Pharmacy fee reimbursement

Effective April 1, 2014, an agreement between the Alberta Pharmacists’ Association, Alberta Blue Cross and the Alberta government was implemented. This agreement includes four years of predictable funding, changes to dispensing fees and an updated pharmacy services framework that compensates pharmacists for the services they provide to Albertans.

Prescription pricing effective April 1, 2014

  • The cost of each drug is based on the Manufacturer List Price (MLP) or the Base Price.
    • The Manufacturer List Price is the price for a drug listed in the Alberta Drug Benefit List (ADBL), which is determined by Alberta Health and the pharmaceutical manufacturer. Read the Alberta Drug Benefit List.
    • The Base Price is the price per unit of a drug, a drug product or a product. This price is established by Alberta Blue Cross and listed in the Alberta Blue Cross Drug Price List. The Base Price applies to drugs not listed on the ADBL.
  • The agreement introduces two new allowable upcharges, referred to as Allowable Upcharge #1 & Allowable Upcharge #2.
  • The agreement also introduces one dispensing fee of $12.30 for each prescription, except for compounded prescriptions or diabetic supplies. This one fee will apply from April 1, 2014 to March 31, 2018.
  • All injectables, oral contraceptives and insulin medications now follow this dispensing fee model. The pricing structure table below is used for most prescriptions dispensed.
     
Year: April 1, 2014 April 1, 2015 April 1, 2016 April 1, 2017
Medication Cost: Manufacturer list price as published in Alberta Drug Benefit List
Allowable Upcharge #1: 3% 3% 3% 3%
Allowable Upcharge #2: 5.5% to a
maximum of $100
6% to a
maximum of $100
6.5% to a
maximum of $100
7% to a
maximum of $100
Dispensing Fee: $12.30 $12.30 $12.30 $12.30

Compounded prescription pricing

Compound prescriptions prepared in a pharmacy

  • Pricing for drug ingredients is based on the pricing in the Alberta Drug Benefit List (ADBL) or Alberta Blue Cross Drug Price List. 
  • The cost of a compounded prescription is the aggregate cost of all ingredients used, plus
    • an upcharge of 7.5%, plus 
    • the dispensing fee for each compounded prescription made in the pharmacy is $18.45.

Purchased compounded prescriptions

  • When compounded prescriptions are purchased from a compounding and repackaging pharmacy, the drug cost is the purchased compound price, plus
    • an allowable upcharge #2 (as noted above), plus
    •  the dispensing fee of $12.30.