Summary of Changes to the Alberta Human Services Drug Benefit Supplement
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1 Summary of Changes to the Alberta Human Services Drug Benefit Supplement Effective April 1, 2018
2 Inquiries should be directed to: Pharmacy Services Alberta Blue Cross Street NW Edmonton AB T5J 3C5 Telephone Number: (780) (Edmonton) (403) (Calgary) (Toll Free) FAX Number: (780) (Toll Free) Website: Administered by Alberta Blue Cross on behalf of Alberta Health. The Drug Benefit List (DBL) is a list of drugs for which coverage may be provided to program participants. The DBL is not intended to be, and must not be used as a diagnostic or prescribing tool. Inclusion of a drug on the DBL does not mean or imply that the drug is fit or effective for any specific purpose. Prescribing professionals must always use their professional judgment and should refer to product monographs and any applicable practice guidelines when prescribing drugs. The product monograph contains information that may be required for the safe and effective use of the product. Copies of the Alberta Drug Benefit List are available from Pharmacy Services, Alberta Blue Cross at the address shown above. Binder and contents: $42.00 ($ $2.00 G.S.T.) Contents only: $36.75 ($ $1.75 G.S.T.) A cheque or money order must accompany the request for copies. ABC 40211/81160 (R2018/04)
3 Table of Contents Product(s) with a Price Change... 1 Discontinued Products... 2 EFFECTIVE APRIL 1, 2018
4 Product(s) with a Price Change The following product(s) had a Price Decrease. The previous higher price will be recognized until April 30, For products within an established IC Grouping, the LCA price may apply. CHILDREN'S ADVIL 20 MG / ML SUSPENSION IBUPROFEN PDH COLYTE G / G / 22.7 G / G / 6.7 G / G / 5.8 G / G / 3 G / G POWDER POLYETHYLENE GLYCOL/ SODIUM SULFATE/ SODIUM BICARBONATE/ SODIUM CHLORIDE/ POTASSIUM CHLORIDE (K+) PPH DUOCAL POWDER NUTRITIONAL PRODUCTS NUN KETOCAL LIQUID NUTRITIONAL PRODUCTS NUN KETOCAL POWDER NUTRITIONAL PRODUCTS NUN LACTAID EXTRA STRENGTH 4500 UNIT TABLET LACTASE MCL LACTAID ULTRA 9000 UNIT CAPLET LACTASE MCL MICOZOLE 2% VAGINAL CREAM MICONAZOLE NITRATE TAR NEOCATE E028 SPLASH LIQUID NUTRITIONAL PRODUCTS NUN NEOCATE JUNIOR POWDER NUTRITIONAL PRODUCTS NUN NEOCATE JUNIOR WITH PREBIOTIC FIBRE POWDER NUTRITIONAL PRODUCTS NUN NEOCATE SPLASH LIQUID NUTRITIONAL PRODUCTS NUN NEOCATE WITH DHA & ARA INFANT FORMULA INFANT FORMULA NUN NICORETTE INHALER 10 MG/DOSE NICOTINE JJI NYADERM 100,000 UNIT / G TOPICAL CREAM NYSTATIN TAR PEDIALYTE MEQ / ML / 0.02 MEQ / ML / MEQ / ML / 0.03 MEQ / ML / G / ML LIQUID PEG-LYTE G / G / 3.05 G / G / G / G / 5.85 G / G / 6.76 G / G POWDER SODIUM/ POTASSIUM/ CHLORIDE/ CITRATE/ DEXTROSE POLYETHYLENE GLYCOL/ POTASSIUM CHLORIDE (K+)/ SODIUM SULFATE/ SODIUM CHLORIDE/ SODIUM BICARBONATE ABN PPH LACTAID 3,000 UNIT TABLET LACTASE MCL RESOURCE THICKENUP ORAL POWDER INSTANT FOOD THICKENER NHN SALINEX 0.9% NASAL SOLUTION SODIUM CHLORIDE SDZ SANDOZ DIMENHYDRINATE 50 MG RECTAL DIMENHYDRINATE SDZ EFFECTIVE APRIL 1,
5 Product(s) with a Price Change, continued SANDOZ DIMENHYDRINATE 100 MG RECTAL SCANDISHAKE ORAL FOOD SUPPLEMENT POWDER THE MAGIC BULLET 10 MG RECTAL DIMENHYDRINATE SDZ NUTRITIONAL PRODUCTS AXC BISACODYL DCM TYLENOL EXTRA STRENGTH 500 MG TABLET ACETAMINOPHEN MCL TYLENOL EXTRA-STRENGTH (CAPLET) 500 MG TABLET ACETAMINOPHEN MCL ZYBAN 150 MG SUSTAINED-RELEASE TABLET BUPROPION HCL VCL Discontinued Listing(s) Notification of discontinuation has been received from the manufacturers. The Alberta government-sponsored drug programs previously covered the following drug product(s). Effective April 1, 2018, the listed product(s) will no longer be a benefit and will not be considered for coverage by special authorization. A transition period will be applied and, as of May 1, 2018 claims will no longer pay for these products. ISOSOURCE HN ORAL LIQUID NUTRITIONAL PRODUCTS NHN RESOURCE THICKENED JUICE LIQUID NUTRITIONAL PRODUCTS NHN 2 EFFECTIVE APRIL 1, 2018
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A Bulletin for PHARMACY Service Providers from Alberta Blue Cross. Alberta Public Health Activities Program (APHAP)
harmacy Benefact A Bulletin for HARMACY Service roviders from Alberta Blue Cross Number 479 September 2014 Alberta ublic Health Activities rogram (AHA) As in past years, pharmacists are invited to participate