Interactive Drug Benefit List
DIN/NPN/PIN 02322374 ABILIFY 2 MG ORAL TABLET ARIPIPRAZOLE
280000 CENTRAL NERVOUS SYSTEM AGENTS
281600 PSYCHOTHERAPEUTIC AGENTS
281608 ANTIPSYCHOTICS
28160804 ATYPICAL ANTIPSYCHOTICS
Date Listed/Coverage Update: 01-Jun-2013
Unit Price: 3.1618
LCA Price: 0.8092
MAC Price:

N/A

Unit of Issue: Tablet
Manufacturer: OTSUKA CANADA PHARMACEUTICAL INC. (OTS)
ATC: N05AX12
1
Interchangeable Products: Yes

Coverage Status: RESTRICTED BENEFIT/RESTRICTED BENEFIT
Applies to Clients of: Non-Group Coverage (Group 1)
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

ALBERTA HEALTH RESTRICTED BENEFIT


ALBERTA HEALTH RESTRICTED BENEFIT

This Drug Product is a benefit for patients 13 to 17 years of age inclusive.


ALBERTA HUMAN SERVICES RESTRICTED BENEFIT


ALBERTA HUMAN SERVICES RESTRICTED BENEFIT

This Drug Product is a benefit for Alberta Human Services clients 13 years of age and older.

Review Status / Past Decisions

Indication Reviewing
Body
Submission
Completion
Date
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
CDR
Recommendation
Review
Status
MAJOR DEPRESSIVE DISORDER Common Drug Review 2013/10/08 2015/04/01 No Change in Benefit Status
MAJOR DEPRESSIVE DISORDER Common Drug Review 2013/10/08 2014/10/22 View CDR - Do not list
MAJOR DEPRESSIVE DISORDER Common Drug Review 2013/10/08 2015/04/01 No Change in Benefit Status
MAJOR DEPRESSIVE DISORDER Common Drug Review 2013/10/08 2014/10/22 View CDR - Do not list
N/A Expert Committee 2013/06/14 2013/09/01 Under Review
N/A Expert Committee 2013/06/14 2013/11/01 No Restricted Benefit Criteria Change
N/A Expert Committee 2013/06/14 2013/09/01 Under Review
N/A Expert Committee 2013/06/14 2013/11/01 No Restricted Benefit Criteria Change
N/A Expert Committee 2012/10/15 2013/03/01 Under Review
N/A Expert Committee 2012/10/15 2013/02/01 Under Review
N/A Expert Committee 2012/10/15 2013/06/01 Restricted Benefit Criteria Change
N/A Expert Committee 2012/10/15 2013/03/01 Under Review
N/A Expert Committee 2012/10/15 2013/02/01 Under Review
N/A Expert Committee 2012/10/15 2013/06/01 Restricted Benefit Criteria Change
SCHIZOPHRENIA AND RELATED PSYCHOTIC DISORDERS Common Drug Review 2011/04/12 2011/11/01 Under Review
SCHIZOPHRENIA AND RELATED PSYCHOTIC DISORDERS Common Drug Review 2011/04/12 2012/01/01 Under Review
SCHIZOPHRENIA AND RELATED PSYCHOTIC DISORDERS Common Drug Review 2011/04/12 2011/07/18 View CDR - List with criteria/condition
SCHIZOPHRENIA AND RELATED PSYCHOTIC DISORDERS Common Drug Review 2011/04/12 2012/03/01 Restricted Benefit
SCHIZOPHRENIA AND RELATED PSYCHOTIC DISORDERS Common Drug Review 2011/04/12 2011/11/01 Under Review
SCHIZOPHRENIA AND RELATED PSYCHOTIC DISORDERS Common Drug Review 2011/04/12 2012/01/01 Under Review
SCHIZOPHRENIA AND RELATED PSYCHOTIC DISORDERS Common Drug Review 2011/04/12 2011/07/18 View CDR - List with criteria/condition
SCHIZOPHRENIA AND RELATED PSYCHOTIC DISORDERS Common Drug Review 2011/04/12 2012/03/01 Restricted Benefit
N/A Expert Committee 2010/10/14 2011/02/01 Not a Benefit
N/A Expert Committee 2010/10/14 2011/02/01 Not a Benefit
SCHIZOPHRENIA Common Drug Review 2009/11/13 2010/07/20 Not a Benefit
SCHIZOPHRENIA Common Drug Review 2009/11/13 2010/04/27 View CDR - Do not list
SCHIZOPHRENIA Common Drug Review 2009/11/13 2010/07/20 Not a Benefit
SCHIZOPHRENIA Common Drug Review 2009/11/13 2010/04/27 View CDR - Do not list
Indication MAJOR DEPRESSIVE DISORDER
Reviewing
Body
Common Drug Review
Submission
Completion
Date
2013/10/08
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2015/04/01
CDR
Recommendation
Review
Status
No Change in Benefit Status
Indication MAJOR DEPRESSIVE DISORDER
Reviewing
Body
Common Drug Review
Submission
Completion
Date
2013/10/08
CDR
Recommendation
Date
2014/10/22
Expert Committee
Recommendation
Date
ADBL
Effective
Date
CDR
Recommendation
View
Review
Status
CDR - Do not list
Indication MAJOR DEPRESSIVE DISORDER
Reviewing
Body
Common Drug Review
Submission
Completion
Date
2013/10/08
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2015/04/01
CDR
Recommendation
Review
Status
No Change in Benefit Status
Indication MAJOR DEPRESSIVE DISORDER
Reviewing
Body
Common Drug Review
Submission
Completion
Date
2013/10/08
CDR
Recommendation
Date
2014/10/22
Expert Committee
Recommendation
Date
ADBL
Effective
Date
CDR
Recommendation
View
Review
Status
CDR - Do not list
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2013/06/14
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2013/09/01
CDR
Recommendation
Review
Status
Under Review
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2013/06/14
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2013/11/01
CDR
Recommendation
Review
Status
No Restricted Benefit Criteria Change
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2013/06/14
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2013/09/01
CDR
Recommendation
Review
Status
Under Review
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2013/06/14
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2013/11/01
CDR
Recommendation
Review
Status
No Restricted Benefit Criteria Change
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2012/10/15
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2013/03/01
CDR
Recommendation
Review
Status
Under Review
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2012/10/15
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2013/02/01
CDR
Recommendation
Review
Status
Under Review
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2012/10/15
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2013/06/01
CDR
Recommendation
Review
Status
Restricted Benefit Criteria Change
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2012/10/15
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2013/03/01
CDR
Recommendation
Review
Status
Under Review
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2012/10/15
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2013/02/01
CDR
Recommendation
Review
Status
Under Review
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2012/10/15
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2013/06/01
CDR
Recommendation
Review
Status
Restricted Benefit Criteria Change
Indication SCHIZOPHRENIA AND RELATED PSYCHOTIC DISORDERS
Reviewing
Body
Common Drug Review
Submission
Completion
Date
2011/04/12
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2011/11/01
CDR
Recommendation
Review
Status
Under Review
Indication SCHIZOPHRENIA AND RELATED PSYCHOTIC DISORDERS
Reviewing
Body
Common Drug Review
Submission
Completion
Date
2011/04/12
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2012/01/01
CDR
Recommendation
Review
Status
Under Review
Indication SCHIZOPHRENIA AND RELATED PSYCHOTIC DISORDERS
Reviewing
Body
Common Drug Review
Submission
Completion
Date
2011/04/12
CDR
Recommendation
Date
2011/07/18
Expert Committee
Recommendation
Date
ADBL
Effective
Date
CDR
Recommendation
View
Review
Status
CDR - List with criteria/condition
Indication SCHIZOPHRENIA AND RELATED PSYCHOTIC DISORDERS
Reviewing
Body
Common Drug Review
Submission
Completion
Date
2011/04/12
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2012/03/01
CDR
Recommendation
Review
Status
Restricted Benefit
Indication SCHIZOPHRENIA AND RELATED PSYCHOTIC DISORDERS
Reviewing
Body
Common Drug Review
Submission
Completion
Date
2011/04/12
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2011/11/01
CDR
Recommendation
Review
Status
Under Review
Indication SCHIZOPHRENIA AND RELATED PSYCHOTIC DISORDERS
Reviewing
Body
Common Drug Review
Submission
Completion
Date
2011/04/12
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2012/01/01
CDR
Recommendation
Review
Status
Under Review
Indication SCHIZOPHRENIA AND RELATED PSYCHOTIC DISORDERS
Reviewing
Body
Common Drug Review
Submission
Completion
Date
2011/04/12
CDR
Recommendation
Date
2011/07/18
Expert Committee
Recommendation
Date
ADBL
Effective
Date
CDR
Recommendation
View
Review
Status
CDR - List with criteria/condition
Indication SCHIZOPHRENIA AND RELATED PSYCHOTIC DISORDERS
Reviewing
Body
Common Drug Review
Submission
Completion
Date
2011/04/12
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2012/03/01
CDR
Recommendation
Review
Status
Restricted Benefit
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2010/10/14
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2011/02/01
CDR
Recommendation
Review
Status
Not a Benefit
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2010/10/14
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2011/02/01
CDR
Recommendation
Review
Status
Not a Benefit
Indication SCHIZOPHRENIA
Reviewing
Body
Common Drug Review
Submission
Completion
Date
2009/11/13
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2010/07/20
CDR
Recommendation
Review
Status
Not a Benefit
Indication SCHIZOPHRENIA
Reviewing
Body
Common Drug Review
Submission
Completion
Date
2009/11/13
CDR
Recommendation
Date
2010/04/27
Expert Committee
Recommendation
Date
ADBL
Effective
Date
CDR
Recommendation
View
Review
Status
CDR - Do not list
Indication SCHIZOPHRENIA
Reviewing
Body
Common Drug Review
Submission
Completion
Date
2009/11/13
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2010/07/20
CDR
Recommendation
Review
Status
Not a Benefit
Indication SCHIZOPHRENIA
Reviewing
Body
Common Drug Review
Submission
Completion
Date
2009/11/13
CDR
Recommendation
Date
2010/04/27
Expert Committee
Recommendation
Date
ADBL
Effective
Date
CDR
Recommendation
View
Review
Status
CDR - Do not list
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Last Updated:
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.