Interactive Drug Benefit List
DIN/NPN/PIN 02248035 AA-CLOZAPINE 100 MG ORAL TABLET CLOZAPINE
280000 CENTRAL NERVOUS SYSTEM AGENTS
281600 PSYCHOTHERAPEUTIC AGENTS
281608 ANTIPSYCHOTICS
28160804 ATYPICAL ANTIPSYCHOTICS
Date Listed/Coverage Update: 01-Jul-2004
Unit Price: 2.6446
LCA Price: 2.6446
MAC Price:

N/A

Unit of Issue: Tablet
Manufacturer: AA PHARMA INC. (AAP)
ATC: N05AH02
1
Interchangeable Products: Yes

Coverage Status: REGULAR BENEFIT
Applies to Clients of: 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)

Special Authorization Request Form:

N/A

N/A

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 2009/07/31 2010/04/01 Interchangeable
N/A Expert Committee 2009/06/24 2009/08/01 Not Interchangeable
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2009/07/31
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2010/04/01
CDR
Recommendation
Review
Status
Interchangeable
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2009/06/24
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2009/08/01
CDR
Recommendation
Review
Status
Not Interchangeable
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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.