Benefact number 436 - Alberta Blue Cross

Pharmacy Benefact
A B U L L E T I N F O R P H A R M A C Y S E R V I C E P R O V I D E R S F R O M A L B E R TA B LU E C R O S S
Number 436 • February 2014
Pan-Canadian Competitive Value Price Initiative for
Generic Drugs
Alberta prices effective April 1, 2014.
Last year, the Council of the Federation, comprised of Canada’s 13 provincial and territorial premiers, announced a price reduction to
18 per cent of the lowest brand price in participating provinces and territories for for six drugs for the Pan-Canadian Competitive Value
Price Initiative for Generic Drugs: Amlodipine, Atorvastatin, Omeprazole, Rabeprazole, Ramipril and Venlafaxine.
This year, four drugs have been added to the Pan-Canadian Competitive Value Price Initiative for Generic Drugs: Citalopram,
Pantoprazole, Rosuvastatin and Simvastatin. The Government of Alberta is taking steps to implement pricing for these drugs for
April 1, 2014.
Manufacturers have confirmed through a Pan-Canadian Price Confirmation process their ability to supply to pharmacies in
participating provinces and territories, including Alberta, the drugs included in this Initiative at the 18 per cent price reduction.
New pricing for drugs affected by this Initiative will become effective immediately on April 1, 2014. The Alberta Drug Benefit List
(ADBL) will be updated at that time to reflect the change to the price of each of the drugs and the Least Cost Alternative (LCA) in the
interchangeable grouping for these drugs.
A transition or washout period will not apply to drug products included in this initiative. Notification of prices is being
provided at this time to allow pharmacies, manufacturers and wholesalers adequate time to adjust inventories and manage
stocks.
Please see the below list of drugs included in the Pan-Canadian Competitive Value Price Initiative for Generic Drugs and the prices for
the ADBL to be effective on April 1, 2014. Pharmacies must begin claiming the LCA amount for the drugs affected by the
Pan-Canadian Competitive Value Price Initiative for Generic Drugs on April 1, 2014.
Please note that for currently listed drugs not affected by this Initiative, where there is a price reduction on
April 1, 2014, a washout or transitional period of 30 days will continue to apply.
AMLODIPINE BESYLATE
2.5 MG (BASE) ORAL TABLET
00002385783
AMLODIPINE
00002297477
CO AMLODIPINE
00002357186
JAMP-AMLODIPINE
00002326760
PHL-AMLODIPINE
00002295148
PMS-AMLODIPINE
00002330474
SANDOZ AMLODIPINE
SIV
COB
JPC
PHH
PMS
SDZ
$
$
$
$
$
$
0.1380
0.1380
0.1380
0.1380
0.1380
0.1380
5 MG (BASE) ORAL TABLET
00002385791
AMLODIPINE
00002331284
AMLODIPINE
00002331934
AMLODIPINE
00002378760
AMLODIPINE-ODAN
00002273373
APO-AMLODIPINE
00002397072
AURO-AMLODIPINE
00002297485
CO AMLODIPINE
SIV
SNS
RAN
ODN
APX
AUR
COB
$
$
$
$
$
$
$
0.2417
0.2417
0.2417
0.2417
0.2417
0.2417
0.2417
continued on next page ...
00002280132
00002357194
00002331071
00002371715
00002362651
00002272113
00002326779
00002284065
00002321858
00002259605
00002284383
00002357712
00002250497
GD-AMLODIPINE
JAMP-AMLODIPINE
JAMP-AMLODIPINE
MAR-AMLODIPINE
MINT-AMLODIPINE
MYLAN-AMLODIPINE
PHL-AMLODIPINE
PMS-AMLODIPINE
RAN-AMLODIPINE
RATIO-AMLODIPINE
SANDOZ AMLODIPINE
SEPTA-AMLODIPINE
TEVA-AMLODIPINE
GMD
JPC
JPC
MAR
MPI
MYP
PHH
PMS
RAN
RPH
SDZ
SEP
TEV
$
$
$
$
$
$
$
$
$
$
$
$
$
00000878928
NORVASC
PFI
$ 1.3426
SIV
RAN
SNS
ODN
APX
AUR
COB
GMD
JPC
JPC
MAR
MPI
MYP
PHH
PMS
RAN
RPH
SDZ
SEP
TEV
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
PFI
$ 1.9930
APX
SNS
SIV
COB
GMD
JPC
MYP
TEV
PMS
RAN
RPH
SDZ
$
$
$
$
$
$
$
$
$
$
$
$
PFI
$ 1.7692
APX
SNS
SIV
COB
GMD
$
$
$
$
$
10 MG (BASE) ORAL TABLET
00002385805
AMLODIPINE
00002331942
AMLODIPINE
00002331292
AMLODIPINE
00002378779
AMLODIPINE-ODAN
00002273381
APO-AMLODIPINE
00002397080
AURO-AMLODIPINE
00002297493
CO AMLODIPINE
00002280140
GD-AMLODIPINE
00002357208
JAMP-AMLODIPINE
00002331098
JAMP-AMLODIPINE
00002371723
MAR-AMLODIPINE
00002362678
MINT-AMLODIPINE
00002272121
MYLAN-AMLODIPINE
00002326787
PHL-AMLODIPINE
00002284073
PMS-AMLODIPINE
00002321866
RAN-AMLODIPINE
00002259613
RATIO-AMLODIPINE
00002284391
SANDOZ AMLODIPINE
00002357720
SEPTA-AMLODIPINE
00002250500
TEVA-AMLODIPINE
00000878936
NORVASC
0.2417
0.2417
0.2417
0.2417
0.2417
0.2417
0.2417
0.2417
0.2417
0.2417
0.2417
0.2417
0.2417
0.3587
0.3587
0.3587
0.3587
0.3587
0.3587
0.3587
0.3587
0.3587
0.3587
0.3587
0.3587
0.3587
0.3587
0.3587
0.3587
0.3587
0.3587
0.3587
0.3587
ATORVASTATIN CALCIUM
10 MG (BASE) ORAL TABLET
00002295261
APO-ATORVASTATIN
00002348705
ATORVASTATIN
00002411350
ATORVASTATIN-10
00002310899
CO ATORVASTATIN
00002288346
GD-ATORVASTATIN
00002391058
JAMP-ATORVASTATIN
00002373203
MYLAN-ATORVASTATIN
00002302675
NOVO-ATORVASTATIN
00002399377
PMS-ATORVASTATIN
00002313707
RAN-ATORVASTATIN
00002350297
RATIO-ATORVASTATIN
00002324946
SANDOZ ATORVASTATIN
00002230711
LIPITOR
20 MG (BASE) ORAL TABLET
00002295288
APO-ATORVASTATIN
00002348713
ATORVASTATIN
00002411369
ATORVASTATIN-20
00002310902
CO ATORVASTATIN
00002288354
GD-ATORVASTATIN
0.3138
0.3138
0.3138
0.3138
0.3138
0.3138
0.3138
0.3138
0.3138
0.3138
0.3138
0.3138
0.3922
0.3922
0.3922
0.3922
0.3922
continued on next page ...
00002391066
00002373211
00002302683
00002399385
00002313715
00002350319
00002324954
JAMP-ATORVASTATIN
MYLAN-ATORVASTATIN
NOVO-ATORVASTATIN
PMS-ATORVASTATIN
RAN-ATORVASTATIN
RATIO-ATORVASTATIN
SANDOZ ATORVASTATIN
JPC
MYP
TEV
PMS
RAN
RPH
SDZ
$
$
$
$
$
$
$
00002230713
LIPITOR
PFI
$ 2.2115
APX
SNS
SIV
COB
GMD
JPC
MYP
TEV
PMS
RAN
RPH
SDZ
$
$
$
$
$
$
$
$
$
$
$
$
PFI
$ 2.3770
APX
SNS
SIV
COB
GMD
JPC
MYP
TEV
PMS
RAN
RPH
SDZ
$
$
$
$
$
$
$
$
$
$
$
$
PFI
$ 2.3770
10 MG (BASE) ORAL TABLET
00002355248
ACCEL-CITALOPRAM
00002370085
JAMP-CITALOPRAM
00002370077
MINT-CITALOPRAM
00002270609
PMS-CITALOPRAM
ACP
JPC
MPI
PMS
$
$
$
$
0.1432
0.1432
0.1432
0.1432
20 MG (BASE) ORAL TABLET
00002355256
ACCEL-CITALOPRAM
00002246056
APO-CITALOPRAM
00002275562
AURO-CITALOPRAM
00002331950
CITALOPRAM
00002353660
CITALOPRAM
00002306239
CITALOPRAM-ODAN
00002248050
CO CITALOPRAM
00002313405
JAMP-CITALOPRAM
00002371898
MAR-CITALOPRAM
00002304686
MINT-CITALOPRAM
00002246594
MYLAN-CITALOPRAM
00002293218
NOVO-CITALOPRAM
00002248944
PHL-CITALOPRAM
ACP
APX
AUR
RAN
SNS
ODN
COB
JPC
MAR
MPI
MYP
TEV
PHH
$
$
$
$
$
$
$
$
$
$
$
$
$
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
40 MG (BASE) ORAL TABLET
00002295296
APO-ATORVASTATIN
00002348721
ATORVASTATIN
00002411377
ATORVASTATIN-40
00002310910
CO ATORVASTATIN
00002288362
GD-ATORVASTATIN
00002391074
JAMP-ATORVASTATIN
00002373238
MYLAN-ATORVASTATIN
00002302691
NOVO-ATORVASTATIN
00002399393
PMS-ATORVASTATIN
00002313723
RAN-ATORVASTATIN
00002350327
RATIO-ATORVASTATIN
00002324962
SANDOZ ATORVASTATIN
00002230714
LIPITOR
80 MG (BASE) ORAL TABLET
00002295318
APO-ATORVASTATIN
00002348748
ATORVASTATIN
00002411385
ATORVASTATIN-80
00002310929
CO ATORVASTATIN
00002288370
GD-ATORVASTATIN
00002391082
JAMP-ATORVASTATIN
00002373246
MYLAN-ATORVASTATIN
00002302713
NOVO-ATORVASTATIN
00002399407
PMS-ATORVASTATIN
00002313758
RAN-ATORVASTATIN
00002350335
RATIO-ATORVASTATIN
00002324970
SANDOZ ATORVASTATIN
00002243097
LIPITOR
0.3922
0.3922
0.3922
0.3922
0.3922
0.3922
0.3922
0.4216
0.4216
0.4216
0.4216
0.4216
0.4216
0.4216
0.4216
0.4216
0.4216
0.4216
0.4216
0.4216
0.4216
0.4216
0.4216
0.4216
0.4216
0.4216
0.4216
0.4216
0.4216
0.4216
0.4216
CITALOPRAM HYDROBROMIDE
continued on next page ...
00002248010
00002285622
00002252112
00002248170
00002355272
PMS-CITALOPRAM
RAN-CITALO
RATIO-CITALOPRAM
SANDOZ CITALOPRAM
SEPTA-CITALOPRAM
PMS
RAN
RPH
SDZ
SEP
$
$
$
$
$
00002239607
CELEXA
LBC
$ 1.3317
ACP
APX
AUR
RAN
SNS
ODN
COB
JPC
MAR
MPI
MYP
TEV
PHH
PMS
RAN
RPH
SDZ
SEP
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
LBC
$ 1.3317
APX
MYP
SNS
SIV
$
$
$
$
PMS
$ 0.4117
PMS
$ 0.4117
RAN
$ 0.4117
RAN
$ 0.4117
SDZ
$ 0.4117
40 MG (BASE) ORAL TABLET
00002355264
ACCEL-CITALOPRAM
00002246057
APO-CITALOPRAM
00002275570
AURO-CITALOPRAM
00002331977
CITALOPRAM
00002353679
CITALOPRAM
00002306247
CITALOPRAM-ODAN
00002248051
CO CITALOPRAM
00002313413
JAMP-CITALOPRAM
00002371901
MAR-CITALOPRAM
00002304694
MINT-CITALOPRAM
00002246595
MYLAN-CITALOPRAM
00002293226
NOVO-CITALOPRAM
00002248945
PHL-CITALOPRAM
00002248011
PMS-CITALOPRAM
00002285630
RAN-CITALO
00002252120
RATIO-CITALOPRAM
00002248171
SANDOZ CITALOPRAM
00002355280
SEPTA-CITALOPRAM
00002239608
CELEXA
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
0.2397
OMEPRAZOLE
20 MG ORAL CAPSULE/SUSTAINED-RELEASE TABLET
00002245058
APO-OMEPRAZOLE (CAPSULE)
00002329433
MYLAN-OMEPRAZOLE (CAPSULE)
00002348691
OMEPRAZOLE (CAPSULE)
00002411857
OMEPRAZOLE-20
00002320851PMS-OMEPRAZOLE
(SUSTAINED-RELEASE CAPSULE)
00002310260
PMS-OMEPRAZOLE DR
(DELAYED RELEASE TABLET)
00002374870RAN-OMEPRAZOLE
(DELAYED RELEASE TABLET)
00002403617RAN-OMEPRAZOLE
(DELAYED-RELEASE CAPSULE)
00002296446
SANDOZ OMEPRAZOLE
(SUSTAINED-RELEASE CAPSULE)
00002295415TEVA-OMEPRAZOLE
(DELAYED RELEASE TABLET)
0000846503
00002190915
0.4117
0.4117
0.4117
0.4117
TEV
$ 0.4117
LOSEC (SUSTAINED-RELEASE CAPSULE) AZC
LOSEC (SUSTAINED-RELEASE TABLET) AZC
$ 1.1000
$ 2.3140
PANTOPRAZOLE
40 MG ORAL ENTERIC-COATED TABLET
00002292920
APO-PANTOPRAZOLE
00002300486
CO PANTOPRAZOLE
00002416565
MAR-PANTOPRAZOLE
00002417448
MINT-PANTOPRAZOLE
00002299585
MYLAN-PANTOPRAZOLE
00002285487
NOVO-PANTOPRAZOLE
00002309866
PANTOPRAZOLE
00002370808
PANTOPRAZOLE
APX
COB
MAR
MPI
MYP
TEV
MEL
SNS
$
$
$
$
$
$
$
$
0.3628
0.3628
0.3628
0.3628
0.3628
0.3628
0.3628
0.3628
continued on next page ...
00002385759
00002307871
00002305046
00002301083
PANTOPRAZOLE
PMS-PANTOPRAZOLE
RAN-PANTOPRAZOLE
SANDOZ PANTOPRAZOLE
SIV
PMS
RAN
SDZ
$
$
$
$
0.3628
0.3628
0.3628
0.3628
00002229453
PANTOLOC
TAK
$ 2.0803
APX
MYP
PAT
PMS
SIV
SNS
RAN
SDZ
TEV
$
$
$
$
$
$
$
$
$
JAI
$ 0.6688
APX
MYP
PAT
PMS
SIV
SNS
RAN
SDZ
TEV
$
$
$
$
$
$
$
$
$
JAI
$ 1.3377
APX
AUR
COB
JPC
MYP
PMS
RAN
RAN
SDZ
$
$
$
$
$
$
$
$
$
SAV
$ 0.7177
APX
AUR
COB
JPC
MYP
PMS
RAN
SNS
SIV
RAN
SDZ
TEV
$
$
$
$
$
$
$
$
$
$
$
$
RABEPRAZOLE SODIUM
10 MG ORAL ENTERIC-COATED TABLET
00002345579
APO-RABEPRAZOLE
00002408392
MYLAN-RABEPRAZOLE
00002381737
PAT-RABEPRAZOLE
00002310805
PMS-RABEPRAZOLE EC
00002385449
RABEPRAZOLE
00002356511
RABEPRAZOLE EC
00002298074
RAN-RABEPRAZOLE
00002314177
SANDOZ RABEPRAZOLE
00002296632
TEVA-RABEPRAZOLE
00002243796
PARIET
20 MG ORAL ENTERIC-COATED TABLET
00002345587
APO-RABEPRAZOLE
00002408406
MYLAN-RABEPRAZOLE
00002381745
PAT-RABEPRAZOLE
00002310813
PMS-RABEPRAZOLE EC
00002385457
RABEPRAZOLE
00002356538
RABEPRAZOLE EC
00002298082
RAN-RABEPRAZOLE
00002314185
SANDOZ RABEPRAZOLE
00002296640
TEVA-RABEPRAZOLE
00002243797
PARIET
0.1204
0.1204
0.1204
0.1204
0.1204
0.1204
0.1204
0.1204
0.1204
0.2408
0.2408
0.2408
0.2408
0.2408
0.2408
0.2408
0.2408
0.2408
RAMIPRIL
1.25 MG ORAL CAPSULE/TABLET
00002251515
APO-RAMIPRIL (CAPSULE)
00002387387
AURO-RAMIPRIL (CAPSULE)
00002295482
CO RAMIPRIL (CAPSULE)
00002331101
JAMP-RAMIPRIL (CAPSULE)
00002301148
MYLAN-RAMIPRIL (CAPSULE)
00002295369
PMS-RAMIPRIL (CAPSULE)
00002332299
RAMIPRIL (CAPSULE)
00002310503
RAN-RAMIPRIL (CAPSULE)
00002291398
SANDOZ RAMIPRIL (TABLET)
00002221829
ALTACE (CAPSULE)
2.5 MG ORAL CAPSULE/TABLET
00002251531
APO-RAMIPRIL (CAPSULE)
00002387395
AURO-RAMIPRIL (CAPSULE)
00002295490
CO RAMIPRIL (CAPSULE)
00002331128
JAMP-RAMIPRIL (CAPSULE)
00002301156
MYLAN-RAMIPRIL (CAPSULE)
00002247917
PMS-RAMIPRIL (CAPSULE)
00002332302
RAMIPRIL (CAPSULE)
00002374846
RAMIPRIL (CAPSULE)
00002411563
RAMIPRIL-2.5 (CAPSULE)
00002310511
RAN-RAMIPRIL (CAPSULE)
00002291401
SANDOZ RAMIPRIL (TABLET)
00002247945
TEVA-RAMIPRIL (CAPSULE)
0.1274
0.1274
0.1274
0.1274
0.1274
0.1274
0.1274
0.1274
0.1274
0.1470
0.1470
0.1470
0.1470
0.1470
0.1470
0.1470
0.1470
0.1470
0.1470
0.1470
0.1470
continued on next page ...
00002221837
ALTACE (CAPSULE)
5 MG ORAL CAPSULE/TABLET
00002251574
APO-RAMIPRIL (CAPSULE)
00002387409
AURO-RAMIPRIL (CAPSULE)
00002295504
CO RAMIPRIL (CAPSULE)
00002331136
JAMP-RAMIPRIL (CAPSULE)
00002301164
MYLAN-RAMIPRIL (CAPSULE)
00002247918
PMS-RAMIPRIL (CAPSULE)
00002374854
RAMIPRIL (CAPSULE)
00002332310
RAMIPRIL (CAPSULE)
00002411571
RAMIPRIL-5 (CAPSULE)
00002310538
RAN-RAMIPRIL (CAPSULE)
00002291428
SANDOZ RAMIPRIL (TABLET)
00002247946
TEVA-RAMIPRIL (CAPSULE)
00002221845
ALTACE (CAPSULE)
10 MG ORAL CAPSULE/TABLET
00002251582
APO-RAMIPRIL (CAPSULE)
00002387417
AURO-RAMIPRIL (CAPSULE)
00002295512
CO RAMIPRIL (CAPSULE)
00002331144
JAMP-RAMIPRIL (CAPSULE)
00002301172
MYLAN-RAMIPRIL (CAPSULE)
00002247919
PMS-RAMIPRIL (CAPSULE)
00002332329
RAMIPRIL (CAPSULE)
00002374862
RAMIPRIL (CAPSULE)
00002411598
RAMIPRIL-10 (CAPSULE)
00002310546
RAN-RAMIPRIL (CAPSULE)
00002291436
SANDOZ RAMIPRIL (TABLET)
00002247947
TEVA-RAMIPRIL (CAPSULE)
00002221853
ALTACE (CAPSULE)
SAV
$ 0.8237
APX
AUR
COB
JPC
MYP
PMS
SNS
RAN
SIV
RAN
SDZ
TEV
$
$
$
$
$
$
$
$
$
$
$
$
SAV
$ 0.8247
APX
AUR
COB
JPC
MYP
PMS
RAN
SNS
SIV
RAN
SDZ
TEV
$
$
$
$
$
$
$
$
$
$
$
$
SAV
$ 1.0460
APX
COB
JPC
MAR
GMP
MPI
MYP
PMS
RAN
SNS
SIV
SDZ
TEV
$
$
$
$
$
$
$
$
$
$
$
$
$
AZC
$ 1.3093
APX
COB
JPC
MAR
GMP
MPI
MYP
PMS
RAN
SNS
$
$
$
$
$
$
$
$
$
$
0.1470
0.1470
0.1470
0.1470
0.1470
0.1470
0.1470
0.1470
0.1470
0.1470
0.1470
0.1470
0.1862
0.1862
0.1862
0.1862
0.1862
0.1862
0.1862
0.1862
0.1862
0.1862
0.1862
0.1862
ROSUVASTATIN CALCIUM
5 MG (BASE) ORAL TABLET
00002337975
APO-ROSUVASTATIN
00002339765
CO ROSUVASTATIN
00002391252
JAMP-ROSUVASTATIN
00002413051
MAR-ROSUVASTATIN
00002399164
MED-ROSUVASTATIN
00002397781
MINT-ROSUVASTATIN
00002381265
MYLAN-ROSUVASTATIN
00002378523
PMS-ROSUVASTATIN
00002382644
RAN-ROSUVASTATIN
00002405628
ROSUVASTATIN
00002411628
ROSUVASTATIN-5
00002338726
SANDOZ ROSUVASTATIN
00002354608
TEVA-ROSUVASTATIN
00002265540
CRESTOR
10 MG (BASE) ORAL TABLET
00002337983
APO-ROSUVASTATIN
00002339773
CO ROSUVASTATIN
00002391260
JAMP-ROSUVASTATIN
00002413078
MAR-ROSUVASTATIN
00002399172
MED-ROSUVASTATIN
00002397803
MINT-ROSUVASTATIN
00002381273
MYLAN-ROSUVASTATIN
00002378531
PMS-ROSUVASTATIN
00002382652
RAN-ROSUVASTATIN
00002405636
ROSUVASTATIN
0.2311
0.2311
0.2311
0.2311
0.2311
0.2311
0.2311
0.2311
0.2311
0.2311
0.2311
0.2311
0.2311
0.2437
0.2437
0.2437
0.2437
0.2437
0.2437
0.2437
0.2437
0.2437
0.2437
continued on next page ...
00002411636
00002338734
00002354616
ROSUVASTATIN-10
SANDOZ ROSUVASTATIN
TEVA-ROSUVASTATIN
SIV
SDZ
TEV
$ 0.2437
$ 0.2437
$ 0.2437
00002247162
CRESTOR
AZC
$ 1.3600
APX
COB
JPC
MAR
GMP
MPI
MYP
PMS
RAN
SNS
SIV
SDZ
TEV
$
$
$
$
$
$
$
$
$
$
$
$
$
AZC
$ 1.7000
APX
COB
JPC
MAR
GMP
MPI
MYP
PMS
RAN
SNS
SIV
SDZ
TEV
$
$
$
$
$
$
$
$
$
$
$
$
$
CRESTOR
AZC
$ 1.9900
APO-SIMVASTATIN
CO SIMVASTATIN
JAMP-SIMVASTATIN
MAR-SIMVASTATIN
MINT-SIMVASTATIN
MYLAN-SIMVASTATIN
PHL-SIMVASTATIN
PMS-SIMVASTATIN
RAN-SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN-ODAN
TEVA-SIMVASTATIN
APX
COB
JPC
MAR
MPI
MYP
PHH
PMS
RAN
RAN
SIV
SNS
ODN
TEV
$
$
$
$
$
$
$
$
$
$
$
$
$
$
ZOCOR
MFC
$ 1.0743
APO-SIMVASTATIN
CO SIMVASTATIN
JAMP-SIMVASTATIN
APX
COB
JPC
$ 0.3642
$ 0.3642
$ 0.3642
20 MG (BASE) ORAL TABLET
00002337991
APO-ROSUVASTATIN
00002339781
CO ROSUVASTATIN
00002391279
JAMP-ROSUVASTATIN
00002413086
MAR-ROSUVASTATIN
00002399180
MED-ROSUVASTATIN
00002397811
MINT-ROSUVASTATIN
00002381281
MYLAN-ROSUVASTATIN
00002378558
PMS-ROSUVASTATIN
00002382660
RAN-ROSUVASTATIN
00002405644
ROSUVASTATIN
00002411644
ROSUVASTATIN-20
00002338742
SANDOZ ROSUVASTATIN
00002354624
TEVA-ROSUVASTATIN
00002247163
CRESTOR
40 MG (BASE) ORAL TABLET
00002338009
APO-ROSUVASTATIN
00002339803
CO ROSUVASTATIN
00002391287
JAMP-ROSUVASTATIN
00002413108
MAR-ROSUVASTATIN
00002399199
MED-ROSUVASTATIN
00002397838
MINT-ROSUVASTATIN
00002381303
MYLAN-ROSUVASTATIN
00002378566
PMS-ROSUVASTATIN
00002382679
RAN-ROSUVASTATIN
00002405652
ROSUVASTATIN
00002411652
ROSUVASTATIN-40
00002338750
SANDOZ ROSUVASTATIN
00002354632
TEVA-ROSUVASTATIN
00002247164
0.3046
0.3046
0.3046
0.3046
0.3046
0.3046
0.3046
0.3046
0.3046
0.3046
0.3046
0.3046
0.3046
0.3582
0.3582
0.3582
0.3582
0.3582
0.3582
0.3582
0.3582
0.3582
0.3582
0.3582
0.3582
0.3582
SIMVASTATIN
5 MG ORAL TABLET
00002247011
00002248103
00002375591
00002375036
00002372932
00002246582
00002281546
00002269252
00002329131
00002331969
00002386291
00002284723
00002378884
00002250144
00000884324
10 MG ORAL TABLET
00002247012
00002248104
00002375605
0.1841
0.1841
0.1841
0.1841
0.1841
0.1841
0.1841
0.1841
0.1841
0.1841
0.1841
0.1841
0.1841
0.1841
continued on next page ...
00002375044
00002372940
00002246583
00002281554
00002269260
00002329158
00002247828
00002284731
00002386305
00002331985
00002378892
00002250152
MAR-SIMVASTATIN
MINT-SIMVASTATIN
MYLAN-SIMVASTATIN
PHL-SIMVASTATIN
PMS-SIMVASTATIN
RAN-SIMVASTATIN
SANDOZ SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN-ODAN
TEVA-SIMVASTATIN
MAR
MPI
MYP
PHH
PMS
RAN
SDZ
SNS
SIV
RAN
ODN
TEV
$
$
$
$
$
$
$
$
$
$
$
$
00000884332
ZOCOR
MFC
$ 2.1131
APO-SIMVASTATIN
CO SIMVASTATIN
JAMP-SIMVASTATIN
MAR-SIMVASTATIN
MINT-SIMVASTATIN
MYLAN-SIMVASTATIN
PHL-SIMVASTATIN
PMS-SIMVASTATIN
RAN-SIMVASTATIN
SANDOZ SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN-ODAN
TEVA-SIMVASTATIN
APX
COB
JPC
MAR
MPI
MYP
PHH
PMS
RAN
SDZ
SIV
RAN
SNS
ODN
TEV
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
ZOCOR
MFC
$ 2.6115
APO-SIMVASTATIN
CO SIMVASTATIN
JAMP-SIMVASTATIN
MAR-SIMVASTATIN
MINT-SIMVASTATIN
MYLAN-SIMVASTATIN
PHL-SIMVASTATIN
PMS-SIMVASTATIN
RAN-SIMVASTATIN
SANDOZ SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN-ODAN
TEVA-SIMVASTATIN
APX
COB
JPC
MAR
MPI
MYP
PHH
PMS
RAN
SDZ
SIV
RAN
SNS
ODN
TEV
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
ZOCOR
MFC
$ 2.6115
APO-SIMVASTATIN
CO SIMVASTATIN
JAMP-SIMVASTATIN
MAR-SIMVASTATIN
MINT-SIMVASTATIN
MYLAN-SIMVASTATIN
PHL-SIMVASTATIN
PMS-SIMVASTATIN
RAN-SIMVASTATIN
APX
COB
JPC
MAR
MPI
MYP
PHH
PMS
RAN
$
$
$
$
$
$
$
$
$
20 MG ORAL TABLET
00002247013
00002248105
00002375613
00002375052
00002372959
00002246737
00002281562
00002269279
00002329166
00002247830
00002386313
00002331993
00002284758
00002378906
00002250160
00884340
40 MG ORAL TABLET
00002247014
00002248106
00002375621
00002375060
00002372967
00002246584
00002281570
00002269287
00002329174
00002247831
00002386321
00002332000
00002284766
00002378914
00002250179
00000884359
80 MG ORAL TABLET
00002247015
00002248107
00002375648
00002375079
00002372975
00002246585
00002281589
00002269295
00002329182
0.3642
0.3642
0.3642
0.3642
0.3642
0.3642
0.3642
0.3642
0.3642
0.3642
0.3642
0.3642
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
continued on next page ...
00002247833
00002332019
00002284774
00002386348
00002378922
00002250187
SANDOZ SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN-ODAN
TEVA-SIMVASTATIN
SDZ
RAN
SNS
SIV
ODN
TEV
$
$
$
$
$
$
0.4501
0.4501
0.4501
0.4501
0.4501
0.4501
00002240332
ZOCOR
MFC
$ 2.6115
APX
COB
GMD
MYP
PMS
RAN
SDZ
TEV
SNS
SIV
$
$
$
$
$
$
$
$
$
$
PFI
$ 0.9381
APX
COB
GMD
MYP
PMS
RAN
SDZ
TEV
SNS
SIV
$
$
$
$
$
$
$
$
$
$
PFI
$ 1.8765
APX
COB
GMD
MYP
PMS
RAN
SDZ
TEV
SIV
SNS
$
$
$
$
$
$
$
$
$
$
PFI
$ 1.9810
VENLAFAXINE HCL
37.5 MG (BASE) ORAL EXTENDED-RELEASE CAPSULE
00002331683
APO-VENLAFAXINE XR
00002304317
CO VENLAFAXINE XR
00002360020
GD-VENLAFAXINE XR
00002310279
MYLAN-VENLAFAXINE XR
00002278545
PMS-VENLAFAXINE XR
00002380072
RAN-VENLAFAXINE XR
00002310317
SANDOZ VENLAFAXINE XR
00002275023
TEVA-VENLAFAXINE XR
00002354713
VENLAFAXINE XR
00002385929
VENLAFAXINE XR
00002237279
EFFEXOR XR
75 MG (BASE) ORAL EXTENDED-RELEASE CAPSULE
00002331691
APO-VENLAFAXINE XR
00002304325
CO VENLAFAXINE XR
00002360039
GD-VENLAFAXINE XR
00002310287
MYLAN-VENLAFAXINE XR
00002278553
PMS-VENLAFAXINE XR
00002380080
RAN-VENLAFAXINE XR
00002310325
SANDOZ VENLAFAXINE XR
00002275031
TEVA-VENLAFAXINE XR
00002354721
VENLAFAXINE XR
00002385937
VENLAFAXINE XR
00002237280
EFFEXOR XR
150 MG (BASE) ORAL EXTENDED-RELEASE CAPSULE
00002331705
APO-VENLAFAXINE XR
00002304333
CO VENLAFAXINE XR
00002360047
GD-VENLAFAXINE XR
00002310295
MYLAN-VENLAFAXINE XR
00002278561
PMS-VENLAFAXINE XR
00002380099
RAN-VENLAFAXINE XR
00002310333
SANDOZ VENLAFAXINE XR
00002275058
TEVA-VENLAFAXINE XR
00002385945
VENLAFAXINE XR
00002354748
VENLAFAXINE XR
00002237282
EFFEXOR XR
0.1643
0.1643
0.1643
0.1643
0.1643
0.1643
0.1643
0.1643
0.1643
0.1643
0.3285
0.3285
0.3285
0.3285
0.3285
0.3285
0.3285
0.3285
0.3285
0.3285
0.3469
0.3469
0.3469
0.3469
0.3469
0.3469
0.3469
0.3469
0.3469
0.3469
When you have questions:
For assistance with benefit or claim inquiries, please contact an Alberta Blue Cross Pharmacy Services Provider Relations call centre
representative at:
780-498-8370 (Edmonton and area) • 403-294-4041 (Calgary and area) • 1-800-361-9632 (toll free)
FAX 780-498-8406 (Edmonton and area) • FAX 1-877-305-9911 (toll free)
®The Blue Cross symbol and name are registered marks of the Canadian Association of Blue
Cross Plans, an association of independent Blue Cross plans. Licensed to ABC Benefits
Corporation for use in operating the Alberta Blue Cross Plan. ABC 82320.436 2014/02