Appendix 5

*2016 UPDATE* This appendix has been updated. Please click here to view the most current version of Appendix 5.

Approximate Cost Reference List 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 $ 0.39/Tab
$ 0.28/Tab
Biguanides
Metformin
 
(Glucophage®, generic)
Metformin ER
(Glumetza®)
500 mg
 
850 mg
 
500 mg
1000 mg
500-2000 mg per day in divided doses
850-2550 mg per day in divided doses
500-2000 mg per day
500-2000 mg per day
$ 0.09/Tab
 
$ 0.19/Tab
 
$ 0.63/Tab
$ 1.29/Tab
Incretin Agents - DPP-4 inhibitors
Linagliptin (Trajenta™)
Saxagliptin (Onglyza®)
 
Sitagliptin (Januvia®)
5 mg
2.5 mg
5 mg
25 mg
 
50 mg
 
100 mg
5 mg once daily
2.5-5 mg once daily
2.5-5 mg once daily
25 mg once daily (depending on renal function)
50 mg once daily (depending on renal function)
100 mg once daily
$ 2.64/Tab
$ 2.48/Tab
$ 2.72/Tab
$ 2.97/Tab
$ 2.97/Tab
$ 2.97/Tab
Incretin Agents – GLP-1 receptor agonists
Exenatide (Byetta®)
 
 
 
 
 
 
 
Liraglutide (Victoza®)
5 mcg prefilled pen (250 µg/mL)
10 mcg prefilled pen (250 µg/mL)
6 mg/mL
10 mcg twice a day
 
 
 
10 mcg twice a day
 
 
 
1.2 -1.8 mg once daily
$ 2.47/5 mcg dose (supplied as prefilled pen)
$ 2.47/10 mcg dose (supplied as prefilled pen)
$ 2.71/0.6 mg dose
$ 5.43/1.2 mg dose
$ 8.13/1.8 mg dose (supplied as prefilled pen)
Insulin Secretagogues – Sulfonylureas
Gliclazide
(Diamicron®, generic)
 
Gliclazide
(Diamicron MR®)
Glimepiride
(Amaryl®, generic)
 
 
 
 
 
 
 
Glyburide
(Diabeta®, generic)
80 mg
 
 
30 mg
60 mg
1 mg
 
 
2 mg
 
 
4 mg
 
 
2.5 mg
5 mg
80-320 mg per day
(doses >160 mg should be twice a day)
30-120 mg once daily
60-120 mg once daily
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)
1.25-20 mg once daily
1.25-20 mg once daily
$ 0.17/Tab
 
 
$ 0.15/Tab
$ 0.28/Tab
$ 0.47/Tab
 
 
$ 0.47/Tab
 
 
$ 0.47/Tab
 
 
$ 0.04/Tab
$ 0.06/Tab
Note: Chlorpropamide and Tolbutamide are still available in Canada, but rarely used

Part B:

Approximate Cost Reference Listi for Antihyperglycemic Agents
Antihyperglycemic Agents Available strengths Usual maintenance dose or usual dosage range Approximate Wholesale cost*/unit
Insulin Secretagogues – Meglitinides
Nateglinide (Starlix®)
 
Repaglinide
(GlucoNorm®, generic)
60 mg
120 mg
0.5 mg
 
1 mg
 
2 mg
120 mg three times a day
120 mg three times a 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)
0.5-4 mg taken with meals
(max daily dose: 16 mg/day)
$ 0.60/Tab
$ 0.63/Tab
$ 0.16/Tab
 
$ 0.16/Tab
 
$ 0.38/Tab
Thiazolidinediones
Pioglitazone (Actos)
generic
 
Rosiglitazone (Avandia®)
15 mg
30 mg
45 mg
2 mg
 
4 mg
15-30 mg once daily
15-30 mg once daily
Maximum daily 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
$ 1.28/Tab
$ 1.94/Tab
$ 2.71/Tab
$ 1.43/Tab
 
$ 2.25/Tab
Weight Loss Agent
Orlistat (Xenical®) 120 mg tab 120 mg three times a day $ 1.78/Tab
Combination products
Linagliptan/Metformin
(Jentadueto®)
 
 
 
 
Rosiglitazone/Metformin
(AvandaMet®)
 
 
 
 
 
 
 
 
 
 
Sitagliptin/Metformin
(Janumet®)
2.5 mg/ 500 mg
2.5 mg/ 850 mg
2.5 mg/ 1000 mg
2 mg/ 500 mg
 
2 mg/ 1000 mg
 
4 mg/ 500 mg
 
4 mg/ 1000 mg
 
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
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
Usual dose 1 tablet twice per day
Usual dose 1 tablet twice per day
Usual dose 1 tablet twice per day
$ 1.45/Tab
 
$ 1.45/Tab
 
$ 1.45/Tab
 
$ 1.23/Tab
 
 
$ 1.33/Tab
 
 
$ 1.68/Tab
 
 
$ 1.83/Tab
 
 
$ 1.58/Tab
 
$ 1.58/Tab
 
$ 1.58/Tab

Part C:

Approximate Cost Reference List for Insulinsii
Antihyperglycemic Agents Available strengths Usual maintenance dose or usual dosage range Approximate Wholesale cost*/unit
PRANDIAL (BOLUS) INSULINS – Rapid-Acting Insulin Analogues
Aspart (NovoRapid®)
 
 
Glulisine (Apidra®)
 
 
Lispro (Humalog®)
100 units/mL (300 units/cartridge)
100 units/mL (300 units/ cartridge)
100 units/mL (300 units/ cartridge)
N/A as dose is determined by response by patient
 
N/A as dose is determined by response by patient
 
N/A as dose is determined by response by patient
$ 0.038/unit
 
 
$ 0.035/unit
 
 
$ 0.038/unit
PRANDIAL (BOLUS) INSULINS – Short-Acting
Insulin regular
(Humulin®-R)
 
Insulin regular
(Novolin®ge Toronto)
100 units/mL (300 units/ cartridge)
100 units/mL (300 units/ cartridge)
N/A as dose is determined by response by patient
 
N/A as dose is determined by response by patient
$ 0.028/unit
 
 
$ 0.022/unit
BASAL INSULINS – Intermediate-acting
Insulin NPH (Humulin®-N)
 
Insulin NPH
(Novolin®ge NPH)
100 units/mL (300 units/ cartridge)
100 units/mL (300 units/ cartridge)
N/A as dose is determined by response by patient
 
N/A as dose is determined by response by patient
$ 0.028/unit
 
 
$ 0.029/unit
BASAL INSULINS – Long-acting Basal Insulin Analogues
Detemir (Levemir®)
 
 
Glargine (Lantus®)
100 units/mL (300 units/ cartridge)
100 units/mL (300 units/ cartridge)
N/A as dose is determined by response by patient
 
N/A as dose is determined by response by patient
$ 0.071/unit
 
 
$ 0.064/unit
PREMIXED INSULINS – Premixed Regular Insulin - NPH
Insulin regular/NPH
(Humulin® 30/70)
 
Insulin regular/NPH
(Novolin®ge
30/70, 40/60, 50/50)
100 units/mL (300 units/ cartridge)
100 units/mL (300 units/ cartridge)
N/A as dose is determined by response by patient
 
N/A as dose is determined by response by patient
$ 0.028/unit
 
 
$ 0.028/unit
PREMIXED INSULINS – Premixed Insulin Analogues
Aspart 30%/aspart
protamine 70%
(NovoMix® 30)
Lispro 25%/lispro
protamine 75%
(Humalog® Mix25)
Lispro 50%/lispro
protamine 50%
(Humalog® Mix50)
100 units/mL (300 units/ cartridge)
100 units/mL (300 units/ cartridge)
100 units/mL (300 units/ cartridge)
N/A as dose is determined by response by patient
 
N/A as dose is determined by response by patient
 
N/A as dose is determined by response by patient
$ 0.038/unit
 
 
$ 0.038/unit
 
 
$ 0.038/unit
*Approximate unit drug cost not including dispensing/professional fee and pharmacy mark-up. Approximate Canadian
Cost average based on wholesale costs derived from McKesson Canada as of March 2013.
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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