Clickable Table

Generic Name Brand Name Strength Dosing 90 Day Cost Coverage Comments Category 1 Category 2
Rosuvastatin Crestor 10 mg, 20 mg QD $30 BC / NIHB - Covered

Maximum Allowable Cost (MAC) pricing exists for statins. See https://www.ab.bluecross.ca/pdfs/MAC-pricing-categories.pdf.

Cardiovascular Lipid Lowering Agents
Atorvastatin Lipitor 10 mg QD $30 BC / NIHB - Covered

Maximum Allowable Cost (MAC) pricing exists for statins. See https://www.ab.bluecross.ca/pdfs/MAC-pricing-categories.pdf.

Cardiovascular Lipid Lowering Agents
Pravastatin Pravachol 20 mg QD $50 BC / NIHB - Covered

Maximum Allowable Cost (MAC) pricing exists for statins. See https://www.ab.bluecross.ca/pdfs/MAC-pricing-categories.pdf.

Cardiovascular Lipid Lowering Agents
Simvastatin Zocor 10 mg QD $35 BC / NIHB - Covered

Maximum Allowable Cost (MAC) pricing exists for statins. See https://www.ab.bluecross.ca/pdfs/MAC-pricing-categories.pdf.

Cardiovascular Lipid Lowering Agents
Ezetimibe Ezetrol 10 mg QD $30 BC / NIHB - Covered Cardiovascular Lipid Lowering Agents
Alirocumab Praluent 75 mg x Q2W SQ Q2W $1830 BC / NIHB - SA Cardiovascular Lipid Lowering Agents
Evolocumab Repatha 140 mg SQ Q2W $1735 BC / NIHB - SA Cardiovascular Lipid Lowering Agents
Sacubitril/Valsartan Entresto 97 mg/103 mg BID $750 BC / NIHB - SA Cardiovascular Neprilysin Inhibitor / ARB Combos
Ramipril Altace 5 mg, 10 mg QD $25 BC / NIHB - Covered

All have HCTZ combo products that are similar in price to the single entity product

Cardiovascular ACE Inhibitors
Perindopril Coversyl 4 mg, 8 mg QD $40 BC / NIHB - Covered

Maximum Allowable Cost (MAC) pricing exists for ACE Inhibitors. See https://www.ab.bluecross.ca/pdfs/MAC-pricing-categories.pdf.

Cardiovascular ACE Inhibitors
Perindopril/Indapamide Coversyl Plus 4 mg/1.25 mg QD $40 BC / NIHB - Covered

Maximum Allowable Cost (MAC) pricing exists for ACE Inhibitors. See https://www.ab.bluecross.ca/pdfs/MAC-pricing-categories.pdf.

Cardiovascular ACE Inhibitors
Enalapril Vasotec 10 mg QD $40 BC / NIHB - Covered

Maximum Allowable Cost (MAC) pricing exists for ACE Inhibitors. See https://www.ab.bluecross.ca/pdfs/MAC-pricing-categories.pdf.

Cardiovascular ACE Inhibitors
Lisinopril Zestril 20 mg QD $35 BC / NIHB - Covered

Maximum Allowable Cost (MAC) pricing exists for ACE Inhibitors. See https://www.ab.bluecross.ca/pdfs/MAC-pricing-categories.pdf.

Cardiovascular ACE Inhibitors
Candesartan Atacand 8 mg QD $35 BC / NIHB - Covered

All have HCTZ combo products that are similar in price to the single entity product

Cardiovascular Angiotensin Receptor Blockers
Losartan Cozaar 50 mg QD $30 BC / NIHB - Covered

All have HCTZ combo products that are similar in price to the single entity product

Cardiovascular Angiotensin Receptor Blockers
Valsartan Diovan 80 mg, 160 mg QD $35 BC / NIHB - Covered

All have HCTZ combo products that are similar in price to the single entity product

Cardiovascular Angiotensin Receptor Blockers
Telmisartan Micardis 80 mg QD $35 BC / NIHB - Covered

All have HCTZ combo products that are similar in price to the single entity product

Cardiovascular Angiotensin Receptor Blockers
Warfarin Coumadin 5 mg QD $20 BC / NIHB - Covered Cardiovascular Anti-Coagulant
Apixaban Eliquis 5 mg BID $95 BC - SA / NIHB - Covered Cardiovascular Anti-Coagulant
Edoxaban Lixiana 60 mg QD $305 BC - SA / NIHB - Covered Cardiovascular Anti-Coagulant
Dabigatran Pradaxa 110 mg, 150 mg BID $265 BC - SA / NIHB - Covered Cardiovascular Anti-Coagulant
Rivaroxaban Xarelto 15 mg, 20 mg QD $300 BC - SA / NIHB - Covered Cardiovascular Anti-Coagulant
Rivaroxaban Xarelto 2.5 mg BID $295 BC / NIHB - SA Cardiovascular Anti-Coagulant
Ticagrelor Brilinta 90 mg BID $250 BC - SA / NIHB - Covered Cardiovascular Anti-Platelet
Clopidogrel Plavix 75 mg QD $40 BC / NIHB - Covered Cardiovascular Anti-Platelet
Telmisartan/Amlodipine Twynsta 80 mg/5 mg QD $70 BC / NIHB - Covered Cardiovascular ARB / CCB Combos
Metoprolol Lopresor 25 mg, 50 mg BID $25 BC / NIHB - Covered Cardiovascular Beta Blockers
Metoprolol-SR Lopresor SR 100 mg, 200 mg QD $50 BC / NIHB - Covered Cardiovascular Beta Blockers
Bisoprolol Monocor 10 mg QD $25 BC / NIHB - Covered Cardiovascular Beta Blockers
Atenolol Tenormin 50 mg QD $25 BC / NIHB - Covered Cardiovascular Beta Blockers
Nifedipine Adalat XL 30 mg QD $75 BC / NIHB - Covered

Maximum Allowable Cost (MAC) pricing exists for Calcium Channel Blockers. See https://www.ab.bluecross.ca/pdfs/MAC-pricing-categories.pdf.

Cardiovascular Calcium Channel Blockers
Amlodipine Norvasc 5 mg, 10 mg QD $35 BC / NIHB - Covered

Maximum Allowable Cost (MAC) pricing exists for Calcium Channel Blockers. See https://www.ab.bluecross.ca/pdfs/MAC-pricing-categories.pdf.

Cardiovascular Calcium Channel Blockers
Diltiazem Tiazac 240 mg QD $50 BC / NIHB - Covered

Generic equivalents of Tiazac-T and Tiazac XC

Cardiovascular Calcium Channel Blockers
Spironolactone Aldactone 25 mg, 100 mg QD $25 BC / NIHB - Covered Cardiovascular Diuretics
Hydrochlorothiazide Hydrodiuril 12.5 mg, 25 mg QD $15 BC / NIHB - Covered Cardiovascular Diuretics
Chlorthalidone Hygroton 50 mg 1/4-1/2 QD $20 BC / NIHB - Covered Cardiovascular Diuretics
Furosemide Lasix 20 mg, 40 mg QD $15 BC / NIHB - Covered Cardiovascular Diuretics
Indapamide Lozide 2.5 mg QD $40 BC / NIHB - Covered Cardiovascular Diuretics
Legend:
BC = Alberta Blue Cross, NIHB = Non-Insured Health Benefits for First Nations and Inuit, NC = Not covered, SA = special authorization, SR = sustained release, OTC = over the counter, SQ = subcutaneous injection, SS=Social Services