Interactive Drug Benefit List
DIN/NPN/PIN 02429861 MAR-AMITRIPTYLINE 10 MG ORAL TABLET AMITRIPTYLINE HCL
280000 CENTRAL NERVOUS SYSTEM AGENTS
281600 PSYCHOTHERAPEUTIC AGENTS
281604 ANTIDEPRESSANTS
28160428 TRICYCLICS AND OTHER NOREPINEPHRINE-REUPTAKE INHIBITORS
Date Listed/Coverage Update:
Unit Price: N/A
LCA Price: N/A
MAC Price:

N/A

Unit of Issue: Tablet
Manufacturer: MARCAN PHARMACEUTICALS INC (MAR)
ATC: N06AA09
1
Interchangeable Products: Yes

Coverage Status: NOT A BENEFIT
Applies to Clients of: N/A
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 2017/02/13 2017/07/01 Not a Benefit
N/A Expert Committee 2015/04/06 2015/07/01 Under Review
N/A Expert Committee 2015/04/06 2016/06/01 Not a Benefit
N/A Expert Committee 2014/08/15 2014/11/01 Not a Benefit
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2017/02/13
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2017/07/01
CDR
Recommendation
Review
Status
Not a Benefit
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2015/04/06
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2015/07/01
CDR
Recommendation
Review
Status
Under Review
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2015/04/06
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2016/06/01
CDR
Recommendation
Review
Status
Not a Benefit
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2014/08/15
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2014/11/01
CDR
Recommendation
Review
Status
Not a Benefit
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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.