List of Therapeutic Nutritional Products - covered by the Québec food program for the treatment of inherited metabolic disorders
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List of Therapeutic Nutritional Products covered by the Québec food program for the treatment of inherited metabolic disorders May 2021
Coordination Committee for the Québec food program for the treatment of inherited metabolic disorders (Programme alimentaire québécois pour le traitement de maladies métaboliques héréditaires) under Direction générale des affaires universitaires, médicales, infirmières et pharmaceutiques at Ministère de la Santé et des Services sociaux Sophie Albert-Martel, dietitian, Centre intégré universitaire de santé et de services sociaux du Saguenay–Lac-Saint-Jean Manon Bouchard, chair of the Coordination Committee and dietitian, Centre hospitalier universitaire Sainte-Justine Jade Falardeau, secretary of the Coordination Committee and medical biology consultant, Ministère de la Santé et des Services sociaux Geneviève Gingras, representative for people with hereditary metabolic diseases and their families Émilie Hébert, dietitian, McGill University Health Centre Dr. Rachel Laframboise, geneticist physician, CHU de Québec – Université Laval Geneviève Lafrance, dietitian, Centre intégré universitaire de santé et de services sociaux de l’Estrie–Centre hospitalier universitaire de Sherbrooke Dr. Alina Levtova, geneticist physician, Centre hospitalier de l’Université de Montréal Denis Ouellet, director, Direction de la biovigilance et de la biologie médicale, Ministère de la Santé et des Services sociaux Angela Perluzzo, budget and financial strategy manager, McGill University Health Centre Published by Direction des communications, Ministère de la Santé et des Services sociaux This document is specifically intended for stakeholders in the Québec health and social services network and is only available in electronic version at the following address: www.msss.gouv.qc.ca, section Publications Legal deposit Bibliothèque et Archives nationales du Québec, 2021 Library and Archives Canada, 2021 ISBN : 978-2-550-89245-8 (PDF) All rights reserved for all countries. Reproduction by any process whatsoever, translation, or distribution of this document, even in part, is prohibited without the prior authorization of Publications du Québec. However, reproduction of this document or its use for personal, private study, or scientific research purposes, but not for commercial purposes, is permitted provided that the source is acknowledged. © Gouvernement du Québec, 2021
TABLE OF CONTENTS
INTRODUCTION ...................................................................................................................................... 1
DESCRIPTION OF THE LIST OF THERAPEUTIC NUTRITIONAL PRODUCTS .................................... 2
LIST OF PRODUCTS ............................................................................................................................... 3
“Basic” Therapeutic Nutritional Products (formulas, modules) .......................................................... 3
Glutaric acidemia type 1................................................................................................................. 3
Isovaleric acidemia......................................................................................................................... 3
Propionic and methylmalonic acidemia .......................................................................................... 3
Urea cycle disorders ...................................................................................................................... 3
Homocystinuria and hypermethioninemia ...................................................................................... 4
Maple syrup urine disease ............................................................................................................. 4
Disorders of Carbohydrate metabolism.......................................................................................... 4
Disorders of lipid metabolism ......................................................................................................... 5
Phenylketonuria ............................................................................................................................. 5
Tyrosinemia.................................................................................................................................... 8
Modules ......................................................................................................................................... 8
Therapeutic Nutritional Products (foods)........................................................................................... 9
Non-capped foods ............................................................................................................................. 9
Pasta and rice ................................................................................................................................ 9
Flour mixtures ................................................................................................................................ 9
Bread and pasta ........................................................................................................................... 10
Sauces and broths ....................................................................................................................... 10
Egg substitutes ............................................................................................................................ 10
Crackers ....................................................................................................................................... 10
Desserts ....................................................................................................................................... 10
Other ............................................................................................................................................ 11
Capped foods .................................................................................................................................. 12
Pasta and rice .............................................................................................................................. 12
Sauces and broths ....................................................................................................................... 12
Cheese ......................................................................................................................................... 12
Bread and pasta ........................................................................................................................... 12
Desserts ....................................................................................................................................... 13
Other ............................................................................................................................................ 13
PRODUCTS REMOVED FROM THE LIST SINCE THE PREVIOUS VERSION ................................... 14
Updated May 2021INTRODUCTION
Since the late 1960s, the Québec health and social services network has been screening newborns for
certain treatable inherited metabolic disorders. Identifying these disorders only a few days after birth
makes it possible to begin treatment quickly and thus avoid significant physical and intellectual damage
to children. For a majority of these diseases, treatment consists of a diet restricted in protein, fat, or
carbohydrates that individuals must follow throughout their life. Inherited metabolic disorders can also be
diagnosed at later ages by specialized medical services. Those diagnosed may be prescribed a diet
restricted in protein, fat, or carbohydrates.
The Québec food program for the treatment of inherited metabolic disorders (Programme alimentaire
québécois pour le traitement de maladies métaboliques héréditaires or PAQTMMH) meets the following
objectives:
• Ensure that people with inherited metabolic disorders requiring a diet restricted in protein, fat, or
carbohydrates have access to the therapeutic nutritional products prescribed to them, regardless
of the health region they live in
• Promote adherence to treatment, given the very serious consequences if treatment is interrupted
(e.g., intellectual disability, neurological complications, death) and the significant social, family,
and individual costs that can result
• Prevent these individuals and their families from having to bear a significant financial burden
Only products on the “List of Therapeutic Nutritional Products” are covered by the program. The prices
indicated include shipping costs. Any changes to this version of the list (including new products) are
highlighted in bold.
NOTICE
• Access to therapeutic nutritional products listed in this document is
limited to those eligible for the PAQTMMH and requires a medical
prescription.
• This document is intended primarily for healthcare professionals (e.g.,
doctors, dietitians, nurses, etc.) specializing in the treatment of
hereditary metabolic diseases and for people registered in the
PAQTMMH.
Updated May 2021 1DESCRIPTION OF THE LIST OF THERAPEUTIC NUTRITIONAL
PRODUCTS
The List of Therapeutic Nutritional Products consists of products covered by the PAQTMMH. The cost of
products not included cannot be covered by the program. The list is updated twice a year.
It has two categories:
1) “Basic” therapeutic nutritional products, also known as “formulas”
2) Therapeutic nutritional products that are “capped and uncapped foods”
Access to products with a code preceded by the “” symbol is conditional on consultation between the
attending physician and the nutritionist. In order for these products to be delivered to the patient, a
prescription from the physician or nutritionist must be sent to the trustee.
“BASIC” THERAPEUTIC NUTRITIONAL PRODUCTS (FORMULAS, MODULES)
Therapeutic nutritional products considered “basic” are formulas or modular products used to develop
special formulations.
THERAPEUTIC NUTRITIONAL PRODUCTS (FOODS)
Non-capped foods
Non-capped foods are:
• Products that form the basis of a diet restricted in protein, fat, or carbohydrates
• Basic ingredients used in the preparation of recipes or dishes that are restricted in protein, fat, or
carbohydrates
• Products that provide variety in a diet restricted in protein, fat, or carbohydrates
Capped foods
Capped foods meet the same criteria as non-capped foods.
These products are subject to an overall annual limit of $1,500 per patient. Their codes are preceded by
the “” symbol.
For greater convenience, “basic” therapeutic products of the special preparation
type are classified by metabolic disease.
Updated May 2021 2LIST OF PRODUCTS
“Basic” Therapeutic Nutritional Products (formulas, modules)
GLUTARIC ACIDEMIA TYPE 1
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
0304 Glutarex-1 Abbott Laboratories 6 400 g 59,17
0314 Glutarex-2 Abbott Laboratories 6 400 g 64,47
1227 XLys, XTrp Analog Nutricia 6 400 g 93,75
1239 XLys, XTrp Maxamum Nutricia 6 454 g 116,31
1349 GlutarAde Junior Nutricia 4 400 g 43,62
1350 GlutarAde / mélange acides aminés Nutricia 4 454 g 221,61
1362 GlutarAde Essential GA-1 Drink Mix Nutricia 4 454 g 99,78
1840 GA Gel sans saveur Vitaflo 30 20 g 14,58
1866 GA Express sans saveur Vitaflo 30 25 g 23,42
ISOVALERIC ACIDEMIA
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
0306 Valex-1 Abbott Laboratories 6 400 g 59,53
0316 Valex-2 Abbott Laboratories 6 400 g 64,49
1242 XLeu Maxamum Nutricia 6 454 g 118,06
1291 IVA Anamix Next Nutricia 6 400 g 112,00
1867 IVA cooler 15 (rouge) Vitaflo 30 130 ml 26,88
PROPIONIC AND METHYLMALONIC ACIDEMIA
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
0310 Propimex-1 Abbott Laboratories 6 400 g 59,27
0320 Propimex-2 Abbott Laboratories 6 400 g 64,47
1220 XMTVI Maxamum Nutricia 6 454 g 118,24
1292 MMA/PA Anamix Next Nutricia 6 400 g 112,00
1823 MMA/PA Gel (sans saveur) Vitaflo 30 20 g 11,49
1824 MMA/PA Express (sans saveur) Vitaflo 30 25 g 23,42
1855 MMA/PA Cooler 15 (rouge) Vitaflo 30 130 ml 23,42
UREA CYCLE DISORDERS
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
0303 Cyclinex-1 Abbott Laboratories 6 400 g 46,27
0313 Cyclinex-2 Abbott Laboratories 6 400 g 49,95
1276 UCD Anamix Junior sans saveur Nutricia 6 400 g 59,30
1277 UCD Anamix Junior Vanille Nutricia 6 400 g 59,30
Updated May 2021 3HOMOCYSTINURIA AND HYPERMETHIONINEMIA
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
0305 Hominex-1 Abbott Laboratories 6 400 g 59,51
0315 Hominex-2 Abbott Laboratories 6 400 g 64,49
1217 XMet Maxamum Nutricia 6 454 g 118,24
1219 XMet Analog Nutricia 6 400 g 95,30
1280 HCU Lophlex LQ Fruits mélangés Nutricia 30 125 ml 18,38
1293 HCU Anamix Next Nutricia 6 400 g 112,00
1808 HCU Gel (sans saveur) Vitaflo 30 20 g 11,49
1809 HCU Express 15 (sans saveur) Vitaflo 30 25 g 23,42
1839 HCU Cooler 15 (orange) Vitaflo 30 130 ml 23,42
1848 HCU Cooler 15 (rouge) Vitaflo 30 130 ml 23,42
1860 HCU Express 20 (sans saveur) Vitaflo 30 34 g 34,00
1861 HCU Cooler 20 (rouge) Vitaflo 30 174 ml 34,00
POA (Pharma North
4006 HCU Easy Tablets 6 77 co/pot 96,02
America)
MAPLE SYRUP URINE DISEASE
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
0307 Ketonex-1 Abbott Laboratories 6 400 g 36,30
0317 Ketonex-2 Abbott Laboratories 6 400 g 48,22
0642 BCAD-1 Mead Johnson 6 454 g 34,74
0645 BCAD-2 Mead Johnson 6 454 g 37,05
1205 MSUD Maxamum Nutricia 6 454 g 118,24
1278 MSUD Lophlex LQ (fruits mélangés) Nutricia 30 125 ml 18,38
1312 Complex MSD / mélange a.aminés Nutricia 4 454 g 229,06
1339 Complex Essential MSD Nutricia 4 454 g 88,75
1347 Complex Junior MSD Drink Mix Nutricia 4 400 g 86,84
1806 MSUD Gel (sans saveur) Vitaflo 30 20 g 11,49
1807 MSUD Express 15 (sans saveur) Vitaflo 30 25 g 23,42
1822 MSUD Cooler 15 (orange) Vitaflo 30 130 ml 23,42
1849 MSUD Cooler 15 (rouge) Vitaflo 30 130 ml 23,42
1862 MSUD Express 20 (sans saveur) Vitaflo 30 34 g 34,00
1863 MSUD Cooler 20 (rouge) Vitaflo 30 174 ml 34,00
POA (Pharm North
4008 MSUD Easy Tablets 6 77 co/pot 96,02
America)
DISORDERS OF CARBOHYDRATE METABOLISM
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
0324 RCF Abbott Laboratories 12 384 ml 10,24
1272 Ketocal 4 : 1 poudre Nutricia 6 300 g 51,28
1273 Ketocal 4 : 1 liquide vanille Nutricia 27 237 ml 9,18
1294 Ketocal 4 : 1 liquide sans saveur Nutricia 27 237 ml 9,18
3137 Ketovie Vanille Ajinomoto Cambrooke 30 250 ml 6,98
3138 Ketovie Chocolat Ajinomoto Cambrooke 30 250 ml 6,98
3156 Ketovie 3 : 1 sans saveur Ajinomoto Cambrooke 30 250 ml 6,06
Updated May 2021 4DISORDERS OF LIPID METABOLISM
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
0611 Portagen Mead Johnson 6 410 g 28,59
1264 Monogen Nutricia 6 400 g 59,23
1832 Lipistart Vitaflo 6 400 g 67,40
1833 MCT Pro-Cal Vitaflo 30 15 g 5,96
PHENYLKETONURIA
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
0308 Phenex-1 Abbott Laboratories 6 400 g 36,30
0319 Phenex-2 Abbott Laboratories 6 400 g 44,71
0325 Phenex-2 (vanille) Abbott Laboratories 6 400 g 44,74
0601 Phenyl Free 1 Mead Johnson 6 454 g 45,50
0636 Phenyl Free 2 Mead Johnson 6 454 g 45,50
0637 Phenyl Free 2 HP Mead Johnson 6 454 g 100,60
1201 XPhe Maxamum (orange) Nutricia 6 454 g 98,23
1211 XPhe Maxamum (sans saveur) Nutricia 6 454 g 98,23
Phlexy-10 Mélange boisson
1230 Nutricia 30 20 g 6,95
(pomme-cassis)
Phlexy-10 Mélange boisson
1231 Nutricia 30 20 g 6,95
(tropical)
1248 Lophlex (baies) Nutricia 30 14,3 g 5,56
1249 Lophlex (orange) Nutricia 30 14,3 g 5,56
1255 Periflex LQ crème à l’orange Nutricia 18 250 ml 14,91
1256 Periflex LQ crème aux baies Nutricia 18 250 ml 14,90
1261 Periflex Advance (orange) Nutricia 6 454 g 91,97
1262 Periflex Advance (sans saveur) Nutricia 6 454 g 91,97
1269 PKU Lophlex LQ 20 (tropical) Nutricia 30 125 ml 8,79
1271 Periflex pour nourrissons Nutricia 6 400 g 37,04
1274 PKU Lophlex LQ 20 (orange) Nutricia 30 125 ml 8,79
PKU Lophlex LQ 20 (fruits
1275 Nutricia 30 125 ml 8,79
mélangés)
1285 Periflex Junior Plus sans saveur Nutricia 6 400 g 82,36
PhenylAde / mélange a. aminés
1306 Nutricia 4 454 g 197,54
MTE
PhenylAde / a. aminés MTE
1315 Nutricia 30 12,4 g 8,29
(sachets)
1319 PhenylAde40 agrumes Nutricia 20 25 g 4,36
1320 PhenylAde40 sans saveur Nutricia 20 25 g 4,36
1330 PhenylAde 60 vanille Nutricia 4 454 g 115,14
1331 PhenylAde Essential Chocolat Nutricia 4 454 g 58,25
1332 PhenylAde Essential Vanille Nutricia 4 454 g 58,25
1333 PhenylAde Essential Orange Nutricia 4 454 g 58,25
1334 PhenylAde Essential Fraise Nutricia 4 454 g 58,25
1335 PhenylAde Essential Chocolat Nutricia 16 40 g 6,11
1336 PhenylAde Essential Vanille Nutricia 16 40 g 6,11
1337 PhenylAde Essential Orange Nutricia 16 40 g 6,11
1338 PhenylAde Essential Fraise Nutricia 16 40 g 6,11
1344 PhenylAde 60 sans saveur Nutricia 4 454 g 115,14
Updated May 2021 5Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
1345 PhenylAde 60 s/saveur (sachets) Nutricia 30 16,7 g 6,44
1346 PhenylAde 60 vanille (sachets) Nutricia 30 16,7 g 6,44
1355 PhenylAde Essential sans saveur Nutricia 4 454 g 58,25
1356 PhenylAde Essential sans saveur Nutricia 16 40 g 6,11
1363 PhenylAde GMP Vanille Nutricia 4 400 g 95,00
1364 PhenylAde GMP vanille (sachet) Nutricia 16 33,3 g 8,51
PhenylAde GMP sans saveur
1365 Nutricia 16 33,3 g 8,51
(sachet)
1366 PhenylAde GMP Mix-in (sachet) Nutricia 20 12,5 g 7,29
1368 PhenylAde GMP Ready Nutricia 18 250 ml 10,24
1369 PhenylAde GMP Ultra (Citron) Nutricia 16 33,4 g 19,43
1370 PhenylAde GMP Ultra (Vanille) Nutricia 16 33,4 g 19,43
1800 PKU Gel (sans saveur) Vitaflo 30 20 g 9,87
1803 PKU Express 15 (sans saveur) Vitaflo 30 25 g 15,07
1804 PKU Express 15 (orange) Vitaflo 30 25 g 15,07
1805 PKU Express 15 (citron) Vitaflo 30 25 g 15,07
1818 PKU Express 15 (tropical) Vitaflo 30 25 g 15,07
1827 PKU Cooler 15 (orange) Vitaflo 30 130 ml 15,07
1828 PKU Cooler 15 (mauve) Vitaflo 30 130 ml 15,07
1829 PKU Cooler 20 (orange) Vitaflo 30 174 ml 19,93
1830 PKU Cooler 20 (mauve) Vitaflo 30 174 ml 19,93
1837 PKU Cooler 15 (blanc) Vitaflo 30 130 ml 15,07
1842 PKU Cooler 20 (blanc) Vitaflo 30 174 ml 19,93
1844 PKU Cooler 15 (rouge) Vitaflo 30 130 ml 15,07
1845 PKU Cooler 20 (rouge) Vitaflo 30 174 ml 19,93
1856 PKU Express 20 (citron) Vitaflo 30 34 g 19,93
1857 PKU Express 20 (orange) Vitaflo 30 34 g 19,93
1858 PKU Express 20 (tropical) Vitaflo 30 34 g 19,93
1859 PKU Express 20 (sans saveur) Vitaflo 30 34 g 19,93
1874 PKU Sphere 20 Vanille Vitaflo 30 35 g 16,60
1875 PKU Sphere 20 Baies Vitaflo 30 35 g 16,60
1878 PKU Sphere 20 Chocolat Vitaflo 30 35 g 16,60
1880 PKU Air (café) Vitaflo 30 174 ml 15,99
1881 PKU Air (citrus) Vitaflo 30 174 ml 15,99
1882 PKU Air (mangue) Vitaflo 30 174 ml 15,99
3115 Glytactin Bettermilk 15 Ajinomoto Cambrooke 30 49 g 11,55
3116 Glytactin Complete 15 – Barre fruits Ajinomoto Cambrooke 7 81 g 10,20
Glytactin Complete 15 – Barre
3117 Ajinomoto Cambrooke 7 81 g 10,20
beurre d’arachides
3120 Glytactin Restore 10 (citron-lime) Ajinomoto Cambrooke 12 500 ml 6,80
3121 Glytactin Restore 10 (tangerine) Ajinomoto Cambrooke 12 500 ml 6,80
3122 Glytactin Complete 10 – Barre fruits Ajinomoto Cambrooke 7 54 g 6,80
Glytactin Complete 10 – Barre
3123 Ajinomoto Cambrooke 7 54 g 6,80
beurre d’arachides
Glytactin Restore 10 Léger (citron-
3124 Ajinomoto Cambrooke 12 500 ml 6,80
lime)
Glytactin Restore 10 Léger
3125 Ajinomoto Cambrooke 12 500 ml 6,80
(tangerine)
Glytactin Bettermilk 15 – crème à
3126 Ajinomoto Cambrooke 30 52 g 11,55
l’orange
Updated May 2021 6Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
3127 Glytactin Bettermilk 15 - fraise Ajinomoto Cambrooke 30 52 g 11,55
3130 Glytactin Swirl 15 Caramel Ajinomoto Cambrooke 14 77 g 11,55
3131 Glytactin RTD 10 Original Ajinomoto Cambrooke 30 250 ml 8,82
3132 Glytactin RTD 10 Chocolat Ajinomoto Cambrooke 30 250 ml 8,82
3133 Glytactin RTD 15 Original Ajinomoto Cambrooke 30 250 ml 12,13
3134 Glytactin RTD 15 Chocolat Ajinomoto Cambrooke 30 250 ml 12,13
3139 Glytactin Bettermilk Léger 20 Ajinomoto Cambrooke 30 49 g 11,55
Glytactin Restore 5 en poudre
3146 Ajinomoto Cambrooke 60 20 g 3,97
(Baies)
Glytactin Restore 5 en poudre
3147 Ajinomoto Cambrooke 60 20 g 3,97
(Orange)
Glytactin Restore 10 Léger poudre
3148 Ajinomoto Cambrooke 30 19 g 6,80
orange
3150 Glytactin Build 10 Ajinomoto Cambrooke 30 16 g 8,20
3152 Glytactin Build 20/20 Ajinomoto Cambrooke 30 32 g 12,30
3153 Glytactin RTD Lite Café Ajinomoto Cambrooke 30 250 ml 12,13
3154 Glytactin RTD Lite Vanille Ajinomoto Cambrooke 30 250 ml 12,13
3157 Glytactin Build 20/20 (vanille) Ajinomoto Cambrooke 30 33 g 12,30
3158 Glytactin Build 20/20 (chocolat) Ajinomoto Cambrooke 30 32 g 12,30
Glytactin Build 20/20 (limonade
3159 Ajinomoto Cambrooke 30 31 g 12,30
framboise)
3160 Glytactin Build 20/20 (smooth) Ajinomoto Cambrooke 30 31 g 12,30
POA (Pharma North
4001 Easy PKU Microtabs 4 110 g 72,40
America)
POA (Pharma North
4005 PKU Easy Tablets 6 77 co/pot 73,95
America)
Updated May 2021 7TYROSINEMIA
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
0311 Tyrex-1 Abbott Laboratories 6 400 g 46,46
0321 Tyrex-2 Abbott Laboratories 6 400 g 49,95
0640 Tyros-1 Mead Johnson 6 454 g 34,74
0643 Tyros-2 Mead Johnson 6 454 g 37,05
1237 XPhe XTyr Analog Nutricia 6 400 g 95,30
XPhen, Tyr Maxamum (sans
1253 Nutricia 3 500 g 137,65
saveur)
1279 TYR Lophlex LQ (fruits mélangés) Nutricia 30 125 ml 18,38
1286 TYR Anamix Next Nutricia 6 400 g 112,00
1367 TYR LophlexGMP Mix-in Nutricia 20 12,5 g 13,90
1810 TYR Gel (sans saveur) Vitaflo 30 20 g 11,49
1811 TYR Express 15 (sans saveur) Vitaflo 30 25 g 23,42
1838 TYR Cooler 15 Orange Vitaflo 30 130 ml 23,42
1847 TYR Cooler 15 Rouge Vitaflo 30 130 ml 23,42
1864 TYR Express 20 (sans saveur) Vitaflo 30 34 g 34,00
1865 TYR Cooler 20 rouge Vitaflo 30 174 ml 34,00
1879 TYR Sphere 20 Baies Vitaflo 30 35 g 26,00
3135 Tylactin Restore 10 Tangerine Ajinomoto Cambrooke 12 500 ml 11,90
3136 Tylactin RTD 15 Original Ajinomoto Cambrooke 30 250 ml 17,98
Tylactin Restore 5 en poudre
3149 Ajinomoto Cambrooke 60 20 g 6,49
(Baies)
Tylactin Complete 15 Barre – beurre
3151 Ajinomoto Cambrooke 14 81 g 19,47
d’arachides
3155 Tylactin Build 20 Ajinomoto Cambrooke 30 28 g 26,00
POA (Pharma North
4004 Easy Tyr Shake & Go 30 34 g 24,00
America)
POA (Pharma North
4007 TYR Easy Tablets 6 77 co/pot 96,02
America)
MODULES
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
0309 Pro-Phree Abbott Laboratories 6 400 g 29,91
0323 ProViMin Abbott Laboratories 6 150 g 52,27
Order the
0621 Microlipid Nestlé 48 X 89 ml 203,64
full case
0641 PFD-1 Mead Johnson 6 454 g 34,74
0644 PFD-2 Mead Johnson 6 454 g 37,05
0703 Complete amino acid Mix Nutricia 6 200 g 149,83
0704 Essential amino acid Mix Nutricia 6 200 g 142,36
1207 Duocal Nutricia 6 400 g 35,30
1233 Phlexy-Vits Nutricia 30 7g 2,09
1287 Liquigen Nutricia 12 250 ml 12,05
1835 EAA supplément acides aminés Vitaflo 50 12,5 g 7,95
1872 Beta Quick Vitaflo 18 250 ml 16,58
Updated May 2021 8Therapeutic Nutritional Products (foods)
Non-capped foods
PASTA AND RICE
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
0201 Anellini Aproten 12 500 g 8,24
0202 Ditalini Aproten 12 500 g 8,24
0203 Rigatini Aproten 12 500 g 8,24
0205 Tagliatelle Aproten 12 250 g 6,37
0208 Spaghetti Aproten 10 500 g 9,28
0210 Fettucini Aproten 12 250 g 6,37
0211 Penne Aproten 12 500 g 8,24
0212 Fusilli Aproten 12 500 g 8,24
0218 Riz Aproten 12 500 g 8,64
0925 Macaroni court Promin Pasta 1 500 g 29,18
0926 Macaroni Rigatini Promin Pasta 1 500 g 29,18
0928 Petites coquilles Promin Pasta 1 500 g 29,18
0932 Couscous Promin Pasta 1 500 g 29,18
0933 Imitation de riz (orzo) Promin Pasta 1 500 g 29,18
0935 Spirales trois couleurs Promin Pasta 1 500 g 29,18
1017 Imitation macaroni et fromage Dietary Specialties 8 170 g 11,79
1108 Penne Loprofin 6 500 g 15,31
1109 Fusilli Loprofin 6 500 g 15,31
1113 Spaghetti Loprofin 6 500 g 15,31
1124 Lasagne Loprofin 12 250 g 11,02
1131 Pâtes en forme d’animaux Loprofin 6 500 g 15,31
1133 Riz Loprofin 6 500 g 15,31
2407 Riz à grain court Ajinomoto Cambrooke 1 992 g 28,49
FLOUR MIXTURES
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
0217 Mélange à pain et gâteau Aproten 6 500 g 11,72
0450 Mélange à pain faible en protéines Taste Connection 6 2,3 kg 43,99
Farine tout usage faible en
0451 Taste Connection 6 2,3 kg 43,99
protéines
0452 Versa Mix Taste Connection 6 2,3 kg 48,06
0454 Fécule de blé Taste Connection 6 2,27 kg 32,99
0911 Mélange à pain (ail et oignon) Chébé 1 212 g 8,77
1001 Mélange cuisson faible en protéines Dietary Specialties 6 1,8 kg 34,87
1005 Mélange pour autocuiseur Dietary Specialties 6 1,8 kg 46,36
1122 Mélange de cuisson Loprofin 18 500 g 11,02
2203 Fécule de blé Ajinomoto Cambrooke 1 907 g 9,99
2301 Mélange cuisson tout usage Ajinomoto Cambrooke 1 907 g 17,99
2302 Mélange rapide Ajinomoto Cambrooke 1 907 g 19,49
2976 Wel-Made mélange à cuisson Ajinomoto Cambrooke 1 907 g 24,11
Updated May 2021 9BREAD AND PASTA
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
1501 Pain de riz tranché Ener-G 6 490 g 8,49
1505 Pain de tapioca tranché Ener-G 6 454 g 5,75
1506 Pâtes à pizza 6" Ener-G 5 252 g 13,61
SAUCES AND BROTHS
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
0944 Consommé brun G. Washington 24 31 g 6,92
0945 Consommé doré G. Washington 24 28 g 6,92
1403 Sauce fromage Dietary Specialties 12 150 g 12,43
2801 Consommé au poulet Ajinomoto Cambrooke 1 170 g 13,49
EGG SUBSTITUTES
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
0506 Substitut d'œufs Pane Riso / Kingsmill 6 350 g 5,59
0951 Imitation d’œufs / omelette Country Sunrise 1 567 g 20,26
1508 Substitut d'œufs Ener-G 12 454 g 7,93
2333 Eggz-Mélange imitation œufs Ajinomoto Cambrooke 1 454 g 19,79
CRACKERS
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
0204 Biscottes (Pane Biscottato) Aproten 6 255 g 14,77
0206 Biscottes minces (Fette Tostate) Aproten 6 250 g 7,68
1107 Craquelins Loprofin 12 150 g 9,08
2943 Craquelins nature Ajinomoto Cambrooke 1 125 g 7,85
2944 Craquelins Plein goût Ajinomoto Cambrooke 1 150 g 7,85
DESSERTS
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
0207 Biscuits secs (Biscotto) Aproten 12 180 g 6,38
0213 Biscuits au chocolat Aproten 12 180 g 6,50
0214 Biscuits aux fruits Aproten 12 180 g 6,53
0957 Mélange à muffin pomme cannelle Country Sunrise 1 291 g 16,12
Mélange à muffin canneberges et
0958 Country Sunrise 1 347 g 16,12
orange
1003 Biscuits brisures de chocolats Dietary Specialties 6 170 g 7,78
1004 Biscuits caramel Dietary Specialties 6 170 g 7,78
1009 Biscuits Graham Dietary Specialties 6 432 g 12,90
1023 Mélange à gâteau vanille Dietary Specialties 6 374 g 9,96
1024 Mélange à gâteau chocolat Dietary Specialties 6 386 g 9,96
1587 Craquelins à la cannelle Ener-G 6 168 g 8,26
Updated May 2021 10OTHER
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
0915 Méthylcellulose Methocel 1 227 g 26,85
0917 Carrés de chocolat Food Club 1 680 g 17,64
0918 Carré de chocolat blanc Western Family 1 680 g 17,64
0936 Semoule (gruau) Promin Pasta 1 500 g 24,58
0946 Beurre d’arachides (imitation) Country Sunrise 1 640 g 49,75
Dietary Specialties /
1016 Rondelles d'oignons 72 14 g 1,03
Wise
1018 Beurre d’arachides Dietary Specialties 1 454 g 21,56
1115 Céréales Loprofin 4 375 g 12,25
Lp-Drink Milupa (substitut de lait
1117 Milupa 2 400 g 18,01
faible en protéines)
1126 Céréales LP Flakes Milupa 6 375 g 11,02
1127 Céréales LP Ringlets Milupa 6 250 g 11,02
1128 Céréales LP Fruity (poire) Milupa 2 300 g 15,92
1129 Céréales LP Fruity (pomme banane) Milupa 2 300 g 15,92
1817 Vitabite (tablette de chocolat) Vitaflo 7 25 g 3,13
2951 Céréales chaudes à la cannelle Ajinomoto Cambrooke – 680 g 17,20
2968 Céréales chaudes à la vanille Ajinomoto Cambrooke – 680 g 18,15
Updated May 2021 11Capped foods
PASTA AND RICE
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
2401 Macaroni Pasta Solo Ajinomoto Cambrooke – 227 g 9,49
2406 Macaroni au fromage Pasta Duets Ajinomoto Cambrooke – 198 g 12,49
2410 Duo riz crémeux brocoli & ail Ajinomoto Cambrooke – 198 g 12,49
Ravioli épinard et champignons
2411 Ajinomoto Cambrooke – 453 g 34,49
Portabella
2412 Pierogi Ajinomoto Cambrooke – 453 g 31,61
2413 Ravioli au fromage Ajinomoto Cambrooke – 453 g 31,61
SAUCES AND BROTHS
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
2802 Mélange pour sauce Alfredo Ajinomoto Cambrooke – 127 g 13,49
CHEESE
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
2309 Fromage à saupoudrer Ajinomoto Cambrooke – 113 g 13,49
2311 Tranches de fromage Ajinomoto Cambrooke – 32 x 19 g 16,66
2312 Tranches de fromage Suisse Ajinomoto Cambrooke – 32 x 19 g 16,66
2314 Fromage Cheddar râpé Ajinomoto Cambrooke – 907 g 16,66
2315 Fromage Mozzarella râpé Ajinomoto Cambrooke – 907 g 16,66
2937 Cheddar Wizard Ajinomoto Cambrooke – 227 g 8,44
BREAD AND PASTA
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
2101 Pain Artisan Ajinomoto Cambrooke – 6 x 156 g 31,04
2110 Pain maison (tranché) Ajinomoto Cambrooke – 794 g 20,11
2111 Pain cannelle et raisin (tranché) Ajinomoto Cambrooke – 793 g 21,26
2112 Focaccia (italien) Ajinomoto Cambrooke – 6 x 51 g 20,69
2115 Pâte à pizza Ajinomoto Cambrooke – 4 x 208 g 30,46
2118 Tortillas Wrap Ajinomoto Cambrooke – 8 x 54 g 12,49
2124 Petits pains Camburgers Ajinomoto Cambrooke – 8 x 80 g 22,41
2616 Pain à hot dog Brookelyn Ajinomoto Cambrooke – 6 x 89 g 14,94
2618 CBF Bagel cannelle et raisins Ajinomoto Cambrooke – 8 x 53 g 20,11
2620 CBF Bagel oignon Ajinomoto Cambrooke – 8 x 53 g 20,11
2621 Pain Pita Ajinomoto Cambrooke – 6 x 90 g 20,11
2622 CBF Bagel nature Ajinomoto Cambrooke – 8 x 53 g 20,11
2625 CBF Barre déjeuner pain doré Ajinomoto Cambrooke – 8 x 53 g 20,11
2630 Gros Bagel – nature Ajinomoto Cambrooke – 6 x 81 g 20,11
2631 Gros Bagel – pomme et cannelle Ajinomoto Cambrooke – 6 x 84 g 20,11
2952 Pâte surgelée Ajinomoto Cambrooke – 720 g 14,83
Updated May 2021 12DESSERTS
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
Biscuits beurre d’arachides et
2506 Ajinomoto Cambrooke – 12 x 35 g 18,99
pépites de chocolat
Biscuits aux pépites de caramel
2507 Ajinomoto Cambrooke – 12 x 35 g 16,99
écossais
2612 Scone à la banane Ajinomoto Cambrooke – 6 x 52 g 18,96
2614 Barre déjeuner aux pommes Ajinomoto Cambrooke – 4 x 63 g 13,21
2617 Barre déjeuner aux bleuets Ajinomoto Cambrooke – 4 x 71 g 13,79
OTHER
Weight, volume,
Code Product Manufacturer Units/case or quantity per Unit price
unit
Boulettes Camburgers
2901 Ajinomoto Cambrooke – 4 x 71 g 16,09
(champignons portabella)
2903 Pizza au fromage Ajinomoto Cambrooke – 3 x 139 g 31,04
2904 CBF Pizza Blanca Ajinomoto Cambrooke – 3 x 150 g 31,04
2908 Pizza Primavera Ajinomoto Cambrooke – 3 x 152 g 31,04
2909 Mini pochettes pizza Ajinomoto Cambrooke – 6 x 42 g 14,94
2910 Saucisses fumées Brookelyn Ajinomoto Cambrooke – 16 x 56 g 37,36
2911 Boulettes de légumes Ajinomoto Cambrooke – 513 g 34,49
2912 Croquettes Tweekz Ajinomoto Cambrooke – 284 g 27,59
2917 Boulettes farcies au fromage Ajinomoto Cambrooke – 513 g 31,04
2919 Meadley meals – Légumes masala Ajinomoto Cambrooke – 320 g 13,79
2921 Meadley meals – Thai Ajinomoto Cambrooke – 320 g 13,79
2930 Go Pockets Fromage et Brocoli Ajinomoto Cambrooke – 2 x 130 g 12,41
2931 Go Pockets Burrito Ajinomoto Cambrooke – 130 g 12,41
2933 Pea-NOT-Butter Ajinomoto Cambrooke – 227 g 10,44
2942 Pommes de terre Yuca Ajinomoto Cambrooke – 907 g 23,11
2947 Mélange pour boulettes poulet Ajinomoto Cambrooke – 680 g 39,99
2948 Mélange pour boulettes burger Ajinomoto Cambrooke – 680 g 39,99
2956 Enchiladas Ajinomoto Cambrooke – 225 g 26,35
Mélange pour boulettes – Fruits de
2978 Ajinomoto Cambrooke 1 680 g 39,99
mer
Updated May 2021 13PRODUCTS REMOVED FROM THE LIST SINCE THE PREVIOUS
VERSION
Weight, volume, or
Code Product Manufacturer Reason for removal
quantity per unit
Little or no use of the
1250 XPhe Maxamum sachet (orange) Nutricia 30 product
XPhe Maxamum sachet (sans Little or no use of the
1251 Nutricia 30 product
saveur)
Little or no use of the
1288 Periflex Junior Plus Baies Nutricia 6 product
Little or no use of the
1289 Periflex Junior Plus Orange Nutricia 6 product
Little or no use of the
1290 Periflex Junior Plus Vanille Nutricia 6 product
Little or no use of the
1801 PKU Gel (orange) Vitaflo 30 product
Little or no use of the
1802 PKU Gel (framboise) Vitaflo 30 product
PKU Cooler 15 and 20
1825 PKU Cooler 10 (orange) Vitaflo 30 available in this flavor
PKU Cooler 15 and 20
1826 PKU Cooler 10 (mauve) Vitaflo 30 available in this flavor
PKU Cooler 15 and 20
1841 PKU Cooler 10 (blanc) Vitaflo 30 available in this flavor
PKU Cooler 15 and 20
1843 PKU Cooler 10 (rouge) Vitaflo 30 available in this flavor
2632 Gros Bagel – ail Ajinomoto Cambrooke 6 x 81 g Discontinued product
2932 Go Pockets Samosa Ajinomoto Cambrooke 130 g Discontinued product
Updated May 2021 1421-923-01WA
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