Interactive Drug Benefit List
DIN/NPN/PIN 02388545 AURO-ALENDRONATE 10 MG ORAL TABLET ALENDRONATE SODIUM
920000 MISCELLANEOUS THERAPEUTIC AGENTS
Date Listed/Coverage Update: 01-Oct-2012
Unit Price: 0.4986
LCA Price: 0.4986
MAC Price:

N/A

Unit of Issue: Tablet
Manufacturer: AURO PHARMA INC. (AUR)
ATC: M05BA04
1
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)
Learners Program (Group 22128)
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.

Paget's Disease:

"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

Indication Reviewing
Body
Submission
Completion
Date
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
CDR
Recommendation
Review
Status
N/A Expert Committee 2012/07/31 2014/02/01 Special Authorization Criteria Change
N/A Expert Committee 2012/07/31 2012/10/01 Special Authorization
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2012/07/31
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2014/02/01
CDR
Recommendation
Review
Status
Special Authorization Criteria Change
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2012/07/31
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2012/10/01
CDR
Recommendation
Review
Status
Special Authorization
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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.