Appendix 5 (2015)

Approximate Cost Reference Listi for Antihyperglycemic Agents

Part A:

Antihyperglycemic Agents Available strengths Usual maintenance dose
or usual dosage range
Approximate
Wholesale cost*/unit
Alpha Glucosidase Inhibitor
Acarbose (Glucobay™) 100 mg
50 mg
50-100 mg three times a day $ 0.41/Tab
$ 0.29/Tab
Biguanides
Metformin
(Glucophage®, generic)
500 mg
850 mg
500-2000 mg per day in divided doses
850-2550 mg per day in divided doses
$ 0.05/Tab
$ 0.06/Tab
Metformin ER
(Glumetza®)
500 mg
1000 mg
500-2000 mg per day
500-2000 mg per day
$ 0.63/Tab
$ 1.27/Tab
Incretin Agents - DPP-4 inhibitors
Alogliptin (Nesina™) 6.25 mg
12.5 mg
25 mg
6.25 mg once daily (depending on renal function)
12.5 mg once daily (depending on renal function)
25 mg once daily (depending on renal function)
$ 2.84/Tab
$ 2.84/Tab
$ 2.84/Tab
Linagliptin (Trajenta®) 5 mg 5 mg once daily $ 2.60/Tab
Saxagliptin (Onglyza®) 2.5 mg
5 mg
2.5-5 mg once daily
2.5-5 mg once daily
$ 2.57/Tab
$ 3.09/Tab
Sitagliptin (Januvia®) 25 mg
50 mg
100 mg
25 mg once daily (depending on renal function)
50 mg once daily (depending on renal function)
100 mg once daily
$ 3.20/Tab
$ 3.20/Tab
$ 3.20/Tab
Incretin Agents – GLP-1 receptor agonists
Albiglutide (Eperzan™) N/A N/A N/A
Exenatide (Byetta®) 5 mcg prefilled pen (250 µg/mL)
10 mcg prefilled pen (250 µg/mL)
10 mcg twice a day
10 mcg twice a day
$ 2.50/5 mcg dose (supplied as prefilled pen)
$ 2.50/10 mcg dose (supplied as prefilled pen)
Liraglutide (Victoza®) 6 mg/mL 1.2 -1.8 mg once daily $ 2.98/0.6 mg dose
$ 5.96/1.2 mg dose
$ 8.95/1.8 mg dose (supplied as prefilled pen)
Insulin Secretagogues – Sulfonylureas
Gliclazide
(Diamicron®, generic)
80 mg 80-320 mg per day
(doses >160 mg should be twice a day)
$ 0.09/Tab
Gliclazide
(Diamicron MR®, generic)
30 mg
60 mg
30-120 mg once daily
60-120 mg once daily
$ 0.09/Tab
$ 0.21/Tab
Glimepiride
(Amaryl®, generic)
1 mg
 
2 mg
 
4 mg
 
1-4 mg once daily
(may increase to a maximum dose of 8 mg/day)
1-4 mg once daily
(may increase to a maximum dose of 8 mg/day)
1-4 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
5 mg
1.25-20 mg once daily
1.25-20 mg once daily
$ 0.04/Tab
$ 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
120 mg three times a day
120 mg three times a day
$ 0.60/Tab
$ 0.63/Tab
Repaglinide
(Gluconorm®, generic)
0.5 mg
1 mg
2 mg
0.5 - 4 mg taken with meals (max daily dose: 16 mg/day)
0.5 - 4 mg taken with meals (max daily dose: 16 mg/day)
0.5 - 4 mg taken with meals (max daily dose: 16 mg/day)
$ 0.15/Tab
$ 0.16/Tab
$ 0.18/Tab
Sodium Glucose co-transporter 2 inhibitors (SGLT2)
Canagliflozin
(Invokana™)
100 mg
300 mg
100 - 300 mg once daily
100 - 300 mg once daily
$ 2.84/Tab
$ 2.84/Tab
Dapagliflozin
(Forxiga®)
5 mg
10 mg
5 - 10 mg once daily
5 - 10 mg once daily
$ 2.84/Tab
$ 2.84/Tab
Empagliflozin
(Jardiance™)
10 mg
25 mg
10 - 25 mg once daily
10 - 25 mg once daily
$ 2.84/Tab
$ 2.84/Tab
Thiazolidinediones
Pioglitazone (Actos)
generic
15 mg
30 mg
45 mg
15 - 30 mg once daily
15 - 30 mg once daily
Maximum daily dose
$ 1.29/Tab
$ 1.81/Tab
$ 2.72/Tab
Rosiglitazone
(Avandia®)
2 mg
4 mg
8 mg
4 - 8 mg daily as a single or as a divided dose
4 - 8 mg daily as a single or as a divided dose
4 - 8 mg daily as a single or as a divided dose
$ 1.49/Tab
$ 2.34/Tab
$ 3.35/Tab
Weight Loss Agent
Orlistst (Xenical®) 120 mg tab 120 mg three times a day $ 1.78/Tab
Combination Products
Alogliptin/Metformin
Kazano™
12.5 mg/ 500 mg
12.5 mg/ 850 mg
12.5 mg/ 1000 mg
Usual dose 1 tablet twice per day
Usual dose 1 tablet twice per day
Usual dose 1 tablet twice per day
$ 1.49/Tab
$ 1.49/Tab
$ 1.49/Tab
Linagliptin/Metformin
(Jentadueto™)
2.5 mg/500 mg
2.5 mg/850 mg
2.5 mg/1000 mg
Usual dose 1 tablet twice per day
Usual dose 1 tablet twice per day
Usual dose 1 tablet twice per day
$ 1.28/Tab
$ 1.28/Tab
$ 1.28/Tab
Rosiglitazone/Metformin
(AvandaMet®)
2 mg/500 mg
 
2 mg/1000 mg
 
4 mg/500 mg
 
4 mg/1000 mg
Starting dose of 2 mg/500 mg may increase to a
maximum dose of 8 mg/2000 mg per day
Starting dose of 2 mg/500 mg may increase to a
maximum dose of 8 mg/2000 mg per day
Starting dose of 2 mg/500 mg may increase to a
maximum dose of 8 mg/2000 mg per day
Starting 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
Usual dose 1 tablet twice per day
Usual dose 1 tablet twice per day
Usual dose 1 tablet twice per day
$ 1.38/Tab
$ 1.38/Tab
$ 1.38/Tab
Sitagliptin/Metformin
(Janumet®)
50 mg/500 mg
50 mg/850 mg
50 mg/1000 mg
Usual dose 1 tablet twice per day
Usual dose 1 tablet twice per day
Usual dose 1 tablet twice per day
$ 1.61/Tab
$ 1.61/Tab
$ 1.61/Tab
Sitagliptan/Metformin
Extended Release
Formula (Janumet XR®)
50 mg/500 mg
50 mg/1000 mg
100 mg/1000 mg
Usual dose 2 tablets once daily
Usual dose 2 tablets once daily
Usual dose 2 tablets once daily
$ 1.61/Tab
$ 1.61/Tab
$ 1.61/Tab

Part B:

Approximate Cost Reference for Insulinsii
Antihyperglycemic Agents Available strengths Usual 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
(300 units/cartridge)
N/A as dose is determined by
response by patient
$ 0.041/unit $ 0.040/unit
Lispro 200 units/mL
(Humalog®)
200 units/mL
(600 units/cartridge)
N/A as dose is determined by
response by patient
N/A $ 0.037/unit
Short-Acting
Insulin regular
(Humulin®-R)
100 units/mL (300 units/ cartridge) N/A as dose is determined by
response by patient
$ 0.033/unit N/A
Insulin regular
(Novolin®ge Toronto)
100 units/mL (300 units/ cartridge) N/A as dose is determined by
response by patient
$ 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) 100 units/mL (300 units/ cartridge) N/A as dose is determined by
response by patient
$ 0.033/unit $ 0.033/unit
Insulin NPH
(Novolin®ge NPH)
100 units/mL (300 units/ cartridge) N/A as dose is determined by
response by patient
$ 0.031/unit N/A
Long-acting Basal Insulin Analogues
Detemir (Levemir®) 100 units/mL (300 units/ cartridge) N/A as dose is determined by
response by patient
$ 0.075/unit $ 0.078/unit
Glargine 100 units/mL
(Lantus®)
100 units/mL (300 units/ cartridge) N/A as dose is determined by
response by patient
$ 0.067/unit $ 0.067/unit
Glargine 300 units/mL
(Toujeo™)
300 units/mL (450 units/prefilled pen) N/A as dose is determined by
response by patient
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.
PREMIXED INSULINS
Premixed Regular Insulin – NPH
Insulin regular/NPH (Humulin® 30/70) 100 units/mL (300 units/cartridge) N/A as dose is determined by
response by patient
$ 0.028/unit N/A
Insulin regular/NPH (Novolin®ge 30/70, 40/60, 50/50) 100 units/mL (300 units/cartridge) N/A as dose is determined by
response by patient
$ 0.031/unit N/A
Premixed Insulin Analogues
Aspart 30%/aspart
protamine 70%
(NovoMix® 30))
100 units/mL (300 units/ cartridge) N/A as dose is determined by
response by patient
$ 0.040/unit N/A
Lispro 25%/lispro
protamine 75%
(Humalog® Mix25)
100 units/mL (300 units/ cartridge) N/A as dose is determined by
response by patient
$ 0.041/unit $ 0.040/unit
Lispro 50%/lispro
protamine 50%
(Humalog® Mix50)
100 units/mL (300 units/ cartridge) N/A as dose is determined by
response by patient
$ 0.040/unit $ 0.040/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.

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