PharmaCare Newsletter

Safety risk: New Rybelsus^® formulation

The new formulation of Rybelsus^® (semaglutide) has increased bioavailability, and thus lower equivalent tablet strengths compared to the original formulation. During the transition period, pharmacists and other health professionals should take extra care to ensure the correct equivalent dose is provided.

The two formulations should not be combined, and should not be interchanged at non-equivalent doses, as this may result in dosing errors and medication safety risks. Care providers should familiarize themselves with the new equivalent dose strengths.

Original formulation					New formulation
DIN	Strength				DIN	Strength
02497581	3 mg	→			02551012	1.5 mg
02497603	7 mg	→			02551020	4 mg
02497611	14 mg	→			02551039	9 mg

Local software systems may not clearly distinguish between the original and new Rybelsus formulations.

The drug identification number (DIN) is unique to each strength. Always check the DIN to confirm which formulation the patient is currently taking. 

PharmaCare does not cover Rybelsus. PharmaCare is sharing this information for patient safety reasons.

Resources

• Product Monograph: Rybelsus^® (PDF, 859KB)
• ALERT: Risk of Dose Errors with Transition to New Formulation of Rybelsus (Institute for Safe Medication Practices Canada)

Reminder: Office-use medication (O-Med) and stock transfers

PharmaCare is reminding pharmacies that they must not use their office-use medication (O-Med) PHN for stock transfers between pharmacies.

Pharmacies are assigned a unique O-Med PHN when they enrol as a PharmaCare provider, which they enter in PharmaNet when dispensing medications for a physician, dentist, veterinarian, or midwife to provide to patients in their clinic or office (but never for the practitioner’s personal use).

Stock transfers are processed in a pharmacy’s local software and are not submitted to PharmaNet. Pharmacies should direct questions about stock transfers to their software vendor rather than the PharmaCare Help Desk.

If a pharmacy does not know their O-Med PHN, they can contact the PharmaCare Help Desk or PharmaNet Data Quality Services at 1-844-660-3200.

Resources

• PharmaCare Policy Manual, Section 3.21: Office-Use Medications
• PharmaCare Policy Manual, Section 11.1: PharmaCare Help Desk and Medical Practitioner Line

Reminder: Correct quantities for Sublocade^® claims

PharmaCare is reminding pharmacies to enter the number of syringes dispensed and not volume in millilitres when submitting Sublocade^® claims. PharmaCare has noticed several billing errors for Sublocade with incorrect quantities.

Visit Correct quantities for PharmaCare claims for the correct units of measurement to use when entering claims in PharmaNet.

Resources

• Correct quantities for PharmaCare claims

TI Letter: Buprenorphine maintenance treatment for opioid use disorder

The Therapeutics Initiative published a new Therapeutics Letter on buprenorphine-naloxone maintenance treatment for opioid use disorder. The Letter describes how primary care providers can support patients receiving this treatment and provides practical guidance for ongoing care.

Read the full letter at Therapeutics Initiative | [163] Buprenorphine maintenance treatment for opioid use disorder.

Resources

• Therapeutics Initiative | [163] Buprenorphine maintenance treatment for opioid use disorder

PharmaCare Spotlight: Correct quantities

Resources

• Correct quantities for PharmaCare claims
• PharmaCare Policy Manual, Section 3.13: Correct Quantities
• PharmaCare Policy Manual, Section 11.1: PharmaCare Help Desk and Medical Practitioner Line

Formulary and listing updates

Limited coverage benefits

PharmaCare has added the following limited coverage items to the PharmaCare drug list. Special Authority (SA) approval is required for coverage.

• delgocitinib (Anzupgo)
• Dexcom G7^® (15-day) continuous glucose monitor
• denosumab biosimilars (Denoza^™ and Idenos^™)

Drug name	delgocitinib (Anzupgo)
Date	October 28, 2026
Indication	For the treatment of moderate to severe chronic hand eczema, including the relief of pain and pruritus, in adults who have had an inadequate response to (or are contraindicated for) topical corticosteroids
DIN	02560704	Strength & form	20 mg/g topical cream
Covered by plans	Fair PharmaCare, Plan B, Plan C, Plan F and Plan W (Special Authority required for all plans)

Drug name	Dexcom G7® (15-day) continuous glucose monitor
Date	November 4, 2026
Indication	For the treatment of diabetes mellitus (DM) that requires multiple daily injections of insulin or insulin pump therapy as part of intensive insulin therapy for patients 18 years of age or older
PIN	43120013	Strength & form	Dexcom G7 (15-day) sensor
Covered by plans	Fair PharmaCare, Plan C, Plan F and Plan W (Special Authority required for all plans)

Drug name	denosumab biosimilars (Denoza™ and Idenos™)
Date	November 4, 2026
Indication	Denoza: For the treatment of osteoporosis (limited coverage benefit) Idenos: Hypercalcemia of malignancy (Plan P)
DINs	Denoza: 02566265 Idenos: 02566273	Strength & form	Denoza: 60 mg/mL pre-filled syringe Idenos: 120 mg/1.7 mL vial
Covered by plans	Denoza: Fair PharmaCare, Plan B, Plan C, Plan F and Plan W (Special Authority required for all plans) Idenos: Plan P
Notes	Idenos is a PharmaCare benefit under Plan P (Palliative Care) only. When entering claims for denosumab, the unit of measurement is volume in millimetres, as per Correct quantities for PharmaCare claims

Non-benefits

PharmaCare has decided not to cover the following drugs for the noted indication.

• enoxaparin (Axberi^®, Axberi HP)
• nipocalimab (Imaavy^®)
• methotrexate sodium (Nordimet^®)
• methotrexate sodium (Methofill^®)
• odevixibat (Bylvay^™)
• ruxolitinib (Opzelura^®)

Drug name	enoxaparin (Axberi®, Axberi HP)
Date	October 21, 2026
Indication	For the treatment and prophylaxis of venous thromboembolism (VTE) conditions
DINs	02539977 02539985 02540002 02540010 02540045 02540029 02540037	Strength & form	30 mg/0.3 mL pre-filled syringe 40 mg/0.4 mL pre-filled syringe 60 mg/0.6 mL pre-filled syringe 80 mg/0.8 mL pre-filled syringe 100 mg/mL pre-filled syringe 120 mg/0.8 mL pre-filled syringe 150 mg/mL pre-filled syringe

Drug name	nipocalimab (Imaavy®)
Date	October 14, 2026
Indication	As an add-on to standard therapy for the treatment of generalized myasthenia gravis
DINs	02563509 02563517	Strength & form	300 mg/1.62 mL solution for intravenous use 1200 mg/6.5 mL solution for intravenous use

Drug name	methotrexate sodium (Nordimet®)
Date	October 21, 2026
Indication	For treatment of severe disabling psoriasis/psoriatic arthritis and severe disabling rheumatoid arthritis (RA) in adults
DINs	02546531 02546558 02546566 02546574 02546582 02546590 02546604 02546612	Strength & form	7.5 mg/0.3 mL pre-filled pen 10 mg/0.4 mL pre-filled pen 12.5 mg/0.5 mL pre-filled pen 15 mg/0.6 mL pre-filled pen 17.5 mg/0.7 mL pre-filled pen 20 mg/0.8 mL pre-filled pen 22.5 mg/0.9 mL pre-filled pen 25 mg/1mL pre-filled pen

Drug name	methotrexate sodium (Methofill®)
Date	October 21, 2026
Indication	For treatment of severe disabling psoriasis/psoriatic arthritis and severe disabling rheumatoid arthritis (RA) in adults
DINs	02530775 02530783 02530791 02530805 02530813 02530848 02530856	Strength & form	10 mg/0.20 mL pre-filled pen 12.5 mg/0.25 mL pre-filled pen 15 mg/0.30 mL pre-filled pen 17.5 mg/0.35 mL pre-filled pen 20 mg/0.40 mL pre-filled pen 22.5 mg/0.45 mL pre-filled pen 25 mg/0.50 mL pre-filled pen

Drug name	odevixibat (Bylvay™)
Date	October 21, 2026
Indication	For the treatment of: pruritus in patients aged 6 months or older with progressive familial intrahepatic cholestasis (PFIC) cholestatic pruritus in patients aged 12 months or older with Alagille syndrome (ALGS)
DINs	02542641 02542676 02542684 02542692	Strength & form	200 mcg capsule 400 mcg capsule 600 mcg capsule 1200 mcg capsule

Drug name	ruxolitinib (Opzelura®)
Date	October 21, 2026
Indication	For the topical treatment of nonsegmental vitiligo (NSV) in adult and pediatric patients 12 years of age and older
DIN	02552434	Strength & form	1.5% topical cream

Price reductions

Effective December 4, 2026, the prices for the following products will be reduced. Prices include 8% markup.

Drug name	rivaroxaban (Xarelto®)
Date effective	December 4, 2026
DIN	Strength & form	Current price per unit	Reduced price per unit
02480808	2.5 mg tablet	$1.5336	$0.3834
02316986	10 mg tablet	$3.0672	$0.7749
02378604	15 mg tablet	$3.0672	$0.7749
02378612	20 mg tablet	$3.0672	$0.7749