Alberta Health - Drug Benefit List

Interactive Drug Benefit List

DIN/NPN/PIN 02244016 REMICADE 100 MG / VIAL INJECTION INFLIXIMAB

920000	MISCELLANEOUS THERAPEUTIC AGENTS
923600	DISEASE-MODIFYING ANTIRHEUMATIC AGENTS

Date Listed/Coverage Update:

Unit Price:

N/A

LCA Price:

N/A

MAC Price:

N/A

Unit of Issue:

Vial

Manufacturer:

JANSSEN INC. (JAI)

ATC:

L04AB02

Provincial Drug Schedule:

Interchangeable Products:

Coverage Status:	NOT A BENEFIT
Applies to Clients of:	N/A
Special Authorization Request Form:	N/A
Coverage Criteria:	N/A

Review Status / Past Decisions

Indication	Reviewing Body	Submission Completion Date	CDR Recommendation Date	ADBL Effective Date	CDR Recommendation	Review Status
N/A	Expert Committee	2021/01/15		2021/01/15		De-list
N/A	Expert Committee	2020/08/23		2020/09/01		Special Authorization Criteria Change
PSORIATIC ARTHRITIS	Expert Committee	2015/03/12		2015/05/01		Under Review
ANKYLOSING SPONDYLITIS	Expert Committee	2015/03/12		2015/05/01		Under Review
PSORIASIS (MODERATE TO SEVERE CHRONIC PLAQUE)	Expert Committee	2015/03/12		2015/05/01		Under Review
RHEUMATOID ARTHRITIS	Expert Committee	2015/03/12		2015/05/01		Under Review
ULCERATIVE COLITIS	Expert Committee	2014/07/24		2014/10/01		Special Authorization Criteria Change - Ulcerative Colitis
N/A	Expert Committee	2008/11/12		2009/03/04		Special Authorization Criteria Change
ULCERATIVE COLITIS	Common Drug Review	2008/10/06		2009/10/01		Not a Benefit
ULCERATIVE COLITIS	Common Drug Review	2008/10/06	2009/04/22		View	CDR - Do not list
ANKYLOSING SPONDYLITIS	Expert Committee	2008/02/14		2008/07/01		Not a Benefit - Ankylosing Spondylitis
ARTHRITIS, RHEUMATOID	Expert Committee	2007/11/20		2008/07/01		Under Review - Rheumatoid Arthritis
ARTHRITIS, RHEUMATOID	Expert Committee	2007/11/20		2009/01/01		Under Review - Rheumatoid Arthritis
ARTHRITIS, RHEUMATOID	Expert Committee	2007/11/20		2010/04/01		Special Authorization Criteria Change - Rheumatoid Arthritis
ARTHRITIS, RHEUMATOID	Expert Committee	2007/11/20		2012/08/01		Special Authorization Criteria Change - Rheumatoid Arthritis
ARTHRITIS, RHEUMATOID	Expert Committee	2007/11/20		2009/10/01		Special Authorization Criteria Change - Rheumatoid Arthritis
PSORIASIS (MODERATE TO SEVERE CHRONIC PLAQUE)	Expert Committee	2007/05/17		2011/09/01		Special Authorization Criteria Change - Psoriasis
ARTHRITIS, PSORIATIC	Expert Committee	2007/05/17		2007/10/01		Not a Benefit - Psoriatic Arthritis
PSORIASIS (MODERATE TO SEVERE CHRONIC PLAQUE)	Expert Committee	2007/05/17		2007/10/01		Not a Benefit - Plaque Psoriasis
ANKYLOSING SPONDYLITIS	Expert Committee	2005/07/25		2006/01/01		Not a Benefit - Ankylosing Spondylitis
N/A	Expert Committee	2004/05/20		2005/01/01		Special Authorization Change - Crohn's Disease
N/A	Expert Committee	2004/05/20		2006/07/01		Under Review - Crohn's Disease
N/A	Expert Committee	2004/05/20		2006/01/01		Under Review - Crohn's Disease
N/A	Expert Committee	2004/05/20		2006/10/01		Under Review - Crohn's Disease
N/A	Expert Committee	2004/05/20		2007/01/01		Under Review - Crohn's Disease
N/A	Expert Committee	2004/05/20		2005/04/01		Under Review - Rheumatoid Arthritis
N/A	Expert Committee	2004/05/20		2005/07/01		Under Review - Rheumatoid Arthritis
N/A	Expert Committee	2004/05/20		2006/04/01		Under Review - Crohn's Disease
N/A	Expert Committee	2004/05/20		2008/08/01		Special Authorization Criteria Change - Rheumatoid Arthritis
N/A	Expert Committee	2004/05/20		2005/10/01		Under Review - Crohn's Disease
N/A	Expert Committee	2004/05/20		2007/04/01		Under Review - Crohn's Disease

Indication	N/A
Reviewing Body	Expert Committee
Submission Completion Date	2021/01/15
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2021/01/15
CDR Recommendation
Review Status	De-list

Indication	N/A
Reviewing Body	Expert Committee
Submission Completion Date	2020/08/23
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2020/09/01
CDR Recommendation
Review Status	Special Authorization Criteria Change

Indication	PSORIATIC ARTHRITIS
Reviewing Body	Expert Committee
Submission Completion Date	2015/03/12
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2015/05/01
CDR Recommendation
Review Status	Under Review

Indication	ANKYLOSING SPONDYLITIS
Reviewing Body	Expert Committee
Submission Completion Date	2015/03/12
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2015/05/01
CDR Recommendation
Review Status	Under Review

Indication	PSORIASIS (MODERATE TO SEVERE CHRONIC PLAQUE)
Reviewing Body	Expert Committee
Submission Completion Date	2015/03/12
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2015/05/01
CDR Recommendation
Review Status	Under Review

Indication	RHEUMATOID ARTHRITIS
Reviewing Body	Expert Committee
Submission Completion Date	2015/03/12
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2015/05/01
CDR Recommendation
Review Status	Under Review

Indication	ULCERATIVE COLITIS
Reviewing Body	Expert Committee
Submission Completion Date	2014/07/24
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2014/10/01
CDR Recommendation
Review Status	Special Authorization Criteria Change - Ulcerative Colitis

Indication	N/A
Reviewing Body	Expert Committee
Submission Completion Date	2008/11/12
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2009/03/04
CDR Recommendation
Review Status	Special Authorization Criteria Change

Indication	ULCERATIVE COLITIS
Reviewing Body	Common Drug Review
Submission Completion Date	2008/10/06
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2009/10/01
CDR Recommendation
Review Status	Not a Benefit

Indication	ULCERATIVE COLITIS
Reviewing Body	Common Drug Review
Submission Completion Date	2008/10/06
CDR Recommendation Date	2009/04/22
Expert Committee Recommendation Date
ADBL Effective Date
CDR Recommendation	View
Review Status	CDR - Do not list

Indication	ANKYLOSING SPONDYLITIS
Reviewing Body	Expert Committee
Submission Completion Date	2008/02/14
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2008/07/01
CDR Recommendation
Review Status	Not a Benefit - Ankylosing Spondylitis

Indication	ARTHRITIS, RHEUMATOID
Reviewing Body	Expert Committee
Submission Completion Date	2007/11/20
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2008/07/01
CDR Recommendation
Review Status	Under Review - Rheumatoid Arthritis

Indication	ARTHRITIS, RHEUMATOID
Reviewing Body	Expert Committee
Submission Completion Date	2007/11/20
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2009/01/01
CDR Recommendation
Review Status	Under Review - Rheumatoid Arthritis

Indication	ARTHRITIS, RHEUMATOID
Reviewing Body	Expert Committee
Submission Completion Date	2007/11/20
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2010/04/01
CDR Recommendation
Review Status	Special Authorization Criteria Change - Rheumatoid Arthritis

Indication	ARTHRITIS, RHEUMATOID
Reviewing Body	Expert Committee
Submission Completion Date	2007/11/20
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2012/08/01
CDR Recommendation
Review Status	Special Authorization Criteria Change - Rheumatoid Arthritis

Indication	ARTHRITIS, RHEUMATOID
Reviewing Body	Expert Committee
Submission Completion Date	2007/11/20
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2009/10/01
CDR Recommendation
Review Status	Special Authorization Criteria Change - Rheumatoid Arthritis

Indication	PSORIASIS (MODERATE TO SEVERE CHRONIC PLAQUE)
Reviewing Body	Expert Committee
Submission Completion Date	2007/05/17
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2011/09/01
CDR Recommendation
Review Status	Special Authorization Criteria Change - Psoriasis

Indication	ARTHRITIS, PSORIATIC
Reviewing Body	Expert Committee
Submission Completion Date	2007/05/17
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2007/10/01
CDR Recommendation
Review Status	Not a Benefit - Psoriatic Arthritis

Indication	PSORIASIS (MODERATE TO SEVERE CHRONIC PLAQUE)
Reviewing Body	Expert Committee
Submission Completion Date	2007/05/17
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2007/10/01
CDR Recommendation
Review Status	Not a Benefit - Plaque Psoriasis

Indication	ANKYLOSING SPONDYLITIS
Reviewing Body	Expert Committee
Submission Completion Date	2005/07/25
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2006/01/01
CDR Recommendation
Review Status	Not a Benefit - Ankylosing Spondylitis

Indication	N/A
Reviewing Body	Expert Committee
Submission Completion Date	2004/05/20
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2005/01/01
CDR Recommendation
Review Status	Special Authorization Change - Crohn's Disease

Indication	N/A
Reviewing Body	Expert Committee
Submission Completion Date	2004/05/20
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2006/07/01
CDR Recommendation
Review Status	Under Review - Crohn's Disease

Indication	N/A
Reviewing Body	Expert Committee
Submission Completion Date	2004/05/20
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2006/01/01
CDR Recommendation
Review Status	Under Review - Crohn's Disease

Indication	N/A
Reviewing Body	Expert Committee
Submission Completion Date	2004/05/20
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2006/10/01
CDR Recommendation
Review Status	Under Review - Crohn's Disease

Indication	N/A
Reviewing Body	Expert Committee
Submission Completion Date	2004/05/20
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2007/01/01
CDR Recommendation
Review Status	Under Review - Crohn's Disease

Indication	N/A
Reviewing Body	Expert Committee
Submission Completion Date	2004/05/20
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2005/04/01
CDR Recommendation
Review Status	Under Review - Rheumatoid Arthritis

Indication	N/A
Reviewing Body	Expert Committee
Submission Completion Date	2004/05/20
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2005/07/01
CDR Recommendation
Review Status	Under Review - Rheumatoid Arthritis

Indication	N/A
Reviewing Body	Expert Committee
Submission Completion Date	2004/05/20
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2006/04/01
CDR Recommendation
Review Status	Under Review - Crohn's Disease

Indication	N/A
Reviewing Body	Expert Committee
Submission Completion Date	2004/05/20
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2008/08/01
CDR Recommendation
Review Status	Special Authorization Criteria Change - Rheumatoid Arthritis

Indication	N/A
Reviewing Body	Expert Committee
Submission Completion Date	2004/05/20
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2005/10/01
CDR Recommendation
Review Status	Under Review - Crohn's Disease

Indication	N/A
Reviewing Body	Expert Committee
Submission Completion Date	2004/05/20
CDR Recommendation Date
Expert Committee Recommendation Date
ADBL Effective Date	2007/04/01
CDR Recommendation
Review Status	Under Review - Crohn's Disease

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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.