTHSTAR RX $30.52 $1.09 Ella Oral Tablet 30 AFAXYS $42.90 $42.90 Emoquette Oral Tablet PAR PHARMACEUTICALS $ $1.40 Enpresse-28 Oral Tablet USA $ $0.98 Enpresse-28 Oral Tablet TEVA/WOMENS HEALTH $ $0.98 Enskyce Oral Tablet LUPIN PHARMACEUTICALS $39.34 $1.41 Errin Oral Tablet 0.35 USA $ $1.32 Estarylla Oral Tablet SANDOZ $96.69 $1.15 Estrostep Fe Oral Tablet 1-20/1-30/1-35 ACTAVIS $ $6.86 Fallback Solo Oral Tablet 1.5 LUPIN PHARMACEUTICALS $36.56 $36.56 Falmina Oral Tablet NORTHSTAR RX $35.16 $1.26 Femcon Fe Oral Tablet Chewable ACTAVIS $ $5.98 3

4 Generess FE Oral Tablet Chewable ACTAVIS PHARMA $ $5.60 Gianvi Oral Tablet USA $70.81 $2.53 Gildagia Oral Tablet PAR PHARMACEUTICALS $ $1.60 Gildess 1.5/30 Oral Tablet PAR PHARMACEUTICALS $28.94 $1.38 Gildess 1/20 Oral Tablet 1-20 PAR PHARMACEUTICALS $28.66 $1.36 Gildess 24 FE Oral Tablet 1-20 (24) PAR PHARMACEUTICALS $ $3.20 Gildess FE 1.5/30 Oral Tablet PAR PHARMACEUTICALS $ $1.03 Gildess FE 1/20 Oral Tablet 1-20 PAR PHARMACEUTICALS $ $1.02 Heather Oral Tablet 0.35 PHARMACEUTICALS $ $1.32 Introvale Oral Tablet SANDOZ $ $1.77 Jencycla Oral Tablet 0.35 LUPIN PHARMACEUTICALS $36.92 $1.32 Jolessa Oral Tablet USA $ $1.77 Jolivette Oral Tablet 0.35 ACTAVIS PHARMA $ $1.32 Juleber Oral Tablet NORTHSTAR RX $34.93 $1.25 Junel 1.5/30 Oral Tablet Junel 1/20 Oral Tablet Junel FE 1.5/30 Oral Tablet Junel FE 1/20 Oral Tablet 1-20 Junel Fe 24 Oral Tablet 1-20 (24) USA $86.81 $1.38 USA $85.97 $1.36 USA $ $1.03 USA $ $1.02 USA $89.54 $3.20 Kaitlib Fe Oral Tablet Chewable LUPIN PHARMACEUTICALS $ $4.36 Kariva Oral Tablet /0.01 (21/5) Kelnor 1/35 Oral Tablet 1-35 USA $ $2.14 USA $ $1.07 4

5 Kimidess Oral Tablet /0.01 (21/5) PAR PHARMACEUTICALS $ $2.14 Kurvelo Oral Tablet LUPIN PHARMACEUTICALS $30.93 $1.10 Larin 1.5/30 Oral Tablet NORTHSTAR RX $28.94 $1.38 Larin 1/20 Oral Tablet NORTHSTAR RX $28.66 $1.36 Larin 24 FE Oral Tablet 1-20 (24) NORTHSTAR RX $89.54 $3.20 Larin Fe 1.5/30 Oral Tablet NORTHSTAR RX $28.94 $1.03 Larin Fe 1/20 Oral Tablet 1-20 NORTHSTAR RX $28.66 $1.02 Layolis FE Oral Tablet Chewable ACTAVIS PHARMA $ $4.36 Leena Oral Tablet 0.5/1/ ACTAVIS PHARMA $ $1.41 Lessina Oral Tablet USA $ $1.25 Levonest Oral Tablet NORTHSTAR RX $27.49 $0.98 Levonorgest-Eth Estrad 91-Day Oral Tablet & 0.01 LUPIN PHARMACEUTICALS $ $2.95 Levonorgest-Eth Estrad 91-Day Oral Tablet &0.01 MYLAN $ $2.95 Levonorgest-Eth Estrad 91-Day Oral Tablet PHARMACEUTICALS $ $1.77 Levonorgest-Eth Estrad 91-Day Oral Tablet LUPIN PHARMACEUTICALS $ $1.77 Levonorgest-Eth Estrad 91-Day Oral Tablet MYLAN $ $1.77 Levonorgestrel Oral Tablet 1.5 PHARMACIST PHARMACEUTICAL LLC $36.56 $36.56 Levonorgestrel-Ethinyl Estrad Oral Tablet LUPIN PHARMACEUTICALS $35.16 $1.26 Levonorgestrel-Ethinyl Estrad Oral Tablet MYLAN $35.16 $1.26 Levonorgestrel-Ethinyl Estrad Oral Tablet MYLAN $92.79 $1.10 Levonorgestrel-Ethinyl Estrad Oral Tablet PHARMACEUTICALS $59.40 $2.12 Levonorg-Eth Estrad Triphasic Oral Tablet LUPIN PHARMACEUTICALS $27.49 $0.98 5

6 Levora 0.15/30 (28) Oral Tablet ACTAVIS PHARMA $ $1.10 Lo Loestrin Fe Oral Tablet 1-10 / 10 ACTAVIS $ $4.61 Loestrin 1.5/30 (21) Oral Tablet TEVA/WOMENS HEALTH $ $5.77 Loestrin 1/20 (21) Oral Tablet 1-20 TEVA/WOMENS HEALTH $ $5.77 Loestrin Fe 1.5/30 Oral Tablet TEVA/WOMENS HEALTH $ $4.33 Loestrin Fe 1/20 Oral Tablet 1-20 TEVA/WOMENS HEALTH $ $4.33 Lomedia 24 FE Oral Tablet 1-20 (24) AMNEAL PHARMACEUTICALS $ $3.20 Loryna Oral Tablet SANDOZ $ $2.53 LoSeasonique Oral Tablet & 0.01 TEVA/WOMENS HEALTH $ $3.87 Low-Ogestrel Oral Tablet ACTAVIS PHARMA $ $1.09 Lutera Oral Tablet ACTAVIS PHARMA $ $1.26 Lyza Oral Tablet 0.35 AFAXYS $36.92 $1.32 Marlissa Oral Tablet PHARMACEUTICALS $30.92 $1.10 Microgestin 1.5/30 Oral Tablet ACTAVIS PHARMA $ $1.23 Microgestin 1/20 Oral Tablet 1-20 ACTAVIS PHARMA $ $1.36 Microgestin 24 Fe Oral Tablet 1-20 ACTAVIS PHARMA $89.54 $3.20 Microgestin FE 1.5/30 Oral Tablet ACTAVIS PHARMA $ $1.03 Microgestin FE 1/20 Oral Tablet 1-20 ACTAVIS PHARMA $ $1.02 Minastrin 24 Fe Oral Tablet Chewable 1-20 (24) ACTAVIS $0.00 $0.00 Mircette Oral Tablet /0.01 (21/5) TEVA/WOMENS HEALTH $ $4.52 Modicon (28) Oral Tablet JANSSEN $ $2.50 Mono-Linyah Oral Tablet NORTHSTAR RX $32.23 $1.15 6

7 MonoNessa Oral Tablet ACTAVIS PHARMA $ $1.22 My Way Oral Tablet 1.5 GAVIS PHARMACEUTICALS $36.56 $36.56 Myzilra Oral Tablet PAR PHARMACEUTICALS $82.47 $0.98 Natazia Oral Tablet 3/2-2/2-3/1 PHARMA $ $6.45 Necon 0.5/35 (28) Oral Tablet ACTAVIS PHARMA $ $1.15 Necon 1/35 (28) Oral Tablet 1-35 ACTAVIS PHARMA $ $1.05 Necon 1/50 (28) Oral Tablet 1-50 ACTAVIS PHARMA $88.41 $1.05 Necon 10/11 (28) Oral Tablet 35 ACTAVIS PHARMA $ $1.15 Necon 7/7/7 Oral Tablet 0.5/0.75/1-35 ACTAVIS PHARMA $ $1.15 Next Choice One Dose Oral Tablet 1.5 ACTAVIS PHARMA $36.56 $36.56 Nikki Oral Tablet LUPIN PHARMACEUTICALS $70.81 $2.53 Nora-BE Oral Tablet 0.35 ACTAVIS PHARMA $ $1.32 Norethin Ace-Eth Estrad-FE Oral Tablet 1-20 MYLAN $85.97 $1.02 Norethin Ace-Eth Estrad-FE Oral Tablet 1-20 (24) MYLAN $ $3.20 Norethindrone Acet-Ethinyl Est Oral Tablet 1-20 PHARMACEUTICALS $85.98 $1.36 Norethindrone Acet-Ethinyl Est Oral Tablet 1-20 MYLAN $85.97 $1.36 Norethindrone Oral Tablet 0.35 PHARMACEUTICALS $ $1.32 Norethindrone Oral Tablet 0.35 LUPIN PHARMACEUTICALS $36.92 $1.32 Norethindrone Oral Tablet 0.35 MYLAN $ $1.32 Norethindrone Oral Tablet 0.35 NORTHSTAR RX $36.92 $1.32 Norethin-Eth Estradiol-Fe Oral Tablet Chewable MYLAN $ $4.36 Norgestimate-Eth Estradiol Oral Tablet PHARMACEUTICALS $36.50 $1.30 7

8 Norgestim-Eth Estrad Triphasic Oral Tablet 0.18/0.215/ PHARMACEUTICALS $ $5.75 Norgestim-Eth Estrad Triphasic Oral Tablet 0.18/0.215/ MYLAN $ $5.23 Norgestim-Eth Estrad Triphasic Oral Tablet 0.18/0.215/ PHARMACEUTICALS $ $1.40 Norinyl 1+35 (28) Oral Tablet 1-35 ACTAVIS PHARMA $ $2.66 Norlyroc Oral Tablet 0.35 OHM LABS $ $3.96 Nor-QD Oral Tablet 0.35 ACTAVIS PHARMA $ $2.66 Nortrel 0.5/35 (28) Oral Tablet Nortrel 1/35 (21) Oral Tablet 1-35 Nortrel 1/35 (28) Oral Tablet 1-35 Nortrel 7/7/7 Oral Tablet 0.5/0.75/1-35 USA $96.52 $1.15 USA $88.50 $1.40 USA $ $1.05 USA $ $1.15 Ocella Oral Tablet USA $76.68 $2.74 Ogestrel Oral Tablet ACTAVIS PHARMA $ $1.60 Opcicon One-Step Oral Tablet 1.5 SUN PHARMACEUTICALS $24.00 $24.00 Orsythia Oral Tablet PAR PHARMACEUTICALS $ $1.26 Ortho Micronor Oral Tablet 0.35 JANSSEN $ $1.97 Ortho Tri-Cyclen (28) Oral Tablet 0.18/0.215/ JANSSEN $ $1.80 Ortho Tri-Cyclen Lo Oral Tablet 0.18/0.215/ JANSSEN $1, $6.40 Ortho-Cyclen (28) Oral Tablet JANSSEN $50.53 $1.80 Ortho-Novum 1/35 (28) Oral Tablet 1-35 JANSSEN $ $3.04 Ortho-Novum 7/7/7 (28) Oral Tablet 0.5/0.75/1-35 JANSSEN $45.82 $1.64 Pimtrea Oral Tablet /0.01 (21/5) NORTHSTAR RX $59.98 $2.14 8

9 Pirmella 1/35 Oral Tablet 1-35 LUPIN PHARMACEUTICALS $29.47 $1.05 Pirmella 7/7/7 Oral Tablet 0.5/0.75/1-35 LUPIN PHARMACEUTICALS $32.23 $1.15 Plan B One-Step Oral Tablet 1.5 TEVA/WOMENS HEALTH $39.00 $39.00 Portia-28 Oral Tablet USA $ $1.10 Previfem Oral Tablet PAR PHARMACEUTICALS $ $1.15 Quartette Oral Tablet DAYS TEVA/WOMENS HEALTH $ $4.64 Quasense Oral Tablet ACTAVIS PHARMA $ $1.77 React Oral Tablet 1.5 WOCKHARDT USA $36.56 $36.56 Reclipsen Oral Tablet ACTAVIS PHARMA $ $1.41 Safyral Oral Tablet PHARMA $ $6.45 Seasonique Oral Tablet &0.01 TEVA/WOMENS HEALTH $ $3.87 Setlakin Oral Tablet NORTHSTAR RX $ $1.77 Sharobel Oral Tablet 0.35 NORTHSTAR RX $37.49 $1.34 Sprintec 28 Oral Tablet USA $ $1.15 Sronyx Oral Tablet ACTAVIS PHARMA $ $1.26 Syeda Oral Tablet SANDOZ $ $2.74 Take Action Oral Tablet 1.5 TEVA/WOMENS HEALTH $39.00 $39.00 Tarina FE 1/20 Oral Tablet 1-20 AFAXYS $28.66 $1.02 Tilia Fe Oral Tablet 1-20/1-30/1-35 ACTAVIS PHARMA $ $2.04 Tri-Estarylla Oral Tablet 0.18/0.215/ SANDOZ $ $1.40 Tri-Legest Fe Oral Tablet 1-20/1-30/1-35 USA $ $2.04 Tri-Linyah Oral Tablet 0.18/0.215/ NORTHSTAR RX $39.32 $1.40 9

10 Tri-Lo-Estarylla Oral Tablet 0.18/0.215/ SANDOZ $ $2.20 Tri-Lo-Marzia Oral Tablet 0.18/0.215/ LUPIN PHARMACEUTICALS $ $5.24 Tri-Lo-Sprintec Oral Tablet 0.18/0.215/ USA $ $5.24 TriNessa (28) Oral Tablet 0.18/0.215/ ACTAVIS PHARMA $ $1.40 TriNessa Lo Oral Tablet 0.18/0.215/ ACTAVIS PHARMA $32.60 $1.16 Tri-Norinyl (28) Oral Tablet 0.5/1/ ACTAVIS PHARMA $ $2.90 Tri-Previfem Oral Tablet 0.18/0.215/ PAR PHARMACEUTICALS $ $1.40 Tri-Sprintec Oral Tablet 0.18/0.215/ USA $ $1.40 Trivora (28) Oral Tablet ACTAVIS PHARMA $ $0.98 Velivet Oral Tablet 0.1/0.125/ USA $ $1.20 Vestura Oral Tablet ACTAVIS PHARMA $70.81 $2.53 Vienva Oral Tablet SANDOZ $88.30 $1.05 Viorele Oral Tablet /0.01 (21/5) PHARMACEUTICALS $59.98 $2.14 Vyfemla Oral Tablet LUPIN PHARMACEUTICALS $ $1.60 Wera Oral Tablet NORTHSTAR RX $16.09 $0.57 Wymzya Fe Oral Tablet Chewable LUPIN PHARMACEUTICALS $ $2.61 Yasmin 28 Oral Tablet YAZ Oral Tablet PHARMA $ $4.42 PHARMA $ $4.42 Zarah Oral Tablet ACTAVIS PHARMA $ $2.74 Zenchent FE Oral Tablet Chewable AMNEAL PHARMACEUTICALS $ $3.20 Zenchent Oral Tablet ACTAVIS PHARMA $ $1.60 Zovia 1/35E (28) Oral Tablet 1-35 ACTAVIS PHARMA $ $

11 Zovia 1/50E (28) Oral Tablet 1-50 ACTAVIS PHARMA $ $1.19 Source: Medispan Release date: July 2016 For additional price comparison information see: 11