DIN/NPN/PIN 02388545 AURO-ALENDRONATE 10 MG ORAL TABLET ALENDRONATE SODIUM |
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Date Listed/Coverage Update: | 01-Oct-2012 | ||
Unit Price: | 0.4986 | ||
LCA Price: | 0.4986 | ||
MAC Price: |
N/A |
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Unit of Issue: | Tablet | ||
Manufacturer: | AURO PHARMA INC. (AUR) | ||
ATC: | M05BA04 | ||
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Interchangeable Products: | Yes | ||
Coverage Status: | SPECIAL AUTHORIZATION |
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: |
Drug Special Authorization Request Form (ABC 60015) Alendronate/Raloxifene/Risedronate For Osteoporosis Special Authorization Request Form (ABC 60043) |
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"For the treatment of osteoporosis in patients with a 20% or greater 10-year fracture risk who have documented intolerance to alendronate 70 mg or risedronate 35 mg. Special authorization may be granted for 6 months." "Requests for other osteoporosis medications covered via special authorization will not be considered until 6 months after the last dose of denosumab 60 mg/syr injection syringe." "Requests for other osteoporosis medications covered via special authorization will not be considered until 12 months after the last dose of zoledronic acid 0.05 mg/ml injection." Note: The fracture risk can be determined by the World Health Organization's fracture risk assessment tool, FRAX, or the most recent (2010) version of the Canadian Association of Radiologists and Osteoporosis Canada (CAROC) table. All requests for alendronate sodium for Osteoporosis must be completed using the Alendronate/Raloxifene/Risedronate for Osteoporosis Special Authorization Request Form (ABC 60043). The following product(s) are eligible for auto-renewal for the treatment of osteoporosis. "For the treatment of Paget's disease. Special Authorization for this criteria may be granted to a maximum of 6 months." "Coverage cannot be provided for two or more medications used in the treatment of Paget's disease when these medications are intended for use in combination or when therapy with two or more medications overlap." |
Review Status / Past Decisions
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