Frequently asked questions

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Frequently asked questions

Use the following questions to help guide you through the use and purpose of the Drug Benefits Lists, interactive Drug Benefit Lists and related publications.

  1. Alberta Blue Cross (Group 1) offered by Alberta Health.
  2. Alberta Blue Cross Coverage for Seniors (Group 66) provided to all Alberta senior citizens (65 years of age or older).
  3. Drug coverage provided to individuals approved by Alberta Health for Palliative Coverage. (For these individuals the Palliative Coverage Drug Benefit Supplement must also be considered).
  4. Drug coverage provided to Alberta Human Services clients. (For these clients the Alberta Human Services Drug Benefit Supplement (HSDBS) (PDF) must also be considered).

The ADBL publications are organized into two main parts, policies and guidelines and eligible product listings.

The Policies and Guidelines (PDF) (Section 1) include information on program and price policies (e.g. drug review process, Least Cost Alternative, etc.) in addition to common guidelines adhered to in the ADBL publications.

Four components contribute to the eligible product listings. These are: Special Authorization (Section 3) (PDF) , Optional Special Authorization (Section 3a) (PDF) , Rare Diseases Drug Coverage Program (Section 4) (PDF), and the regular Listing of Benefits (PDF) under Alberta government-sponsored drug programs. Special Authorization drugs include drug products that are eligible under Alberta government sponsored drug programs when specific criteria for coverage are met. The regular benefits are eligible drug products that do not require special authorization although there may be restrictions.

The ADBL publications are designed to be used primarily by health professionals, especially pharmacists and physicians. Specific drug product information is provided, including product name (ingredient, strength and dosage form), Drug Identification Number (DIN), manufacturer/distributor of the product, and pricing information. The pricing information in the ADBL publications reflect the drug material per unit cost only and does not reflect the dispensing fees claimed by your pharmacist. The product listings are generally organized by "pharmacologic-therapeutic classification" (PTC) classification as seen in the Listing of Benefits (PDF) .

These are explained in the Legend (PDF) in the ADBL publications.

The prices listed in the ADBL publications are based on the manufacturers' responses to Alberta Price Confirmation (APC) for the period of time during which the ADBL publications are effective. The pricing information in the ADBL publications reflect the drug material per unit cost only and does not reflect the dispensing fee claimed by your pharmacist. It is presented for information purposes only.

If the medication you are interested in is within an "interchangeable" grouping of medications (with the same active ingredients, dosage and form), the program may pay up o the Least Cost Alternative (LCA) price, if one has been established for that grouping. In these cases, the LCA price appears bolded. For more information, see the Price Policy (PDF) .

In some cases, Maximum Allowable Cost (MAC) pricing is established for a specific drug product or selected group of interchangeable drug products. MAC pricing appears in bold italic type in the first price column (after the manufacturer code). For more information, see the Price Policy (PDF) .

The Least Cost Alternative (LCA) price is the lowest unit cost established for a drug product within a set of interchangeable drug products. LCA prices appear in bold type in the ADBL publications. The LCA price policy is applied to selected interchangeable groups as identified in the List.

The bolded prices represent the Least Cost Alternative (LCA) price. The Least Cost Alternative (LCA) price is the lowest unit cost established for a drug product within a set of interchangeable drug products. The LCA price policy is applied to selected interchangeable groups as identified in the ADBL publications. The Alberta government-sponsored drug programs follow the LCA price policy.

To confirm the spelling of the product go to the Alphabetical List of Pharmaceutical Products (PDF) . Once spelling is confirmed, proceed to search the ADBL(PDF) or search the appropriate part of the ADBL publication:

Section 3 - Criteria for Special Authorization of Select Drug Products (PDF) , or Section 3a - Criteria for Optional Special Authorization of Select Drug Products (PDF) , or Section 4 - Rare Diseases Drug Coverage Program (PDF) , or Listing of Benefits by Pharmacologic-Therapeutic classification (PDF) . Refer to tips for searching PDF documents.

Prescription drug benefits for those covered under Alberta Human Services programs are found by searching both the Alberta Human Services Drug Benefit Supplement (HSDBS) (PDF) and the Alberta Drug Benefit List (ADBL) (PDF) .

If you do not find the drug product in one of these locations, check the ADBL publications for any Updates to the ADBL that have been issued since the last Monthly Update. You can also search products using our interactive DBL (iDBL).

If your physician has prescribed a medication that is covered through Special Authorization (PDF) , your physician must complete the appropriate drug Special Authorization Request form and fax or mail that form to Alberta Blue Cross for review. Information regarding the status of a special authorization request will be ready within three working days of Alberta Blue Cross receiving the request from the physician.

Call Alberta Blue Cross Customer Services at 780-498-8000 (Edmonton and area), 403-234-9666 (Calgary) or 1-800-661-6995 (toll-free from anywhere else in Canada) to confirm the status (approval, pending more information, denial) of the Special Authorization request.

If you go to your pharmacist, he or she may be able to tell you if it has been approved—if not it may still be in the process of being assessed. If more information is required for further assessment of the request, this will be communicated directly to your physician. If the request is declined, Alberta Blue Cross will send a letter to your physician and to you, the patient.

Yes. Some selected devices or drug products are eligible benefits with limits or restrictions in the ADBL publications. For these products, a "Restricted Benefit" or "Limited Restricted Benefit" comment is displayed in the ADBL publications after the ingredient name or specific strength of the ingredient which explains the limits or restriction. For more information, refer to Restricted Benefits (PDF) of the ADBL publications.

If the drug product is not listed anywhere in the ADBL (PDF) or its components: 3 - Criteria for Special Authorization of Select Drug Products (PDF) , Section 3a - Criteria for Optional Special Authorization of Select Drug Products (PDF) , (Section 4 - Rare Diseases Drug Coverage Program (PDF) , or Listing of Benefits by Pharmacologic-Therapeutic Classification (PDF) , or Updates to the ADBL), it generally will not be provided as a benefit under the applicable government-sponsored drug program. In these cases the patient pays the complete cost of the medication or can contact his or her physician for an alternative medication that is a benefit.

The ADBL publications are published annually, effective April 1, with normally scheduled monthly updates when applicable.

Alberta Blue Cross administers the prescription drug benefit programs sponsored by Alberta Health and maintains and publishes the ADBL.

You can view, search or print the ADBL publications in Acrobat Document Format (PDF). You will need to download Acrobat Reader which is available free of charge from the Adobe web site. For more information on using Adobe Acrobat, please refer to the tips on this site. The documents vary in length.

Printed versions of the ADBL publications, including supplements and Updates, are available from Alberta Blue Cross at the address shown below.

Costs are:

  • Binder and contents: $42.00 ($40.00 + $2.00 G.S.T.)
  • Contents only:$36.75 ($35.00 + $1.75 G.S.T.)

A cheque or money order must accompany the request for additional copies.

Alberta Blue Cross

10009 108 Street NW

Edmonton AB T5J 3C5

If your physician has prescribed a medication that is covered through Special Authorization (PDF) , your physician must complete the appropriate drug Special Authorization Request form (PDF) and fax or mail that form to Alberta Blue Cross for review. Information regarding the status of a special authorization request will be ready within three working days of Alberta Blue Cross receiving the request from the physician.

Call Alberta Blue Cross Customer Services at 780-498-8000 (Edmonton and area), 403-234-9666 (Calgary) or 1-800-661-6995 (toll-free from anywhere else in Alberta). Pharmacy service providers may call Alberta Blue Cross pharmacy services representatives at 780-498-8370 (Edmonton and area), 403-294-4041 (Calgary and area) or 1-800-361-9632 toll free.

OR

Simply e-mail Alberta Blue Cross.

Note: Information pertaining to Albertans covered under Alberta Human Services sponsored prescription drug programs is located on the Alberta Human Services web site.

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.