Price Comparison of Commonly Prescribed Pharmaceuticals in ...

Price Comparison of Commonly Prescribed

Pharmaceuticals in Alberta 2014

Price Comparison of Commonly Prescribed Pharmaceuticals in Alberta 2014

What would your patients do with extra cash? Perhaps buy new running

shoes and a gym membership, or take a trip to escape the Canadian winter? We

could be saving our patients and the health care system substantial money if

prescribers chose lower cost (often equivalent) medications, instead of higher

cost medications, which may not be covered by provincial drug plans. Choosing

sitagliptin (Januvia) over metformin for diabetes, perindopril (Coversyl) over

thiazides for hypertension and pregabalin (Lyrica) over amitriptyline (Elavil) for

chronic pain can add up quickly.

Physicians have limited knowledge and poor access to information about

drug plans.1 With this in mind, we endeavored to create a document listing the

price of medications commonly prescribed by Albertan primary care health

providers. Although medication choice should be based on clinical situations,

many medications are therapeutically interchangeable and using this reference

allows prescribers to consider costs when prescribing. Other cost savings

methods to be considered include: increasing prescription lengths for long-term

medications, using combination products, and pill splitting where possible.

Costs listed are primarily for the generic product (with generic name

bolded) as provincial drug plans will generally only pay for the lowest cost

formulation available. Brand name prices (with brand name bolded) are for

products still under patent protection. We also provide information on coverage

by Alberta Blue Cross (BC) and Indian Affairs (IA) formularies and which

products require Special Authorization (SA).

Calculating medication costs

The prices represent the entire retail cost of the prescription filled at a

community pharmacy in Alberta, including markup and dispensing fees. This

does not reflect what a patient would pay if covered under a drug plan, but

rather the cost to an individual without coverage, or the cost to the health care

system. Prices have been rounded to the nearest $5. Although prices may differ

between wholesalers and pharmacies (especially for oral contraceptives and

insulins), this tool allows for relative cost comparisons between medications in

the same class or for treating the same disease. This list is not exhaustive and

we encourage you to contact your neighborhood pharmacist for information on

medications not included that you use in your practice.

This document is up to date as of January 1, 2014. Since the 2013 edition,

generic prices have changed substantially, dropping in price in most cases.

For 2014, we have added a section on hormone replacement therapy and

Alzheimer¡¯s disease medications. Please forward any feedback, including prices

that surprised you or cases where knowledge of prices made a difference in your

practice to nickonchuks@.

Michael Kolber BSc, MD, CCFP, MSc

Associate Clinical Professor

Department of Family Medicine, University of Alberta

Jayson Lee BSc Pharm

Clinical Pharmacist, Pharmacare Specialty Pharmacy #2

Edmonton, Alberta

Tony Nickonchuk BSc Pharm CDE APA

Manager, Walmart Pharmacy

Peace River, Alberta

Medication costs were calculated by adding the wholesale cost of the medication plus mark up dispensing fee. Alberta Health & Wellness determines the

maximum markup and dispensing fee that can be charged based on the acquisition cost of the medication and is illustrated in the table below.

This table is accurate for all medications except oral contraceptives, insulins, and injectables, where the total charge can be as high as 2/3 of the acquisition

cost to a maximum of $100 per prescription.

Acquisition Cost

Dispensing Fee

Markup

Total Fee

$0-74.99

$10.22

$1.71

$11.93

$75-149.99

$15.53

$2.00

$17.53

$150+

$20.94

$5.03

$25.97

Acknowledgements

We wish to thank Stacy Jardine, BSc. Pharm, Jamie Hoy, BSc. Pharm, Mike Allan MD, CCFP and Tina Korownyk MD, CCFP for their contributions to this project.

Reference

1. Allan GM, Lexchin J, Wiebe N. Physician Awareness of Drug Cost: A Systematic Review PLoS Med. 2007 Sep;4(9):e283.

Table of Contents

CARDIOVASCULAR.........................................................................................................................................................5

Lipid Lowering Agents, Beta Blockers, Calcium Channel Blockers.........................................................................................................................5

Angiotensin Converting Enzyme Inhibitors (ACEIs), Angiotensin Receptor Blockers (ARBs), Diuretics................................................6

Anti-platelet, Anti-coagulant..................................................................................................................................................................................................7

HYPOGLYCEMIC AGENTS............................................................................................................................................8

RESPIRATORY.................................................................................................................................................................. 9

SMOKING CESSATION.................................................................................................................................................10

GASTROINTESTINAL..................................................................................................................................................... 11

PSYCHIATRY.................................................................................................................................................................... 12

contraceptives....................................................................................................................................................... 13

HORMONE REPLACEMENT THERAPY.................................................................................................................14

ANALGESICS.................................................................................................................................................................... 15

UROLOGY.......................................................................................................................................................................... 16

Miscellaneous.......................................................................................................................................................... 17

Antibiotics, Osteoporosis, Alzheimer¡¯s

Price Comparison of Commonly Prescribed Pharmaceuticals in Alberta 2014 | 5

Generic Name

Brand name

Strength

Dosing

90 Day Cost (unless

otherwise noted)

Coverage

CARDIOVASCULAR

Lipid Lowering Agents

Atorvastatin

Lipitor

10mg

QD

$40

BC / IA covered

Rosuvastatin

Crestor

10mg

QD

$45

BC / IA covered

Atorvastatin

Lipitor

20mg

QD

$45

BC / IA covered

Rosuvastatin

Crestor

20mg

QD

$50

BC / IA covered

Atorvastatin

Lipitor

40mg, 80mg

QD

$50

BC / IA covered

Pravastatin

Pravachol

20mg

QD

$55

BC / IA covered

Simvastatin

Zocor

10mg

QD

$55

BC / IA covered

Ezetimibe

Ezetrol

10mg

QD

$200

SA req¡¯d for BC and IA

Bisoprolol

Monocor

5mg

QD

$20

BC / IA covered

Metoprolol

Lopresor

25mg, 50mg

BID

$25

BC / IA covered

Metoprolol-SR

Lopresor SR

100mg

QD

$25

BC / IA covered

Bisoprolol

Monocor

10mg

QD

$25

BC / IA covered

Atenolol

Tenormin

50mg

QD

$25

BC / IA covered

Metoprolol-SR

Lopresor SR

200mg

QD

$35

BC / IA covered

Atenolol

Tenormin

100mg

QD

$35

BC / IA covered

Beta Blockers

Calcium Channel Blockers

Amlodipine

Norvasc

5mg

QD

$35

BC / IA covered

Diltiazem-T

Tiazac

240mg

QD

$45

BC / IA covered

Amlodipine

Norvasc

10mg

QD

$45

BC / IA covered

Nifedipine

Adalat XL

30mg

QD

$65

BC / IA covered

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

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