Interactive Drug Benefit List
DIN/NPN/PIN 02458349 HUMIRA (40 MG/0.4 ML INJ SYR) 40 MG / SYR INJECTION SYRINGE ADALIMUMAB
920000 MISCELLANEOUS THERAPEUTIC AGENTS
923600 DISEASE-MODIFYING ANTIRHEUMATIC AGENTS
Date Listed/Coverage Update:
Unit Price: N/A
LCA Price: N/A
MAC Price:

N/A

Unit of Issue: Syringe
Manufacturer: ABBVIE CORPORATION (ABV)
ATC: L04AB04
1
Interchangeable Products: No

Coverage Status: UNDER REVIEW
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 2016/12/06 2017/03/01 Under Review
Indication N/A
Reviewing
Body
Expert Committee
Submission
Completion
Date
2016/12/06
CDR
Recommendation
Date
Expert Committee
Recommendation
Date
ADBL
Effective
Date
2017/03/01
CDR
Recommendation
Review
Status
Under Review
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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.