Low Cost Alternative (LCA) and Reference Drug Program (RDP) Data Files for Round 2 of the Pharmacy Services Agreement

Background

Under the terms of the Pharmacy Services Agreement (PDF 594K) (Section 3.4), the Province established the following phased pricing changes to the maximum accepted list price (MALP) for drugs included in the Low Cost Alternative program.

PharmaCare Reimbursement Pricing Period New Price for LCA Program Drugs (as a percentage of branded list price)
Round 1
Oct 15, 2010 – Jul 03, 2011		 Existing generic drugs:  50%
New generic drugs:  42%
Round 2
Jul 04, 2011 – Apr 1, 2012		 Existing and new generic drugs:  40%
Round 3
Apr 02, 2012 onward		 Existing and new generic drugs :  35%

With exception to the drugs that are subject to the reduced mark-up for high cost drugs policy, the MALP, plus 8%, becomes the LCA price for an LCA category and is the maximum PharmaCare will reimburse.

Effective July 4, 2011, generic products deemed ineligible for PharmaCare coverage through the Round 2 price confirmation process because of their list price will not be covered by PharmaCare and will be removed from the PharmaCare formulary.

Manufacturers’ list prices for generic drugs deemed eligible for PharmaCare coverage through the Round 2 price confirmation process should reflect the pricing listed in the Round 2 LCA Pricing Spreadsheet by June 4, 2011 (30 days before the new reimbursement limits come into effect).

Round 2 Pricing for drugs included in the LCA and RDP Programs

Downloadable Files

The following Excel spreadsheets provide details on the Round 2 maximum reimbursement limits and prices that come into effect on July 4, 2011.

  1. Round 2 LCA Pricing Spreadsheet (xls 829K) (first posted on June 1, 2011, last updated on June 21, 2011) - includes all drugs within the LCA program with the Round 2 reimbursement limits
  2. Round 2 RDP Spreadsheet (xls 92K) - includes information on all drugs within the RDP program with the RDP prices
  3. Round 2 Drug Removal Spreadsheet (xls 49K) (first posted on June 1, 2011, last updated on June 21, 2011) - lists the generic drugs deemed ineligible for PharmaCare coverage through the Round 2 price confirmation process. Effective July 4, 2011, these drugs will no longer be reimbursed by PharmaCare.
Note: The above Excel spreadsheets shall be effective from July 4, 2011 through to no later than April 1, 2012. These spreadsheets are subject to updates.
Future and ongoing LCA and RDP Programs data files and updates after this Round 2 posting will continue to be available at Low Cost Alternative (LCA) and Reference Drug Program (RDP) Data Files page.

Other special updates

On occasion, PharmaCare will post additional information on certain regular or mid-cycle updates to the LCA and RDP program data files. Any such updates are listed immediately below.

File Format

The files are in Excel (XLS) format ready for use in any spreadsheet or database. This new format lets users search, sort and filter the data to suit their needs.

How to Interpret the Data Files

The Pharmacare Low Cost Alternative and Reference Drug Program Guide (pdf 240K) contains

  • background information on the LCA and RDP programs
  • detailed explanations of the data fields in the LCA Pricing and the RDP spreadsheets

Additional References