Alberta Health - Drug Benefit List

Interactive Drug Benefit List

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Products Found: 56

DIN/NPN/ PIN	Generic Name	Product Name, Strength & Dosage Form	Unit Price, Unit of Issue	Manufacturer	LCA Price	MAC Price	Interchangeable Products	Coverage Status
00330582	5-FLUOROURACIL	EFUDEX 50 MG / G TOPICAL CREAM	1.0040 G	VCL	N/A	N/A	NO	REGULAR BENEFIT	Details
02528371	ABROCITINIB	CIBINQO 100 MG ORAL TABLET	48.6667 TAB	PFI	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02528398	ABROCITINIB	CIBINQO 200 MG ORAL TABLET	54.4667 TAB	PFI	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02528363	ABROCITINIB	CIBINQO 50 MG ORAL TABLET	48.6667 TAB	PFI	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02468840	ACITRETIN	MINT-ACITRETIN 10 MG ORAL CAPSULE	1.2965 CAP	MPI	1.2965	N/A	YES	REGULAR BENEFIT	Details
02070847	ACITRETIN	SORIATANE 10 MG ORAL CAPSULE	2.5805 CAP	ALR	1.2965	N/A	YES	REGULAR BENEFIT	Details
02466074	ACITRETIN	TARO-ACITRETIN 10 MG ORAL CAPSULE	1.2965 CAP	TAR	1.2965	N/A	YES	REGULAR BENEFIT	Details
02468859	ACITRETIN	MINT-ACITRETIN 25 MG ORAL CAPSULE	2.2770 CAP	MPI	2.2770	N/A	YES	REGULAR BENEFIT	Details
02070863	ACITRETIN	SORIATANE 25 MG ORAL CAPSULE	4.5314 CAP	ALR	2.2770	N/A	YES	REGULAR BENEFIT	Details
02466082	ACITRETIN	TARO-ACITRETIN 25 MG ORAL CAPSULE	2.2770 CAP	TAR	2.2770	N/A	YES	REGULAR BENEFIT	Details
02337649	ALITRETINOIN	TOCTINO 30 MG ORAL CAPSULE	N/A CAP	GST	N/A	N/A	NO	NOT A BENEFIT	Details
02270811	AZELAIC ACID	FINACEA 15 % TOPICAL GEL	0.6680 G	LEO	N/A	N/A	NO	REGULAR BENEFIT	Details
02525275	BIMEKIZUMAB	BIMZELX (AUTO-INJECTOR) 160 MG / SYR INJECTION SYRINGE	1,625.0000 SYR	UCB	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02525267	BIMEKIZUMAB	BIMZELX 160 MG / SYR INJECTION SYRINGE	1,625.0000 SYR	UCB	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02473623	BRODALUMAB	SILIQ (1.5 ML PREFILLED SYRINGE) 210 MG / SYR INJECTION SYRINGE	N/A SYR	VCL	N/A	N/A	NO	NOT A BENEFIT	Details
01976133	CALCIPOTRIOL	DOVONEX 50 MCG / G TOPICAL OINTMENT	0.8550 G	LEO	N/A	N/A	NO	REGULAR BENEFIT	Details
02319012	CALCIPOTRIOL MONOHYDRATE/ BETAMETHASONE DIPROPIONATE	DOVOBET 50 MCG / G * 0.5 MG / G TOPICAL GEL	1.6539 G	LEO	0.0000	0.0000	YES	REGULAR BENEFIT	Details
02457393	CALCIPOTRIOL MONOHYDRATE/ BETAMETHASONE DIPROPIONATE	ENSTILAR 50 MCG / G * 0.5 MG / G TOPICAL FOAM	1.6323 G	LEO	N/A	N/A	NO	REGULAR BENEFIT	Details
02525178	CALCIPOTRIOL MONOHYDRATE/ BETAMETHASONE DIPROPIONATE	TARO-CALCIPOTRIOL / BETAMETHASONE GEL 50 MCG / G * 0.5 MG / G TOPICAL GEL	1.3142 G	TAR	0.0000	0.0000	YES	REGULAR BENEFIT	Details
02338572	CALCITRIOL	SILKIS 3 MCG / G TOPICAL OINTMENT	N/A G	GAL	N/A	N/A	NO	NOT A BENEFIT	Details
02063670	COLLAGENASE	SANTYL 250 UNIT / G TOPICAL OINTMENT	3.2480 G	SNE	N/A	N/A	NO	REGULAR BENEFIT	Details
02524252	DUPILUMAB	DUPIXENT (PEN) 200 MG / SYR INJECTION SYRINGE	978.7000 SYR	SAV	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02492504	DUPILUMAB	DUPIXENT 200 MG / SYR INJECTION	978.7000 SYR	SAV	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02510049	DUPILUMAB	DUPIXENT (PEN) 300 MG / SYR INJECTION SYRINGE	978.7000 SYR	SAV	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02470365	DUPILUMAB	DUPIXENT 300 MG / SYR INJECTION	978.7000 SYR	SAV	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02469758	GUSELKUMAB	TREMFYA 100 MG / SYR INJECTION SYRINGE	3,059.7400 SYR	JAI	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02487314	GUSELKUMAB	TREMFYA ONE-PRESS 100 MG / SYR INJECTION SYRINGE	3,059.7400 SYR	JAI	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02239505	IMIQUIMOD	ALDARA P 50 MG/G / G TOPICAL CREAM	57.7455 G	VCL	43.4350	N/A	YES	SPECIAL AUTHORIZATION	Details
02482983	IMIQUIMOD	TARO-IMIQUIMOD PUMP 50 MG/G / G TOPICAL CREAM	43.4350 G	TAR	43.4350	N/A	YES	SPECIAL AUTHORIZATION	Details
00582344	ISOTRETINOIN	ACCUTANE 10 MG ORAL CAPSULE	0.9547 CAP	HLR	0.9313	N/A	YES	REGULAR BENEFIT	Details
02257955	ISOTRETINOIN	CLARUS 10 MG ORAL CAPSULE	0.9313 CAP	MYP	0.9313	N/A	YES	REGULAR BENEFIT	Details
02396971	ISOTRETINOIN	EPURIS 10 MG ORAL CAPSULE	N/A CAP	CIP	N/A	N/A	YES	NOT A BENEFIT	Details
02539055	ISOTRETINOIN	ABSORICA LD 16 MG ORAL CAPSULE	N/A CAP	SPF	N/A	N/A	NO	NOT A BENEFIT	Details
02396998	ISOTRETINOIN	EPURIS 20 MG ORAL CAPSULE	N/A CAP	CIP	N/A	N/A	NO	NOT A BENEFIT	Details
02539063	ISOTRETINOIN	ABSORICA LD 24 MG ORAL CAPSULE	N/A CAP	SPF	N/A	N/A	NO	NOT A BENEFIT	Details
02397005	ISOTRETINOIN	EPURIS 30 MG ORAL CAPSULE	N/A CAP	CIP	N/A	N/A	NO	NOT A BENEFIT	Details
02539071	ISOTRETINOIN	ABSORICA LD 32 MG ORAL CAPSULE	N/A CAP	SPF	N/A	N/A	NO	NOT A BENEFIT	Details
00582352	ISOTRETINOIN	ACCUTANE 40 MG ORAL CAPSULE	1.9480 CAP	HLR	1.9003	N/A	YES	REGULAR BENEFIT	Details
02257963	ISOTRETINOIN	CLARUS 40 MG ORAL CAPSULE	1.9003 CAP	MYP	1.9003	N/A	YES	REGULAR BENEFIT	Details
02397013	ISOTRETINOIN	EPURIS 40 MG ORAL CAPSULE	N/A CAP	CIP	N/A	N/A	YES	NOT A BENEFIT	Details
02539047	ISOTRETINOIN	ABSORICA LD 8 MG ORAL CAPSULE	N/A CAP	SPF	N/A	N/A	NO	NOT A BENEFIT	Details
02455110	IXEKIZUMAB	TALTZ 80 MG / SYR INJECTION SYRINGE	1,769.2800 SYR	LIL	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02455102	IXEKIZUMAB	TALTZ AUTOINJECTOR 80 MG / SYR INJECTION SYRINGE	1,769.2800 SYR	LIL	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02323273	METHYL AMINOLEVULINATE HYDROCHLORIDE	METVIX 16.8 % TOPICAL CREAM	N/A G	GAL	N/A	N/A	NO	NOT A BENEFIT	Details
02247238	PIMECROLIMUS	ELIDEL 1 % TOPICAL CREAM	N/A G	VCL	N/A	N/A	NO	NOT A BENEFIT	Details
02519291	RISANKIZUMAB	SKYRIZI (PEN) 150 MG / SYR INJECTION SYRINGE	4,935.0000 SYR	ABV	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02519283	RISANKIZUMAB	SKYRIZI 150 MG / SYR INJECTION SYRINGE	4,935.0000 SYR	ABV	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02532093	RISANKIZUMAB	SKYRIZI 360 MG INJECTION CARTRIDGE	4,593.1400 CTG	ABV	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02532107	RISANKIZUMAB	SKYRIZI 600 MG / VIAL INJECTION	4,593.1400 VIAL	ABV	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02438070	SECUKINUMAB	COSENTYX 150 MG / SYR INJECTION SYRINGE	906.6200 SYR	NOV	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02244149	TACROLIMUS	PROTOPIC 0.03 % TOPICAL OINTMENT	2.4657 G	LEO	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02244148	TACROLIMUS	PROTOPIC 0.1 % TOPICAL OINTMENT	2.6177 G	LEO	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02517868	TAZAROTENE	ARAZLO 0.045 % TOPICAL LOTION	1.4051 G	VCL	N/A	N/A	NO	REGULAR BENEFIT	Details
02516098	TILDRAKIZUMAB	ILUMYA 100 MG / SYR INJECTION SYRINGE	4,935.0000 SYR	SPF	N/A	N/A	NO	SPECIAL AUTHORIZATION	Details
02543036	USTEKINUMAB	JAMTEKI (0.5 ML SYRINGE) 45 MG / SYR INJECTION SYRINGE	N/A SYR	JPC	N/A	N/A	NO	UNDER REVIEW	Details
02543044	USTEKINUMAB	JAMTEKI (1 ML SYRINGE) 90 MG / SYR INJECTION SYRINGE	N/A SYR	JPC	N/A	N/A	NO	UNDER REVIEW	Details

DIN/NPN/ PIN	00330582
Generic Name	5-FLUOROURACIL
Product Name, Strength & Dosage Form	EFUDEX 50 MG / G TOPICAL CREAM
Unit Price, Unit of Issue	1.0040
Manufacturer	VCL
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	REGULAR BENEFIT
Details

DIN/NPN/ PIN	02528371
Generic Name	ABROCITINIB
Product Name, Strength & Dosage Form	CIBINQO 100 MG ORAL TABLET
Unit Price, Unit of Issue	48.6667
Manufacturer	PFI
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02528398
Generic Name	ABROCITINIB
Product Name, Strength & Dosage Form	CIBINQO 200 MG ORAL TABLET
Unit Price, Unit of Issue	54.4667
Manufacturer	PFI
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02528363
Generic Name	ABROCITINIB
Product Name, Strength & Dosage Form	CIBINQO 50 MG ORAL TABLET
Unit Price, Unit of Issue	48.6667
Manufacturer	PFI
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02468840
Generic Name	ACITRETIN
Product Name, Strength & Dosage Form	MINT-ACITRETIN 10 MG ORAL CAPSULE
Unit Price, Unit of Issue	1.2965
Manufacturer	MPI
LCA Price	1.2965
MAC Price	N/A
Interchangeable Products	YES
Coverage Status	REGULAR BENEFIT
Details

DIN/NPN/ PIN	02070847
Generic Name	ACITRETIN
Product Name, Strength & Dosage Form	SORIATANE 10 MG ORAL CAPSULE
Unit Price, Unit of Issue	2.5805
Manufacturer	ALR
LCA Price	1.2965
MAC Price	N/A
Interchangeable Products	YES
Coverage Status	REGULAR BENEFIT
Details

DIN/NPN/ PIN	02466074
Generic Name	ACITRETIN
Product Name, Strength & Dosage Form	TARO-ACITRETIN 10 MG ORAL CAPSULE
Unit Price, Unit of Issue	1.2965
Manufacturer	TAR
LCA Price	1.2965
MAC Price	N/A
Interchangeable Products	YES
Coverage Status	REGULAR BENEFIT
Details

DIN/NPN/ PIN	02468859
Generic Name	ACITRETIN
Product Name, Strength & Dosage Form	MINT-ACITRETIN 25 MG ORAL CAPSULE
Unit Price, Unit of Issue	2.2770
Manufacturer	MPI
LCA Price	2.2770
MAC Price	N/A
Interchangeable Products	YES
Coverage Status	REGULAR BENEFIT
Details

DIN/NPN/ PIN	02070863
Generic Name	ACITRETIN
Product Name, Strength & Dosage Form	SORIATANE 25 MG ORAL CAPSULE
Unit Price, Unit of Issue	4.5314
Manufacturer	ALR
LCA Price	2.2770
MAC Price	N/A
Interchangeable Products	YES
Coverage Status	REGULAR BENEFIT
Details

DIN/NPN/ PIN	02466082
Generic Name	ACITRETIN
Product Name, Strength & Dosage Form	TARO-ACITRETIN 25 MG ORAL CAPSULE
Unit Price, Unit of Issue	2.2770
Manufacturer	TAR
LCA Price	2.2770
MAC Price	N/A
Interchangeable Products	YES
Coverage Status	REGULAR BENEFIT
Details

DIN/NPN/ PIN	02337649
Generic Name	ALITRETINOIN
Product Name, Strength & Dosage Form	TOCTINO 30 MG ORAL CAPSULE
Unit Price, Unit of Issue	N/A
Manufacturer	GST
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	NOT A BENEFIT
Details

DIN/NPN/ PIN	02270811
Generic Name	AZELAIC ACID
Product Name, Strength & Dosage Form	FINACEA 15 % TOPICAL GEL
Unit Price, Unit of Issue	0.6680
Manufacturer	LEO
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	REGULAR BENEFIT
Details

DIN/NPN/ PIN	02525275
Generic Name	BIMEKIZUMAB
Product Name, Strength & Dosage Form	BIMZELX (AUTO-INJECTOR) 160 MG / SYR INJECTION SYRINGE
Unit Price, Unit of Issue	1,625.0000
Manufacturer	UCB
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02525267
Generic Name	BIMEKIZUMAB
Product Name, Strength & Dosage Form	BIMZELX 160 MG / SYR INJECTION SYRINGE
Unit Price, Unit of Issue	1,625.0000
Manufacturer	UCB
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02473623
Generic Name	BRODALUMAB
Product Name, Strength & Dosage Form	SILIQ (1.5 ML PREFILLED SYRINGE) 210 MG / SYR INJECTION SYRINGE
Unit Price, Unit of Issue	N/A
Manufacturer	VCL
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	NOT A BENEFIT
Details

DIN/NPN/ PIN	01976133
Generic Name	CALCIPOTRIOL
Product Name, Strength & Dosage Form	DOVONEX 50 MCG / G TOPICAL OINTMENT
Unit Price, Unit of Issue	0.8550
Manufacturer	LEO
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	REGULAR BENEFIT
Details

DIN/NPN/ PIN	02319012
Generic Name	CALCIPOTRIOL MONOHYDRATE/ BETAMETHASONE DIPROPIONATE
Product Name, Strength & Dosage Form	DOVOBET 50 MCG / G * 0.5 MG / G TOPICAL GEL
Unit Price, Unit of Issue	1.6539
Manufacturer	LEO
LCA Price	0.0000
MAC Price	0.0000
Interchangeable Products	YES
Coverage Status	REGULAR BENEFIT
Details

DIN/NPN/ PIN	02457393
Generic Name	CALCIPOTRIOL MONOHYDRATE/ BETAMETHASONE DIPROPIONATE
Product Name, Strength & Dosage Form	ENSTILAR 50 MCG / G * 0.5 MG / G TOPICAL FOAM
Unit Price, Unit of Issue	1.6323
Manufacturer	LEO
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	REGULAR BENEFIT
Details

DIN/NPN/ PIN	02525178
Generic Name	CALCIPOTRIOL MONOHYDRATE/ BETAMETHASONE DIPROPIONATE
Product Name, Strength & Dosage Form	TARO-CALCIPOTRIOL / BETAMETHASONE GEL 50 MCG / G * 0.5 MG / G TOPICAL GEL
Unit Price, Unit of Issue	1.3142
Manufacturer	TAR
LCA Price	0.0000
MAC Price	0.0000
Interchangeable Products	YES
Coverage Status	REGULAR BENEFIT
Details

DIN/NPN/ PIN	02338572
Generic Name	CALCITRIOL
Product Name, Strength & Dosage Form	SILKIS 3 MCG / G TOPICAL OINTMENT
Unit Price, Unit of Issue	N/A
Manufacturer	GAL
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	NOT A BENEFIT
Details

DIN/NPN/ PIN	02063670
Generic Name	COLLAGENASE
Product Name, Strength & Dosage Form	SANTYL 250 UNIT / G TOPICAL OINTMENT
Unit Price, Unit of Issue	3.2480
Manufacturer	SNE
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	REGULAR BENEFIT
Details

DIN/NPN/ PIN	02524252
Generic Name	DUPILUMAB
Product Name, Strength & Dosage Form	DUPIXENT (PEN) 200 MG / SYR INJECTION SYRINGE
Unit Price, Unit of Issue	978.7000
Manufacturer	SAV
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02492504
Generic Name	DUPILUMAB
Product Name, Strength & Dosage Form	DUPIXENT 200 MG / SYR INJECTION
Unit Price, Unit of Issue	978.7000
Manufacturer	SAV
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02510049
Generic Name	DUPILUMAB
Product Name, Strength & Dosage Form	DUPIXENT (PEN) 300 MG / SYR INJECTION SYRINGE
Unit Price, Unit of Issue	978.7000
Manufacturer	SAV
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02470365
Generic Name	DUPILUMAB
Product Name, Strength & Dosage Form	DUPIXENT 300 MG / SYR INJECTION
Unit Price, Unit of Issue	978.7000
Manufacturer	SAV
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02469758
Generic Name	GUSELKUMAB
Product Name, Strength & Dosage Form	TREMFYA 100 MG / SYR INJECTION SYRINGE
Unit Price, Unit of Issue	3,059.7400
Manufacturer	JAI
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02487314
Generic Name	GUSELKUMAB
Product Name, Strength & Dosage Form	TREMFYA ONE-PRESS 100 MG / SYR INJECTION SYRINGE
Unit Price, Unit of Issue	3,059.7400
Manufacturer	JAI
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02239505
Generic Name	IMIQUIMOD
Product Name, Strength & Dosage Form	ALDARA P 50 MG/G / G TOPICAL CREAM
Unit Price, Unit of Issue	57.7455
Manufacturer	VCL
LCA Price	43.4350
MAC Price	N/A
Interchangeable Products	YES
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02482983
Generic Name	IMIQUIMOD
Product Name, Strength & Dosage Form	TARO-IMIQUIMOD PUMP 50 MG/G / G TOPICAL CREAM
Unit Price, Unit of Issue	43.4350
Manufacturer	TAR
LCA Price	43.4350
MAC Price	N/A
Interchangeable Products	YES
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	00582344
Generic Name	ISOTRETINOIN
Product Name, Strength & Dosage Form	ACCUTANE 10 MG ORAL CAPSULE
Unit Price, Unit of Issue	0.9547
Manufacturer	HLR
LCA Price	0.9313
MAC Price	N/A
Interchangeable Products	YES
Coverage Status	REGULAR BENEFIT
Details

DIN/NPN/ PIN	02257955
Generic Name	ISOTRETINOIN
Product Name, Strength & Dosage Form	CLARUS 10 MG ORAL CAPSULE
Unit Price, Unit of Issue	0.9313
Manufacturer	MYP
LCA Price	0.9313
MAC Price	N/A
Interchangeable Products	YES
Coverage Status	REGULAR BENEFIT
Details

DIN/NPN/ PIN	02396971
Generic Name	ISOTRETINOIN
Product Name, Strength & Dosage Form	EPURIS 10 MG ORAL CAPSULE
Unit Price, Unit of Issue	N/A
Manufacturer	CIP
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	YES
Coverage Status	NOT A BENEFIT
Details

DIN/NPN/ PIN	02539055
Generic Name	ISOTRETINOIN
Product Name, Strength & Dosage Form	ABSORICA LD 16 MG ORAL CAPSULE
Unit Price, Unit of Issue	N/A
Manufacturer	SPF
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	NOT A BENEFIT
Details

DIN/NPN/ PIN	02396998
Generic Name	ISOTRETINOIN
Product Name, Strength & Dosage Form	EPURIS 20 MG ORAL CAPSULE
Unit Price, Unit of Issue	N/A
Manufacturer	CIP
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	NOT A BENEFIT
Details

DIN/NPN/ PIN	02539063
Generic Name	ISOTRETINOIN
Product Name, Strength & Dosage Form	ABSORICA LD 24 MG ORAL CAPSULE
Unit Price, Unit of Issue	N/A
Manufacturer	SPF
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	NOT A BENEFIT
Details

DIN/NPN/ PIN	02397005
Generic Name	ISOTRETINOIN
Product Name, Strength & Dosage Form	EPURIS 30 MG ORAL CAPSULE
Unit Price, Unit of Issue	N/A
Manufacturer	CIP
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	NOT A BENEFIT
Details

DIN/NPN/ PIN	02539071
Generic Name	ISOTRETINOIN
Product Name, Strength & Dosage Form	ABSORICA LD 32 MG ORAL CAPSULE
Unit Price, Unit of Issue	N/A
Manufacturer	SPF
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	NOT A BENEFIT
Details

DIN/NPN/ PIN	00582352
Generic Name	ISOTRETINOIN
Product Name, Strength & Dosage Form	ACCUTANE 40 MG ORAL CAPSULE
Unit Price, Unit of Issue	1.9480
Manufacturer	HLR
LCA Price	1.9003
MAC Price	N/A
Interchangeable Products	YES
Coverage Status	REGULAR BENEFIT
Details

DIN/NPN/ PIN	02257963
Generic Name	ISOTRETINOIN
Product Name, Strength & Dosage Form	CLARUS 40 MG ORAL CAPSULE
Unit Price, Unit of Issue	1.9003
Manufacturer	MYP
LCA Price	1.9003
MAC Price	N/A
Interchangeable Products	YES
Coverage Status	REGULAR BENEFIT
Details

DIN/NPN/ PIN	02397013
Generic Name	ISOTRETINOIN
Product Name, Strength & Dosage Form	EPURIS 40 MG ORAL CAPSULE
Unit Price, Unit of Issue	N/A
Manufacturer	CIP
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	YES
Coverage Status	NOT A BENEFIT
Details

DIN/NPN/ PIN	02539047
Generic Name	ISOTRETINOIN
Product Name, Strength & Dosage Form	ABSORICA LD 8 MG ORAL CAPSULE
Unit Price, Unit of Issue	N/A
Manufacturer	SPF
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	NOT A BENEFIT
Details

DIN/NPN/ PIN	02455110
Generic Name	IXEKIZUMAB
Product Name, Strength & Dosage Form	TALTZ 80 MG / SYR INJECTION SYRINGE
Unit Price, Unit of Issue	1,769.2800
Manufacturer	LIL
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02455102
Generic Name	IXEKIZUMAB
Product Name, Strength & Dosage Form	TALTZ AUTOINJECTOR 80 MG / SYR INJECTION SYRINGE
Unit Price, Unit of Issue	1,769.2800
Manufacturer	LIL
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02323273
Generic Name	METHYL AMINOLEVULINATE HYDROCHLORIDE
Product Name, Strength & Dosage Form	METVIX 16.8 % TOPICAL CREAM
Unit Price, Unit of Issue	N/A
Manufacturer	GAL
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	NOT A BENEFIT
Details

DIN/NPN/ PIN	02247238
Generic Name	PIMECROLIMUS
Product Name, Strength & Dosage Form	ELIDEL 1 % TOPICAL CREAM
Unit Price, Unit of Issue	N/A
Manufacturer	VCL
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	NOT A BENEFIT
Details

DIN/NPN/ PIN	02519291
Generic Name	RISANKIZUMAB
Product Name, Strength & Dosage Form	SKYRIZI (PEN) 150 MG / SYR INJECTION SYRINGE
Unit Price, Unit of Issue	4,935.0000
Manufacturer	ABV
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02519283
Generic Name	RISANKIZUMAB
Product Name, Strength & Dosage Form	SKYRIZI 150 MG / SYR INJECTION SYRINGE
Unit Price, Unit of Issue	4,935.0000
Manufacturer	ABV
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02532093
Generic Name	RISANKIZUMAB
Product Name, Strength & Dosage Form	SKYRIZI 360 MG INJECTION CARTRIDGE
Unit Price, Unit of Issue	4,593.1400
Manufacturer	ABV
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02532107
Generic Name	RISANKIZUMAB
Product Name, Strength & Dosage Form	SKYRIZI 600 MG / VIAL INJECTION
Unit Price, Unit of Issue	4,593.1400
Manufacturer	ABV
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02438070
Generic Name	SECUKINUMAB
Product Name, Strength & Dosage Form	COSENTYX 150 MG / SYR INJECTION SYRINGE
Unit Price, Unit of Issue	906.6200
Manufacturer	NOV
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02244149
Generic Name	TACROLIMUS
Product Name, Strength & Dosage Form	PROTOPIC 0.03 % TOPICAL OINTMENT
Unit Price, Unit of Issue	2.4657
Manufacturer	LEO
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02244148
Generic Name	TACROLIMUS
Product Name, Strength & Dosage Form	PROTOPIC 0.1 % TOPICAL OINTMENT
Unit Price, Unit of Issue	2.6177
Manufacturer	LEO
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02517868
Generic Name	TAZAROTENE
Product Name, Strength & Dosage Form	ARAZLO 0.045 % TOPICAL LOTION
Unit Price, Unit of Issue	1.4051
Manufacturer	VCL
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	REGULAR BENEFIT
Details

DIN/NPN/ PIN	02516098
Generic Name	TILDRAKIZUMAB
Product Name, Strength & Dosage Form	ILUMYA 100 MG / SYR INJECTION SYRINGE
Unit Price, Unit of Issue	4,935.0000
Manufacturer	SPF
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	SPECIAL AUTHORIZATION
Details

DIN/NPN/ PIN	02543036
Generic Name	USTEKINUMAB
Product Name, Strength & Dosage Form	JAMTEKI (0.5 ML SYRINGE) 45 MG / SYR INJECTION SYRINGE
Unit Price, Unit of Issue	N/A
Manufacturer	JPC
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	UNDER REVIEW
Details

DIN/NPN/ PIN	02543044
Generic Name	USTEKINUMAB
Product Name, Strength & Dosage Form	JAMTEKI (1 ML SYRINGE) 90 MG / SYR INJECTION SYRINGE
Unit Price, Unit of Issue	N/A
Manufacturer	JPC
LCA Price	N/A
MAC Price	N/A
Interchangeable Products	NO
Coverage Status	UNDER REVIEW
Details

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The DBL, DBS and related publications require knowledgeable interpretation and are intended primarily for professional health care practitioners, pharmacies, hospitals and organizations associated with the manufacture, distribution and use of pharmaceutical preparations.

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Alberta Health reserves the right to make changes, without notice, to the List through the Interactive DBL(iDBL), and any such changes to the Interactive DBL(iDBL) are effective the date of the change (unless otherwise stated) and regardless of the date of publication in the paper version or updates.