Acid reflux medication coverage changes

Effective October 1, 2016, coverage for acid reflux medications (known as proton pump inhibitors) is changing. These medications are prescription drugs that keep the stomach from making too much acid, and to treat gastroesophageal reflux disease and other acid-related disorders.
  • There are different types of proton pump inhibitors varying in price, but evidence shows all these medications are equally effective.

Beginning October 1, 2016, coverage for the lowest cost medications, which are the generic versions of Pariet (rabeprazole) and Tecta (pantoprazole magnesium) will be covered under the Alberta Health Care Insurance Plan.

If you are currently prescribed a different acid reflux medication, you have a 4-month transition period to discuss these changes with your doctor or pharmacist and switch to the generic drug. The transition period ends January 31, 2017.You may choose to still use a different acid reflux medication, but after the transition period, you will be required to pay the larger cost difference.

If you choose to use the lower cost medication, you will have a lower co-payment and could save you up to $82.48 annually. If you choose to use a different medication, only the cost of the lowest cost medication will be applied, and your co-payments will be more.

  • If you experience a severe allergic reaction to rabeprazole or pantoprazole magnesium, your doctor can request an exception by submitting a special authorization request form to Alberta Blue Cross.

It is important for you to know, when taking these medications, it is best to take the lowest dose possible and for the shortest time period. They are not intended for long-term use and are rarely needed for an extended time period.

According to work done by the Canadian Agency for Drugs and Technologies in Health, all medications for acid reflux conditions are considered therapeutically similar and equally effective. However, the cost difference between medications can be significant. That is why the Alberta government is introducing this change. This change will help ensure our health dollars are spent wisely. This change will save money for patients and for government.

Questions?

  • If you have any questions about this change or your use of this medication, speak with your doctor or pharmacist.
  • Contact Alberta Blue Cross for specific information about your drug plan at 1-800-661-6995.