Clickable Table

Generic Name Brand Name Strength Dosing 90 Day Cost Coverage Comments Category 1 Category 2
Hydrocortisone Cortate 1.00% As dir $20 BC / IA - Covered

Price is for a 30g tube of cream; since majority of price is from dispensing fee, large quantities cause small price increases.

Topicals Topical Corticosteroids
Amcinonide Cyclocort 0.10% As dir $20 BC / IA - Covered

Price is for a 30g tube of cream; since majority of price is from dispensing fee, large quantities cause small price increases.

Topicals Topical Corticosteroids
Clobetasol 17-propionate Dermovate 0.05% As dir $20 BC / IA - Covered

Price is for a 30g tube of cream; since majority of price is from dispensing fee, large quantities cause small price increases.

Topicals Topical Corticosteroids
Desonide Desonate 0.05% As dir $25 BC / IA - Covered

Price is for a 30g tube of cream; since majority of price is from dispensing fee, large quantities cause small price increases.

Topicals Topical Corticosteroids
Betamethasone Dipropionate Glycol Diprolene 0.05% As dir $30 BC / IA - Covered

Price is for a 30g tube of cream; since majority of price is from dispensing fee, large quantities cause small price increases.

Topicals Topical Corticosteroids
Betamethasone Dipropionate Diprosone 0.05% As dir $20 BC / IA - Covered

Price is for a 30g tube of cream; since majority of price is from dispensing fee, large quantities cause small price increases.

Topicals Topical Corticosteroids
Mometasone Furoate Elocom 0.10% As dir $35 BC / IA - Covered

Price is for a 30g tube of cream; since majority of price is from dispensing fee, large quantities cause small price increases.

Topicals Topical Corticosteroids
Isotretinoin Accutane 40 mg QD x 90 days $205 BC / IA - Covered Topicals Acne Treatments
Benzoyl Peroxide/Clindamycin Clindoxyl (45g tube) 5%/1% As dir $50 BC - SA / IA Covered Topicals Acne Treatments
Adapalene Differin (60g tube) 0.10% As dir $150 BC - NC; IA - Covered Topicals Acne Treatments
Minocycline Minocin 100 mg QD x 90 days $35 BC - Covered / IA - SA Topicals Acne Treatments
Tretinoin Cream Stieva-A (25g tube) 0.025% As dir $25 BC - SA / IA Covered Topicals Acne Treatments
Permethrin Nix 1% As dir $25 BC / IA - Covered Topicals Lice
Dimethicone Nyda 50% As dir $40 BC / IA - Covered Topicals Lice
Pyrethrins/Piperonyl Butoxide R&C 0.33%/3% As dir $25 BC / IA - Covered Topicals Lice
Isopropyl Myristate Resultz 50% As dir $30 BC / IA - Covered Topicals Lice
Imiquimod Aldara (24x250mg) 5% As dir $300 BC / IA - SA Topicals Miscellaneous Topicals
Betamethasone/Calcipotriol Dovobet (60g tube) 0.05/0.005% As dir $115 BC / IA - Covered Topicals Miscellaneous Topicals
Tacrolimus Protopic (30g tube) 0.03% As dir $90 BC / IA - SA Topicals Miscellaneous Topicals
Betamethasone Valerate Betaderm/Betnovate 0.10% As dir $15 BC / IA - Covered

Price is for a 30g tube of cream; since majority of price is from dispensing fee, large quantities cause small price increases.

Topicals Topical Corticosteroids
Legend:
BC = Alberta Blue Cross, IA = Indian Affairs, NC = Not covered, SA = special authorization, SR = sustained release, OTC = over the counter, SQ = subcutaneous injection, SS=Social Services