Non-Group Coverage (Group 1) Coverage for Seniors (Group 66) Palliative Coverage (Group 20514, Please note your client may have Group 1 or Group 66 coverage) Child and Family Services (Group 20403) Alberta Child Health Benefit (Group 20400) Children and Youth Services (Group 19824) Income Support (Group 19823) Alberta Human Services (AISH) (Group 19823) Alberta Adult Health Benefit (AAHB) (Group 23609)
"For use in patients with manual dexterity problems or visual limitations who are unable to prepare a dose of the drug using the multi-dose solution."
"For use in patients who are hypersensitive to preservatives contained in multi-dose solutions."
"Special authorization for both criteria may be granted for 24 months."
Information is required regarding the nature of the difficulties experienced by the patient in preparing a dose using the multi-dose preparation; or the nature of the patient's hypersensitivity to the preservatives contained in the multi-dose solution.
The following product(s) are eligible for auto-renewal.
Review Status / Past Decisions
Indication
Reviewing Body
Submission Completion Date
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date
CDR Recommendation
Review Status
N/A
Expert Committee
1997/09/16
2009/07/01
Special Authorization Criteria Change
Indication
N/A
Reviewing Body
Expert Committee
Submission Completion Date
1997/09/16
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date
2009/07/01
CDR Recommendation
Review Status
Special Authorization Criteria Change
PHARMASCIENCE INC. (PMS)
Telephone:(514) 340-1114
Toll-Free:(514) 340-5022
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NOTICE:
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.
Electronic versions of all DBL and DBS related publications are unofficial versions and are provided for convenience and private use only. Official paper versions can be obtained from Alberta Blue Cross who publishes them on behalf of Alberta Health and Alberta Human Services.
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.