Low Cost Alternative (LCA) program
The Low Cost Alternative (LCA) program groups drugs based on active ingredient, strength and formulation (e.g. tablet, capsule). Each category typically includes a brand name drug(s) and a generic drug(s). PharmaCare assigns a maximum price it will cover for any product in the category. The generic drugs are fully covered*.
Fully covered: PharmaCare fully covers the drugs in the category that are priced at or below the PharmaCare maximum price. These are usually generic drugs.
Partially covered: PharmaCare partially covers the drugs in the category that are priced above the maximum price—up to the maximum price. These are usually brand-name drugs.
*Actual coverage is subject to the rules of the patient's PharmaCare plan, including any deductible requirements.
A generic drug is a copy of a brand name drug. Generics:
- Are as safe and effective and have bioequivalence
- Are manufactured to the same Health Canada standards and Food and Drugs Act regulations
- Contain the identical medicinal ingredients
- Vary only in minor (non-medicinal) ingredients (e.g. dyes, coatings, binding agents)
The real difference is price. Generics can cost between 15% and 90% less. They save B.C. residents and insurers significant costs without compromising quality of care
Generic LCA drugs are fully covered. Your prescriber or pharmacist should be able to let you know if a generic drug is available. You can also search the list of drugs in the LCA program. Note: Generic drugs may become available after patent protections on the original drug expire.
If you cannot take a generic drug, your prescriber may request Special Authority for full coverage of another drug.
Sometimes a prescriber writes "no substitution" on a prescription. If your prescriber insists on a certain product that is not fully covered (and has not requested a Special Authority), you will receive only partial coverage. Your pharmacist may contact your doctor and request a prescription for a full benefit drug.
If you do not want a generic LCA drug, you can purchase the partially covered drug. PharmaCare will cover up to the maximum while you pay the difference in cost.
The coverage amount is based on a percentage of the price of the brand name drug. If a manufacturer wants its generic drug included on the list of LCA drugs that PharmaCare covers, it has to agree to sell the generic drug to pharmacies at or below the maximum price. PharmaCare covers the drug up to the maximum list price plus a fixed markup for pharmacies (usually 8 percent).
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