Clickable Table

Generic Name Brand Name Strength Dosing 90 Day Cost Coverage Comments Category 1 Category 2
Dutasteride Avodart 0.5 mg QD $45 BC - Covered / IA - SA Urology Benign Prostatic Hyperplasia (BPH)
Tamsulosin CR Flomax CR 0.4 mg QD $30 BC / IA - Covered Urology Benign Prostatic Hyperplasia (BPH)
Terazosin Hytrin 2 mg QD $35 BC / IA - Covered Urology Benign Prostatic Hyperplasia (BPH)
Finasteride Proscar 5 mg QD $55 BC - Covered / IA - SA Urology Benign Prostatic Hyperplasia (BPH)
Tadalafil Cialis 20 mg As dir $70 BC / IA - NC

4 tablets; may split tablet for lower dose to save costs

Urology Erectile Dysfunction
Vardenafil Levitra 20 mg As dir $70 BC / IA - NC

4 tablets; may split tablet for lower dose to save costs

Urology Erectile Dysfunction
Sildenafil Viagra 50 mg, 100 mg As dir $55 BC / IA - NC

4 tablets; may split tablet for lower dose to save costs

Urology Erectile Dysfunction
Testosterone Undecanoate Andriol 40 mg BID $105 BC - SA / IA Covered Urology Testosterone Replacement
Testosterone Patch Androderm 5 mg/day QD $445 BC / IA - SA Urology Testosterone Replacement
Testosterone Gel Androgel 5 g QD $440 BC - NC / IA - SA Urology Testosterone Replacement
Testosterone Enanthate Delatestryl 200 mg/ml 400mg Q30D $85 BC / IA - Covered Urology Testosterone Replacement
Testosterone Cypionate Depo-Testosterone 100 mg/ml 200mg Q2W $75 BC / IA - Covered Urology Testosterone Replacement
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