Low Cost Alternative (LCA) Program


The Low Cost Alternative (LCA) program groups generic drugs that contain the same active ingredients in the same strength and formulation. For example, one category is acebutolol 100 mg tablets, another is acebutolol 200 mg tablets.

PharmaCare assigns a maximum price it will cover for all the products in a category. Each category typically includes a brand-name drug(s) and one or more generic drugs, priced at or below the PharmaCare maximum price.

PharmaCare fully covers drugs in the category that are priced at or below the PharmaCare maximum price. These are usually generic drugs.

PharmaCare partially covers drugs priced above the maximum price—up to the maximum price. These are usually brand-name drugs.

If a patient cannot take an LCA drug, prescribers can submit a Special Authority request for full coverage of another drug.


LCA pricing exceptions

The following exceptions may affect how an LCA price is calculated:

  • If the price of a capsule, sustained-release tablet or enteric-coated tablet is significantly higher than the tablet price, LCA prices are based on the tablet price
  • If a product strength is priced significantly higher (proportionally) than others, LCA prices are pro-rated based on the lowest-cost strength
  • If the price of a suspension is significantly higher than the price of the solution, LCA prices are based on the solution price
  • For creams and ointments, if the tube's per-unit price is significantly higher than the jar's per-unit price, LCA prices are based on the jar price
LCA Pricing Exceptions - Updated on May 7, 2021
Product Pricing
desmopressin acetate (DDAVP Melt) tablet 60 mcg The LCA price for DDAVP Melt tablet 60 mcg is set at the LCA price of desmopressin acetate 0.1mg tablet.
desmopressin acetate (DDAVP Melt) tablet 120 mcg The LCA price for DDAVP Melt tablet 120 mcg is set at the LCA price of desmopressin acetate 0.2 mg tablet.
desmopressin acetate (DDAVP Melt) tablet 240 mcg The LCA price for DDAVP Melt tablet 240 mcg is set at the LCA price of two desmopressin acetate 0.2 mg tablets.
fenofibrate (Lipidil EZ) tablet 145 mg The LCA price is set at the LCA price for fenofibrate FC tablet 160 mg.
fenofibrate (Lipidil EZ) tablet 48 mg The LCA price is pro-rated to the LCA price for Lipidil EZ tablet 145 mg.