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									                                                                                     Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                  (Regular Benefits)


                                                                                                                                                                           DISTRIBUTION   DISTRIBUTION     LCA               LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION       DIN / PIN            PRODUCT NAME   IC            GENERIC NAME            STRENGTH            ROUTE              FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE       PRICE         STATUS
           ETHANOLAMINE DERIVATIVES
040404     /                        00596612        DIPHENHYDRAMINE       N    DIPHENHYDRAMINE HCL             50 MG / ML    INJECTION                               SDZ        W            7.50%          N      3.7630                REGULAR BENEFIT
                                                1
           PHENOTHIAZINE DERIVATIVES
040412     /                         00567434       PROMETHAZINE          N    PROMETHAZINE HCL                25 MG / ML    INJECTION                               SDZ        W            7.50%          N      1.0698                REGULAR BENEFIT
                                                1
           PHENOTHIAZINE DERIVATIVES
040412     /                         01926306       PANECTYL              N    TRIMEPRAZINE TARTRATE           2.5 MG        ORAL             TABLET                 ERF        W            7.50%          N      0.2710                REGULAR BENEFIT
                                                1
           PHENOTHIAZINE DERIVATIVES
040412     /                         01926292       PANECTYL              N    TRIMEPRAZINE TARTRATE           5 MG          ORAL             TABLET                 ERF        W            7.50%          N      0.3325                REGULAR BENEFIT
                                                1

049200     OTHER ANTIHISTAMINES /    02176084       NOVO-KETOTIFEN        N    KETOTIFEN FUMARATE              0.2 MG / ML   ORAL             SYRUP                  TEV        B                           N      0.1397                REGULAR BENEFIT
                                                1

049200     OTHER ANTIHISTAMINES /    00577308       ZADITEN               N    KETOTIFEN FUMARATE              1 MG          ORAL             TABLET                 TEV        B                           N      1.6722                REGULAR BENEFIT
                                                1

080800     ANTHELMINTICS /           00556734       VERMOX                N    MEBENDAZOLE                     100 MG        ORAL             CHEWABLE TABLET        JAI        W            7.50%          N      3.8536                REGULAR BENEFIT
                                                1

081202     AMINOGLYCOSIDES /         02242652       GENTAMICIN            N    GENTAMICIN SULFATE              40 MG / ML    INJECTION                               SDZ        W            7.50%          N      2.7581                REGULAR BENEFIT
                                                1

081202     AMINOGLYCOSIDES /         02365154       TOBI PODHALER         N    TOBRAMYCIN                      28 MG         INHALATION       CAPSULE                NOV        W            7.50%          N      12.8588               REGULAR BENEFIT
                                                1

081202     AMINOGLYCOSIDES /         02239630       TOBI                  N    TOBRAMYCIN SULFATE              60 MG / ML    INHALATION       SOLUTION               NOV        W            7.50%          N      10.2870               REGULAR BENEFIT
                                                1

081202     AMINOGLYCOSIDES /         02241209       TOBRAMYCIN            N    TOBRAMYCIN SULFATE              10 MG / ML    INJECTION                               SDZ        W            7.50%          N      2.1535                REGULAR BENEFIT
                                                1

081202     AMINOGLYCOSIDES /         02241210       TOBRAMYCIN            N    TOBRAMYCIN SULFATE              40 MG / ML    INJECTION                               SDZ        W            7.50%          N      2.9860                REGULAR BENEFIT
                                                1
           CEPHALOSPORINS / FIRST
           GENERATION
08120604   CEPHALOSPORINS            02237137       CEFAZOLIN             N    CEFAZOLIN SODIUM                500 MG / VIAL INJECTION                               PPC        B                           N      2.5000     4.0000     REGULAR BENEFIT
                                                1
           CEPHALOSPORINS / FIRST
           GENERATION
08120604   CEPHALOSPORINS            02237138       CEFAZOLIN             N    CEFAZOLIN SODIUM                1 G / VIAL    INJECTION                               PPC        B                           N      3.7500     6.0000     REGULAR BENEFIT
                                                1
           CEPHALOSPORINS / FIRST
           GENERATION
08120604   CEPHALOSPORINS            02237140       CEFAZOLIN             N    CEFAZOLIN SODIUM                10 G / VIAL   INJECTION                               PPC        B                           N      35.0000    56.0000    REGULAR BENEFIT
                                                1




                                                                                                                Updated July 1, 2012                                                                                                        Page 1 of 254
                                                                                   Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                (Regular Benefits)


                                                                                                                                                                         DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION      DIN / PIN           PRODUCT NAME   IC               GENERIC NAME         STRENGTH           ROUTE             FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           CEPHALOSPORINS / FIRST
           GENERATION
08120604   CEPHALOSPORINS            00342084       NOVO-LEXIN          N    CEPHALEXIN                      250 MG       ORAL              CAPSULE                TEV        B                           N      0.3515               REGULAR BENEFIT
                                                1
           CEPHALOSPORINS / FIRST
           GENERATION
08120604   CEPHALOSPORINS            00342114       NOVO-LEXIN          N    CEPHALEXIN                      500 MG       ORAL              CAPSULE                TEV        B                           N      0.6646               REGULAR BENEFIT
                                                1
           CEPHALOSPORINS / FIRST
           GENERATION
08120604   CEPHALOSPORINS            00342106       NOVO-LEXIN          N    CEPHALEXIN                      25 MG / ML   ORAL              SUSPENSION             TEV        B                           N      0.0885               REGULAR BENEFIT
                                                1
           CEPHALOSPORINS / FIRST
           GENERATION
08120604   CEPHALOSPORINS            00342092       NOVO-LEXIN          N    CEPHALEXIN                      50 MG / ML   ORAL              SUSPENSION             TEV        B                           N      0.1390               REGULAR BENEFIT
                                                1
           CEPHALOSPORINS / FIRST
           GENERATION
08120604   CEPHALOSPORINS            00768723       APO-CEPHALEX        Y    CEPHALEXIN                      250 MG       ORAL              TABLET                 APX        B                           Y      0.2250    0.2250     REGULAR BENEFIT
           CEPHALOSPORINS / FIRST
           GENERATION
08120604   CEPHALOSPORINS            00583413       NOVO-LEXIN          Y    CEPHALEXIN                      250 MG       ORAL              TABLET                 TEV        B                           Y      0.2250    0.2250     REGULAR BENEFIT
                                                2
           CEPHALOSPORINS / FIRST
           GENERATION
08120604   CEPHALOSPORINS            00583421       NOVO-LEXIN          Y    CEPHALEXIN                      500 MG       ORAL              TABLET                 TEV        B                           Y      0.4500    0.4500     REGULAR BENEFIT
           CEPHALOSPORINS / FIRST
           GENERATION
08120604   CEPHALOSPORINS            00768715       APO-CEPHALEX        Y    CEPHALEXIN                      500 MG       ORAL              TABLET                 APX        B                           Y      0.4500    0.4500     REGULAR BENEFIT
                                                2
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02303426       SANDOZ CEFPROZIL    Y    CEFPROZIL                       25 MG / ML   ORAL              SUSPENSION             SDZ        W                           Y      0.0618    0.0618     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02293943       APO-CEFPROZIL       Y    CEFPROZIL                       25 MG / ML   ORAL              SUSPENSION             APX        B                           Y      0.0618    0.0618     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02329204       RAN-CEFPROZIL       Y    CEFPROZIL                       25 MG / ML   ORAL              SUSPENSION             RAN        B                           Y      0.0618    0.0618     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02362864       AVA-CEFPROZIL       Y    CEFPROZIL                       25 MG / ML   ORAL              SUSPENSION             AVA        W                           Y      0.0618    0.0618     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02347261       AURO-CEFPROZIL      Y    CEFPROZIL                       25 MG / ML   ORAL              SUSPENSION             AUR        B                           Y      0.0618    0.0618     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02163675       CEFZIL              Y    CEFPROZIL                       25 MG / ML   ORAL              SUSPENSION             BMS        B                           N      0.1765    0.0618     REGULAR BENEFIT
                                                6




                                                                                                              Updated July 1, 2012                                                                                                       Page 2 of 254
                                                                                   Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                (Regular Benefits)


                                                                                                                                                                         DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION       DIN / PIN           PRODUCT NAME   IC               GENERIC NAME         STRENGTH           ROUTE               FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02293951       APO-CEFPROZIL       Y    CEFPROZIL                       50 MG / ML   ORAL              SUSPENSION             APX        B                           Y      0.1234    0.1234     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02293579       RAN-CEFPROZIL       Y    CEFPROZIL                       50 MG / ML   ORAL              SUSPENSION             RAN        B                           Y      0.1234    0.1234     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02362872       AVA-CEFPROZIL       Y    CEFPROZIL                       50 MG / ML   ORAL              SUSPENSION             AVA        W                           Y      0.1234    0.1234     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02347288       AURO-CEFPROZIL      Y    CEFPROZIL                       50 MG / ML   ORAL              SUSPENSION             AUR        B                           Y      0.1234    0.1234     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02303434       SANDOZ CEFPROZIL    Y    CEFPROZIL                       50 MG / ML   ORAL              SUSPENSION             SDZ        W                           Y      0.1234    0.1234     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02332027       CEFPROZIL           Y    CEFPROZIL                       50 MG / ML   ORAL              SUSPENSION             RAN        B                           Y      0.1234    0.1234     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02163683       CEFZIL              Y    CEFPROZIL                       50 MG / ML   ORAL              SUSPENSION             BMS        B                           N      0.3526    0.1234     REGULAR BENEFIT
                                                7
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02293528       RAN-CEFPROZIL       Y    CEFPROZIL                       250 MG       ORAL              TABLET                 RAN        B                           Y      0.6319    0.6319     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02292998       APO-CEFPROZIL       Y    CEFPROZIL                       250 MG       ORAL              TABLET                 APX        B                           Y      0.6319    0.6319     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02362848       AVA-CEFPROZIL       Y    CEFPROZIL                       250 MG       ORAL              TABLET                 AVA        W                           Y      0.6319    0.6319     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02347245       AURO-CEFPROZIL      Y    CEFPROZIL                       250 MG       ORAL              TABLET                 AUR        B                           Y      0.6319    0.6319     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02302179       SANDOZ CEFPROZIL    Y    CEFPROZIL                       250 MG       ORAL              TABLET                 SDZ        W                           Y      0.6319    0.6319     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02332035       CEFPROZIL           Y    CEFPROZIL                       250 MG       ORAL              TABLET                 RAN        B                           Y      0.6319    0.6319     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02163659       CEFZIL              Y    CEFPROZIL                       250 MG       ORAL              TABLET                 BMS        B                           N      1.8054    0.6319     REGULAR BENEFIT
                                                7
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02293536       RAN-CEFPROZIL       Y    CEFPROZIL                       500 MG       ORAL              TABLET                 RAN        B                           Y      1.2389    1.2389     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02362856       AVA-CEFPROZIL       Y    CEFPROZIL                       500 MG       ORAL              TABLET                 AVA        W                           Y      1.2389    1.2389     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02347253       AURO-CEFPROZIL      Y    CEFPROZIL                       500 MG       ORAL              TABLET                 AUR        B                           Y      1.2389    1.2389     REGULAR BENEFIT




                                                                                                              Updated July 1, 2012                                                                                                       Page 3 of 254
                                                                                   Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                (Regular Benefits)


                                                                                                                                                                         DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION      DIN / PIN           PRODUCT NAME   IC               GENERIC NAME         STRENGTH           ROUTE               FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02302187       SANDOZ CEFPROZIL    Y    CEFPROZIL                       500 MG       ORAL              TABLET                 SDZ        W                           Y      1.2389    1.2389     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02332043       CEFPROZIL           Y    CEFPROZIL                       500 MG       ORAL              TABLET                 RAN        B                           Y      1.2389    1.2389     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02293005       APO-CEFPROZIL       Y    CEFPROZIL                       500 MG       ORAL              TABLET                 APX        B                           Y      1.2389    1.2389     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02163667       CEFZIL              Y    CEFPROZIL                       500 MG       ORAL              TABLET                 BMS        B                           N      3.5398    1.2389     REGULAR BENEFIT
                                                7
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02244393       APO-CEFUROXIME      Y    CEFUROXIME AXETIL               250 MG       ORAL              TABLET                 APX        B                           Y      0.7237    0.7237     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02344823       AURO-CEFUROXIME     Y    CEFUROXIME AXETIL               250 MG       ORAL              TABLET                 AUR        W                           Y      0.7237    0.7237     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02242656       RATIO-CEFUROXIME    Y    CEFUROXIME AXETIL               250 MG       ORAL              TABLET                 RPH        B                           Y      0.7237    0.7237     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02212277       CEFTIN              Y    CEFUROXIME AXETIL               250 MG       ORAL              TABLET                 GSK        W            7.50%          N      1.6527    0.7237     REGULAR BENEFIT
                                                4
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02242657       RATIO-CEFUROXIME    Y    CEFUROXIME AXETIL               500 MG       ORAL              TABLET                 RPH        B                           Y      1.4337    1.4337     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02244394       APO-CEFUROXIME      Y    CEFUROXIME AXETIL               500 MG       ORAL              TABLET                 APX        B                           Y      1.4337    1.4337     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02344831       AURO-CEFUROXIME     Y    CEFUROXIME AXETIL               500 MG       ORAL              TABLET                 AUR        B                           Y      1.4337    1.4337     REGULAR BENEFIT
           CEPHALOSPORINS / SECOND
           GENERATION
08120608   CEPHALOSPORINS            02212285       CEFTIN              Y    CEFUROXIME AXETIL               500 MG       ORAL              TABLET                 GSK        W            7.50%          N      3.2740    1.4337     REGULAR BENEFIT
                                                4
           CEPHALOSPORINS / THIRD
           GENERATION
08120612   CEPHALOSPORINS            00868965       SUPRAX              N    CEFIXIME                        20 MG / ML   ORAL              SUSPENSION             SAV        W            7.50%          N      0.4166               REGULAR BENEFIT
                                                1
           CEPHALOSPORINS / THIRD
           GENERATION
08120612   CEPHALOSPORINS            00868981       SUPRAX              N    CEFIXIME                        400 MG       ORAL              TABLET                 SAV        W            7.50%          N      3.5400               REGULAR BENEFIT
                                                1
           CEPHALOSPORINS / THIRD
           GENERATION
08120612   CEPHALOSPORINS            02225085       CLAFORAN            N    CEFOTAXIME SODIUM               500 MG / VIAL INJECTION                               SAV        W            7.50%          N      6.0900               REGULAR BENEFIT
                                                1




                                                                                                              Updated July 1, 2012                                                                                                       Page 4 of 254
                                                                                    Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                 (Regular Benefits)


                                                                                                                                                                          DISTRIBUTION   DISTRIBUTION     LCA                LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION     DIN / PIN             PRODUCT NAME   IC            GENERIC NAME            STRENGTH              ROUTE          FORM            MFG      METHOD       ALLOWANCE     PRODUCT    PRICE       PRICE         STATUS
           CEPHALOSPORINS / THIRD
           GENERATION
08120612   CEPHALOSPORINS           02225093       CLAFORAN              N    CEFOTAXIME SODIUM               1 G / VIAL      INJECTION                             SAV        W            7.50%          N       9.5800                REGULAR BENEFIT
                                               1
           CEPHALOSPORINS / THIRD
           GENERATION
08120612   CEPHALOSPORINS           02225107       CLAFORAN              N    CEFOTAXIME SODIUM               2 G / VIAL      INJECTION                             SAV        W            7.50%          N      19.1800                REGULAR BENEFIT
                                               1
           CEPHALOSPORINS / THIRD
           GENERATION
08120612   CEPHALOSPORINS           02212218       FORTAZ                N    CEFTAZIDIME                     1 G / VIAL      INJECTION                             GSK        W            7.50%          N      22.5880                REGULAR BENEFIT
                                               1
           CEPHALOSPORINS / THIRD
           GENERATION
08120612   CEPHALOSPORINS           02212226       FORTAZ                N    CEFTAZIDIME                     2 G / VIAL      INJECTION                             GSK        W            7.50%          N      44.4110                REGULAR BENEFIT
                                               1
           CEPHALOSPORINS / THIRD
           GENERATION
08120612   CEPHALOSPORINS           02212234       FORTAZ                N    CEFTAZIDIME                     6 G / VIAL      INJECTION                             GSK        W            7.50%          N      133.2967               REGULAR BENEFIT
                                               1
           CEPHALOSPORINS / THIRD
           GENERATION                              CEFTRIAXONE FOR
08120612   CEPHALOSPORINS           02292866       INJECTION USP         N    CEFTRIAXONE SODIUM              0.25 G / VIAL   INJECTION                             APX        B                           N       7.5250                REGULAR BENEFIT
                                               1
           CEPHALOSPORINS / THIRD
           GENERATION                              CEFTRIAXONE FOR
08120612   CEPHALOSPORINS           02292270       INJECTION USP         Y    CEFTRIAXONE SODIUM              1 G / VIAL      INJECTION                             SDZ        W                           Y      23.8000     23.8000    REGULAR BENEFIT
           CEPHALOSPORINS / THIRD
           GENERATION                              CEFTRIAXONE FOR
08120612   CEPHALOSPORINS           02292874       INJECTION USP         Y    CEFTRIAXONE SODIUM              1 G / VIAL      INJECTION                             APX        B                           Y      23.8000     23.8000    REGULAR BENEFIT
                                               2
           CEPHALOSPORINS / THIRD
           GENERATION                              CEFTRIAXONE FOR
08120612   CEPHALOSPORINS           02292882       INJECTION USP         Y    CEFTRIAXONE SODIUM              2 G / VIAL      INJECTION                             APX        B                           Y      29.3125     29.3125    REGULAR BENEFIT
           CEPHALOSPORINS / THIRD
           GENERATION                              CEFTRIAXONE FOR
08120612   CEPHALOSPORINS           02292289       INJECTION USP         Y    CEFTRIAXONE SODIUM              2 G / VIAL      INJECTION                             SDZ        W                           Y      29.3125     29.3125    REGULAR BENEFIT
                                               2
                                                                              CHLORAMPHENICOL SODIUM
081208     CHLORAMPHENICOL /        00312363       CHLOROMYCETIN         N    SUCCINATE                       1 G / VIAL      INJECTION                             ERF        W            7.50%          N      18.4123                REGULAR BENEFIT
                                               1

           MACROLIDES /                                                                                                                      CAPSULE (ENTERIC-
08121204   ERYTHROMYCINS            00726672       ERYTHRO-EC            Y    ERYTHROMYCIN                    250 MG          ORAL           COATED PELLET)         AAP        W                           Y       0.4193     0.4193     REGULAR BENEFIT
           MACROLIDES /                                                                                                                      CAPSULE (ENTERIC-
08121204   ERYTHROMYCINS            00607142       ERYC                  Y    ERYTHROMYCIN                    250 MG          ORAL           COATED PELLET)         PFI        W            7.50%          N       0.4916     0.4193     REGULAR BENEFIT
                                               2

           MACROLIDES /                                                                                                                      CAPSULE (ENTERIC-
08121204   ERYTHROMYCINS            01925938       ERYTHRO-EC            Y    ERYTHROMYCIN                    333 MG          ORAL           COATED PELLET)         AAP        W                           Y       0.4657     0.4657     REGULAR BENEFIT




                                                                                                               Updated July 1, 2012                                                                                                         Page 5 of 254
                                                                                  Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                               (Regular Benefits)


                                                                                                                                                                        DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION   DIN / PIN             PRODUCT NAME    IC            GENERIC NAME            STRENGTH           ROUTE               FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           MACROLIDES /                                                                                                                    CAPSULE (ENTERIC-
08121204   ERYTHROMYCINS         00873454       ERYC                   Y    ERYTHROMYCIN                    333 MG       ORAL              COATED PELLET)         PFI        W            7.50%          N      0.5462    0.4657     REGULAR BENEFIT
                                            2
           MACROLIDES /
08121204   ERYTHROMYCINS         00682020       ERYTHRO-BASE           N    ERYTHROMYCIN                    250 MG       ORAL              TABLET                 AAP        W            7.50%          N      0.1828               REGULAR BENEFIT
                                            1
           MACROLIDES /
08121204   ERYTHROMYCINS         00262595       NOVO-RYTHRO ESTOLATE   N    ERYTHROMYCIN ESTOLATE           50 MG / ML   ORAL              SUSPENSION             TEV        B                           N      0.1270               REGULAR BENEFIT
                                            1
           MACROLIDES /
08121204   ERYTHROMYCINS         00605859       NOVO-RYTHRO EES        N    ERYTHROMYCIN ETHYLSUCCINATE     40 MG / ML   ORAL              SUSPENSION             TEV        B                           N      0.0967               REGULAR BENEFIT
                                            1
           MACROLIDES /
08121204   ERYTHROMYCINS         00652318       NOVO-RYTHRO EES        N    ERYTHROMYCIN ETHYLSUCCINATE     80 MG / ML   ORAL              SUSPENSION             TEV        B                           N      0.1464               REGULAR BENEFIT
                                            1
           MACROLIDES /
08121204   ERYTHROMYCINS         00637416       ERYTHRO-ES             N    ERYTHROMYCIN ETHYLSUCCINATE     600 MG       ORAL              TABLET                 AAP        W            7.50%          N      0.3363               REGULAR BENEFIT
                                            1
           MACROLIDES /
08121204   ERYTHROMYCINS         00545678       ERYTHRO-S              N    ERYTHROMYCIN STEARATE           250 MG       ORAL              TABLET                 AAP        W            7.50%          N      0.2118               REGULAR BENEFIT
                                            1
           MACROLIDES /
08121204   ERYTHROMYCINS         00688568       ERYTHRO-S              N    ERYTHROMYCIN STEARATE           500 MG       ORAL              TABLET                 AAP        W            7.50%          N      0.5425               REGULAR BENEFIT
                                            1
           MACROLIDES / OTHER
08121292   MACROLIDES            02274388       PMS-AZITHROMYCIN       Y    AZITHROMYCIN                    20 MG / ML   ORAL              SUSPENSION             PMS        B                           Y      0.4090    0.4090     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02363372       AVA-AZITHROMYCIN       Y    AZITHROMYCIN                    20 MG / ML   ORAL              SUSPENSION             AVA        W                           Y      0.4090    0.4090     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02315157       NOVO-AZITHROMYCIN      Y    AZITHROMYCIN                    20 MG / ML   ORAL              SUSPENSION             TEV        B                           Y      0.4090    0.4090     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02332388       SANDOZ AZITHROMYCIN    Y    AZITHROMYCIN                    20 MG / ML   ORAL              SUSPENSION             SDZ        W                           Y      0.4090    0.4090     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02223716       ZITHROMAX              Y    AZITHROMYCIN                    20 MG / ML   ORAL              SUSPENSION             PFI        W            7.50%          N      1.0871    0.4090     REGULAR BENEFIT
                                            5
           MACROLIDES / OTHER
08121292   MACROLIDES            02274396       PMS-AZITHROMYCIN       Y    AZITHROMYCIN                    40 MG / ML   ORAL              SUSPENSION             PMS        B                           Y      0.5796    0.5796     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02363380       AVA-AZITHROMYCIN       Y    AZITHROMYCIN                    40 MG / ML   ORAL              SUSPENSION             AVA        W                           Y      0.5796    0.5796     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02315165       NOVO-AZITHROMYCIN      Y    AZITHROMYCIN                    40 MG / ML   ORAL              SUSPENSION             TEV        B                           Y      0.5796    0.5796     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02332396       SANDOZ AZITHROMYCIN    Y    AZITHROMYCIN                    40 MG / ML   ORAL              SUSPENSION             SDZ        W                           Y      0.5796    0.5796     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02223724       ZITHROMAX              Y    AZITHROMYCIN                    40 MG / ML   ORAL              SUSPENSION             PFI        W            7.50%          N      1.5404    0.5796     REGULAR BENEFIT
                                            5
           MACROLIDES / OTHER
08121292   MACROLIDES            02275287       RATIO-AZITHROMYCIN     Y    AZITHROMYCIN                    250 MG       ORAL              TABLET                 RPH        B                           Y      1.8922    1.8922     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02278359       MYLAN-AZITHROMYCIN     Y    AZITHROMYCIN                    250 MG       ORAL              TABLET                 MYP        W                           Y      1.8922    1.8922     REGULAR BENEFIT




                                                                                                             Updated July 1, 2012                                                                                                       Page 6 of 254
                                                                                   Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                (Regular Benefits)


                                                                                                                                                                         DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION   DIN / PIN           PRODUCT NAME       IC            GENERIC NAME            STRENGTH           ROUTE               FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           MACROLIDES / OTHER
08121292   MACROLIDES            02261634       PMS-AZITHROMYCIN        Y    AZITHROMYCIN                    250 MG       ORAL              TABLET                 PMS        B                           Y      1.8922    1.8922     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02265826       SANDOZ AZITHROMYCIN     Y    AZITHROMYCIN                    250 MG       ORAL              TABLET                 SDZ        W                           Y      1.8922    1.8922     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02267845       NOVO-AZITHROMYCIN       Y    AZITHROMYCIN                    250 MG       ORAL              TABLET                 TEV        B                           Y      1.8922    1.8922     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02255340       CO AZITHROMYCIN         Y    AZITHROMYCIN                    250 MG       ORAL              TABLET                 COB        W                           Y      1.8922    1.8922     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02247423       APO-AZITHROMYCIN        Y    AZITHROMYCIN                    250 MG       ORAL              TABLET                 APX        B                           Y      1.8922    1.8922     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02363364       AVA-AZITHROMYCIN        Y    AZITHROMYCIN                    250 MG       ORAL              TABLET                 AVA        W                           Y      1.8922    1.8922     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02274531       GD-AZITHROMYCIN         Y    AZITHROMYCIN                    250 MG       ORAL              TABLET                 GMD        W                           Y      1.8922    1.8922     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02330881       AZITHROMYCIN            Y    AZITHROMYCIN                    250 MG       ORAL              TABLET                 SNS        W                           Y      1.8922    1.8922     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02278588       PHL-AZITHROMYCIN        Y    AZITHROMYCIN                    250 MG       ORAL              TABLET                 PHH        B                           Y      1.8922    1.8922     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02212021       ZITHROMAX               Y    AZITHROMYCIN                    250 MG       ORAL              TABLET                 PFI        W            7.50%          N      5.0290    1.8922     REGULAR BENEFIT
                                        12
           MACROLIDES / OTHER                                                                                                               EXTENDED-RELEASE
08121292   MACROLIDES            02244756       BIAXIN XL               N    CLARITHROMYCIN                  500 MG       ORAL              TABLET                 ABB        B                           N      2.5144               REGULAR BENEFIT
                                            1
           MACROLIDES / OTHER
08121292   MACROLIDES            02146908       BIAXIN                  N    CLARITHROMYCIN                  25 MG / ML   ORAL              SUSPENSION             ABB        B                           N      0.2924               REGULAR BENEFIT
                                            1
           MACROLIDES / OTHER
08121292   MACROLIDES            02244641       BIAXIN                  N    CLARITHROMYCIN                  50 MG / ML   ORAL              SUSPENSION             ABB        B                           N      0.5674               REGULAR BENEFIT
                                            1
           MACROLIDES / OTHER
08121292   MACROLIDES            02266539       SANDOZ CLARITHROMYCIN   Y    CLARITHROMYCIN                  250 MG       ORAL              TABLET                 SDZ        W                           Y      0.5892    0.5892     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02247573       PMS-CLARITHROMYCIN      Y    CLARITHROMYCIN                  250 MG       ORAL              TABLET                 PMS        B                           Y      0.5892    0.5892     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02247818       RATIO-CLARITHROMYCIN    Y    CLARITHROMYCIN                  250 MG       ORAL              TABLET                 RPH        B                           Y      0.5892    0.5892     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02248856       MYLAN-CLARITHROMYCIN    Y    CLARITHROMYCIN                  250 MG       ORAL              TABLET                 MYP        W                           Y      0.5892    0.5892     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            01984853       BIAXIN BID              Y    CLARITHROMYCIN                  250 MG       ORAL              TABLET                 ABB        B                           N      1.6833    0.5892     REGULAR BENEFIT
                                            5
           MACROLIDES / OTHER
08121292   MACROLIDES            02366398       AVA-CLARITHROMYCIN      Y    CLARITHROMYCIN                  500 MG       ORAL              TABLET                 AVA        W                           Y      1.6293    1.6293     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02266547       SANDOZ CLARITHROMYCIN   Y    CLARITHROMYCIN                  500 MG       ORAL              TABLET                 SDZ        W                           Y      1.6293    1.6293     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02247819       RATIO-CLARITHROMYCIN    Y    CLARITHROMYCIN                  500 MG       ORAL              TABLET                 RPH        B                           Y      1.6293    1.6293     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02248857       MYLAN-CLARITHROMYCIN    Y    CLARITHROMYCIN                  500 MG       ORAL              TABLET                 MYP        W                           Y      1.6293    1.6293     REGULAR BENEFIT
           MACROLIDES / OTHER
08121292   MACROLIDES            02247574       PMS-CLARITHROMYCIN      Y    CLARITHROMYCIN                  500 MG       ORAL              TABLET                 PMS        B                           Y      1.6293    1.6293     REGULAR BENEFIT




                                                                                                              Updated July 1, 2012                                                                                                       Page 7 of 254
                                                                                    Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                 (Regular Benefits)


                                                                                                                                                                          DISTRIBUTION   DISTRIBUTION     LCA               LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION    DIN / PIN           PRODUCT NAME     IC             GENERIC NAME            STRENGTH           ROUTE               FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE       PRICE         STATUS
           MACROLIDES / OTHER
08121292   MACROLIDES              02126710       BIAXIN BID            Y    CLARITHROMYCIN                   500 MG       ORAL              TABLET                 ABB        B                           N      3.3271     1.6293     REGULAR BENEFIT
                                              6
           PENICILLINS / NATURAL                                                                              1,000,000 IU /
08121604   PENICILLINS             01930672       PENICILLIN G SODIUM   N    PENICILLIN G SODIUM              VIAL           INJECTION                              TEV        B                           N      2.9003                REGULAR BENEFIT
                                              1
           PENICILLINS / NATURAL                                                                              5,000,000 IU /
08121604   PENICILLINS             00883751       PENICILLIN G SODIUM   N    PENICILLIN G SODIUM              VIAL           INJECTION                              TEV        B                           N      6.1617                REGULAR BENEFIT
                                              1
           PENICILLINS / NATURAL                                                                              10,000,000 IU
08121604   PENICILLINS             01930680       PENICILLIN G SODIUM   N    PENICILLIN G SODIUM              / VIAL        INJECTION                               TEV        B                           N      10.7537               REGULAR BENEFIT
                                              1
           PENICILLINS / NATURAL
08121604   PENICILLINS             00642223       APO-PEN-VK            N    PENICILLIN V POTASSIUM           25 MG / ML   ORAL              LIQUID                 APX        B                           N      0.0535                REGULAR BENEFIT
                                              1
           PENICILLINS / NATURAL
08121604   PENICILLINS             00391603       NOVO-PEN-VK           Y    PENICILLIN V POTASSIUM           60 MG / ML   ORAL              LIQUID                 TEV        B                           Y      0.0472     0.0472     REGULAR BENEFIT
           PENICILLINS / NATURAL
08121604   PENICILLINS             00642231       APO-PEN-VK            Y    PENICILLIN V POTASSIUM           60 MG / ML   ORAL              LIQUID                 APX        B                           N      0.0618     0.0472     REGULAR BENEFIT
                                              2
           PENICILLINS / NATURAL
08121604   PENICILLINS             00642215       APO-PEN-VK            Y    PENICILLIN V POTASSIUM           300 MG       ORAL              TABLET                 APX        B                           Y      0.0710     0.0710     REGULAR BENEFIT
           PENICILLINS / NATURAL
08121604   PENICILLINS             00021202       NOVO-PEN-VK           Y    PENICILLIN V POTASSIUM           300 MG       ORAL              TABLET                 TEV        B                           Y      0.0710     0.0710     REGULAR BENEFIT
                                              2
           PENICILLINS /
08121608   AMINOPENICILLINS        00628115       APO-AMOXI             Y    AMOXICILLIN TRIHYDRATE           250 MG       ORAL              CAPSULE                APX        B                           Y      0.1750     0.1750     REGULAR BENEFIT
           PENICILLINS /
08121608   AMINOPENICILLINS        02230243       PMS-AMOXICILLIN       Y    AMOXICILLIN TRIHYDRATE           250 MG       ORAL              CAPSULE                PMS        B                           Y      0.1750     0.1750     REGULAR BENEFIT
           PENICILLINS /
08121608   AMINOPENICILLINS        02352710       AMOXICILLIN           Y    AMOXICILLIN TRIHYDRATE           250 MG       ORAL              CAPSULE                SNS        W                           Y      0.1750     0.1750     REGULAR BENEFIT
           PENICILLINS /
08121608   AMINOPENICILLINS        02238171       MYLAN-AMOXICILLIN     Y    AMOXICILLIN TRIHYDRATE           250 MG       ORAL              CAPSULE                MYP        W                           Y      0.1750     0.1750     REGULAR BENEFIT
           PENICILLINS /
08121608   AMINOPENICILLINS        00406724       NOVAMOXIN             Y    AMOXICILLIN TRIHYDRATE           250 MG       ORAL              CAPSULE                TEV        B                           Y      0.1750     0.1750     REGULAR BENEFIT
                                              5
           PENICILLINS /
08121608   AMINOPENICILLINS        00628123       APO-AMOXI             Y    AMOXICILLIN TRIHYDRATE           500 MG       ORAL              CAPSULE                APX        B                           Y      0.3417     0.3417     REGULAR BENEFIT
           PENICILLINS /
08121608   AMINOPENICILLINS        02230244       PMS-AMOXICILLIN       Y    AMOXICILLIN TRIHYDRATE           500 MG       ORAL              CAPSULE                PMS        B                           Y      0.3417     0.3417     REGULAR BENEFIT
           PENICILLINS /
08121608   AMINOPENICILLINS        02352729       AMOXICILLIN           Y    AMOXICILLIN TRIHYDRATE           500 MG       ORAL              CAPSULE                SNS        W                           Y      0.3417     0.3417     REGULAR BENEFIT
           PENICILLINS /
08121608   AMINOPENICILLINS        02238172       MYLAN-AMOXICILLIN     Y    AMOXICILLIN TRIHYDRATE           500 MG       ORAL              CAPSULE                MYP        W                           Y      0.3417     0.3417     REGULAR BENEFIT
           PENICILLINS /
08121608   AMINOPENICILLINS        00406716       NOVAMOXIN             Y    AMOXICILLIN TRIHYDRATE           500 MG       ORAL              CAPSULE                TEV        B                           Y      0.3417     0.3417     REGULAR BENEFIT
                                              5
           PENICILLINS /
08121608   AMINOPENICILLINS        02036347       NOVAMOXIN             N    AMOXICILLIN TRIHYDRATE           125 MG       ORAL              CHEWABLE TABLET        TEV        B                           N      0.4505                REGULAR BENEFIT
                                              1




                                                                                                               Updated July 1, 2012                                                                                                        Page 8 of 254
                                                                                  Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                               (Regular Benefits)


                                                                                                                                                                        DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION   DIN / PIN           PRODUCT NAME    IC            GENERIC NAME             STRENGTH             ROUTE           FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           PENICILLINS /
08121608   AMINOPENICILLINS       02036355       NOVAMOXIN            N    AMOXICILLIN TRIHYDRATE           250 MG         ORAL            CHEWABLE TABLET        TEV        B                           N      0.6519               REGULAR BENEFIT
                                             1
           PENICILLINS /                         NOVAMOXIN SUGAR-
08121608   AMINOPENICILLINS       01934171       REDUCED              Y    AMOXICILLIN TRIHYDRATE           25 MG / ML     ORAL            SUSPENSION             TEV        B                           Y      0.0352    0.0352     REGULAR BENEFIT
           PENICILLINS /                         AMOXICILLIN SUGAR-
08121608   AMINOPENICILLINS       02352761       REDUCED              Y    AMOXICILLIN TRIHYDRATE           25 MG / ML     ORAL            SUSPENSION             SNS        W                           Y      0.0352    0.0352     REGULAR BENEFIT
           PENICILLINS /
08121608   AMINOPENICILLINS       02352745       AMOXICILLIN          Y    AMOXICILLIN TRIHYDRATE           25 MG / ML     ORAL            SUSPENSION             SNS        W                           Y      0.0352    0.0352     REGULAR BENEFIT
           PENICILLINS /
08121608   AMINOPENICILLINS       00452149       NOVAMOXIN            Y    AMOXICILLIN TRIHYDRATE           25 MG / ML     ORAL            SUSPENSION             TEV        B                           Y      0.0352    0.0352     REGULAR BENEFIT
           PENICILLINS /
08121608   AMINOPENICILLINS       00628131       APO-AMOXI            Y    AMOXICILLIN TRIHYDRATE           25 MG / ML     ORAL            SUSPENSION             APX        B                           N      0.0353    0.0352     REGULAR BENEFIT
           PENICILLINS /
08121608   AMINOPENICILLINS       02230245       PMS-AMOXICILLIN      Y    AMOXICILLIN TRIHYDRATE           25 MG / ML     ORAL            SUSPENSION             PMS        B                           N      0.0353    0.0352     REGULAR BENEFIT
                                             6
           PENICILLINS /                         NOVAMOXIN SUGAR-
08121608   AMINOPENICILLINS       01934163       REDUCED              Y    AMOXICILLIN TRIHYDRATE           50 MG / ML     ORAL            SUSPENSION             TEV        B                           Y      0.0540    0.0540     REGULAR BENEFIT
           PENICILLINS /
08121608   AMINOPENICILLINS       00628158       APO-AMOXI            Y    AMOXICILLIN TRIHYDRATE           50 MG / ML     ORAL            SUSPENSION             APX        B                           Y      0.0540    0.0540     REGULAR BENEFIT
           PENICILLINS /
08121608   AMINOPENICILLINS       02230246       PMS-AMOXICILLIN      Y    AMOXICILLIN TRIHYDRATE           50 MG / ML     ORAL            SUSPENSION             PMS        B                           Y      0.0540    0.0540     REGULAR BENEFIT
           PENICILLINS /                         AMOXICILLIN SUGAR-
08121608   AMINOPENICILLINS       02352788       REDUCED              Y    AMOXICILLIN TRIHYDRATE           50 MG / ML     ORAL            SUSPENSION             SNS        W                           Y      0.0540    0.0540     REGULAR BENEFIT
           PENICILLINS /
08121608   AMINOPENICILLINS       02352753       AMOXICILLIN          Y    AMOXICILLIN TRIHYDRATE           50 MG / ML     ORAL            SUSPENSION             SNS        W                           Y      0.0540    0.0540     REGULAR BENEFIT
           PENICILLINS /
08121608   AMINOPENICILLINS       00452130       NOVAMOXIN            Y    AMOXICILLIN TRIHYDRATE           50 MG / ML     ORAL            SUSPENSION             TEV        B                           Y      0.0540    0.0540     REGULAR BENEFIT
                                             6

           PENICILLINS /                         RATIO-ACLAVULANATE        AMOXICILLIN TRIHYDRATE/          25 MG / ML *
08121608   AMINOPENICILLINS       02244646       125F                 Y    CLAVULANATE POTASSIUM            6.25 MG / ML ORAL              SUSPENSION             RPH        B                           Y      0.0517    0.0517     REGULAR BENEFIT

           PENICILLINS /                                                   AMOXICILLIN TRIHYDRATE/          25 MG / ML *
08121608   AMINOPENICILLINS       02243986       APO-AMOXI CLAV       Y    CLAVULANATE POTASSIUM            6.25 MG / ML ORAL              SUSPENSION             APX        B                           Y      0.0517    0.0517     REGULAR BENEFIT
           PENICILLINS /                                                   AMOXICILLIN TRIHYDRATE/          25 MG / ML *
08121608   AMINOPENICILLINS       01916882       CLAVULIN-125F        Y    CLAVULANATE POTASSIUM            6.25 MG / ML   ORAL            SUSPENSION             GSK        W            7.50%          N      0.1170    0.0517     REGULAR BENEFIT
                                             3
           PENICILLINS /                                                   AMOXICILLIN TRIHYDRATE/          40 MG / ML *
08121608   AMINOPENICILLINS       02238831       CLAVULIN-200         N    CLAVULANATE POTASSIUM            5.7 MG / ML    ORAL            SUSPENSION             GSK        W            7.50%          N      0.1440               REGULAR BENEFIT
                                             1

           PENICILLINS /                         RATIO-ACLAVULANATE        AMOXICILLIN TRIHYDRATE/          50 MG / ML *
08121608   AMINOPENICILLINS       02244647       250F                 Y    CLAVULANATE POTASSIUM            12.5 MG / ML ORAL              SUSPENSION             RPH        B                           Y      0.0869    0.0869     REGULAR BENEFIT

           PENICILLINS /                                                   AMOXICILLIN TRIHYDRATE/          50 MG / ML *
08121608   AMINOPENICILLINS       02243987       APO-AMOXI CLAV       Y    CLAVULANATE POTASSIUM            12.5 MG / ML ORAL              SUSPENSION             APX        B                           Y      0.0869    0.0869     REGULAR BENEFIT
           PENICILLINS /                                                   AMOXICILLIN TRIHYDRATE/          50 MG / ML *
08121608   AMINOPENICILLINS       01916874       CLAVULIN-250F        Y    CLAVULANATE POTASSIUM            12.5 MG / ML   ORAL            SUSPENSION             GSK        W            7.50%          N      0.2011    0.0869     REGULAR BENEFIT
                                             3




                                                                                                             Updated July 1, 2012                                                                                                       Page 9 of 254
                                                                                        Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                     (Regular Benefits)


                                                                                                                                                                              DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION         DIN / PIN           PRODUCT NAME    IC            GENERIC NAME             STRENGTH             ROUTE             FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           PENICILLINS /                                                         AMOXICILLIN TRIHYDRATE/          80 MG / ML *
08121608   AMINOPENICILLINS            02238830        CLAVULIN-400         N    CLAVULANATE POTASSIUM            11.4 MG / ML   ORAL            SUSPENSION             GSK        W            7.50%          N      0.2753               REGULAR BENEFIT
                                                   1
           PENICILLINS /                                                         AMOXICILLIN TRIHYDRATE/          250 MG * 125
08121608   AMINOPENICILLINS            02243350        APO-AMOXI CLAV       N    CLAVULANATE POTASSIUM            MG           ORAL              TABLET                 APX        B                           N      0.9375               REGULAR BENEFIT
                                                   1
           PENICILLINS /                                                         AMOXICILLIN TRIHYDRATE/          500 MG * 125
08121608   AMINOPENICILLINS            02243771        RATIO-ACLAVULANATE   Y    CLAVULANATE POTASSIUM            MG           ORAL              TABLET                 RPH        B                           Y      0.6673    0.6673     REGULAR BENEFIT
           PENICILLINS /                                                         AMOXICILLIN TRIHYDRATE/          500 MG * 125
08121608   AMINOPENICILLINS            02243351        APO-AMOXI CLAV       Y    CLAVULANATE POTASSIUM            MG           ORAL              TABLET                 APX        B                           N      0.8911    0.6673     REGULAR BENEFIT
           PENICILLINS /                                                         AMOXICILLIN TRIHYDRATE/          500 MG * 125
08121608   AMINOPENICILLINS            01916858        CLAVULIN-500F        Y    CLAVULANATE POTASSIUM            MG           ORAL              TABLET                 GSK        W            7.50%          N      1.4800    0.6673     REGULAR BENEFIT
                                                   3
           PENICILLINS /                                                         AMOXICILLIN TRIHYDRATE/          875 MG * 125
08121608   AMINOPENICILLINS            02247021        RATIO-ACLAVULANATE   Y    CLAVULANATE POTASSIUM            MG           ORAL              TABLET                 RPH        B                           Y      0.8355    0.8355     REGULAR BENEFIT
           PENICILLINS /                                                         AMOXICILLIN TRIHYDRATE/          875 MG * 125
08121608   AMINOPENICILLINS            02245623        APO-AMOXI CLAV       Y    CLAVULANATE POTASSIUM            MG           ORAL              TABLET                 APX        B                           Y      0.8355    0.8355     REGULAR BENEFIT
           PENICILLINS /                                                         AMOXICILLIN TRIHYDRATE/          875 MG * 125
08121608   AMINOPENICILLINS            02248138        NOVO-CLAVAMOXIN      Y    CLAVULANATE POTASSIUM            MG           ORAL              TABLET                 TEV        B                           Y      0.8355    0.8355     REGULAR BENEFIT
           PENICILLINS /                                                         AMOXICILLIN TRIHYDRATE/          875 MG * 125
08121608   AMINOPENICILLINS            02238829        CLAVULIN-875         Y    CLAVULANATE POTASSIUM            MG           ORAL              TABLET                 GSK        W            7.50%          N      2.2205    0.8355     REGULAR BENEFIT
                                                   4
           PENICILLINS /
08121608   AMINOPENICILLINS            00872644        AMPICILLIN SODIUM    N    AMPICILLIN SODIUM                250 MG / VIAL INJECTION                               TEV        B                           N      2.8193               REGULAR BENEFIT
                                                   1
           PENICILLINS /
08121608   AMINOPENICILLINS            00872652        AMPICILLIN SODIUM    N    AMPICILLIN SODIUM                500 MG / VIAL INJECTION                               TEV        B                           N      2.9568               REGULAR BENEFIT
                                                   1
           PENICILLINS /
08121608   AMINOPENICILLINS            01933345        AMPICILLIN SODIUM    N    AMPICILLIN SODIUM                1 G / VIAL     INJECTION                              TEV        B                           N      4.9500               REGULAR BENEFIT
                                                   1
           PENICILLINS /
08121608   AMINOPENICILLINS            01933353        AMPICILLIN SODIUM    N    AMPICILLIN SODIUM                2 G / VIAL     INJECTION                              TEV        B                           N      9.9000               REGULAR BENEFIT
                                                   1
           PENICILLINS / PENICILLINASE-
08121612   RESISTANT PENICILLINS        01912429       CLOXACILLIN SODIUM   N    CLOXACILLIN SODIUM               500 MG / VIAL INJECTION                               TEV        B                           N      5.5097               REGULAR BENEFIT
                                                   1
           PENICILLINS / PENICILLINASE-
08121612   RESISTANT PENICILLINS        01975447       CLOXACILLIN SODIUM   N    CLOXACILLIN SODIUM               1 G / VIAL     INJECTION                              TEV        B                           N      6.7724               REGULAR BENEFIT
                                                   1
           PENICILLINS / PENICILLINASE-
08121612   RESISTANT PENICILLINS        01912410       CLOXACILLIN SODIUM   N    CLOXACILLIN SODIUM               2 G / VIAL     INJECTION                              TEV        B                           N      8.8389               REGULAR BENEFIT
                                                   1
           PENICILLINS / PENICILLINASE-
08121612   RESISTANT PENICILLINS        00337765       NOVO-CLOXIN          N    CLOXACILLIN SODIUM               250 MG         ORAL            CAPSULE                TEV        B                           N      0.3515               REGULAR BENEFIT
                                                   1
           PENICILLINS / PENICILLINASE-
08121612   RESISTANT PENICILLINS        00337773       NOVO-CLOXIN          N    CLOXACILLIN SODIUM               500 MG         ORAL            CAPSULE                TEV        B                           N      0.6646               REGULAR BENEFIT
                                                   1




                                                                                                                   Updated July 1, 2012                                                                                                      Page 10 of 254
                                                                                        Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                     (Regular Benefits)


                                                                                                                                                                              DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION         DIN / PIN          PRODUCT NAME      IC            GENERIC NAME             STRENGTH            ROUTE             FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           PENICILLINS / PENICILLINASE-
08121612   RESISTANT PENICILLINS        00337757       NOVO-CLOXIN           N    CLOXACILLIN SODIUM               25 MG / ML    ORAL            LIQUID                 TEV        B                           N      0.0898               REGULAR BENEFIT
                                                   1

081218     QUINOLONES /                02229524        APO-NORFLOX           Y    NORFLOXACIN                      400 MG        ORAL            TABLET                 APX        B                           Y      0.7628    0.7628     REGULAR BENEFIT

081218     QUINOLONES /                02237682        NOVO-NORFLOXACIN      Y    NORFLOXACIN                      400 MG        ORAL            TABLET                 TEV        B                           Y      0.7628    0.7628     REGULAR BENEFIT

081218     QUINOLONES /                02246596        PMS-NORFLOXACIN       Y    NORFLOXACIN                      400 MG        ORAL            TABLET                 PMS        B                           Y      0.7628    0.7628     REGULAR BENEFIT
                                                   3
                                                                                                                 80 MG / ML *
081220     SULFONAMIDES /              00550086        SEPTRA                N    SULFAMETHOXAZOLE/ TRIMETHOPRIM 16 MG / ML      INJECTION                              TPI        W            7.50%          N      1.3239               REGULAR BENEFIT
                                                   1
                                                                                                                 40 MG / ML * 8
081220     SULFONAMIDES /              00726540        NOVO-TRIMEL           N    SULFAMETHOXAZOLE/ TRIMETHOPRIM MG / ML        ORAL             SUSPENSION             TEV        B                           N      0.0954               REGULAR BENEFIT
                                                   1
                                                                                                                 100 MG * 20
081220     SULFONAMIDES /              00445266        APO-SULFATRIM         N    SULFAMETHOXAZOLE/ TRIMETHOPRIM MG              ORAL            TABLET                 APX        B                           N      0.0911               REGULAR BENEFIT
                                                   1
                                                                                  SULFAMETHOXAZOLE/                400 MG * 80
081220     SULFONAMIDES /              00510637        NOVO-TRIMEL           Y    TRIMETHOPRIM                     MG            ORAL            TABLET                 TEV        B                           Y      0.0482    0.0482     REGULAR BENEFIT
                                                                                  SULFAMETHOXAZOLE/                400 MG * 80
081220     SULFONAMIDES /              00445274        APO-SULFATRIM         Y    TRIMETHOPRIM                     MG            ORAL            TABLET                 APX        B                           Y      0.0482    0.0482     REGULAR BENEFIT
                                                   2
                                                                                  SULFAMETHOXAZOLE/                800 MG * 160
081220     SULFONAMIDES /              00445282        APO-SULFATRIM DS      Y    TRIMETHOPRIM                     MG           ORAL             TABLET                 APX        B                           Y      0.1221    0.1221     REGULAR BENEFIT
                                                                                  SULFAMETHOXAZOLE/                800 MG * 160
081220     SULFONAMIDES /              00510645        NOVO-TRIMEL DS        Y    TRIMETHOPRIM                     MG           ORAL             TABLET                 TEV        B                           Y      0.1221    0.1221     REGULAR BENEFIT
                                                   2
                                                                                                                                                 ENTERIC-COATED
081220     SULFONAMIDES /              00598488        PMS-SULFASALAZINE     Y    SULFASALAZINE                    500 MG        ORAL            TABLET                 PMS        B                           Y      0.3382    0.3382     REGULAR BENEFIT
                                                                                                                                                 ENTERIC-COATED
081220     SULFONAMIDES /              02064472        SALAZOPYRIN EN-TABS   Y    SULFASALAZINE                    500 MG        ORAL            TABLET                 PFI        W            7.50%          N      0.4027    0.3382     REGULAR BENEFIT
                                                   2

081220     SULFONAMIDES /              00598461        PMS-SULFASALAZINE     Y    SULFASALAZINE                    500 MG        ORAL            TABLET                 PMS        B                           Y      0.2221    0.2221     REGULAR BENEFIT

081220     SULFONAMIDES /              02064480        SALAZOPYRIN           Y    SULFASALAZINE                    500 MG        ORAL            TABLET                 PFI        W            7.50%          N      0.2557    0.2221     REGULAR BENEFIT
                                                   2

081224     TETRACYCLINES /             02351234        DOXYCYCLINE           Y    DOXYCYCLINE HYCLATE              100 MG        ORAL            CAPSULE                SNS        W                           Y      0.5860    0.5860     REGULAR BENEFIT

081224     TETRACYCLINES /             00725250        NOVO-DOXYLIN          Y    DOXYCYCLINE HYCLATE              100 MG        ORAL            CAPSULE                TEV        B                           Y      0.5860    0.5860     REGULAR BENEFIT

081224     TETRACYCLINES /             00740713        APO-DOXY              Y    DOXYCYCLINE HYCLATE              100 MG        ORAL            CAPSULE                APX        B                           Y      0.5860    0.5860     REGULAR BENEFIT

081224     TETRACYCLINES /             00024368        VIBRAMYCIN            Y    DOXYCYCLINE HYCLATE              100 MG        ORAL            CAPSULE                PFI        W            7.50%          N      1.7304    0.5860     REGULAR BENEFIT
                                                   4

081224     TETRACYCLINES /             00874256        APO-DOXY              Y    DOXYCYCLINE HYCLATE              100 MG        ORAL            TABLET                 APX        B                           Y      0.5860    0.5860     REGULAR BENEFIT




                                                                                                                    Updated July 1, 2012                                                                                                     Page 11 of 254
                                                                                 Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                              (Regular Benefits)


                                                                                                                                                                       DISTRIBUTION   DISTRIBUTION     LCA               LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION   DIN / PIN          PRODUCT NAME     IC            GENERIC NAME            STRENGTH           ROUTE             FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE       PRICE         STATUS

081224     TETRACYCLINES /        02158574       NOVO-DOXYLIN         Y    DOXYCYCLINE HYCLATE             100 MG       ORAL              TABLET                 TEV        B                           Y      0.5860     0.5860     REGULAR BENEFIT

081224     TETRACYCLINES /        02351242       DOXYCYCLINE          Y    DOXYCYCLINE HYCLATE             100 MG       ORAL              TABLET                 SNS        W                           Y      0.5860     0.5860     REGULAR BENEFIT
                                             3

081224     TETRACYCLINES /        02294419       PMS-MINOCYCLINE      Y    MINOCYCLINE HCL                 50 MG        ORAL              CAPSULE                PMS        B                           Y      0.3344     0.3344     REGULAR BENEFIT

081224     TETRACYCLINES /        02230735       MYLAN-MINOCYCLINE    Y    MINOCYCLINE HCL                 50 MG        ORAL              CAPSULE                MYP        W                           Y      0.3344     0.3344     REGULAR BENEFIT

081224     TETRACYCLINES /        02084090       APO-MINOCYCLINE      Y    MINOCYCLINE HCL                 50 MG        ORAL              CAPSULE                APX        B                           Y      0.3344     0.3344     REGULAR BENEFIT

081224     TETRACYCLINES /        02108143       NOVO-MINOCYCLINE     Y    MINOCYCLINE HCL                 50 MG        ORAL              CAPSULE                TEV        B                           Y      0.3344     0.3344     REGULAR BENEFIT

081224     TETRACYCLINES /        02287226       MINOCYCLINE          Y    MINOCYCLINE HCL                 50 MG        ORAL              CAPSULE                SNS        W                           Y      0.3344     0.3344     REGULAR BENEFIT

081224     TETRACYCLINES /        02237313       SANDOZ MINOCYCLINE   Y    MINOCYCLINE HCL                 50 MG        ORAL              CAPSULE                SDZ        W                           Y      0.3344     0.3344     REGULAR BENEFIT
                                             6

081224     TETRACYCLINES /        02294427       PMS-MINOCYCLINE      Y    MINOCYCLINE HCL                 100 MG       ORAL              CAPSULE                PMS        B                           Y      0.6458     0.6458     REGULAR BENEFIT

081224     TETRACYCLINES /        02230736       MYLAN-MINOCYCLINE    Y    MINOCYCLINE HCL                 100 MG       ORAL              CAPSULE                MYP        W                           Y      0.6458     0.6458     REGULAR BENEFIT

081224     TETRACYCLINES /        02084104       APO-MINOCYCLINE      Y    MINOCYCLINE HCL                 100 MG       ORAL              CAPSULE                APX        B                           Y      0.6458     0.6458     REGULAR BENEFIT

081224     TETRACYCLINES /        02108151       NOVO-MINOCYCLINE     Y    MINOCYCLINE HCL                 100 MG       ORAL              CAPSULE                TEV        B                           Y      0.6458     0.6458     REGULAR BENEFIT

081224     TETRACYCLINES /        02237314       SANDOZ MINOCYCLINE   Y    MINOCYCLINE HCL                 100 MG       ORAL              CAPSULE                SDZ        W                           Y      0.6458     0.6458     REGULAR BENEFIT

081224     TETRACYCLINES /        02287234       MINOCYCLINE          Y    MINOCYCLINE HCL                 100 MG       ORAL              CAPSULE                SNS        W                           Y      0.6458     0.6458     REGULAR BENEFIT
                                             6

081224     TETRACYCLINES /        00580929       TETRACYCLINE         N    TETRACYCLINE HCL                250 MG       ORAL              CAPSULE                AAP        W            7.50%          N      0.0657                REGULAR BENEFIT
                                             1
           MISCELLANEOUS
           ANTIBACTERIALS /
08122816   GLYCOPEPTIDES          02241820       PMS-VANCOMYCIN       Y    VANCOMYCIN HCL                  500 MG / VIAL INJECTION                               PMS        B                           Y      31.0500    31.0500    REGULAR BENEFIT
           MISCELLANEOUS
           ANTIBACTERIALS /
08122816   GLYCOPEPTIDES          02342855       VAL-VANCO            Y    VANCOMYCIN HCL                  500 MG / VIAL INJECTION                               VLP        W                           Y      31.0500    31.0500    REGULAR BENEFIT
                                             2
           MISCELLANEOUS
           ANTIBACTERIALS /
08122816   GLYCOPEPTIDES          02342863       VAL-VANCO            Y    VANCOMYCIN HCL                  1 G / VIAL   INJECTION                                VLP        W                           Y      58.9900    58.9900    REGULAR BENEFIT
           MISCELLANEOUS
           ANTIBACTERIALS /
08122816   GLYCOPEPTIDES          02241821       PMS-VANCOMYCIN       Y    VANCOMYCIN HCL                  1 G / VIAL   INJECTION                                PMS        B                           Y      58.9900    58.9900    REGULAR BENEFIT
                                             2
           MISCELLANEOUS
           ANTIBACTERIALS /
08122820   LINCOMYCINS            02245232       APO-CLINDAMYCIN      Y    CLINDAMYCIN HCL                 150 MG       ORAL              CAPSULE                APX        B                           Y      0.3541     0.3541     REGULAR BENEFIT




                                                                                                            Updated July 1, 2012                                                                                                       Page 12 of 254
                                                                                        Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                     (Regular Benefits)


                                                                                                                                                                              DISTRIBUTION   DISTRIBUTION     LCA               LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION   DIN / PIN           PRODUCT NAME           IC            GENERIC NAME            STRENGTH            ROUTE              FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE       PRICE         STATUS
           MISCELLANEOUS
           ANTIBACTERIALS /
08122820   LINCOMYCINS            02258331       MYLAN-CLINDAMYCIN           Y    CLINDAMYCIN HCL                 150 MG        ORAL             CAPSULE                MYP        W                           Y      0.3541     0.3541     REGULAR BENEFIT
           MISCELLANEOUS
           ANTIBACTERIALS /
08122820   LINCOMYCINS            02241709       TEVA-CLINDAMYCIN            Y    CLINDAMYCIN HCL                 150 MG        ORAL             CAPSULE                TEV        B                           Y      0.3541     0.3541     REGULAR BENEFIT
           MISCELLANEOUS
           ANTIBACTERIALS /
08122820   LINCOMYCINS            02364719       AVA-CLINDAMYCIN             Y    CLINDAMYCIN HCL                 150 MG        ORAL             CAPSULE                AVA        W                           Y      0.3541     0.3541     REGULAR BENEFIT
           MISCELLANEOUS
           ANTIBACTERIALS /
08122820   LINCOMYCINS            00030570       DALACIN C                   Y    CLINDAMYCIN HCL                 150 MG        ORAL             CAPSULE                PFI        W            7.50%          N      0.9412     0.3541     REGULAR BENEFIT
                                             5
           MISCELLANEOUS
           ANTIBACTERIALS /
08122820   LINCOMYCINS            02245233       APO-CLINDAMYCIN             Y    CLINDAMYCIN HCL                 300 MG        ORAL             CAPSULE                APX        B                           Y      0.7082     0.7082     REGULAR BENEFIT
           MISCELLANEOUS
           ANTIBACTERIALS /
08122820   LINCOMYCINS            02241710       TEVA-CLINDAMYCIN            Y    CLINDAMYCIN HCL                 300 MG        ORAL             CAPSULE                TEV        B                           Y      0.7082     0.7082     REGULAR BENEFIT
           MISCELLANEOUS
           ANTIBACTERIALS /
08122820   LINCOMYCINS            02258358       MYLAN-CLINDAMYCIN           Y    CLINDAMYCIN HCL                 300 MG        ORAL             CAPSULE                MYP        W                           Y      0.7082     0.7082     REGULAR BENEFIT
           MISCELLANEOUS
           ANTIBACTERIALS /
08122820   LINCOMYCINS            02364727       AVA-CLINDAMYCIN             Y    CLINDAMYCIN HCL                 300 MG        ORAL             CAPSULE                AVA        W                           Y      0.7082     0.7082     REGULAR BENEFIT
           MISCELLANEOUS
           ANTIBACTERIALS /
08122820   LINCOMYCINS            02182866       DALACIN C                   Y    CLINDAMYCIN HCL                 300 MG        ORAL             CAPSULE                PFI        W            7.50%          N      1.8823     0.7082     REGULAR BENEFIT
                                             5
           MISCELLANEOUS
           ANTIBACTERIALS /
08122820   LINCOMYCINS            00225851       DALACIN C PALMITATE         N    CLINDAMYCIN PALMITATE HCL       15 MG / ML    ORAL             SOLUTION               PFI        W            7.50%          N      0.1243                REGULAR BENEFIT
                                             1
           MISCELLANEOUS
           ANTIBACTERIALS /
08122820   LINCOMYCINS            02230535       CLINDAMYCIN (60 & 120 ML)   Y    CLINDAMYCIN PHOSPHATE           150 MG / ML   INJECTION                               SDZ        W                           N      3.3250     0.0000     REGULAR BENEFIT
           MISCELLANEOUS
           ANTIBACTERIALS /
08122820   LINCOMYCINS            02230540       CLINDAMYCIN                 Y    CLINDAMYCIN PHOSPHATE           150 MG / ML   INJECTION                               SDZ        W                           N      3.3250     0.0000     REGULAR BENEFIT
           MISCELLANEOUS
           ANTIBACTERIALS /
08122820   LINCOMYCINS            00260436       DALACIN C PHOSPHATE         Y    CLINDAMYCIN PHOSPHATE           150 MG / ML   INJECTION                               PFI        W            7.50%          N      4.0994     0.0000     REGULAR BENEFIT
                                             3
           MISCELLANEOUS
           ANTIBACTERIALS /                      COLISTIMETHATE FOR
08122828   POLYMYXINS             02244849       INJECTION                   N    COLISTIMETHATE SODIUM           150 MG / VIAL INJECTION                               STM        W            7.50%          N      32.9446               REGULAR BENEFIT
                                             1

081404     ALLYLAMINES /          02262177       SANDOZ TERBINAFINE          Y    TERBINAFINE HCL                 250 MG        ORAL             TABLET                 SDZ        W                           Y      1.8525     1.8525     REGULAR BENEFIT

081404     ALLYLAMINES /          02240346       NOVO-TERBINAFINE            Y    TERBINAFINE HCL                 250 MG        ORAL             TABLET                 TEV        B                           N      1.8526     1.8525     REGULAR BENEFIT




                                                                                                                   Updated July 1, 2012                                                                                                       Page 13 of 254
                                                                              Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                           (Regular Benefits)


                                                                                                                                                                    DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION   DIN / PIN           PRODUCT NAME   IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

081404   ALLYLAMINES /          02239893       APO-TERBINAFINE     Y    TERBINAFINE HCL                 250 MG      ORAL               TABLET                 APX        B                           N      1.8527    1.8525     REGULAR BENEFIT

081404   ALLYLAMINES /          02254727       CO TERBINAFINE      Y    TERBINAFINE HCL                 250 MG      ORAL               TABLET                 COB        W                           N      1.8527    1.8525     REGULAR BENEFIT

081404   ALLYLAMINES /          02320134       AURO-TERBINAFINE    Y    TERBINAFINE HCL                 250 MG      ORAL               TABLET                 AUR        B                           N      1.8527    1.8525     REGULAR BENEFIT

081404   ALLYLAMINES /          02353121       TERBINAFINE         Y    TERBINAFINE HCL                 250 MG      ORAL               TABLET                 SNS        W                           N      1.8527    1.8525     REGULAR BENEFIT

081404   ALLYLAMINES /          02294273       PMS-TERBINAFINE     Y    TERBINAFINE HCL                 250 MG      ORAL               TABLET                 PMS        B                           N      1.8527    1.8525     REGULAR BENEFIT

081404   ALLYLAMINES /          02242503       MYLAN-TERBINAFINE   Y    TERBINAFINE HCL                 250 MG      ORAL               TABLET                 MYP        W                           N      1.8527    1.8525     REGULAR BENEFIT

081404   ALLYLAMINES /          02240807       PMS-TERBINAFINE     Y    TERBINAFINE HCL                 250 MG      ORAL               TABLET                 PMS        B                           N      1.8527    1.8525     REGULAR BENEFIT

081404   ALLYLAMINES /          02031116       LAMISIL             Y    TERBINAFINE HCL                 250 MG      ORAL               TABLET                 NOV        W            7.50%          N      4.1300    1.8525     REGULAR BENEFIT
                                       10

081408   AZOLES /               02247749       FLUCONAZOLE OMEGA   Y    FLUCONAZOLE                     2 MG / ML   INJECTION                                 OMG        W                           Y      0.3187    0.3187     REGULAR BENEFIT

081408   AZOLES /               02247922       FLUCONAZOLE         Y    FLUCONAZOLE                     2 MG / ML   INJECTION                                 TEV        B                           Y      0.3187    0.3187     REGULAR BENEFIT

081408   AZOLES /               00891835       DIFLUCAN            Y    FLUCONAZOLE                     2 MG / ML   INJECTION                                 PFI        W            7.50%          N      0.5014    0.3187     REGULAR BENEFIT
                                           3

081408   AZOLES /               02237370       APO-FLUCONAZOLE     Y    FLUCONAZOLE                     50 MG       ORAL               TABLET                 APX        B                           Y      1.8241    1.8241     REGULAR BENEFIT

081408   AZOLES /               02281260       CO FLUCONAZOLE      Y    FLUCONAZOLE                     50 MG       ORAL               TABLET                 COB        W                           Y      1.8241    1.8241     REGULAR BENEFIT

081408   AZOLES /               02245643       PMS-FLUCONAZOLE     Y    FLUCONAZOLE                     50 MG       ORAL               TABLET                 PMS        B                           Y      1.8241    1.8241     REGULAR BENEFIT

081408   AZOLES /               02245292       MYLAN-FLUCONAZOLE   Y    FLUCONAZOLE                     50 MG       ORAL               TABLET                 MYP        W                           Y      1.8241    1.8241     REGULAR BENEFIT

081408   AZOLES /               02236978       NOVO-FLUCONAZOLE    Y    FLUCONAZOLE                     50 MG       ORAL               TABLET                 TEV        B                           Y      1.8241    1.8241     REGULAR BENEFIT
                                           5

081408   AZOLES /               02237371       APO-FLUCONAZOLE     Y    FLUCONAZOLE                     100 MG      ORAL               TABLET                 APX        B                           Y      3.2354    3.2354     REGULAR BENEFIT

081408   AZOLES /               02245644       PMS-FLUCONAZOLE     Y    FLUCONAZOLE                     100 MG      ORAL               TABLET                 PMS        B                           Y      3.2354    3.2354     REGULAR BENEFIT

081408   AZOLES /               02281279       CO FLUCONAZOLE      Y    FLUCONAZOLE                     100 MG      ORAL               TABLET                 COB        W                           Y      3.2354    3.2354     REGULAR BENEFIT

081408   AZOLES /               02236979       NOVO-FLUCONAZOLE    Y    FLUCONAZOLE                     100 MG      ORAL               TABLET                 TEV        B                           Y      3.2354    3.2354     REGULAR BENEFIT

081408   AZOLES /               02245293       MYLAN-FLUCONAZOLE   Y    FLUCONAZOLE                     100 MG      ORAL               TABLET                 MYP        W                           Y      3.2354    3.2354     REGULAR BENEFIT
                                           5

081408   AZOLES /               02047454       SPORANOX            N    ITRACONAZOLE                    100 MG      ORAL               CAPSULE                JAI        W            7.50%          N      4.1109               REGULAR BENEFIT
                                           1

081408   AZOLES /               02237235       APO-KETOCONAZOLE    Y    KETOCONAZOLE                    200 MG      ORAL               TABLET                 APX        B                           Y      0.9393    0.9393     REGULAR BENEFIT




                                                                                                         Updated July 1, 2012                                                                                                      Page 14 of 254
                                                                              Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                           (Regular Benefits)


                                                                                                                                                                    DISTRIBUTION   DISTRIBUTION     LCA               LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION   DIN / PIN          PRODUCT NAME    IC              GENERIC NAME          STRENGTH             ROUTE             FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE       PRICE         STATUS

081408   AZOLES /               02231061       NOVO-KETOCONAZOLE   Y    KETOCONAZOLE                    200 MG         ORAL            TABLET                 TEV        B                           Y      0.9393     0.9393     REGULAR BENEFIT
                                           2

081428   POLYENES /             00029149       FUNGIZONE IV        N    AMPHOTERICIN B                  50 MG / VIAL   INJECTION                              BMS        B                           N      72.4931               REGULAR BENEFIT
                                           1
                                                                                                        100,000 UNIT
081428   POLYENES /             02194201       RATIO-NYSTATIN      Y    NYSTATIN                        / ML         ORAL              SUSPENSION             RPH        B                           Y      0.0520     0.0520     REGULAR BENEFIT
                                                                                                        100,000 UNIT
081428   POLYENES /             00792667       PMS-NYSTATIN        Y    NYSTATIN                        / ML         ORAL              SUSPENSION             PMS        B                           Y      0.0520     0.0520     REGULAR BENEFIT
                                           2

081428   POLYENES /             02194198       RATIO-NYSTATIN      N    NYSTATIN                        500,000 UNIT ORAL              TABLET                 RPH        B                           N      0.2594                REGULAR BENEFIT
                                           1
         MISCELLANEOUS
081692   ANTIMYCOBACTERIALS /   02041510       DAPSONE             N    DAPSONE                         100 MG         ORAL            TABLET                 NTI        W            7.50%          N      1.3400                REGULAR BENEFIT
                                           1
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          00886157       ZOVIRAX             N    ACYCLOVIR                       40 MG / ML     ORAL            SUSPENSION             GSK        W            7.50%          N      0.2557                REGULAR BENEFIT
                                           1
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          02286556       ACYCLOVIR           Y    ACYCLOVIR                       200 MG         ORAL            TABLET                 SNS        W                           Y      0.6397     0.6397     REGULAR BENEFIT
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          02242784       MYLAN-ACYCLOVIR     Y    ACYCLOVIR                       200 MG         ORAL            TABLET                 MYP        W                           Y      0.6397     0.6397     REGULAR BENEFIT
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          02078627       RATIO-ACYCLOVIR     Y    ACYCLOVIR                       200 MG         ORAL            TABLET                 RPH        B                           Y      0.6397     0.6397     REGULAR BENEFIT
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          02285959       NOVO-ACYCLOVIR      Y    ACYCLOVIR                       200 MG         ORAL            TABLET                 TEV        B                           Y      0.6397     0.6397     REGULAR BENEFIT
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          02207621       APO-ACYCLOVIR       Y    ACYCLOVIR                       200 MG         ORAL            TABLET                 APX        B                           Y      0.6397     0.6397     REGULAR BENEFIT
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          00634506       ZOVIRAX             Y    ACYCLOVIR                       200 MG         ORAL            TABLET                 GSK        W            7.50%          N      1.3063     0.6397     REGULAR BENEFIT
                                           6
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          02286564       ACYCLOVIR           Y    ACYCLOVIR                       400 MG         ORAL            TABLET                 SNS        W                           Y      1.2700     1.2700     REGULAR BENEFIT
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          02242463       MYLAN-ACYCLOVIR     Y    ACYCLOVIR                       400 MG         ORAL            TABLET                 MYP        W                           Y      1.2700     1.2700     REGULAR BENEFIT
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          02078635       RATIO-ACYCLOVIR     Y    ACYCLOVIR                       400 MG         ORAL            TABLET                 RPH        B                           Y      1.2700     1.2700     REGULAR BENEFIT
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          02285967       NOVO-ACYCLOVIR      Y    ACYCLOVIR                       400 MG         ORAL            TABLET                 TEV        B                           Y      1.2700     1.2700     REGULAR BENEFIT
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          02207648       APO-ACYCLOVIR       Y    ACYCLOVIR                       400 MG         ORAL            TABLET                 APX        B                           Y      1.2700     1.2700     REGULAR BENEFIT
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          01911627       ZOVIRAX             Y    ACYCLOVIR                       400 MG         ORAL            TABLET                 GSK        W            7.50%          N      2.6320     1.2700     REGULAR BENEFIT
                                           6
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          02286572       ACYCLOVIR           Y    ACYCLOVIR                       800 MG         ORAL            TABLET                 SNS        W                           Y      1.7848     1.7848     REGULAR BENEFIT
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          02242464       MYLAN-ACYCLOVIR     Y    ACYCLOVIR                       800 MG         ORAL            TABLET                 MYP        W                           Y      1.7848     1.7848     REGULAR BENEFIT




                                                                                                         Updated July 1, 2012                                                                                                       Page 15 of 254
                                                                                 Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                              (Regular Benefits)


                                                                                                                                                                       DISTRIBUTION   DISTRIBUTION     LCA               LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION   DIN / PIN           PRODUCT NAME      IC            GENERIC NAME            STRENGTH           ROUTE               FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE       PRICE         STATUS
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          02078651       RATIO-ACYCLOVIR        Y    ACYCLOVIR                       800 MG       ORAL              TABLET                 RPH        B                           Y      1.7848     1.7848     REGULAR BENEFIT
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          02285975       NOVO-ACYCLOVIR         Y    ACYCLOVIR                       800 MG       ORAL              TABLET                 TEV        B                           Y      1.7848     1.7848     REGULAR BENEFIT
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          02207656       APO-ACYCLOVIR          Y    ACYCLOVIR                       800 MG       ORAL              TABLET                 APX        B                           Y      1.7848     1.7848     REGULAR BENEFIT
                                           5
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          02162695       CYTOVENE               N    GANCICLOVIR SODIUM              500 MG / VIAL INJECTION                               HLR        W            7.50%          N      42.0380               REGULAR BENEFIT
                                           1
         NUCLEOSIDES AND                       MYLAN-VALACYCLOVIR
081832   NUCLEOTIDES /          02351579       (CAPLET)               Y    VALACYCLOVIR                    500 MG       ORAL              TABLET                 MYP        W                           Y      1.2765     1.2765     REGULAR BENEFIT
         NUCLEOSIDES AND                       PMS-VALACYCLOVIR
081832   NUCLEOTIDES /          02298457       (CAPLET)               Y    VALACYCLOVIR                    500 MG       ORAL              TABLET                 PMS        B                           Y      1.2765     1.2765     REGULAR BENEFIT
         NUCLEOSIDES AND                       APO-VALACYCLOVIR
081832   NUCLEOTIDES /          02295822       (CAPLET)               Y    VALACYCLOVIR                    500 MG       ORAL              TABLET                 APX        B                           Y      1.2765     1.2765     REGULAR BENEFIT
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          02331748       CO VALACYCLOVIR        Y    VALACYCLOVIR                    500 MG       ORAL              TABLET                 COB        W                           Y      1.2765     1.2765     REGULAR BENEFIT
         NUCLEOSIDES AND
081832   NUCLEOTIDES /          02219492       VALTREX (CAPLET)       Y    VALACYCLOVIR                    500 MG       ORAL              TABLET                 GSK        W            7.50%          N      3.3927     1.2765     REGULAR BENEFIT
                                           5
         NUCLEOSIDES AND                       APO-VALACYCLOVIR
081832   NUCLEOTIDES /          02354705       (CAPLET)               N    VALACYCLOVIR                    1,000 MG     ORAL              TABLET                 APX        B                           N      3.0531                REGULAR BENEFIT
                                           1

083004   AMEBICIDES /           01997769       DIODOQUIN              N    IODOQUINOL                      210 MG       ORAL              TABLET                 GLE        W            7.50%          N      0.6488                REGULAR BENEFIT
                                           1

083004   AMEBICIDES /           01997750       DIODOQUIN              N    IODOQUINOL                      650 MG       ORAL              TABLET                 GLE        W            7.50%          N      0.8051                REGULAR BENEFIT
                                           1

083008   ANTIMALARIALS /        00021261       NOVO-CHLOROQUINE       N    CHLOROQUINE PHOSPHATE           250 MG       ORAL              TABLET                 TEV        B                           N      0.4020                REGULAR BENEFIT
                                           1

083008   ANTIMALARIALS /        02246691       APO-HYDROXYQUINE       Y    HYDROXYCHLOROQUINE SULFATE      200 MG       ORAL              TABLET                 APX        B                           Y      0.2620     0.2620     REGULAR BENEFIT
                                               MYLAN-
083008   ANTIMALARIALS /        02252600       HYDROXYCHLOROQUINE     Y    HYDROXYCHLOROQUINE SULFATE      200 MG       ORAL              TABLET                 MYP        W                           Y      0.2620     0.2620     REGULAR BENEFIT

083008   ANTIMALARIALS /        02017709       PLAQUENIL SULFATE      Y    HYDROXYCHLOROQUINE SULFATE      200 MG       ORAL              TABLET                 SAV        W            7.50%          N      0.6154     0.2620     REGULAR BENEFIT
                                           3

083008   ANTIMALARIALS /        02017776       PRIMAQUINE PHOSPHATE   N    PRIMAQUINE PHOSPHATE            15 MG        ORAL              TABLET                 SAV        W            7.50%          N      0.3988                REGULAR BENEFIT
                                           1

083008   ANTIMALARIALS /        00004774       DARAPRIM               N    PYRIMETHAMINE                   25 MG        ORAL              TABLET                 COR        W            7.50%          N      1.3770                REGULAR BENEFIT
                                           1

083008   ANTIMALARIALS /        02254514       APO-QUININE            Y    QUININE SULFATE                 200 MG       ORAL              CAPSULE                APX        B                           Y      0.2390     0.2390     REGULAR BENEFIT

083008   ANTIMALARIALS /        00021008       NOVO-QUININE           Y    QUININE SULFATE                 200 MG       ORAL              CAPSULE                TEV        B                           Y      0.2390     0.2390     REGULAR BENEFIT




                                                                                                            Updated July 1, 2012                                                                                                       Page 16 of 254
                                                                                    Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                 (Regular Benefits)


                                                                                                                                                                          DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION        DIN / PIN          PRODUCT NAME     IC            GENERIC NAME            STRENGTH            ROUTE              FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                                2

083008   ANTIMALARIALS /             02254522       APO-QUININE          Y    QUININE SULFATE                 300 MG        ORAL             CAPSULE                APX        B                           Y      0.2888    0.2888     REGULAR BENEFIT

083008   ANTIMALARIALS /             00021016       NOVO-QUININE         Y    QUININE SULFATE                 300 MG        ORAL             CAPSULE                TEV        B                           N      0.3750    0.2888     REGULAR BENEFIT
                                                2
         MISCELLANEOUS
083092   ANTIPROTOZOALS /            02217422       MEPRON               N    ATOVAQUONE                      150 MG / ML   ORAL             SUSPENSION             GSK        W            7.50%          N      2.6162               REGULAR BENEFIT
                                                1
         MISCELLANEOUS
083092   ANTIPROTOZOALS /            00649074       METRONIDAZOLE        N    METRONIDAZOLE                   5 MG / ML     INJECTION                               HSP        W            7.50%          N      0.1739    0.1869     REGULAR BENEFIT
                                                1
         MISCELLANEOUS
083092   ANTIPROTOZOALS /            00545066       METRONIDAZOLE        N    METRONIDAZOLE                   250 MG        ORAL             TABLET                 AAP        W            7.50%          N      0.0595               REGULAR BENEFIT
                                                1

                                                                                                                                             CAPSULE
083600   URINARY ANTI-INFECTIVES /   02231015       NOVO-FURANTOIN       N    NITROFURANTOIN                  50 MG         ORAL             (MACROCRYSTALS)        TEV        B                           N      0.3984               REGULAR BENEFIT
                                                1

                                                                                                                                             CAPSULE
083600   URINARY ANTI-INFECTIVES /   02231016       NOVO-FURANTOIN       N    NITROFURANTOIN                  100 MG        ORAL             (MACROCRYSTALS)        TEV        B                           N      0.7638               REGULAR BENEFIT
                                                1
                                                                                                                                             CAPSULE
                                                                                                                                             (MACROCRYSTALS/M
083600   URINARY ANTI-INFECTIVES /   02063662       MACROBID             N    NITROFURANTOIN                  100 MG        ORAL             ONOHYDRATE)      WCC              W            7.50%          N      0.7230               REGULAR BENEFIT
                                                1

083600   URINARY ANTI-INFECTIVES /   00319511       NITROFURANTOIN       N    NITROFURANTOIN                  50 MG         ORAL             TABLET                 AAP        W            7.50%          N      0.1670               REGULAR BENEFIT
                                                1

083600   URINARY ANTI-INFECTIVES /   00312738       NITROFURANTOIN       N    NITROFURANTOIN                  100 MG        ORAL             TABLET                 AAP        W            7.50%          N      0.2227               REGULAR BENEFIT
                                                1

083600   URINARY ANTI-INFECTIVES /   02243116       TRIMETHOPRIM         N    TRIMETHOPRIM                    100 MG        ORAL             TABLET                 AAP        W            7.50%          N      0.2566               REGULAR BENEFIT
                                                1

083600   URINARY ANTI-INFECTIVES /   02243117       TRIMETHOPRIM         N    TRIMETHOPRIM                    200 MG        ORAL             TABLET                 AAP        W            7.50%          N      0.5273               REGULAR BENEFIT
                                                1

100000   ANTINEOPLASTIC AGENTS /     02170698       METHOTREXATE         Y    METHOTREXATE                    2.5 MG        ORAL             TABLET                 WAY        W            7.50%          Y      0.6325    0.6325     REGULAR BENEFIT
                                                    RATIO-METHOTREXATE
100000   ANTINEOPLASTIC AGENTS /     02244798       SODIUM               Y    METHOTREXATE                    2.5 MG        ORAL             TABLET                 RPH        B                           Y      0.6325    0.6325     REGULAR BENEFIT

100000   ANTINEOPLASTIC AGENTS /     02182963       APO-METHOTREXATE     Y    METHOTREXATE                    2.5 MG        ORAL             TABLET                 APX        B                           Y      0.6325    0.6325     REGULAR BENEFIT
                                                3

100000   ANTINEOPLASTIC AGENTS /     02182750       METHOTREXATE         N    METHOTREXATE                    10 MG         ORAL             TABLET                 HSP        W            7.50%          N      2.5018               REGULAR BENEFIT




                                                                                                               Updated July 1, 2012                                                                                                      Page 17 of 254
                                                                                   Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                (Regular Benefits)


                                                                                                                                                                         DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION      DIN / PIN          PRODUCT NAME      IC            GENERIC NAME            STRENGTH             ROUTE             FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                              1
                                                  METHOTREXATE SOD.
100000   ANTINEOPLASTIC AGENTS /   02182777       (PRESERVED)           N    METHOTREXATE SODIUM             25 MG / ML     INJECTION                              HSP        W            7.50%          N      8.3719               REGULAR BENEFIT
                                              1
                                                  METHOTREXATE
100000   ANTINEOPLASTIC AGENTS /   02099705       SOD.(UNPRESERVED)     Y    METHOTREXATE SODIUM             25 MG / ML     INJECTION                              TEV        B                           Y      4.3574    4.3574     REGULAR BENEFIT
                                                  METHOTREXATE
100000   ANTINEOPLASTIC AGENTS /   02182955       SOD.(UNPRESERVED)     Y    METHOTREXATE SODIUM             25 MG / ML     INJECTION                              HSP        W                           N      6.0100    4.3574     REGULAR BENEFIT
                                              2
         PARASYMPATHOMIMETIC
120400   (CHOLINERGIC) AGENTS /    00869945       PROSTIGMIN            N    NEOSTIGMINE BROMIDE             15 MG          ORAL            TABLET                 VCL        W            7.50%          N      0.4562               REGULAR BENEFIT
                                              1
         PARASYMPATHOMIMETIC
120400   (CHOLINERGIC) AGENTS /    02216345       SALAGEN               N    PILOCARPINE HCL                 5 MG           ORAL            TABLET                 PFI        W            7.50%          N      1.1150               REGULAR BENEFIT
                                              1
         PARASYMPATHOMIMETIC                                                                                                                SUSTAINED-
120400   (CHOLINERGIC) AGENTS /    00869953       MESTINON-SR           N    PYRIDOSTIGMINE BROMIDE          180 MG         ORAL            RELEASE TABLET         VCL        W            7.50%          N      0.9807               REGULAR BENEFIT
                                              1
         PARASYMPATHOMIMETIC
120400   (CHOLINERGIC) AGENTS /    00869961       MESTINON              N    PYRIDOSTIGMINE BROMIDE          60 MG          ORAL            TABLET                 VCL        W            7.50%          N      0.4484               REGULAR BENEFIT
                                              1
         ANTIMUSCARINICS /
120808   ANTISPASMODICS /          00392782       ATROPINE SULFATE      N    ATROPINE SULFATE                0.4 MG / ML    INJECTION                              SDZ        W            7.50%          N      1.7023               REGULAR BENEFIT
                                              1
         ANTIMUSCARINICS /
120808   ANTISPASMODICS /          00392693       ATROPINE SULFATE      N    ATROPINE SULFATE                0.6 MG / ML    INJECTION                              SDZ        W            7.50%          N      1.8512               REGULAR BENEFIT
                                              1
         ANTIMUSCARINICS /                                                   BELLADONNA/ ERGOTAMINE          0.2 MG * 0.6                   SUSTAINED-
120808   ANTISPASMODICS /          00176141       BELLERGAL SPACETABS   N    TARTRATE/ PHENOBARBITAL         MG * 40 MG     ORAL            RELEASE TABLET         TPI        W            7.50%          N      1.2848               REGULAR BENEFIT
                                              1
         ANTIMUSCARINICS /                        DICYCLOMINE
120808   ANTISPASMODICS /          00392812       HYDROCHLORIDE         N    DICYCLOMINE HCL                 10 MG / ML     INJECTION                              SDZ        W            7.50%          N      3.3395               REGULAR BENEFIT
                                              1
         ANTIMUSCARINICS /
120808   ANTISPASMODICS /          02102978       BENTYLOL              N    DICYCLOMINE HCL                 2 MG / ML      ORAL            SYRUP                  AXC        W            7.50%          N      0.0626               REGULAR BENEFIT
                                              1
         ANTIMUSCARINICS /
120808   ANTISPASMODICS /          02103087       BENTYLOL              N    DICYCLOMINE HCL                 10 MG          ORAL            TABLET                 AXC        W            7.50%          N      0.1169               REGULAR BENEFIT
                                              1
         ANTIMUSCARINICS /
120808   ANTISPASMODICS /          02103095       BENTYLOL              N    DICYCLOMINE HCL                 20 MG          ORAL            TABLET                 AXC        W            7.50%          N      0.2207               REGULAR BENEFIT
                                              1
         ANTIMUSCARINICS /
120808   ANTISPASMODICS /          02039508       GLYCOPYRROLATE        N    GLYCOPYRROLATE                  0.2 MG / ML    INJECTION                              SDZ        W            7.50%          N      3.4419               REGULAR BENEFIT
                                              1
         ANTIMUSCARINICS /
120808   ANTISPASMODICS /          00363839       BUSCOPAN              N    HYOSCINE BUTYLBROMIDE           20 MG / ML     INJECTION                              BOE        B                           N      4.3860               REGULAR BENEFIT
                                              1




                                                                                                              Updated July 1, 2012                                                                                                      Page 18 of 254
                                                                                       Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                    (Regular Benefits)


                                                                                                                                                                             DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION      DIN / PIN          PRODUCT NAME       IC            GENERIC NAME             STRENGTH            ROUTE              FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           ANTIMUSCARINICS /
120808     ANTISPASMODICS /         00363812       BUSCOPAN                N    HYOSCINE BUTYLBROMIDE            10 MG        ORAL              TABLET                 BOE        B                           N      0.3222               REGULAR BENEFIT
                                               1
           ANTIMUSCARINICS /                                                                                     20 MCG /                       METERED DOSE
120808     ANTISPASMODICS /         02247686       ATROVENT HFA            N    IPRATROPIUM BROMIDE              DOSE                           AEROSOL                BOE        B                           N      0.0946               REGULAR BENEFIT
                                               1
           ANTIMUSCARINICS /
120808     ANTISPASMODICS /         02126222       APO-IPRAVENT            Y    IPRATROPIUM BROMIDE              250 MCG / ML INHALATION        SOLUTION               APX        B                           Y      0.3456    0.3456     REGULAR BENEFIT
           ANTIMUSCARINICS /
120808     ANTISPASMODICS /         02231136       PMS-IPRATROPIUM         Y    IPRATROPIUM BROMIDE              250 MCG / ML INHALATION        SOLUTION               PMS        B                           Y      0.3456    0.3456     REGULAR BENEFIT
           ANTIMUSCARINICS /
120808     ANTISPASMODICS /         02239131       MYLAN-IPRATROPIUM       Y    IPRATROPIUM BROMIDE              250 MCG / ML INHALATION        SOLUTION               MYP        W                           Y      0.3456    0.3456     REGULAR BENEFIT
           ANTIMUSCARINICS /
120808     ANTISPASMODICS /         02210479       NOVO-IPRAMIDE           Y    IPRATROPIUM BROMIDE              250 MCG / ML INHALATION        SOLUTION               TEV        B                           Y      0.3456    0.3456     REGULAR BENEFIT
                                               4
           ANTIMUSCARINICS /
120808     ANTISPASMODICS /         02239627       PMS-IPRATROPIUM         Y    IPRATROPIUM BROMIDE              0.03 %       NASAL             SPRAY                  PMS        B                           Y      0.5561    0.5561     REGULAR BENEFIT
           ANTIMUSCARINICS /
120808     ANTISPASMODICS /         02163705       ATROVENT                Y    IPRATROPIUM BROMIDE              0.03 %       NASAL             SPRAY                  BOE        B                           N      0.9930    0.5561     REGULAR BENEFIT
                                               2
           ANTIMUSCARINICS /                                                    IPRATROPIUM BROMIDE/             0.2 MG / ML *
120808     ANTISPASMODICS /         02243789       RATIO-IPRA SAL UDV      Y    SALBUTAMOL SULFATE               1 MG / ML     INHALATION       SOLUTION               RPH        B                           Y      0.2936    0.2936     REGULAR BENEFIT
           ANTIMUSCARINICS /                                                    IPRATROPIUM BROMIDE/             0.2 MG / ML *
120808     ANTISPASMODICS /         02272695       MYLAN-COMBO STERINEBS   Y    SALBUTAMOL SULFATE               1 MG / ML     INHALATION       SOLUTION               MYP        W                           Y      0.2936    0.2936     REGULAR BENEFIT
           ANTIMUSCARINICS /                                                    IPRATROPIUM BROMIDE/ SALBUTAMOL 0.2 MG / ML *
120808     ANTISPASMODICS /         02231675       COMBIVENT UDV           Y    SULFATE                         1 MG / ML     INHALATION        SOLUTION               BOE        B                           N      0.6030    0.2936     REGULAR BENEFIT
                                               3
           ANTIMUSCARINICS /                                                    TIOTROPIUM BROMIDE
120808     ANTISPASMODICS /         02246793       SPIRIVA                 N    MONOHYDRATE                      18 MCG       INHALATION        CAPSULE                BOE        B                           N      2.1667               REGULAR BENEFIT
                                               1
           ALPHA-ADRENERGIC
121204     AGONISTS /               02278677       MIDODRINE               N    MIDODRINE HCL                    2.5 MG       ORAL              TABLET                 AAP        W            7.50%          N      0.3378               REGULAR BENEFIT
                                               1
           ALPHA-ADRENERGIC
121204     AGONISTS /               02278685       MIDODRINE               N    MIDODRINE HCL                    5 MG         ORAL              TABLET                 AAP        W            7.50%          N      0.5630               REGULAR BENEFIT
                                               1

           BETA-ADRENERGIC AGONISTS                                                                              100 MCG /                      METERED
           / SELECTIVE BETA 2-                     SYMBICORT 100                BUDESONIDE/ FORMOTEROL           DOSE * 6                       INHALATION
12120812   ADRENERGIC AGONISTS      02245385       TURBUHALER              N    FUMARATE DIHYDRATE               MCG / DOSE                     POWDER                 AZC        W            7.50%          N      0.5208               REGULAR BENEFIT
                                               1


           BETA-ADRENERGIC AGONISTS                                                                              200 MCG /                      METERED
           / SELECTIVE BETA 2-                     SYMBICORT 200                BUDESONIDE/ FORMOTEROL           DOSE * 6                       INHALATION
12120812   ADRENERGIC AGONISTS      02245386       TURBUHALER              N    FUMARATE DIHYDRATE               MCG / DOSE                     POWDER                 AZC        W            7.50%          N      0.6771               REGULAR BENEFIT
                                               1

           BETA-ADRENERGIC AGONISTS
           / SELECTIVE BETA 2-
12120812   ADRENERGIC AGONISTS      02230898       FORADIL                 N    FORMOTEROL FUMARATE              12 MCG       INHALATION        CAPSULE                NOV        W            7.50%          N      0.8181               REGULAR BENEFIT




                                                                                                                  Updated July 1, 2012                                                                                                      Page 19 of 254
                                                                                         Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                      (Regular Benefits)


                                                                                                                                                                               DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION        DIN / PIN          PRODUCT NAME        IC            GENERIC NAME            STRENGTH            ROUTE             FORM           MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                                  1

           BETA-ADRENERGIC AGONISTS                                                                                                               METERED
           / SELECTIVE BETA 2-                                                                                   6 MCG /                          INHALATION
12120812   ADRENERGIC AGONISTS      02237225          OXEZE TURBUHALER        N    FORMOTEROL FUMARATE DIHYDRATE DOSE                             POWDER                 AZC        W            7.50%          N      0.5540               REGULAR BENEFIT
                                                  1

           BETA-ADRENERGIC AGONISTS                                                                                                               METERED
           / SELECTIVE BETA 2-                                                                                   12 MCG /                         INHALATION
12120812   ADRENERGIC AGONISTS      02237224          OXEZE TURBUHALER        N    FORMOTEROL FUMARATE DIHYDRATE DOSE                             POWDER                 AZC        W            7.50%          N      0.7380               REGULAR BENEFIT
                                                  1


           BETA-ADRENERGIC AGONISTS
           / SELECTIVE BETA 2-
12120812   ADRENERGIC AGONISTS      02236783          APO-ORCIPRENALINE       N    ORCIPRENALINE SULFATE           2 MG / ML     ORAL             SYRUP                  APX        B                           N      0.0574               REGULAR BENEFIT
                                                  1

           BETA-ADRENERGIC AGONISTS
           / SELECTIVE BETA 2-                                                                                     100 MCG /                      METERED DOSE
12120812   ADRENERGIC AGONISTS      02232570          AIROMIR CFC-FREE        Y    SALBUTAMOL                      DOSE                           AEROSOL                MEP        W            7.50%          N      0.0250    0.0269     REGULAR BENEFIT


           BETA-ADRENERGIC AGONISTS
           / SELECTIVE BETA 2-                                                                                     100 MCG /                      METERED DOSE
12120812   ADRENERGIC AGONISTS      02241497          VENTOLIN HFA            Y    SALBUTAMOL                      DOSE                           AEROSOL                GSK        W                           N      0.0325    0.0269     REGULAR BENEFIT


           BETA-ADRENERGIC AGONISTS
           / SELECTIVE BETA 2-                                                                                     100 MCG /                      METERED DOSE
12120812   ADRENERGIC AGONISTS      02245669          APO-SALVENT CFC FREE    Y    SALBUTAMOL                      DOSE                           AEROSOL                APX        B                           N      0.0325    0.0269     REGULAR BENEFIT
                                                  3

           BETA-ADRENERGIC
           AGONISTS / SELECTIVE BETA                  RATIO-SALBUTAMOL UNIT
12120812   2-ADRENERGIC AGONISTS       02239365       DOSE P.F                Y    SALBUTAMOL SULFATE              0.5 MG / ML   INHALATION       SOLUTION               RPH        B                           Y      0.1074    0.1074     REGULAR BENEFIT

           BETA-ADRENERGIC
           AGONISTS / SELECTIVE BETA
12120812   2-ADRENERGIC AGONISTS       02208245       PMS-SALBUTAMOL          Y    SALBUTAMOL SULFATE              0.5 MG / ML   INHALATION       SOLUTION               PMS        B                           Y      0.1074    0.1074     REGULAR BENEFIT
                                                  2

           BETA-ADRENERGIC
           AGONISTS / SELECTIVE BETA
12120812   2-ADRENERGIC AGONISTS       02208229       PMS-SALBUTAMOL          Y    SALBUTAMOL SULFATE              1 MG / ML     INHALATION       SOLUTION               PMS        B                           Y      0.1555    0.1555     REGULAR BENEFIT

           BETA-ADRENERGIC
           AGONISTS / SELECTIVE BETA                  RATIO-SALBUTAMOL SULF
12120812   2-ADRENERGIC AGONISTS       01986864       U.D.P.F.                Y    SALBUTAMOL SULFATE              1 MG / ML     INHALATION       SOLUTION               RPH        B                           Y      0.1555    0.1555     REGULAR BENEFIT

           BETA-ADRENERGIC
           AGONISTS / SELECTIVE BETA                  MYLAN-SALBUTAMOL
12120812   2-ADRENERGIC AGONISTS       01926934       STERINEBS P.F.          Y    SALBUTAMOL SULFATE              1 MG / ML     INHALATION       SOLUTION               MYP        W                           Y      0.1555    0.1555     REGULAR BENEFIT




                                                                                                                    Updated July 1, 2012                                                                                                      Page 20 of 254
                                                                                         Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                      (Regular Benefits)


                                                                                                                                                                               DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION        DIN / PIN           PRODUCT NAME       IC           GENERIC NAME             STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS


           BETA-ADRENERGIC AGONISTS
           / SELECTIVE BETA 2-
12120812   ADRENERGIC AGONISTS      02213419          VENTOLIN NEBULES P.F.   Y    SALBUTAMOL SULFATE              1 MG / ML   INHALATION         SOLUTION               GSK        W            7.50%          N      0.4134    0.1555     REGULAR BENEFIT
                                                  4

           BETA-ADRENERGIC
           AGONISTS / SELECTIVE BETA
12120812   2-ADRENERGIC AGONISTS       02154412       SANDOZ SALBUTAMOL       Y    SALBUTAMOL SULFATE              5 MG / ML   INHALATION         SOLUTION               SDZ        W                           Y      0.3774    0.3774     REGULAR BENEFIT

           BETA-ADRENERGIC
           AGONISTS / SELECTIVE BETA
12120812   2-ADRENERGIC AGONISTS       02069571       PMS-SALBUTAMOL          Y    SALBUTAMOL SULFATE              5 MG / ML   INHALATION         SOLUTION               PMS        B                           Y      0.3774    0.3774     REGULAR BENEFIT

           BETA-ADRENERGIC
           AGONISTS / SELECTIVE BETA
12120812   2-ADRENERGIC AGONISTS       00860808       RATIO-SALBUTAMOL        Y    SALBUTAMOL SULFATE              5 MG / ML   INHALATION         SOLUTION               RPH        B                           Y      0.3774    0.3774     REGULAR BENEFIT

           BETA-ADRENERGIC AGONISTS
           / SELECTIVE BETA 2-
12120812   ADRENERGIC AGONISTS      02213486          VENTOLIN                Y    SALBUTAMOL SULFATE              5 MG / ML   INHALATION         SOLUTION               GSK        W            7.50%          N      1.0030    0.3774     REGULAR BENEFIT
                                                  4

           BETA-ADRENERGIC
           AGONISTS / SELECTIVE BETA                  RATIO-SALBUTAMOL UNI                                                                        UNIT DOSE
12120812   2-ADRENERGIC AGONISTS       02239366       DOSE P.F.               Y    SALBUTAMOL SULFATE              2 MG / ML   INHALATION         SOLUTION               RPH        B                           Y      0.2954    0.2954     REGULAR BENEFIT

           BETA-ADRENERGIC
           AGONISTS / SELECTIVE BETA                  PMS-SALBUTAMOL                                                                              UNIT DOSE
12120812   2-ADRENERGIC AGONISTS       02208237       POLYNEB                 Y    SALBUTAMOL SULFATE              2 MG / ML   INHALATION         SOLUTION               PMS        B                           Y      0.2954    0.2954     REGULAR BENEFIT

           BETA-ADRENERGIC
           AGONISTS / SELECTIVE BETA                  MYLAN-SALBUTAMOL                                                                            UNIT DOSE
12120812   2-ADRENERGIC AGONISTS       02173360       STERINEBS P.F.          Y    SALBUTAMOL SULFATE              2 MG / ML   INHALATION         SOLUTION               MYP        W                           Y      0.2954    0.2954     REGULAR BENEFIT

           BETA-ADRENERGIC AGONISTS
           / SELECTIVE BETA 2-                                                                                                                    UNIT DOSE
12120812   ADRENERGIC AGONISTS      02213427          VENTOLIN NEBULES P.F.   Y    SALBUTAMOL SULFATE              2 MG / ML   INHALATION         SOLUTION               GSK        W            7.50%          N      0.7852    0.2954     REGULAR BENEFIT
                                                  4

           BETA-ADRENERGIC AGONISTS
           / SELECTIVE BETA 2-
12120812   ADRENERGIC AGONISTS      02146843          APO-SALVENT             N    SALBUTAMOL SULFATE              2 MG        ORAL               TABLET                 APX        B                           N      0.1274               REGULAR BENEFIT
                                                  1

           BETA-ADRENERGIC AGONISTS
           / SELECTIVE BETA 2-
12120812   ADRENERGIC AGONISTS      02146851          APO-SALVENT             N    SALBUTAMOL SULFATE              4 MG        ORAL               TABLET                 APX        B                           N      0.2134               REGULAR BENEFIT
                                                  1




                                                                                                                    Updated July 1, 2012                                                                                                      Page 21 of 254
                                                                                       Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                    (Regular Benefits)


                                                                                                                                                                             DISTRIBUTION   DISTRIBUTION     LCA               LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION      DIN / PIN          PRODUCT NAME        IC            GENERIC NAME            STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE       PRICE         STATUS


           BETA-ADRENERGIC AGONISTS                                                                                                             METERED
           / SELECTIVE BETA 2-                                                                                   50 MCG /                       INHALATION
12120812   ADRENERGIC AGONISTS      02231129       SEREVENT DISKUS          N    SALMETEROL XINAFOATE            DOSE                           POWDER                 GSK        W            7.50%          N      0.9350                REGULAR BENEFIT
                                               1


           BETA-ADRENERGIC AGONISTS
           / SELECTIVE BETA 2-                                                                                   50 MCG /
12120812   ADRENERGIC AGONISTS      02214261       SEREVENT                 N    SALMETEROL XINAFOATE            DOSE         INHALATION        DISK                   GSK        W            7.50%          N      3.7400                REGULAR BENEFIT
                                               1

           BETA-ADRENERGIC AGONISTS                                                                              25 MCG /
           / SELECTIVE BETA 2-                                                   SALMETEROL XINAFOATE/           DOSE * 125                     METERED DOSE
12120812   ADRENERGIC AGONISTS      02245126       ADVAIR 125               N    FLUTICASONE PROPIONATE          MCG / DOSE                     AEROSOL                GSK        W            7.50%          N      0.7999                REGULAR BENEFIT
                                               1


           BETA-ADRENERGIC AGONISTS                                                                              25 MCG /
           / SELECTIVE BETA 2-                                                   SALMETEROL XINAFOATE/           DOSE * 250                     METERED DOSE
12120812   ADRENERGIC AGONISTS      02245127       ADVAIR 250               N    FLUTICASONE PROPIONATE          MCG / DOSE                     AEROSOL                GSK        W            7.50%          N      1.1356                REGULAR BENEFIT
                                               1


           BETA-ADRENERGIC AGONISTS                                                                              50 MCG /                       METERED
           / SELECTIVE BETA 2-                                                   SALMETEROL XINAFOATE/           DOSE * 100                     INHALATION
12120812   ADRENERGIC AGONISTS      02240835       ADVAIR 100 DISKUS        N    FLUTICASONE PROPIONATE          MCG / DOSE                     POWDER                 GSK        W            7.50%          N      1.3365                REGULAR BENEFIT
                                               1


           BETA-ADRENERGIC AGONISTS                                                                              50 MCG /                       METERED
           / SELECTIVE BETA 2-                                                   SALMETEROL XINAFOATE/           DOSE * 250                     INHALATION
12120812   ADRENERGIC AGONISTS      02240836       ADVAIR 250 DISKUS        N    FLUTICASONE PROPIONATE          MCG / DOSE                     POWDER                 GSK        W            7.50%          N      1.5998                REGULAR BENEFIT
                                               1

           BETA-ADRENERGIC AGONISTS                                                                              50 MCG /                       METERED
           / SELECTIVE BETA 2-                                                   SALMETEROL XINAFOATE/           DOSE * 500                     INHALATION
12120812   ADRENERGIC AGONISTS      02240837       ADVAIR 500 DISKUS        N    FLUTICASONE PROPIONATE          MCG / DOSE                     POWDER                 GSK        W            7.50%          N      2.2712                REGULAR BENEFIT
                                               1


           BETA-ADRENERGIC AGONISTS                                                                                                             METERED
           / SELECTIVE BETA 2-                                                                                   0.5 MG /                       INHALATION
12120812   ADRENERGIC AGONISTS      00786616       BRICANYL TURBUHALER      N    TERBUTALINE SULFATE             DOSE                           POWDER                 AZC        W            7.50%          N      0.0764                REGULAR BENEFIT
                                               1
           ALPHA- AND BETA-
121212     ADRENERGIC AGONISTS /    02268205       TWINJECT AUTO INJECTOR   N    EPINEPHRINE                     0.15 MG / SYR INJECTION        SYRINGE                PAL        B                           N      82.4580               REGULAR BENEFIT
           ALPHA- AND BETA-
121212     ADRENERGIC AGONISTS /    00578657       EPIPEN JR                N    EPINEPHRINE                     0.15 MG / SYR INJECTION        SYRINGE                KNG        W            7.50%          N      82.6200               REGULAR BENEFIT
                                               2
           ALPHA- AND BETA-
121212     ADRENERGIC AGONISTS /    02247310       TWINJECT AUTO INJECTOR   N    EPINEPHRINE                     0.3 MG / SYR INJECTION         SYRINGE                PAL        B                           N      82.4580               REGULAR BENEFIT
           ALPHA- AND BETA-
121212     ADRENERGIC AGONISTS /    00509558       EPIPEN                   N    EPINEPHRINE                     0.3 MG / SYR INJECTION         SYRINGE                KNG        W            7.50%          N      82.6200               REGULAR BENEFIT
                                               2




                                                                                                                  Updated July 1, 2012                                                                                                       Page 22 of 254
                                                                                     Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                  (Regular Benefits)


                                                                                                                                                                           DISTRIBUTION   DISTRIBUTION     LCA               LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION       DIN / PIN          PRODUCT NAME       IC              GENERIC NAME          STRENGTH              ROUTE            FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE       PRICE         STATUS
         ALPHA- AND BETA-
121212   ADRENERGIC AGONISTS /      00155357       ADRENALIN              N    EPINEPHRINE HCL                 1 MG / ML      INJECTION                              ERF        W            7.50%          N      0.5626                REGULAR BENEFIT
                                               1
         SYMPATHOLYTIC
         (ADRENERGIC BLOCKING)                     DIHYDROERGOTAMINE
121600   AGENTS /                   02241163       MESYLATE               Y    DIHYDROERGOTAMINE MESYLATE      1 MG / ML      INJECTION                              SDZ        W                           Y      3.7933     3.7933     REGULAR BENEFIT
         SYMPATHOLYTIC
         (ADRENERGIC BLOCKING)                     DIHYDROERGOTAMINE
121600   AGENTS /                   00027243       (DHE)                  Y    DIHYDROERGOTAMINE MESYLATE      1 MG / ML      INJECTION                              STM        W            7.50%          N      3.8210     3.7933     REGULAR BENEFIT
                                               2
         SYMPATHOLYTIC
         (ADRENERGIC BLOCKING)
121600   AGENTS /                   02228947       MIGRANAL               N    DIHYDROERGOTAMINE MESYLATE      4 MG / ML      NASAL           SPRAY                  STM        W            7.50%          N      10.2043               REGULAR BENEFIT
                                               1
         SYMPATHOLYTIC
         (ADRENERGIC BLOCKING)
121600   AGENTS /                   00176176       HYDERGINE              N    ERGOLOID MESYLATES              1 MG           ORAL            TABLET                 STM        W            7.50%          N      1.0029                REGULAR BENEFIT
                                               1
         SYMPATHOLYTIC
         (ADRENERGIC BLOCKING)                                                                                 1 MG * 100
121600   AGENTS /                   00176095       CAFERGOT               N    ERGOTAMINE TARTRATE/ CAFFEINE   MG             ORAL            TABLET                 NOV        W            7.50%          N      0.8286                REGULAR BENEFIT
                                               1
         DIRECT-ACTING SKELETAL
122008   MUSCLE RELAXANTS /         01997602       DANTRIUM               N    DANTROLENE SODIUM               25 MG          ORAL            CAPSULE                JHP        B                           N      0.3780                REGULAR BENEFIT
                                               1
         DIRECT-ACTING SKELETAL
122008   MUSCLE RELAXANTS /         01997653       DANTRIUM               N    DANTROLENE SODIUM               100 MG         ORAL            CAPSULE                JHP        B                           N      0.7684                REGULAR BENEFIT
                                               1

         GABA-DERIVATIVE SKELETAL
122012   MUSCLE RELAXANTS /         02131048       LIORESAL INTRATHECAL   N    BACLOFEN                        0.05 MG / ML   INJECTION                              NOV        W            7.50%          N      13.8277               REGULAR BENEFIT
                                               1

         GABA-DERIVATIVE SKELETAL
122012   MUSCLE RELAXANTS /         02131056       LIORESAL INTRATHECAL   N    BACLOFEN                        0.5 MG / ML    INJECTION                              NOV        W            7.50%          N      10.3610               REGULAR BENEFIT
                                               1

         GABA-DERIVATIVE SKELETAL
122012   MUSCLE RELAXANTS /         02131064       LIORESAL INTRATHECAL   N    BACLOFEN                        2 MG / ML      INJECTION                              NOV        W            7.50%          N      41.4444               REGULAR BENEFIT
                                               1

         GABA-DERIVATIVE SKELETAL
122012   MUSCLE RELAXANTS /       02287021         BACLOFEN               Y    BACLOFEN                        10 MG          ORAL            TABLET                 SNS        W                           Y      0.2517     0.2517     REGULAR BENEFIT

         GABA-DERIVATIVE SKELETAL
122012   MUSCLE RELAXANTS /       02371413         AVA-BACLOFEN           Y    BACLOFEN                        10 MG          ORAL            TABLET                 AVA        W                           Y      0.2517     0.2517     REGULAR BENEFIT

         GABA-DERIVATIVE SKELETAL
122012   MUSCLE RELAXANTS /       02063735         PMS-BACLOFEN           Y    BACLOFEN                        10 MG          ORAL            TABLET                 PMS        B                           Y      0.2517     0.2517     REGULAR BENEFIT




                                                                                                                Updated July 1, 2012                                                                                                       Page 23 of 254
                                                                                    Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                 (Regular Benefits)


                                                                                                                                                                          DISTRIBUTION   DISTRIBUTION     LCA               LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION       DIN / PIN           PRODUCT NAME   IC              GENERIC NAME          STRENGTH           ROUTE               FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE       PRICE         STATUS

           GABA-DERIVATIVE SKELETAL
122012     MUSCLE RELAXANTS /       02088398         MYLAN-BACLOFEN      Y    BACLOFEN                        10 MG        ORAL              TABLET                 MYP        W                           Y      0.2517     0.2517     REGULAR BENEFIT

           GABA-DERIVATIVE SKELETAL
122012     MUSCLE RELAXANTS /       02139332         APO-BACLOFEN        Y    BACLOFEN                        10 MG        ORAL              TABLET                 APX        B                           Y      0.2517     0.2517     REGULAR BENEFIT

           GABA-DERIVATIVE SKELETAL
122012     MUSCLE RELAXANTS /       02236507         RATIO-BACLOFEN      Y    BACLOFEN                        10 MG        ORAL              TABLET                 RPH        B                           Y      0.2517     0.2517     REGULAR BENEFIT

           GABA-DERIVATIVE SKELETAL
122012     MUSCLE RELAXANTS /       02236963         PHL-BACLOFEN        Y    BACLOFEN                        10 MG        ORAL              TABLET                 PHH        B                           Y      0.2517     0.2517     REGULAR BENEFIT

           GABA-DERIVATIVE SKELETAL
122012     MUSCLE RELAXANTS /         00455881       LIORESAL            Y    BACLOFEN                        10 MG        ORAL              TABLET                 NOV        W            7.50%          N      0.6688     0.2517     REGULAR BENEFIT
                                                 8

           GABA-DERIVATIVE SKELETAL
122012     MUSCLE RELAXANTS /       02287048         BACLOFEN            Y    BACLOFEN                        20 MG        ORAL              TABLET                 SNS        W                           Y      0.4898     0.4898     REGULAR BENEFIT

           GABA-DERIVATIVE SKELETAL
122012     MUSCLE RELAXANTS /       02371421         AVA-BACLOFEN        Y    BACLOFEN                        20 MG        ORAL              TABLET                 AVA        W                           Y      0.4898     0.4898     REGULAR BENEFIT

           GABA-DERIVATIVE SKELETAL
122012     MUSCLE RELAXANTS /       02063743         PMS-BACLOFEN        Y    BACLOFEN                        20 MG        ORAL              TABLET                 PMS        B                           Y      0.4898     0.4898     REGULAR BENEFIT

           GABA-DERIVATIVE SKELETAL
122012     MUSCLE RELAXANTS /       02088401         MYLAN-BACLOFEN      Y    BACLOFEN                        20 MG        ORAL              TABLET                 MYP        W                           Y      0.4898     0.4898     REGULAR BENEFIT

           GABA-DERIVATIVE SKELETAL
122012     MUSCLE RELAXANTS /       02139391         APO-BACLOFEN        Y    BACLOFEN                        20 MG        ORAL              TABLET                 APX        B                           Y      0.4898     0.4898     REGULAR BENEFIT

           GABA-DERIVATIVE SKELETAL
122012     MUSCLE RELAXANTS /       02236508         RATIO-BACLOFEN      Y    BACLOFEN                        20 MG        ORAL              TABLET                 RPH        B                           Y      0.4898     0.4898     REGULAR BENEFIT

           GABA-DERIVATIVE SKELETAL
122012     MUSCLE RELAXANTS /       02236964         PHL-BACLOFEN        Y    BACLOFEN                        20 MG        ORAL              TABLET                 PHH        B                           Y      0.4898     0.4898     REGULAR BENEFIT

           GABA-DERIVATIVE SKELETAL
122012     MUSCLE RELAXANTS /         00636576       LIORESAL D.S.       Y    BACLOFEN                        20 MG        ORAL              TABLET                 NOV        W            7.50%          N      1.3018     0.4898     REGULAR BENEFIT
                                                 8

200404     IRON PREPARATIONS /        02205963       DEXIRON             N    IRON DEXTRAN COMPLEX            50 MG / ML   INJECTION                                LPI        W            7.50%          N      13.7500               REGULAR BENEFIT

200404     IRON PREPARATIONS /        02221780       INFUFER             N    IRON DEXTRAN COMPLEX            50 MG / ML   INJECTION                                SDZ        W            7.50%          N      13.7910               REGULAR BENEFIT
                                                 2
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES       00010383       SINTROM             N    ACENOCOUMAROL                   1 MG         ORAL              TABLET                 PAL        B                           N      0.5087                REGULAR BENEFIT
                                                 1
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES       00010391       SINTROM             N    ACENOCOUMAROL                   4 MG         ORAL              TABLET                 PAL        B                           N      1.5997                REGULAR BENEFIT




                                                                                                               Updated July 1, 2012                                                                                                       Page 24 of 254
                                                                               Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                            (Regular Benefits)


                                                                                                                                                                     DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION    DIN / PIN          PRODUCT NAME   IC           GENERIC NAME             STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                             1
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   02344025       WARFARIN           Y    WARFARIN SODIUM                 1 MG        ORAL               TABLET                 SNS        W                           Y      0.1147    0.1147     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   02265273       NOVO-WARFARIN      Y    WARFARIN SODIUM                 1 MG        ORAL               TABLET                 TEV        B                           Y      0.1147    0.1147     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   02244462       MYLAN-WARFARIN     Y    WARFARIN SODIUM                 1 MG        ORAL               TABLET                 MYP        W                           Y      0.1147    0.1147     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   02242680       TARO-WARFARIN      Y    WARFARIN SODIUM                 1 MG        ORAL               TABLET                 TAR        W                           Y      0.1147    0.1147     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   02242924       APO-WARFARIN       Y    WARFARIN SODIUM                 1 MG        ORAL               TABLET                 APX        B                           Y      0.1147    0.1147     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   01918311       COUMADIN           Y    WARFARIN SODIUM                 1 MG        ORAL               TABLET                 BMS        B                           N      0.3277    0.1147     REGULAR BENEFIT
                                             6
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   02344033       WARFARIN           Y    WARFARIN SODIUM                 2 MG        ORAL               TABLET                 SNS        W                           Y      0.1213    0.1213     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   02265281       NOVO-WARFARIN      Y    WARFARIN SODIUM                 2 MG        ORAL               TABLET                 TEV        B                           Y      0.1213    0.1213     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   02244463       MYLAN-WARFARIN     Y    WARFARIN SODIUM                 2 MG        ORAL               TABLET                 MYP        W                           Y      0.1213    0.1213     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   02242681       TARO-WARFARIN      Y    WARFARIN SODIUM                 2 MG        ORAL               TABLET                 TAR        W                           Y      0.1213    0.1213     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   02242925       APO-WARFARIN       Y    WARFARIN SODIUM                 2 MG        ORAL               TABLET                 APX        B                           Y      0.1213    0.1213     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   01918338       COUMADIN           Y    WARFARIN SODIUM                 2 MG        ORAL               TABLET                 BMS        B                           N      0.3467    0.1213     REGULAR BENEFIT
                                             6
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   02242926       APO-WARFARIN       Y    WARFARIN SODIUM                 2.5 MG      ORAL               TABLET                 APX        B                           Y      0.0971    0.0971     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   02344041       WARFARIN           Y    WARFARIN SODIUM                 2.5 MG      ORAL               TABLET                 SNS        W                           Y      0.0971    0.0971     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   02265303       NOVO-WARFARIN      Y    WARFARIN SODIUM                 2.5 MG      ORAL               TABLET                 TEV        B                           Y      0.0971    0.0971     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   02244464       MYLAN-WARFARIN     Y    WARFARIN SODIUM                 2.5 MG      ORAL               TABLET                 MYP        W                           Y      0.0971    0.0971     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   02242682       TARO-WARFARIN      Y    WARFARIN SODIUM                 2.5 MG      ORAL               TABLET                 TAR        W                           Y      0.0971    0.0971     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   01918346       COUMADIN           Y    WARFARIN SODIUM                 2.5 MG      ORAL               TABLET                 BMS        B                           N      0.2775    0.0971     REGULAR BENEFIT
                                             6
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   02344068       WARFARIN           Y    WARFARIN SODIUM                 3 MG        ORAL               TABLET                 SNS        W                           Y      0.1504    0.1504     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   02287498       MYLAN-WARFARIN     Y    WARFARIN SODIUM                 3 MG        ORAL               TABLET                 MYP        W                           Y      0.1504    0.1504     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   02265311       NOVO-WARFARIN      Y    WARFARIN SODIUM                 3 MG        ORAL               TABLET                 TEV        B                           Y      0.1504    0.1504     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   02245618       APO-WARFARIN       Y    WARFARIN SODIUM                 3 MG        ORAL               TABLET                 APX        B                           Y      0.1504    0.1504     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES   02242683       TARO-WARFARIN      Y    WARFARIN SODIUM                 3 MG        ORAL               TABLET                 TAR        W                           Y      0.1504    0.1504     REGULAR BENEFIT




                                                                                                          Updated July 1, 2012                                                                                                      Page 25 of 254
                                                                                  Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                               (Regular Benefits)


                                                                                                                                                                        DISTRIBUTION   DISTRIBUTION     LCA               LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION       DIN / PIN         PRODUCT NAME   IC            GENERIC NAME            STRENGTH           ROUTE               FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE       PRICE         STATUS
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES      02240205       COUMADIN           Y    WARFARIN SODIUM                 3 MG         ORAL              TABLET                 BMS        B                           N      0.4297     0.1504     REGULAR BENEFIT
                                                6
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES      02242927       APO-WARFARIN       Y    WARFARIN SODIUM                 4 MG         ORAL              TABLET                 APX        B                           Y      0.1504     0.1504     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES      02344076       WARFARIN           Y    WARFARIN SODIUM                 4 MG         ORAL              TABLET                 SNS        W                           Y      0.1504     0.1504     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES      02265338       NOVO-WARFARIN      Y    WARFARIN SODIUM                 4 MG         ORAL              TABLET                 TEV        B                           Y      0.1504     0.1504     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES      02244465       MYLAN-WARFARIN     Y    WARFARIN SODIUM                 4 MG         ORAL              TABLET                 MYP        W                           Y      0.1504     0.1504     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES      02242684       TARO-WARFARIN      Y    WARFARIN SODIUM                 4 MG         ORAL              TABLET                 TAR        W                           Y      0.1504     0.1504     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES      02007959       COUMADIN           Y    WARFARIN SODIUM                 4 MG         ORAL              TABLET                 BMS        B                           N      0.4297     0.1504     REGULAR BENEFIT
                                                6
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES      02242928       APO-WARFARIN       Y    WARFARIN SODIUM                 5 MG         ORAL              TABLET                 APX        B                           Y      0.0973     0.0973     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES      02344084       WARFARIN           Y    WARFARIN SODIUM                 5 MG         ORAL              TABLET                 SNS        W                           Y      0.0973     0.0973     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES      02265346       NOVO-WARFARIN      Y    WARFARIN SODIUM                 5 MG         ORAL              TABLET                 TEV        B                           Y      0.0973     0.0973     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES      02244466       MYLAN-WARFARIN     Y    WARFARIN SODIUM                 5 MG         ORAL              TABLET                 MYP        W                           Y      0.0973     0.0973     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES      02242685       TARO-WARFARIN      Y    WARFARIN SODIUM                 5 MG         ORAL              TABLET                 TAR        W                           Y      0.0973     0.0973     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES      01918354       COUMADIN           Y    WARFARIN SODIUM                 5 MG         ORAL              TABLET                 BMS        B                           N      0.2780     0.0973     REGULAR BENEFIT
                                                6
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES      02242686       TARO-WARFARIN      N    WARFARIN SODIUM                 6 MG         ORAL              TABLET                 TAR        W            5.00%          N      0.2895                REGULAR BENEFIT
                                                1
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES      02242697       TARO-WARFARIN      N    WARFARIN SODIUM                 7.5 MG       ORAL              TABLET                 TAR        W            5.00%          N      0.3111                REGULAR BENEFIT
                                                1
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES      02242929       APO-WARFARIN       Y    WARFARIN SODIUM                 10 MG        ORAL              TABLET                 APX        B                           Y      0.1746     0.1746     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES      02344114       WARFARIN           Y    WARFARIN SODIUM                 10 MG        ORAL              TABLET                 SNS        W                           Y      0.1746     0.1746     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES      02244467       MYLAN-WARFARIN     Y    WARFARIN SODIUM                 10 MG        ORAL              TABLET                 MYP        W                           Y      0.1746     0.1746     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES      02242687       TARO-WARFARIN      Y    WARFARIN SODIUM                 10 MG        ORAL              TABLET                 TAR        W                           Y      0.1746     0.1746     REGULAR BENEFIT
           ANTICOAGULANTS /
20120408   COUMARIN DERIVATIVES      01918362       COUMADIN           Y    WARFARIN SODIUM                 10 MG        ORAL              TABLET                 BMS        B                           N      0.4989     0.1746     REGULAR BENEFIT
                                                5

20120416   ANTICOAGULANTS / HEPARINS 02132664       FRAGMIN            N    DALTEPARIN SODIUM               10,000 IU / ML INJECTION                              PFI        W            7.50%          N      15.9291               REGULAR BENEFIT
                                                1




                                                                                                             Updated July 1, 2012                                                                                                       Page 26 of 254
                                                                                           Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                        (Regular Benefits)


                                                                                                                                                                                 DISTRIBUTION   DISTRIBUTION     LCA               LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION       DIN / PIN          PRODUCT NAME           IC            GENERIC NAME            STRENGTH            ROUTE            FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE       PRICE         STATUS

20120416   ANTICOAGULANTS / HEPARINS 02231171       FRAGMIN                     N    DALTEPARIN SODIUM               25,000 IU / ML INJECTION                              PFI        W            7.50%          N      39.8199               REGULAR BENEFIT
                                                1

20120416   ANTICOAGULANTS / HEPARINS 02132621       FRAGMIN (0.2 ML SYRINGE)    N    DALTEPARIN SODIUM               2,500 IU / SYR INJECTION       SYRINGE                PFI        W            7.50%          N      5.0440                REGULAR BENEFIT
                                                1

20120416   ANTICOAGULANTS / HEPARINS 02352648       FRAGMIN (0.3 ML SYRINGE)    N    DALTEPARIN SODIUM               7,500 IU / SYR INJECTION       SYRINGE                PFI        W            7.50%          N      15.1320               REGULAR BENEFIT
                                                1

20120416   ANTICOAGULANTS / HEPARINS 02132648       FRAGMIN (0.2 ML SYRINGE)    N    DALTEPARIN SODIUM               5,000 IU / SYR INJECTION       SYRINGE                PFI        W            7.50%          N      10.0880               REGULAR BENEFIT
                                                1
                                                                                                                     10,000 IU /
20120416   ANTICOAGULANTS / HEPARINS 02352656       FRAGMIN (0.4 ML SYRINGE)    N    DALTEPARIN SODIUM               SYR            INJECTION       SYRINGE                PFI        W            7.50%          N      20.1760               REGULAR BENEFIT
                                                1
                                                                                                                     12,500 IU /
20120416   ANTICOAGULANTS / HEPARINS 02352664       FRAGMIN (0.5 ML SYRINGE)    N    DALTEPARIN SODIUM               SYR            INJECTION       SYRINGE                PFI        W            7.50%          N      25.2200               REGULAR BENEFIT
                                                1
                                                                                                                     15,000 IU /
20120416   ANTICOAGULANTS / HEPARINS 02352672       FRAGMIN (0.6 ML SYRINGE)    N    DALTEPARIN SODIUM               SYR            INJECTION       SYRINGE                PFI        W            7.50%          N      30.2640               REGULAR BENEFIT
                                                1
                                                                                                                     18,000 IU /
20120416   ANTICOAGULANTS / HEPARINS 02352680       FRAGMIN (0.72 ML SYRINGE)   N    DALTEPARIN SODIUM               SYR            INJECTION       SYRINGE                PFI        W            7.50%          N      36.3160               REGULAR BENEFIT
                                                1

20120416   ANTICOAGULANTS / HEPARINS 02236564       LOVENOX                     N    ENOXAPARIN SODIUM               100 MG / ML    INJECTION                              SAV        W            7.50%          N      20.9300               REGULAR BENEFIT
                                                1
                                                    LOVENOX (0.4 - 1 ML
20120416   ANTICOAGULANTS / HEPARINS 02236883       SYRINGE)                    N    ENOXAPARIN SODIUM               100 MG / ML    INJECTION       SYRINGE                SAV        W            7.50%          N      20.9310               REGULAR BENEFIT
                                                1
                                                    LOVENOX HP (0.8ML/1ML
20120416   ANTICOAGULANTS / HEPARINS 02242692       SYRINGE)                    N    ENOXAPARIN SODIUM               150 MG / ML    INJECTION       SYRINGE                SAV        W            7.50%          N      31.3960               REGULAR BENEFIT
                                                1

20120416   ANTICOAGULANTS / HEPARINS 02012472       LOVENOX (0.3 ML SYRINGE)    N    ENOXAPARIN SODIUM               30 MG / SYR    INJECTION       SYRINGE                SAV        W            7.50%          N      6.3200                REGULAR BENEFIT
                                                1
                                                                                                                     1,000 UNIT /
20120416   ANTICOAGULANTS / HEPARINS 00453811       HEPARIN LEO                 N    HEPARIN SODIUM                  ML             INJECTION                              LEO        W            7.50%          N      0.5158     0.0000     REGULAR BENEFIT
                                                1
                                                                                                                     10,000 UNIT /
20120416   ANTICOAGULANTS / HEPARINS 00579718       HEPARIN LEO                 N    HEPARIN SODIUM                  ML            INJECTION                               LEO        W            7.50%          N      2.5671                REGULAR BENEFIT
                                                1
                                                                                                                     25,000 UNIT /
20120416   ANTICOAGULANTS / HEPARINS 00453781       HEPARIN LEO                 N    HEPARIN SODIUM                  ML            INJECTION                               LEO        W            7.50%          N      8.2155                REGULAR BENEFIT
                                                1

20120416   ANTICOAGULANTS / HEPARINS 00727520       HEPARIN LEO                 N    HEPARIN SODIUM                  100 UNIT / ML INJECTION        LOCK FLUSH             LEO        W            7.50%          N      0.4387     0.0000     REGULAR BENEFIT
                                                1




                                                                                                                      Updated July 1, 2012                                                                                                       Page 27 of 254
                                                                                            Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                         (Regular Benefits)


                                                                                                                                                                                  DISTRIBUTION   DISTRIBUTION     LCA               LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION       DIN / PIN          PRODUCT NAME           IC            GENERIC NAME             STRENGTH              ROUTE          FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE       PRICE         STATUS

20120416   ANTICOAGULANTS / HEPARINS 02236913       FRAXIPARINE (.3-1ML SYR)    N    NADROPARIN CALCIUM               9,500 IU / ML   INJECTION      SYRINGE                GSK        W            7.50%          N      9.1290                REGULAR BENEFIT
                                                1
                                                    FRAXIPARINE FORTE (.6-
20120416   ANTICOAGULANTS / HEPARINS 02240114       1ML SYR)                    N    NADROPARIN CALCIUM               19,000 IU / ML INJECTION       SYRINGE                GSK        W            7.50%          N      18.2580               REGULAR BENEFIT
                                                1

20120416   ANTICOAGULANTS / HEPARINS 02167840       INNOHEP                     N    TINZAPARIN SODIUM                10,000 IU / ML INJECTION                              LEO        W            7.50%          N      16.7604               REGULAR BENEFIT
                                                1

20120416   ANTICOAGULANTS / HEPARINS 02229515       INNOHEP                     N    TINZAPARIN SODIUM                20,000 IU / ML INJECTION                              LEO        W            7.50%          N      34.0445               REGULAR BENEFIT
                                                1

20120416   ANTICOAGULANTS / HEPARINS 02229755       INNOHEP (0.25 ML SYRINGE)   N    TINZAPARIN SODIUM                2,500 IU / SYR INJECTION       SYRINGE                LEO        W            7.50%          N      16.9070               REGULAR BENEFIT
                                                1

20120416   ANTICOAGULANTS / HEPARINS 02358158       INNOHEP (0.35 ML SYRINGE)   N    TINZAPARIN SODIUM                3,500 IU / SYR INJECTION       SYRINGE                LEO        W            7.50%          N      16.8950               REGULAR BENEFIT
                                                1

20120416   ANTICOAGULANTS / HEPARINS 02358166       INNOHEP (0.45 ML SYRINGE)   N    TINZAPARIN SODIUM                4,500 IU / SYR INJECTION       SYRINGE                LEO        W            7.50%          N      16.9000               REGULAR BENEFIT
                                                1
                                                                                                                      10,000 IU /
20120416   ANTICOAGULANTS / HEPARINS 02231478       INNOHEP (0.5 ML SYRINGE)    N    TINZAPARIN SODIUM                SYR             INJECTION      SYRINGE                LEO        W            7.50%          N      34.5058               REGULAR BENEFIT
                                                1
                                                                                                                      14,000 IU /
20120416   ANTICOAGULANTS / HEPARINS 02358174       INNOHEP (0.7 ML SYRINGE)    N    TINZAPARIN SODIUM                SYR             INJECTION      SYRINGE                LEO        W            7.50%          N      34.5263               REGULAR BENEFIT
                                                1
                                                                                                                      18,000 IU /
20120416   ANTICOAGULANTS / HEPARINS 02358182       INNOHEP (0.9 ML SYRINGE)    N    TINZAPARIN SODIUM                SYR             INJECTION      SYRINGE                LEO        W            7.50%          N      34.5217               REGULAR BENEFIT
                                                1
           ANTICOAGULANTS /
           MISCELLANEOUS
20120492   ANTICOAGULANTS            02245531       ARIXTRA (0.5 ML SYRINGE)    N    FONDAPARINUX SODIUM              2.5 MG / SYR INJECTION         SYRINGE                GSK        W            7.50%          N      15.7561               REGULAR BENEFIT
                                                1
           ANTICOAGULANTS /
           MISCELLANEOUS
20120492   ANTICOAGULANTS            02258056       ARIXTRA (0.6 ML SYRINGE)    N    FONDAPARINUX SODIUM              7.5 MG / SYR INJECTION         SYRINGE                GSK        W            7.50%          N      25.5250               REGULAR BENEFIT
                                                1
           PLATELET AGGREGATION                                                                                       200 MG * 25
201218     INHIBITORS /              02242119       AGGRENOX                    N    DIPYRIDAMOLE/ ASA                MG              ORAL           CAPSULE                BOE        B                           N      0.8492                REGULAR BENEFIT
                                                1
           PLATELET AGGREGATION
201218     INHIBITORS /              02236848       NOVO-TICLOPIDINE            Y    TICLOPIDINE HCL                  250 MG          ORAL           TABLET                 TEV        B                           Y      0.4303     0.4303     REGULAR BENEFIT
           PLATELET AGGREGATION
201218     INHIBITORS /              02243587       SANDOZ TICLOPIDINE          Y    TICLOPIDINE HCL                  250 MG          ORAL           TABLET                 SDZ        W                           Y      0.4303     0.4303     REGULAR BENEFIT
           PLATELET AGGREGATION
201218     INHIBITORS /              02237701       APO-TICLOPIDINE             Y    TICLOPIDINE HCL                  250 MG          ORAL           TABLET                 APX        B                           Y      0.4303     0.4303     REGULAR BENEFIT
                                                3




                                                                                                                       Updated July 1, 2012                                                                                                       Page 28 of 254
                                                                                       Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                    (Regular Benefits)


                                                                                                                                                                             DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION      DIN / PIN          PRODUCT NAME        IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                                                                                                                                SUSTAINED-
202400     HEMORRHEOLOGIC AGENTS / 02230090         APO-PENTOXIFYLLINE SR   Y    PENTOXIFYLLINE                  400 MG      ORAL               RELEASE TABLET         APX        B                           Y      0.5846    0.5846     REGULAR BENEFIT
                                                                                                                                                SUSTAINED-
202400     HEMORRHEOLOGIC AGENTS / 02221977         TRENTAL                 Y    PENTOXIFYLLINE                  400 MG      ORAL               RELEASE TABLET         SAV        W            7.50%          N      0.8097    0.5846     REGULAR BENEFIT
                                                2

202816     HEMOSTATICS /             02064405       CYKLOKAPRON             N    TRANEXAMIC ACID                 500 MG      ORAL               TABLET                 PFI        W            7.50%          N      1.1530               REGULAR BENEFIT
                                                1
           ANTIARRHYTHMIC AGENTS /
24040404   CLASS IA ANTIARRYTHMICS   02224801       RYTHMODAN               N    DISOPYRAMIDE                    100 MG      ORAL               CAPSULE                SAV        W            7.50%          N      0.2714               REGULAR BENEFIT
                                                1
           ANTIARRHYTHMIC AGENTS /
24040404   CLASS IA ANTIARRYTHMICS   02224828       RYTHMODAN               N    DISOPYRAMIDE                    150 MG      ORAL               CAPSULE                SAV        W            7.50%          N      0.3924               REGULAR BENEFIT
                                                1
           ANTIARRHYTHMIC AGENTS /                                                                                                              SUSTAINED-
24040404   CLASS IA ANTIARRYTHMICS   00638692       PROCAN SR               N    PROCAINAMIDE HCL                250 MG      ORAL               RELEASE TABLET         ERF        W            7.50%          N      0.3675               REGULAR BENEFIT
                                                1
           ANTIARRHYTHMIC AGENTS /                                                                                                              SUSTAINED-
24040404   CLASS IA ANTIARRYTHMICS   00638676       PROCAN SR               N    PROCAINAMIDE HCL                500 MG      ORAL               RELEASE TABLET         ERF        W            7.50%          N      0.5065               REGULAR BENEFIT
                                                1
           ANTIARRHYTHMIC AGENTS /                                                                                                              SUSTAINED-
24040404   CLASS IA ANTIARRYTHMICS   00638684       PROCAN SR               N    PROCAINAMIDE HCL                750 MG      ORAL               RELEASE TABLET         ERF        W            7.50%          N      0.8155               REGULAR BENEFIT
                                                1
           ANTIARRHYTHMIC AGENTS /
24040408   CLASS IB ANTIARRYTHMICS   02230359       NOVO-MEXILETINE         N    MEXILETINE HCL                  100 MG      ORAL               CAPSULE                TEV        B                           N      1.0203               REGULAR BENEFIT
                                                1
           ANTIARRHYTHMIC AGENTS /
24040408   CLASS IB ANTIARRYTHMICS   02230360       NOVO-MEXILETINE         N    MEXILETINE HCL                  200 MG      ORAL               CAPSULE                TEV        B                           N      1.3663               REGULAR BENEFIT
                                                1

           ANTIARRHYTHMIC AGENTS /
24040412   CLASS IC ANTIARRYTHMICS   02275538       FLECAINIDE              Y    FLECAINIDE ACETATE              50 MG       ORAL               TABLET                 AAP        W                           Y      0.4253    0.4253     REGULAR BENEFIT
           ANTIARRHYTHMIC AGENTS /
24040412   CLASS IC ANTIARRYTHMICS   01966197       TAMBOCOR                Y    FLECAINIDE ACETATE              50 MG       ORAL               TABLET                 MEP        W            7.50%          N      0.5384    0.4253     REGULAR BENEFIT
                                                2

           ANTIARRHYTHMIC AGENTS /
24040412   CLASS IC ANTIARRYTHMICS   02275546       FLECAINIDE              Y    FLECAINIDE ACETATE              100 MG      ORAL               TABLET                 AAP        W                           Y      0.8505    0.8505     REGULAR BENEFIT
           ANTIARRHYTHMIC AGENTS /
24040412   CLASS IC ANTIARRYTHMICS   01966200       TAMBOCOR                Y    FLECAINIDE ACETATE              100 MG      ORAL               TABLET                 MEP        W            7.50%          N      1.0770    0.8505     REGULAR BENEFIT
                                                2

           ANTIARRHYTHMIC AGENTS /
24040412   CLASS IC ANTIARRYTHMICS   02243324       APO-PROPAFENONE         Y    PROPAFENONE HCL                 150 MG      ORAL               TABLET                 APX        B                           Y      0.4275    0.4275     REGULAR BENEFIT
           ANTIARRHYTHMIC AGENTS /
24040412   CLASS IC ANTIARRYTHMICS   00603708       RYTHMOL                 Y    PROPAFENONE HCL                 150 MG      ORAL               TABLET                 ABB        B                           N      1.1834    0.4275     REGULAR BENEFIT
                                                2




                                                                                                                  Updated July 1, 2012                                                                                                      Page 29 of 254
                                                                                    Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                 (Regular Benefits)


                                                                                                                                                                          DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION       DIN / PIN           PRODUCT NAME   IC             GENERIC NAME           STRENGTH             ROUTE             FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

           ANTIARRHYTHMIC AGENTS /
24040412   CLASS IC ANTIARRYTHMICS    02243325       APO-PROPAFENONE     Y    PROPAFENONE HCL                 300 MG         ORAL            TABLET                 APX        B                           Y      0.7537    0.7537     REGULAR BENEFIT
           ANTIARRHYTHMIC AGENTS /
24040412   CLASS IC ANTIARRYTHMICS    00603716       RYTHMOL             Y    PROPAFENONE HCL                 300 MG         ORAL            TABLET                 ABB        B                           N      2.0859    0.7537     REGULAR BENEFIT
                                                 2

           ANTIARRHYTHMIC AGENTS /
24040420   CLASS III ANTIARRYTHMICS   02242472       PMS-AMIODARONE      Y    AMIODARONE HCL                  200 MG         ORAL            TABLET                 PMS        B                           Y      0.7747    0.7747     REGULAR BENEFIT

           ANTIARRHYTHMIC AGENTS /
24040420   CLASS III ANTIARRYTHMICS   02243836       SANDOZ AMIODARONE   Y    AMIODARONE HCL                  200 MG         ORAL            TABLET                 SDZ        W                           Y      0.7747    0.7747     REGULAR BENEFIT

           ANTIARRHYTHMIC AGENTS /
24040420   CLASS III ANTIARRYTHMICS   02240604       MYLAN-AMIODARONE    Y    AMIODARONE HCL                  200 MG         ORAL            TABLET                 MYP        W                           Y      0.7747    0.7747     REGULAR BENEFIT

           ANTIARRHYTHMIC AGENTS /
24040420   CLASS III ANTIARRYTHMICS   02240071       RATIO-AMIODARONE    Y    AMIODARONE HCL                  200 MG         ORAL            TABLET                 RPH        B                           Y      0.7747    0.7747     REGULAR BENEFIT

           ANTIARRHYTHMIC AGENTS /
24040420   CLASS III ANTIARRYTHMICS   02246194       APO-AMIODARONE      Y    AMIODARONE HCL                  200 MG         ORAL            TABLET                 APX        B                           Y      0.7747    0.7747     REGULAR BENEFIT

           ANTIARRHYTHMIC AGENTS /
24040420   CLASS III ANTIARRYTHMICS   02364336       AMIODARONE          Y    AMIODARONE HCL                  200 MG         ORAL            TABLET                 SNS        W                           Y      0.7747    0.7747     REGULAR BENEFIT

           ANTIARRHYTHMIC AGENTS /
24040420   CLASS III ANTIARRYTHMICS   02364263       AVA-AMIODARONE      Y    AMIODARONE HCL                  200 MG         ORAL            TABLET                 AVA        W                           Y      0.7747    0.7747     REGULAR BENEFIT

           ANTIARRHYTHMIC AGENTS /
24040420   CLASS III ANTIARRYTHMICS   02239835       TEVA-AMIODARONE     Y    AMIODARONE HCL                  200 MG         ORAL            TABLET                 TEV        B                           Y      0.7747    0.7747     REGULAR BENEFIT
           ANTIARRHYTHMIC AGENTS /
24040420   CLASS III ANTIARRYTHMICS   02036282       CORDARONE           Y    AMIODARONE HCL                  200 MG         ORAL            TABLET                 WAY        W            7.50%          N      2.0589    0.7747     REGULAR BENEFIT
                                                 9
           ANTIARRHYTHMIC AGENTS /
24040420   CLASS III ANTIARRYTHMICS   02292173       PMS-AMIODARONE      N    AMIODARONE HCL                  100 MG         ORAL            TABLET                 PMS        B                           N      0.7269               REGULAR BENEFIT
                                                 1

240408     CARDIOTONIC AGENTS /       02048272       DIGOXIN PEDIATRIC   N    DIGOXIN                         0.05 MG / ML   INJECTION                              SDZ        W            7.50%          N      7.2279               REGULAR BENEFIT
                                                 1

240408     CARDIOTONIC AGENTS /       02048264       DIGOXIN             N    DIGOXIN                         0.25 MG / ML   INJECTION                              SDZ        W            7.50%          N      2.9116               REGULAR BENEFIT
                                                 1

240408     CARDIOTONIC AGENTS /       02242320       TOLOXIN PEDIATRIC   N    DIGOXIN                         0.05 MG / ML   ORAL            ELIXIR                 PPH        W            7.50%          N      1.0411               REGULAR BENEFIT
                                                 1

240408     CARDIOTONIC AGENTS /       02335700       TOLOXIN             N    DIGOXIN                         0.0625 MG      ORAL            TABLET                 PPH        W            7.50%          N      0.2516               REGULAR BENEFIT
                                                 1

240408     CARDIOTONIC AGENTS /       02335719       TOLOXIN             N    DIGOXIN                         0.125 MG       ORAL            TABLET                 PPH        W            7.50%          N      0.2516               REGULAR BENEFIT




                                                                                                               Updated July 1, 2012                                                                                                      Page 30 of 254
                                                                                         Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                      (Regular Benefits)


                                                                                                                                                                               DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION        DIN / PIN           PRODUCT NAME         IC             GENERIC NAME           STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                                1

240408   CARDIOTONIC AGENTS /        02335727       TOLOXIN                   N    DIGOXIN                         0.25 MG     ORAL               TABLET                 PPH        W            7.50%          N      0.2516               REGULAR BENEFIT
                                                1

240604   BILE ACID SEQUESTRANTS /    02210320       OLESTYR REGULAR           Y    CHOLESTYRAMINE RESIN            4G          ORAL               POWDER PACKET          MMT        W                           Y      1.4900    1.4900     REGULAR BENEFIT

240604   BILE ACID SEQUESTRANTS /    00890960       OLESTYR LIGHT             Y    CHOLESTYRAMINE RESIN            4G          ORAL               POWDER PACKET          MMT        W                           Y      1.4900    1.4900     REGULAR BENEFIT
                                                2

240604   BILE ACID SEQUESTRANTS /    02132699       COLESTID ORANGE           Y    COLESTIPOL HCL                  5G          ORAL               POWDER PACKET          PFI        W            7.50%          N      0.9211    0.9902     REGULAR BENEFIT

240604   BILE ACID SEQUESTRANTS /    00642975       COLESTID                  Y    COLESTIPOL HCL                  5G          ORAL               POWDER PACKET          PFI        W            7.50%          N      0.9211    0.9902     REGULAR BENEFIT
                                                2

240604   BILE ACID SEQUESTRANTS /    02132680       COLESTID                  N    COLESTIPOL HCL                  1G          ORAL               TABLET                 PFI        W            7.50%          N      0.2576               REGULAR BENEFIT
                                                1
                                                                                                                                                  SUSTAINED-
240606   FIBRIC ACID DERIVATIVES /   02083523       BEZALIP                   N    BEZAFIBRATE                     400 MG      ORAL               RELEASE TABLET         ACV        W            7.50%          N      1.8269               REGULAR BENEFIT
                                                1

240606   FIBRIC ACID DERIVATIVES /   02356589       FENOFIBRATE-S (TABLET)    Y    FENOFIBRATE                     160 MG      ORAL               CAPSULE/TABLET         SNS        W                           Y      0.4488    0.4488     REGULAR BENEFIT
                                                    SANDOZ FENOFIBRATE S
240606   FIBRIC ACID DERIVATIVES /   02288052       (TABLET)                  Y    FENOFIBRATE                     160 MG      ORAL               CAPSULE/TABLET         SDZ        W                           Y      0.4488    0.4488     REGULAR BENEFIT

240606   FIBRIC ACID DERIVATIVES /   02246860       APO-FENO-SUPER (TABLET)   Y    FENOFIBRATE                     160 MG      ORAL               CAPSULE/TABLET         APX        B                           Y      0.4488    0.4488     REGULAR BENEFIT
                                                    NOVO-FENOFIBRATE-S
240606   FIBRIC ACID DERIVATIVES /   02289091       (TABLET)                  Y    FENOFIBRATE                     160 MG      ORAL               CAPSULE/TABLET         TEV        B                           Y      0.4488    0.4488     REGULAR BENEFIT

240606   FIBRIC ACID DERIVATIVES /   02241602       LIPIDIL SUPRA (TABLET)    Y    FENOFIBRATE                     160 MG      ORAL               CAPSULE/TABLET         FAB        B                           N      1.2823    0.4488     REGULAR BENEFIT
                                                5

240606   FIBRIC ACID DERIVATIVES /   02243180       APO-FENO-MICRO            Y    FENOFIBRATE                     67 MG       ORAL               CAPSULE                APX        B                           Y      0.4325    0.4325     REGULAR BENEFIT
                                                    NOVO-FENOFIBRATE
240606   FIBRIC ACID DERIVATIVES /   02243551       MICRONIZED                Y    FENOFIBRATE                     67 MG       ORAL               CAPSULE                TEV        B                           Y      0.4325    0.4325     REGULAR BENEFIT
                                                2

240606   FIBRIC ACID DERIVATIVES /   02225980       APO-FENOFIBRATE           N    FENOFIBRATE                     100 MG      ORAL               CAPSULE                APX        B                           N      0.6105               REGULAR BENEFIT
                                                1

240606   FIBRIC ACID DERIVATIVES /   02250039       RATIO-FENOFIBRATE MC      Y    FENOFIBRATE                     200 MG      ORAL               CAPSULE                RPH        B                           Y      0.6806    0.6806     REGULAR BENEFIT

240606   FIBRIC ACID DERIVATIVES /   02239864       APO-FENO-MICRO            Y    FENOFIBRATE                     200 MG      ORAL               CAPSULE                APX        B                           Y      0.6806    0.6806     REGULAR BENEFIT

240606   FIBRIC ACID DERIVATIVES /   02364409       AVA-FENOFIBRATE MICRO     Y    FENOFIBRATE                     200 MG      ORAL               CAPSULE                AVA        W                           Y      0.6806    0.6806     REGULAR BENEFIT

240606   FIBRIC ACID DERIVATIVES /   02286092       FENOFIBRATE MICRO         Y    FENOFIBRATE                     200 MG      ORAL               CAPSULE                SNS        W                           Y      0.6806    0.6806     REGULAR BENEFIT

240606   FIBRIC ACID DERIVATIVES /   02273551       PMS-FENOFIBRATE MICRO     Y    FENOFIBRATE                     200 MG      ORAL               CAPSULE                PMS        B                           Y      0.6806    0.6806     REGULAR BENEFIT




                                                                                                                    Updated July 1, 2012                                                                                                      Page 31 of 254
                                                                                      Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                   (Regular Benefits)


                                                                                                                                                                            DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION        DIN / PIN           PRODUCT NAME      IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                                    MYLAN-FENOFIBRATE
240606   FIBRIC ACID DERIVATIVES /   02240210       MICRO                  Y    FENOFIBRATE                     200 MG      ORAL               CAPSULE                MYP        W                           Y      0.6806    0.6806     REGULAR BENEFIT
                                                    NOVO-FENOFIBRATE
240606   FIBRIC ACID DERIVATIVES /   02243552       MICRONIZED             Y    FENOFIBRATE                     200 MG      ORAL               CAPSULE                TEV        B                           Y      0.6806    0.6806     REGULAR BENEFIT

240606   FIBRIC ACID DERIVATIVES /   02146959       LIPIDIL MICRO          Y    FENOFIBRATE                     200 MG      ORAL               CAPSULE                FAB        B                           N      1.0890    0.6806     REGULAR BENEFIT
                                                8

240606   FIBRIC ACID DERIVATIVES /   02356570       FENOFIBRATE-S          Y    FENOFIBRATE                     100 MG      ORAL               TABLET                 SNS        W                           Y      0.5407    0.5407     REGULAR BENEFIT

240606   FIBRIC ACID DERIVATIVES /   02246859       APO-FENO-SUPER         Y    FENOFIBRATE                     100 MG      ORAL               TABLET                 APX        B                           Y      0.5407    0.5407     REGULAR BENEFIT

240606   FIBRIC ACID DERIVATIVES /   02289083       NOVO-FENOFIBRATE-S     Y    FENOFIBRATE                     100 MG      ORAL               TABLET                 TEV        B                           Y      0.5407    0.5407     REGULAR BENEFIT

240606   FIBRIC ACID DERIVATIVES /   02288044       SANDOZ FENOFIBRATE S   Y    FENOFIBRATE                     100 MG      ORAL               TABLET                 SDZ        W                           N      0.5409    0.5407     REGULAR BENEFIT

240606   FIBRIC ACID DERIVATIVES /   02241601       LIPIDIL SUPRA          Y    FENOFIBRATE                     100 MG      ORAL               TABLET                 FAB        B                           N      1.1130    0.5407     REGULAR BENEFIT
                                                5

240606   FIBRIC ACID DERIVATIVES /   02185407       MYLAN-GEMFIBROZIL      Y    GEMFIBROZIL                     300 MG      ORAL               CAPSULE                MYP        W                           Y      0.1853    0.1853     REGULAR BENEFIT

240606   FIBRIC ACID DERIVATIVES /   01979574       APO-GEMFIBROZIL        Y    GEMFIBROZIL                     300 MG      ORAL               CAPSULE                APX        B                           Y      0.1853    0.1853     REGULAR BENEFIT

240606   FIBRIC ACID DERIVATIVES /   02239951       PMS-GEMFIBROZIL        Y    GEMFIBROZIL                     300 MG      ORAL               CAPSULE                PMS        B                           Y      0.1853    0.1853     REGULAR BENEFIT

240606   FIBRIC ACID DERIVATIVES /   02241704       NOVO-GEMFIBROZIL       Y    GEMFIBROZIL                     300 MG      ORAL               CAPSULE                TEV        B                           Y      0.1853    0.1853     REGULAR BENEFIT
                                                4

240606   FIBRIC ACID DERIVATIVES /   02230476       MYLAN-GEMFIBROZIL      Y    GEMFIBROZIL                     600 MG      ORAL               TABLET                 MYP        W                           Y      0.5157    0.5157     REGULAR BENEFIT

240606   FIBRIC ACID DERIVATIVES /   02142074       NOVO-GEMFIBROZIL       Y    GEMFIBROZIL                     600 MG      ORAL               TABLET                 TEV        B                           Y      0.5157    0.5157     REGULAR BENEFIT

240606   FIBRIC ACID DERIVATIVES /   01979582       APO-GEMFIBROZIL        Y    GEMFIBROZIL                     600 MG      ORAL               TABLET                 APX        B                           Y      0.5157    0.5157     REGULAR BENEFIT

240606   FIBRIC ACID DERIVATIVES /   02230183       PMS-GEMFIBROZIL        Y    GEMFIBROZIL                     600 MG      ORAL               TABLET                 PMS        B                           Y      0.5157    0.5157     REGULAR BENEFIT
                                                4
         HMG-COA REDUCTASE
240608   INHIBITORS /                02288346       GD-ATORVASTATIN        Y    ATORVASTATIN CALCIUM            10 MG       ORAL               TABLET                 GMD        W                           Y      0.6558    0.6558     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /                02348705       ATORVASTATIN           Y    ATORVASTATIN CALCIUM            10 MG       ORAL               TABLET                 SNS        W                           Y      0.6558    0.6558     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /                02350297       RATIO-ATORVASTATIN     Y    ATORVASTATIN CALCIUM            10 MG       ORAL               TABLET                 RPH        B                           Y      0.6558    0.6558     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /                02302675       NOVO-ATORVASTATIN      Y    ATORVASTATIN CALCIUM            10 MG       ORAL               TABLET                 TEV        B                           Y      0.6558    0.6558     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /                02310899       CO ATORVASTATIN        Y    ATORVASTATIN CALCIUM            10 MG       ORAL               TABLET                 COB        B                           Y      0.6558    0.6558     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /                02324946       SANDOZ ATORVASTATIN    Y    ATORVASTATIN CALCIUM            10 MG       ORAL               TABLET                 SDZ        B                           Y      0.6558    0.6558     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /                02313707       RAN-ATORVASTATIN       Y    ATORVASTATIN CALCIUM            10 MG       ORAL               TABLET                 RAN        B                           Y      0.6558    0.6558     REGULAR BENEFIT




                                                                                                                 Updated July 1, 2012                                                                                                      Page 32 of 254
                                                                            Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                         (Regular Benefits)


                                                                                                                                                                  DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION   DIN / PIN        PRODUCT NAME     IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         HMG-COA REDUCTASE
240608   INHIBITORS /          02295261    APO-ATORVASTATIN      Y    ATORVASTATIN CALCIUM            10 MG       ORAL               TABLET                 APX        B                           Y      0.6558    0.6558     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02373203    MYLAN-ATORVASTATIN    Y    ATORVASTATIN CALCIUM            10 MG       ORAL               TABLET                 MYP        W                           Y      0.6558    0.6558     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02313448    PMS-ATORVASTATIN      Y    ATORVASTATIN CALCIUM            10 MG       ORAL               TABLET                 PMS        B                           Y      0.6558    0.6558     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02230711    LIPITOR               Y    ATORVASTATIN CALCIUM            10 MG       ORAL               TABLET                 PFI        W            7.50%          N      1.7431    0.6558     REGULAR BENEFIT
                                      11
         HMG-COA REDUCTASE
240608   INHIBITORS /          02288354    GD-ATORVASTATIN       Y    ATORVASTATIN CALCIUM            20 MG       ORAL               TABLET                 GMD        W                           Y      0.8198    0.8198     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02348713    ATORVASTATIN          Y    ATORVASTATIN CALCIUM            20 MG       ORAL               TABLET                 SNS        W                           Y      0.8198    0.8198     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02313456    PMS-ATORVASTATIN      Y    ATORVASTATIN CALCIUM            20 MG       ORAL               TABLET                 PMS        B                           Y      0.8198    0.8198     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02302683    NOVO-ATORVASTATIN     Y    ATORVASTATIN CALCIUM            20 MG       ORAL               TABLET                 TEV        B                           Y      0.8198    0.8198     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02350319    RATIO-ATORVASTATIN    Y    ATORVASTATIN CALCIUM            20 MG       ORAL               TABLET                 RPH        B                           Y      0.8198    0.8198     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02310902    CO ATORVASTATIN       Y    ATORVASTATIN CALCIUM            20 MG       ORAL               TABLET                 COB        B                           Y      0.8198    0.8198     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02324954    SANDOZ ATORVASTATIN   Y    ATORVASTATIN CALCIUM            20 MG       ORAL               TABLET                 SDZ        B                           Y      0.8198    0.8198     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02313715    RAN-ATORVASTATIN      Y    ATORVASTATIN CALCIUM            20 MG       ORAL               TABLET                 RAN        B                           Y      0.8198    0.8198     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02295288    APO-ATORVASTATIN      Y    ATORVASTATIN CALCIUM            20 MG       ORAL               TABLET                 APX        B                           Y      0.8198    0.8198     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02373211    MYLAN-ATORVASTATIN    Y    ATORVASTATIN CALCIUM            20 MG       ORAL               TABLET                 MYP        W                           Y      0.8198    0.8198     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02230713    LIPITOR               Y    ATORVASTATIN CALCIUM            20 MG       ORAL               TABLET                 PFI        W            7.50%          N      2.1788    0.8198     REGULAR BENEFIT
                                      11
         HMG-COA REDUCTASE
240608   INHIBITORS /          02295296    APO-ATORVASTATIN      Y    ATORVASTATIN CALCIUM            40 MG       ORAL               TABLET                 APX        B                           Y      0.8812    0.8812     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02288362    GD-ATORVASTATIN       Y    ATORVASTATIN CALCIUM            40 MG       ORAL               TABLET                 GMD        W                           Y      0.8812    0.8812     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02348721    ATORVASTATIN          Y    ATORVASTATIN CALCIUM            40 MG       ORAL               TABLET                 SNS        W                           Y      0.8812    0.8812     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02313464    PMS-ATORVASTATIN      Y    ATORVASTATIN CALCIUM            40 MG       ORAL               TABLET                 PMS        B                           Y      0.8812    0.8812     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02302691    NOVO-ATORVASTATIN     Y    ATORVASTATIN CALCIUM            40 MG       ORAL               TABLET                 TEV        B                           Y      0.8812    0.8812     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02350327    RATIO-ATORVASTATIN    Y    ATORVASTATIN CALCIUM            40 MG       ORAL               TABLET                 RPH        B                           Y      0.8812    0.8812     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02310910    CO ATORVASTATIN       Y    ATORVASTATIN CALCIUM            40 MG       ORAL               TABLET                 COB        B                           Y      0.8812    0.8812     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02324962    SANDOZ ATORVASTATIN   Y    ATORVASTATIN CALCIUM            40 MG       ORAL               TABLET                 SDZ        B                           Y      0.8812    0.8812     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02313723    RAN-ATORVASTATIN      Y    ATORVASTATIN CALCIUM            40 MG       ORAL               TABLET                 RAN        B                           Y      0.8812    0.8812     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02373238    MYLAN-ATORVASTATIN    Y    ATORVASTATIN CALCIUM            40 MG       ORAL               TABLET                 MYP        W                           Y      0.8812    0.8812     REGULAR BENEFIT




                                                                                                       Updated July 1, 2012                                                                                                      Page 33 of 254
                                                                               Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                            (Regular Benefits)


                                                                                                                                                                     DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION   DIN / PIN           PRODUCT NAME     IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         HMG-COA REDUCTASE
240608   INHIBITORS /          02230714       LIPITOR               Y    ATORVASTATIN CALCIUM            40 MG       ORAL               TABLET                 PFI        W            7.50%          N      2.3420    0.8812     REGULAR BENEFIT
                                      11
         HMG-COA REDUCTASE
240608   INHIBITORS /          02295318       APO-ATORVASTATIN      Y    ATORVASTATIN CALCIUM            80 MG       ORAL               TABLET                 APX        B                           Y      0.8812    0.8812     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02288370       GD-ATORVASTATIN       Y    ATORVASTATIN CALCIUM            80 MG       ORAL               TABLET                 GMD        W                           Y      0.8812    0.8812     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02348748       ATORVASTATIN          Y    ATORVASTATIN CALCIUM            80 MG       ORAL               TABLET                 SNS        W                           Y      0.8812    0.8812     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02313472       PMS-ATORVASTATIN      Y    ATORVASTATIN CALCIUM            80 MG       ORAL               TABLET                 PMS        B                           Y      0.8812    0.8812     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02302713       NOVO-ATORVASTATIN     Y    ATORVASTATIN CALCIUM            80 MG       ORAL               TABLET                 TEV        B                           Y      0.8812    0.8812     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02350335       RATIO-ATORVASTATIN    Y    ATORVASTATIN CALCIUM            80 MG       ORAL               TABLET                 RPH        B                           Y      0.8812    0.8812     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02310929       CO ATORVASTATIN       Y    ATORVASTATIN CALCIUM            80 MG       ORAL               TABLET                 COB        B                           Y      0.8812    0.8812     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02324970       SANDOZ ATORVASTATIN   Y    ATORVASTATIN CALCIUM            80 MG       ORAL               TABLET                 SDZ        B                           Y      0.8812    0.8812     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02313758       RAN-ATORVASTATIN      Y    ATORVASTATIN CALCIUM            80 MG       ORAL               TABLET                 RAN        B                           Y      0.8812    0.8812     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02373246       MYLAN-ATORVASTATIN    Y    ATORVASTATIN CALCIUM            80 MG       ORAL               TABLET                 MYP        W                           Y      0.8812    0.8812     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02243097       LIPITOR               Y    ATORVASTATIN CALCIUM            80 MG       ORAL               TABLET                 PFI        W            7.50%          N      2.3421    0.8812     REGULAR BENEFIT
                                      11
         HMG-COA REDUCTASE
240608   INHIBITORS /          02061562       LESCOL                N    FLUVASTATIN SODIUM              20 MG       ORAL               CAPSULE                NOV        W            7.50%          N      0.8732               REGULAR BENEFIT
                                          1
         HMG-COA REDUCTASE
240608   INHIBITORS /          02061570       LESCOL                N    FLUVASTATIN SODIUM              40 MG       ORAL               CAPSULE                NOV        W            7.50%          N      1.2261               REGULAR BENEFIT
                                          1
         HMG-COA REDUCTASE                                                                                                              EXTENDED-RELEASE
240608   INHIBITORS /          02250527       LESCOL XL             N    FLUVASTATIN SODIUM              80 MG       ORAL               TABLET                 NOV        W            7.50%          N      1.4756               REGULAR BENEFIT
                                          1
         HMG-COA REDUCTASE
240608   INHIBITORS /          02364239       AVA-LOVASTATIN        Y    LOVASTATIN                      20 MG       ORAL               TABLET                 AVA        W                           Y      0.7213    0.7213     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02353229       LOVASTATIN            Y    LOVASTATIN                      20 MG       ORAL               TABLET                 SNS        W                           Y      0.7213    0.7213     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02243127       MYLAN-LOVASTATIN      Y    LOVASTATIN                      20 MG       ORAL               TABLET                 MYP        W                           Y      0.7213    0.7213     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02246542       NOVO-LOVASTATIN       Y    LOVASTATIN                      20 MG       ORAL               TABLET                 TEV        B                           Y      0.7213    0.7213     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247056       SANDOZ LOVASTATIN     Y    LOVASTATIN                      20 MG       ORAL               TABLET                 SDZ        W                           Y      0.7213    0.7213     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02245822       RATIO-LOVASTATIN      Y    LOVASTATIN                      20 MG       ORAL               TABLET                 RPH        B                           Y      0.7213    0.7213     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02246013       PMS-LOVASTATIN        Y    LOVASTATIN                      20 MG       ORAL               TABLET                 PMS        B                           Y      0.7213    0.7213     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02248572       CO LOVASTATIN         Y    LOVASTATIN                      20 MG       ORAL               TABLET                 COB        W                           Y      0.7213    0.7213     REGULAR BENEFIT




                                                                                                          Updated July 1, 2012                                                                                                      Page 34 of 254
                                                                           Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                        (Regular Benefits)


                                                                                                                                                                 DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION   DIN / PIN       PRODUCT NAME     IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         HMG-COA REDUCTASE
240608   INHIBITORS /          02220172    APO-LOVASTATIN       Y    LOVASTATIN                      20 MG       ORAL               TABLET                 APX        B                           Y      0.7213    0.7213     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          00795860    MEVACOR              Y    LOVASTATIN                      20 MG       ORAL               TABLET                 MFC        B                           N      2.0609    0.7213     REGULAR BENEFIT
                                      10
         HMG-COA REDUCTASE
240608   INHIBITORS /          02364247    AVA-LOVASTATIN       Y    LOVASTATIN                      40 MG       ORAL               TABLET                 AVA        W                           Y      1.3176    1.3176     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02353237    LOVASTATIN           Y    LOVASTATIN                      40 MG       ORAL               TABLET                 SNS        W                           Y      1.3176    1.3176     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02220180    APO-LOVASTATIN       Y    LOVASTATIN                      40 MG       ORAL               TABLET                 APX        B                           Y      1.3176    1.3176     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02243129    MYLAN-LOVASTATIN     Y    LOVASTATIN                      40 MG       ORAL               TABLET                 MYP        W                           Y      1.3176    1.3176     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02246543    NOVO-LOVASTATIN      Y    LOVASTATIN                      40 MG       ORAL               TABLET                 TEV        B                           Y      1.3176    1.3176     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247057    SANDOZ LOVASTATIN    Y    LOVASTATIN                      40 MG       ORAL               TABLET                 SDZ        W                           Y      1.3176    1.3176     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02245823    RATIO-LOVASTATIN     Y    LOVASTATIN                      40 MG       ORAL               TABLET                 RPH        B                           Y      1.3176    1.3176     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02246014    PMS-LOVASTATIN       Y    LOVASTATIN                      40 MG       ORAL               TABLET                 PMS        B                           Y      1.3176    1.3176     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02248573    CO LOVASTATIN        Y    LOVASTATIN                      40 MG       ORAL               TABLET                 COB        W                           Y      1.3176    1.3176     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          00795852    MEVACOR              Y    LOVASTATIN                      40 MG       ORAL               TABLET                 MFC        B                           N      3.7647    1.3176     REGULAR BENEFIT
                                      10
         HMG-COA REDUCTASE
240608   INHIBITORS /          02257092    MYLAN-PRAVASTATIN    Y    PRAVASTATIN SODIUM              10 MG       ORAL               TABLET                 MYP        W                           Y      0.5956    0.5956     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02248182    CO PRAVASTATIN       Y    PRAVASTATIN SODIUM              10 MG       ORAL               TABLET                 COB        W                           Y      0.5956    0.5956     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02284421    RAN-PRAVASTATIN      Y    PRAVASTATIN SODIUM              10 MG       ORAL               TABLET                 RAN        B                           Y      0.5956    0.5956     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02332191    PRAVASTATIN          Y    PRAVASTATIN SODIUM              10 MG       ORAL               TABLET                 RAN        B                           Y      0.5956    0.5956     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02317451    MINT-PRAVASTATIN     Y    PRAVASTATIN SODIUM              10 MG       ORAL               TABLET                 MPI        B                           Y      0.5956    0.5956     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02243506    APO-PRAVASTATIN      Y    PRAVASTATIN SODIUM              10 MG       ORAL               TABLET                 APX        B                           Y      0.5956    0.5956     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247008    NOVO-PRAVASTATIN     Y    PRAVASTATIN SODIUM              10 MG       ORAL               TABLET                 TEV        B                           Y      0.5956    0.5956     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247655    PMS-PRAVASTATIN      Y    PRAVASTATIN SODIUM              10 MG       ORAL               TABLET                 PMS        B                           Y      0.5956    0.5956     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247856    SANDOZ PRAVASTATIN   Y    PRAVASTATIN SODIUM              10 MG       ORAL               TABLET                 SDZ        W                           Y      0.5956    0.5956     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02356546    PRAVASTATIN          Y    PRAVASTATIN SODIUM              10 MG       ORAL               TABLET                 SNS        W                           Y      0.5956    0.5956     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02330954    JAMP-PRAVASTATIN     Y    PRAVASTATIN SODIUM              10 MG       ORAL               TABLET                 JPC        B                           Y      0.5956    0.5956     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          00893749    PRAVACHOL            Y    PRAVASTATIN SODIUM              10 MG       ORAL               TABLET                 BMS        B                           N      0.9530    0.5956     REGULAR BENEFIT
                                      12




                                                                                                      Updated July 1, 2012                                                                                                      Page 35 of 254
                                                                           Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                        (Regular Benefits)


                                                                                                                                                                 DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION   DIN / PIN       PRODUCT NAME     IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247857    SANDOZ PRAVASTATIN   Y    PRAVASTATIN SODIUM              20 MG       ORAL               TABLET                 SDZ        W                           Y      0.7027    0.7027     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02257106    MYLAN-PRAVASTATIN    Y    PRAVASTATIN SODIUM              20 MG       ORAL               TABLET                 MYP        W                           Y      0.7027    0.7027     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02248183    CO PRAVASTATIN       Y    PRAVASTATIN SODIUM              20 MG       ORAL               TABLET                 COB        W                           Y      0.7027    0.7027     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02284448    RAN-PRAVASTATIN      Y    PRAVASTATIN SODIUM              20 MG       ORAL               TABLET                 RAN        B                           Y      0.7027    0.7027     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02332205    PRAVASTATIN          Y    PRAVASTATIN SODIUM              20 MG       ORAL               TABLET                 RAN        B                           Y      0.7027    0.7027     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02317478    MINT-PRAVASTATIN     Y    PRAVASTATIN SODIUM              20 MG       ORAL               TABLET                 MPI        B                           Y      0.7027    0.7027     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02243507    APO-PRAVASTATIN      Y    PRAVASTATIN SODIUM              20 MG       ORAL               TABLET                 APX        B                           Y      0.7027    0.7027     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247009    NOVO-PRAVASTATIN     Y    PRAVASTATIN SODIUM              20 MG       ORAL               TABLET                 TEV        B                           Y      0.7027    0.7027     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247656    PMS-PRAVASTATIN      Y    PRAVASTATIN SODIUM              20 MG       ORAL               TABLET                 PMS        B                           Y      0.7027    0.7027     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02356554    PRAVASTATIN          Y    PRAVASTATIN SODIUM              20 MG       ORAL               TABLET                 SNS        W                           Y      0.7027    0.7027     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02330962    JAMP-PRAVASTATIN     Y    PRAVASTATIN SODIUM              20 MG       ORAL               TABLET                 JPC        B                           Y      0.7027    0.7027     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          00893757    PRAVACHOL            Y    PRAVASTATIN SODIUM              20 MG       ORAL               TABLET                 BMS        B                           N      1.1243    0.7027     REGULAR BENEFIT
                                      12
         HMG-COA REDUCTASE
240608   INHIBITORS /          02330970    JAMP-PRAVASTATIN     Y    PRAVASTATIN SODIUM              40 MG       ORAL               TABLET                 JPC        B                           Y      0.8464    0.8464     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02257114    MYLAN-PRAVASTATIN    Y    PRAVASTATIN SODIUM              40 MG       ORAL               TABLET                 MYP        W                           Y      0.8464    0.8464     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02248184    CO PRAVASTATIN       Y    PRAVASTATIN SODIUM              40 MG       ORAL               TABLET                 COB        W                           Y      0.8464    0.8464     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02284456    RAN-PRAVASTATIN      Y    PRAVASTATIN SODIUM              40 MG       ORAL               TABLET                 RAN        B                           Y      0.8464    0.8464     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02332213    PRAVASTATIN          Y    PRAVASTATIN SODIUM              40 MG       ORAL               TABLET                 RAN        B                           Y      0.8464    0.8464     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02317486    MINT-PRAVASTATIN     Y    PRAVASTATIN SODIUM              40 MG       ORAL               TABLET                 MPI        B                           Y      0.8464    0.8464     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02243508    APO-PRAVASTATIN      Y    PRAVASTATIN SODIUM              40 MG       ORAL               TABLET                 APX        B                           Y      0.8464    0.8464     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247010    NOVO-PRAVASTATIN     Y    PRAVASTATIN SODIUM              40 MG       ORAL               TABLET                 TEV        B                           Y      0.8464    0.8464     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247657    PMS-PRAVASTATIN      Y    PRAVASTATIN SODIUM              40 MG       ORAL               TABLET                 PMS        B                           Y      0.8464    0.8464     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02356562    PRAVASTATIN          Y    PRAVASTATIN SODIUM              40 MG       ORAL               TABLET                 SNS        W                           Y      0.8464    0.8464     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247858    SANDOZ PRAVASTATIN   Y    PRAVASTATIN SODIUM              40 MG       ORAL               TABLET                 SDZ        W                           Y      0.8464    0.8464     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02222051    PRAVACHOL            Y    PRAVASTATIN SODIUM              40 MG       ORAL               TABLET                 BMS        B                           N      1.3543    0.8464     REGULAR BENEFIT
                                      12
         HMG-COA REDUCTASE
240608   INHIBITORS /          02337975    APO-ROSUVASTATIN     Y    ROSUVASTATIN CALCIUM            5 MG        ORAL               TABLET                 APX        B                           Y      0.4854    0.4854     REGULAR BENEFIT




                                                                                                      Updated July 1, 2012                                                                                                      Page 36 of 254
                                                                               Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                            (Regular Benefits)


                                                                                                                                                                     DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION   DIN / PIN          PRODUCT NAME      IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         HMG-COA REDUCTASE
240608   INHIBITORS /          02381265       MYLAN-ROSUVASTATIN    Y    ROSUVASTATIN CALCIUM            5 MG        ORAL               TABLET                 MYP        W                           Y      0.4854    0.4854     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02338726       SANDOZ ROSUVASTATIN   Y    ROSUVASTATIN CALCIUM            5 MG        ORAL               TABLET                 SDZ        W                           Y      0.4854    0.4854     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02339765       CO ROSUVASTATIN       Y    ROSUVASTATIN CALCIUM            5 MG        ORAL               TABLET                 COB        W                           Y      0.4854    0.4854     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02354608       TEVA-ROSUVASTATIN     Y    ROSUVASTATIN CALCIUM            5 MG        ORAL               TABLET                 TEV        B                           Y      0.4854    0.4854     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02378523       PMS-ROSUVASTATIN      Y    ROSUVASTATIN CALCIUM            5 MG        ORAL               TABLET                 PMS        B                           Y      0.4854    0.4854     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02382644       RAN-ROSUVASTATIN      Y    ROSUVASTATIN CALCIUM            5 MG        ORAL               TABLET                 RAN        B                           Y      0.4854    0.4854     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02265540       CRESTOR               Y    ROSUVASTATIN CALCIUM            5 MG        ORAL               TABLET                 AZC        W            7.50%          N      1.2900    0.4854     REGULAR BENEFIT
                                          8
         HMG-COA REDUCTASE
240608   INHIBITORS /          02337983       APO-ROSUVASTATIN      Y    ROSUVASTATIN CALCIUM            10 MG       ORAL               TABLET                 APX        B                           Y      0.5117    0.5117     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02381273       MYLAN-ROSUVASTATIN    Y    ROSUVASTATIN CALCIUM            10 MG       ORAL               TABLET                 MYP        W                           Y      0.5117    0.5117     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02338734       SANDOZ ROSUVASTATIN   Y    ROSUVASTATIN CALCIUM            10 MG       ORAL               TABLET                 SDZ        W                           Y      0.5117    0.5117     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02339773       CO ROSUVASTATIN       Y    ROSUVASTATIN CALCIUM            10 MG       ORAL               TABLET                 COB        W                           Y      0.5117    0.5117     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02354616       TEVA-ROSUVASTATIN     Y    ROSUVASTATIN CALCIUM            10 MG       ORAL               TABLET                 TEV        B                           Y      0.5117    0.5117     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02378531       PMS-ROSUVASTATIN      Y    ROSUVASTATIN CALCIUM            10 MG       ORAL               TABLET                 PMS        B                           Y      0.5117    0.5117     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02382652       RAN-ROSUVASTATIN      Y    ROSUVASTATIN CALCIUM            10 MG       ORAL               TABLET                 RAN        B                           Y      0.5117    0.5117     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247162       CRESTOR               Y    ROSUVASTATIN CALCIUM            10 MG       ORAL               TABLET                 AZC        W            7.50%          N      1.3600    0.5117     REGULAR BENEFIT
                                          8
         HMG-COA REDUCTASE
240608   INHIBITORS /          02337991       APO-ROSUVASTATIN      Y    ROSUVASTATIN CALCIUM            20 MG       ORAL               TABLET                 APX        B                           Y      0.6396    0.6396     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02381281       MYLAN-ROSUVASTATIN    Y    ROSUVASTATIN CALCIUM            20 MG       ORAL               TABLET                 MYP        W                           Y      0.6396    0.6396     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02338742       SANDOZ ROSUVASTATIN   Y    ROSUVASTATIN CALCIUM            20 MG       ORAL               TABLET                 SDZ        W                           Y      0.6396    0.6396     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02339781       CO ROSUVASTATIN       Y    ROSUVASTATIN CALCIUM            20 MG       ORAL               TABLET                 COB        W                           Y      0.6396    0.6396     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02354624       TEVA-ROSUVASTATIN     Y    ROSUVASTATIN CALCIUM            20 MG       ORAL               TABLET                 TEV        B                           Y      0.6396    0.6396     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02378558       PMS-ROSUVASTATIN      Y    ROSUVASTATIN CALCIUM            20 MG       ORAL               TABLET                 PMS        B                           Y      0.6396    0.6396     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02382660       RAN-ROSUVASTATIN      Y    ROSUVASTATIN CALCIUM            20 MG       ORAL               TABLET                 RAN        B                           Y      0.6396    0.6396     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247163       CRESTOR               Y    ROSUVASTATIN CALCIUM            20 MG       ORAL               TABLET                 AZC        W            7.50%          N      1.7000    0.6396     REGULAR BENEFIT
                                          8
         HMG-COA REDUCTASE
240608   INHIBITORS /          02382679       RAN-ROSUVASTATIN      Y    ROSUVASTATIN CALCIUM            40 MG       ORAL               TABLET                 RAN        B                           Y      0.7487    0.7487     REGULAR BENEFIT




                                                                                                          Updated July 1, 2012                                                                                                      Page 37 of 254
                                                                               Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                            (Regular Benefits)


                                                                                                                                                                     DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION   DIN / PIN          PRODUCT NAME      IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         HMG-COA REDUCTASE
240608   INHIBITORS /          02338009       APO-ROSUVASTATIN      Y    ROSUVASTATIN CALCIUM            40 MG       ORAL               TABLET                 APX        B                           Y      0.7487    0.7487     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02381303       MYLAN-ROSUVASTATIN    Y    ROSUVASTATIN CALCIUM            40 MG       ORAL               TABLET                 MYP        W                           Y      0.7487    0.7487     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02338750       SANDOZ ROSUVASTATIN   Y    ROSUVASTATIN CALCIUM            40 MG       ORAL               TABLET                 SDZ        W                           Y      0.7487    0.7487     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02339803       CO ROSUVASTATIN       Y    ROSUVASTATIN CALCIUM            40 MG       ORAL               TABLET                 COB        W                           Y      0.7487    0.7487     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02354632       TEVA-ROSUVASTATIN     Y    ROSUVASTATIN CALCIUM            40 MG       ORAL               TABLET                 TEV        B                           Y      0.7487    0.7487     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02378566       PMS-ROSUVASTATIN      Y    ROSUVASTATIN CALCIUM            40 MG       ORAL               TABLET                 PMS        B                           Y      0.7487    0.7487     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247164       CRESTOR               Y    ROSUVASTATIN CALCIUM            40 MG       ORAL               TABLET                 AZC        W            7.50%          N      1.9900    0.7487     REGULAR BENEFIT
                                          8
         HMG-COA REDUCTASE
240608   INHIBITORS /          02248103       CO SIMVASTATIN        Y    SIMVASTATIN                     5 MG        ORAL               TABLET                 COB        W                           Y      0.3704    0.3704     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247011       APO-SIMVASTATIN       Y    SIMVASTATIN                     5 MG        ORAL               TABLET                 APX        B                           Y      0.3704    0.3704     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02269252       PMS-SIMVASTATIN       Y    SIMVASTATIN                     5 MG        ORAL               TABLET                 PMS        B                           Y      0.3704    0.3704     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02250144       TEVA-SIMVASTATIN      Y    SIMVASTATIN                     5 MG        ORAL               TABLET                 TEV        B                           Y      0.3704    0.3704     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02331020       JAMP-SIMVASTATIN      Y    SIMVASTATIN                     5 MG        ORAL               TABLET                 JPC        B                           Y      0.3704    0.3704     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02246582       MYLAN-SIMVASTATIN     Y    SIMVASTATIN                     5 MG        ORAL               TABLET                 MYP        W                           Y      0.3704    0.3704     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02378884       SIMVASTATIN-ODAN      Y    SIMVASTATIN                     5 MG        ORAL               TABLET                 ODN        B                           Y      0.3704    0.3704     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02375036       MAR-SIMVASTATIN       Y    SIMVASTATIN                     5 MG        ORAL               TABLET                 MAR        W                           Y      0.3704    0.3704     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02281546       PHL-SIMVASTATIN       Y    SIMVASTATIN                     5 MG        ORAL               TABLET                 PHH        B                           Y      0.3704    0.3704     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02329131       RAN-SIMVASTATIN       Y    SIMVASTATIN                     5 MG        ORAL               TABLET                 RAN        B                           Y      0.3704    0.3704     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02284723       SIMVASTATIN           Y    SIMVASTATIN                     5 MG        ORAL               TABLET                 SNS        W                           Y      0.3704    0.3704     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02331969       SIMVASTATIN           Y    SIMVASTATIN                     5 MG        ORAL               TABLET                 RAN        B                           Y      0.3704    0.3704     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02372932       MINT-SIMVASTATIN      Y    SIMVASTATIN                     5 MG        ORAL               TABLET                 MPI        B                           Y      0.3704    0.3704     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          00884324       ZOCOR                 Y    SIMVASTATIN                     5 MG        ORAL               TABLET                 MFC        B                           N      1.0584    0.3704     REGULAR BENEFIT
                                      14
         HMG-COA REDUCTASE
240608   INHIBITORS /          02248104       CO SIMVASTATIN        Y    SIMVASTATIN                     10 MG       ORAL               TABLET                 COB        W                           Y      0.7287    0.7287     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247828       SANDOZ SIMVASTATIN    Y    SIMVASTATIN                     10 MG       ORAL               TABLET                 SDZ        W                           Y      0.7287    0.7287     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02269260       PMS-SIMVASTATIN       Y    SIMVASTATIN                     10 MG       ORAL               TABLET                 PMS        B                           Y      0.7287    0.7287     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02250152       TEVA-SIMVASTATIN      Y    SIMVASTATIN                     10 MG       ORAL               TABLET                 TEV        B                           Y      0.7287    0.7287     REGULAR BENEFIT




                                                                                                          Updated July 1, 2012                                                                                                      Page 38 of 254
                                                                           Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                        (Regular Benefits)


                                                                                                                                                                 DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION   DIN / PIN       PRODUCT NAME     IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         HMG-COA REDUCTASE
240608   INHIBITORS /          02331039    JAMP-SIMVASTATIN     Y    SIMVASTATIN                     10 MG       ORAL               TABLET                 JPC        B                           Y      0.7287    0.7287     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247012    APO-SIMVASTATIN      Y    SIMVASTATIN                     10 MG       ORAL               TABLET                 APX        B                           Y      0.7287    0.7287     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02246583    MYLAN-SIMVASTATIN    Y    SIMVASTATIN                     10 MG       ORAL               TABLET                 MYP        W                           Y      0.7287    0.7287     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02378892    SIMVASTATIN-ODAN     Y    SIMVASTATIN                     10 MG       ORAL               TABLET                 ODN        B                           Y      0.7287    0.7287     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02375044    MAR-SIMVASTATIN      Y    SIMVASTATIN                     10 MG       ORAL               TABLET                 MAR        W                           Y      0.7287    0.7287     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02281554    PHL-SIMVASTATIN      Y    SIMVASTATIN                     10 MG       ORAL               TABLET                 PHH        B                           Y      0.7287    0.7287     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02329158    RAN-SIMVASTATIN      Y    SIMVASTATIN                     10 MG       ORAL               TABLET                 RAN        B                           Y      0.7287    0.7287     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02284731    SIMVASTATIN          Y    SIMVASTATIN                     10 MG       ORAL               TABLET                 SNS        W                           Y      0.7287    0.7287     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02331985    SIMVASTATIN          Y    SIMVASTATIN                     10 MG       ORAL               TABLET                 RAN        B                           Y      0.7287    0.7287     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02372940    MINT-SIMVASTATIN     Y    SIMVASTATIN                     10 MG       ORAL               TABLET                 MPI        B                           Y      0.7287    0.7287     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          00884332    ZOCOR                Y    SIMVASTATIN                     10 MG       ORAL               TABLET                 MFC        B                           N      2.0819    0.7287     REGULAR BENEFIT
                                      15
         HMG-COA REDUCTASE
240608   INHIBITORS /          02248105    CO SIMVASTATIN       Y    SIMVASTATIN                     20 MG       ORAL               TABLET                 COB        W                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247830    SANDOZ SIMVASTATIN   Y    SIMVASTATIN                     20 MG       ORAL               TABLET                 SDZ        W                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02269279    PMS-SIMVASTATIN      Y    SIMVASTATIN                     20 MG       ORAL               TABLET                 PMS        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02250160    TEVA-SIMVASTATIN     Y    SIMVASTATIN                     20 MG       ORAL               TABLET                 TEV        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02331047    JAMP-SIMVASTATIN     Y    SIMVASTATIN                     20 MG       ORAL               TABLET                 JPC        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247013    APO-SIMVASTATIN      Y    SIMVASTATIN                     20 MG       ORAL               TABLET                 APX        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02246737    MYLAN-SIMVASTATIN    Y    SIMVASTATIN                     20 MG       ORAL               TABLET                 MYP        W                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02378906    SIMVASTATIN-ODAN     Y    SIMVASTATIN                     20 MG       ORAL               TABLET                 ODN        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02375052    MAR-SIMVASTATIN      Y    SIMVASTATIN                     20 MG       ORAL               TABLET                 MAR        W                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02281562    PHL-SIMVASTATIN      Y    SIMVASTATIN                     20 MG       ORAL               TABLET                 PHH        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02329166    RAN-SIMVASTATIN      Y    SIMVASTATIN                     20 MG       ORAL               TABLET                 RAN        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02284758    SIMVASTATIN          Y    SIMVASTATIN                     20 MG       ORAL               TABLET                 SNS        W                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02331993    SIMVASTATIN          Y    SIMVASTATIN                     20 MG       ORAL               TABLET                 RAN        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02372959    MINT-SIMVASTATIN     Y    SIMVASTATIN                     20 MG       ORAL               TABLET                 MPI        B                           Y      0.9005    0.9005     REGULAR BENEFIT




                                                                                                      Updated July 1, 2012                                                                                                      Page 39 of 254
                                                                           Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                        (Regular Benefits)


                                                                                                                                                                 DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION   DIN / PIN       PRODUCT NAME     IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         HMG-COA REDUCTASE
240608   INHIBITORS /          00884340    ZOCOR                Y    SIMVASTATIN                     20 MG       ORAL               TABLET                 MFC        B                           N      2.5729    0.9005     REGULAR BENEFIT
                                      15
         HMG-COA REDUCTASE
240608   INHIBITORS /          02250179    TEVA-SIMVASTATIN     Y    SIMVASTATIN                     40 MG       ORAL               TABLET                 TEV        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02372967    MINT-SIMVASTATIN     Y    SIMVASTATIN                     40 MG       ORAL               TABLET                 MPI        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02248106    CO SIMVASTATIN       Y    SIMVASTATIN                     40 MG       ORAL               TABLET                 COB        W                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247831    SANDOZ SIMVASTATIN   Y    SIMVASTATIN                     40 MG       ORAL               TABLET                 SDZ        W                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02269287    PMS-SIMVASTATIN      Y    SIMVASTATIN                     40 MG       ORAL               TABLET                 PMS        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02331055    JAMP-SIMVASTATIN     Y    SIMVASTATIN                     40 MG       ORAL               TABLET                 JPC        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02281570    PHL-SIMVASTATIN      Y    SIMVASTATIN                     40 MG       ORAL               TABLET                 PHH        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247014    APO-SIMVASTATIN      Y    SIMVASTATIN                     40 MG       ORAL               TABLET                 APX        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02246584    MYLAN-SIMVASTATIN    Y    SIMVASTATIN                     40 MG       ORAL               TABLET                 MYP        W                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02378914    SIMVASTATIN-ODAN     Y    SIMVASTATIN                     40 MG       ORAL               TABLET                 ODN        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02375060    MAR-SIMVASTATIN      Y    SIMVASTATIN                     40 MG       ORAL               TABLET                 MAR        W                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02329174    RAN-SIMVASTATIN      Y    SIMVASTATIN                     40 MG       ORAL               TABLET                 RAN        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02284766    SIMVASTATIN          Y    SIMVASTATIN                     40 MG       ORAL               TABLET                 SNS        W                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02332000    SIMVASTATIN          Y    SIMVASTATIN                     40 MG       ORAL               TABLET                 RAN        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          00884359    ZOCOR                Y    SIMVASTATIN                     40 MG       ORAL               TABLET                 MFC        B                           N      2.5729    0.9005     REGULAR BENEFIT
                                      15
         HMG-COA REDUCTASE
240608   INHIBITORS /          02250187    TEVA-SIMVASTATIN     Y    SIMVASTATIN                     80 MG       ORAL               TABLET                 TEV        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02372975    MINT-SIMVASTATIN     Y    SIMVASTATIN                     80 MG       ORAL               TABLET                 MPI        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02248107    CO SIMVASTATIN       Y    SIMVASTATIN                     80 MG       ORAL               TABLET                 COB        W                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247833    SANDOZ SIMVASTATIN   Y    SIMVASTATIN                     80 MG       ORAL               TABLET                 SDZ        W                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02269295    PMS-SIMVASTATIN      Y    SIMVASTATIN                     80 MG       ORAL               TABLET                 PMS        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02329182    RAN-SIMVASTATIN      Y    SIMVASTATIN                     80 MG       ORAL               TABLET                 RAN        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02331063    JAMP-SIMVASTATIN     Y    SIMVASTATIN                     80 MG       ORAL               TABLET                 JPC        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02281589    PHL-SIMVASTATIN      Y    SIMVASTATIN                     80 MG       ORAL               TABLET                 PHH        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /          02247015    APO-SIMVASTATIN      Y    SIMVASTATIN                     80 MG       ORAL               TABLET                 APX        B                           Y      0.9005    0.9005     REGULAR BENEFIT




                                                                                                      Updated July 1, 2012                                                                                                      Page 40 of 254
                                                                                   Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                (Regular Benefits)


                                                                                                                                                                         DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION       DIN / PIN          PRODUCT NAME    IC               GENERIC NAME          STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         HMG-COA REDUCTASE
240608   INHIBITORS /               02246585       MYLAN-SIMVASTATIN   Y    SIMVASTATIN                      80 MG       ORAL               TABLET                 MYP        W                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /               02378922       SIMVASTATIN-ODAN    Y    SIMVASTATIN                      80 MG       ORAL               TABLET                 ODN        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /               02375079       MAR-SIMVASTATIN     Y    SIMVASTATIN                      80 MG       ORAL               TABLET                 MAR        W                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /               02284774       SIMVASTATIN         Y    SIMVASTATIN                      80 MG       ORAL               TABLET                 SNS        W                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /               02332019       SIMVASTATIN         Y    SIMVASTATIN                      80 MG       ORAL               TABLET                 RAN        B                           Y      0.9005    0.9005     REGULAR BENEFIT
         HMG-COA REDUCTASE
240608   INHIBITORS /               02240332       ZOCOR               Y    SIMVASTATIN                      80 MG       ORAL               TABLET                 MFC        B                           N      2.5729    0.9005     REGULAR BENEFIT
                                           15

240816   CENTRAL ALPHA-AGONISTS /   02046121       NOVO-CLONIDINE      Y    CLONIDINE HCL                    0.1 MG      ORAL               TABLET                 TEV        B                           Y      0.1765    0.1765     REGULAR BENEFIT

240816   CENTRAL ALPHA-AGONISTS /   00259527       CATAPRES            Y    CLONIDINE HCL                    0.1 MG      ORAL               TABLET                 BOE        B                           N      0.1853    0.1765     REGULAR BENEFIT
                                               2

240816   CENTRAL ALPHA-AGONISTS /   02046148       NOVO-CLONIDINE      Y    CLONIDINE HCL                    0.2 MG      ORAL               TABLET                 TEV        B                           Y      0.3149    0.3149     REGULAR BENEFIT

240816   CENTRAL ALPHA-AGONISTS /   00291889       CATAPRES            Y    CLONIDINE HCL                    0.2 MG      ORAL               TABLET                 BOE        B                           N      0.3306    0.3149     REGULAR BENEFIT
                                               2

240816   CENTRAL ALPHA-AGONISTS /   00360252       METHYLDOPA          N    METHYLDOPA                       125 MG      ORAL               TABLET                 AAP        W            7.50%          N      0.0989               REGULAR BENEFIT
                                               1

240816   CENTRAL ALPHA-AGONISTS /   00360260       METHYLDOPA          N    METHYLDOPA                       250 MG      ORAL               TABLET                 AAP        W            7.50%          N      0.1433               REGULAR BENEFIT
                                               1

240816   CENTRAL ALPHA-AGONISTS /   00426830       METHYLDOPA          N    METHYLDOPA                       500 MG      ORAL               TABLET                 AAP        W            7.50%          N      0.2537               REGULAR BENEFIT
                                               1

240820   DIRECT VASODILATORS /      00503347       PROGLYCEM           N    DIAZOXIDE                        100 MG      ORAL               CAPSULE                MFC        B                           N      1.6179               REGULAR BENEFIT
                                               1

240820   DIRECT VASODILATORS /      00441619       APO-HYDRALAZINE     N    HYDRALAZINE HCL                  10 MG       ORAL               TABLET                 APX        B                           N      0.1347               REGULAR BENEFIT
                                               1

240820   DIRECT VASODILATORS /      00441627       APO-HYDRALAZINE     N    HYDRALAZINE HCL                  25 MG       ORAL               TABLET                 APX        B                           N      0.2314               REGULAR BENEFIT
                                               1

240820   DIRECT VASODILATORS /      00441635       APO-HYDRALAZINE     N    HYDRALAZINE HCL                  50 MG       ORAL               TABLET                 APX        B                           N      0.3633               REGULAR BENEFIT
                                               1

240820   DIRECT VASODILATORS /      00514497       LONITEN             N    MINOXIDIL                        2.5 MG      ORAL               TABLET                 PFI        W            7.50%          N      0.3432               REGULAR BENEFIT
                                               1

240820   DIRECT VASODILATORS /      00514500       LONITEN             N    MINOXIDIL                        10 MG       ORAL               TABLET                 PFI        W            7.50%          N      0.7565               REGULAR BENEFIT




                                                                                                              Updated July 1, 2012                                                                                                      Page 41 of 254
                                                                                          Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                       (Regular Benefits)


                                                                                                                                                                                DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION          DIN / PIN              PRODUCT NAME   IC            GENERIC NAME            STRENGTH           ROUTE               FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                                    1

24082408   DIURETICS / LOOP DIURETICS 02258528          EDECRIN                N    ETHACRYNIC ACID                 25 MG        ORAL              TABLET                 VCL        W            7.50%          N      3.3000               REGULAR BENEFIT
                                                    1

24082408   DIURETICS / LOOP DIURETICS 00527033          FUROSEMIDE             N    FUROSEMIDE                      10 MG / ML   INJECTION                                SDZ        W            7.50%          N      0.8047               REGULAR BENEFIT
                                                    1

24082408   DIURETICS / LOOP DIURETICS 02224720          LASIX                  N    FUROSEMIDE                      10 MG / ML   ORAL              SOLUTION               SAV        W            7.50%          N      0.2756               REGULAR BENEFIT
                                                    1

24082408   DIURETICS / LOOP DIURETICS 00396788          APO-FUROSEMIDE         Y    FUROSEMIDE                      20 MG        ORAL              TABLET                 APX        B                           Y      0.0373    0.0373     REGULAR BENEFIT

24082408   DIURETICS / LOOP DIURETICS 02351420          FUROSEMIDE             Y    FUROSEMIDE                      20 MG        ORAL              TABLET                 SNS        W                           Y      0.0373    0.0373     REGULAR BENEFIT

24082408   DIURETICS / LOOP DIURETICS 02364573          AVA-FUROSEMIDE         Y    FUROSEMIDE                      20 MG        ORAL              TABLET                 AVA        W                           Y      0.0373    0.0373     REGULAR BENEFIT

24082408   DIURETICS / LOOP DIURETICS 00337730          NOVO-SEMIDE            Y    FUROSEMIDE                      20 MG        ORAL              TABLET                 TEV        B                           Y      0.0373    0.0373     REGULAR BENEFIT

24082408   DIURETICS / LOOP DIURETICS 02224690          LASIX                  Y    FUROSEMIDE                      20 MG        ORAL              TABLET                 SAV        W            7.50%          N      0.0873    0.0373     REGULAR BENEFIT
                                                    5

24082408   DIURETICS / LOOP DIURETICS 00362166          APO-FUROSEMIDE         Y    FUROSEMIDE                      40 MG        ORAL              TABLET                 APX        B                           Y      0.0558    0.0558     REGULAR BENEFIT

24082408   DIURETICS / LOOP DIURETICS 02351439          FUROSEMIDE             Y    FUROSEMIDE                      40 MG        ORAL              TABLET                 SNS        W                           Y      0.0558    0.0558     REGULAR BENEFIT

24082408   DIURETICS / LOOP DIURETICS 02364581          AVA-FUROSEMIDE         Y    FUROSEMIDE                      40 MG        ORAL              TABLET                 AVA        W                           Y      0.0558    0.0558     REGULAR BENEFIT

24082408   DIURETICS / LOOP DIURETICS 00337749          NOVO-SEMIDE            Y    FUROSEMIDE                      40 MG        ORAL              TABLET                 TEV        B                           Y      0.0558    0.0558     REGULAR BENEFIT

24082408   DIURETICS / LOOP DIURETICS 02224704          LASIX                  Y    FUROSEMIDE                      40 MG        ORAL              TABLET                 SAV        W            7.50%          N      0.1307    0.0558     REGULAR BENEFIT
                                                    5

24082408   DIURETICS / LOOP DIURETICS 02351447          FUROSEMIDE             Y    FUROSEMIDE                      80 MG        ORAL              TABLET                 SNS        W                           Y      0.1220    0.1220     REGULAR BENEFIT

24082408   DIURETICS / LOOP DIURETICS 02364603          AVA-FUROSEMIDE         Y    FUROSEMIDE                      80 MG        ORAL              TABLET                 AVA        W                           Y      0.1220    0.1220     REGULAR BENEFIT

24082408   DIURETICS / LOOP DIURETICS 00707570          APO-FUROSEMIDE         Y    FUROSEMIDE                      80 MG        ORAL              TABLET                 APX        B                           Y      0.1220    0.1220     REGULAR BENEFIT

24082408   DIURETICS / LOOP DIURETICS 00765953          NOVO-SEMIDE            Y    FUROSEMIDE                      80 MG        ORAL              TABLET                 TEV        B                           Y      0.1220    0.1220     REGULAR BENEFIT
                                                    4

24082408   DIURETICS / LOOP DIURETICS 02224755          LASIX SPECIAL          N    FUROSEMIDE                      500 MG       ORAL              TABLET                 SAV        W            7.50%          N      3.0150               REGULAR BENEFIT
                                                    1
           RENIN-ANGIOTENSIN-
           ALDOSTERONE SYSTEM
           INHIBITORS / ANGIOTENSIN II
24084408   RECEPTOR ANTAGONISTS          02318660       OLMETEC                N    OLMESARTAN MEDOXOMIL            20 MG        ORAL              TABLET                 MFC        B                           N      1.0187               REGULAR BENEFIT
                                                    1




                                                                                                                     Updated July 1, 2012                                                                                                      Page 42 of 254
                                                                                         Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                      (Regular Benefits)


                                                                                                                                                                               DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION          DIN / PIN             PRODUCT NAME   IC            GENERIC NAME            STRENGTH             ROUTE             FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           RENIN-ANGIOTENSIN-
           ALDOSTERONE SYSTEM
           INHIBITORS / ANGIOTENSIN II
24084408   RECEPTOR ANTAGONISTS          02318679       OLMETEC               N    OLMESARTAN MEDOXOMIL            40 MG          ORAL            TABLET                 MFC        B                           N      1.0187               REGULAR BENEFIT
                                                    1
           RENIN-ANGIOTENSIN-
           ALDOSTERONE SYSTEM
           INHIBITORS / ANGIOTENSIN II                                             OLMESARTAN MEDOXOMIL/           20 MG * 12.5
24084408   RECEPTOR ANTAGONISTS          02319616       OLMETEC PLUS          N    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 MFC        B                           N      1.0187               REGULAR BENEFIT
                                                    1
           RENIN-ANGIOTENSIN-
           ALDOSTERONE SYSTEM
           INHIBITORS / ANGIOTENSIN II                                             OLMESARTAN MEDOXOMIL/           40 MG * 12.5
24084408   RECEPTOR ANTAGONISTS          02319624       OLMETEC PLUS          N    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 MFC        B                           N      1.0187               REGULAR BENEFIT
                                                    1
           RENIN-ANGIOTENSIN-
           ALDOSTERONE SYSTEM
           INHIBITORS / ANGIOTENSIN II                                             OLMESARTAN MEDOXOMIL/           40 MG * 25
24084408   RECEPTOR ANTAGONISTS          02319632       OLMETEC PLUS          N    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 MFC        B                           N      1.0187               REGULAR BENEFIT
                                                    1

241208     NITRATES AND NITRITES /       00670944       ISDN                  N    ISOSORBIDE DINITRATE            5 MG           ORAL            SUBLINGUAL TABLET      AAP        W            7.50%          N      0.0621               REGULAR BENEFIT
                                                    1
                                                                                                                                                  SUSTAINED-
241208     NITRATES AND NITRITES /       00740721       CEDOCARD-SR           N    ISOSORBIDE DINITRATE            20 MG          ORAL            RELEASE TABLET         PAL        B                           N      0.4195               REGULAR BENEFIT
                                                    1

241208     NITRATES AND NITRITES /       00441686       ISDN                  N    ISOSORBIDE DINITRATE            10 MG          ORAL            TABLET                 AAP        W            7.50%          N      0.0365               REGULAR BENEFIT
                                                    1

241208     NITRATES AND NITRITES /       00441694       ISDN                  N    ISOSORBIDE DINITRATE            30 MG          ORAL            TABLET                 AAP        W            7.50%          N      0.0857               REGULAR BENEFIT
                                                    1
                                                                                                                                                  EXTENDED-RELEASE
241208     NITRATES AND NITRITES /       02272830       APO-ISMN              Y    ISOSORBIDE-5-MONONITRATE        60 MG          ORAL            TABLET           APX              B                           Y      0.3523    0.3523     REGULAR BENEFIT
                                                                                                                                                  EXTENDED-RELEASE
241208     NITRATES AND NITRITES /       02301288       PMS-ISMN              Y    ISOSORBIDE-5-MONONITRATE        60 MG          ORAL            TABLET           PMS              B                           Y      0.3523    0.3523     REGULAR BENEFIT
                                                                                                                                                  EXTENDED-RELEASE
241208     NITRATES AND NITRITES /       02126559       IMDUR                 Y    ISOSORBIDE-5-MONONITRATE        60 MG          ORAL            TABLET                 AZC        W            7.50%          N      0.6850    0.3523     REGULAR BENEFIT
                                                    3

241208     NITRATES AND NITRITES /       00037613       NITROSTAT             N    NITROGLYCERIN                   0.3 MG         ORAL            SUBLINGUAL TABLET      PFI        W            7.50%          N      0.1169               REGULAR BENEFIT
                                                    1

241208     NITRATES AND NITRITES /       00037621       NITROSTAT             N    NITROGLYCERIN                   0.6 MG         ORAL            SUBLINGUAL TABLET      PFI        W            7.50%          N      0.1169               REGULAR BENEFIT
                                                    1
                                                                                                                   0.4 MG /                       METERED DOSE
241208     NITRATES AND NITRITES /       02238998       RHO-NITRO PUMPSPRAY   Y    NITROGLYCERIN                   DOSE           SUBLINGUAL      SPRAY                  SDZ        W                           Y      0.0421    0.0421     REGULAR BENEFIT
                                                                                                                   0.4 MG /                       METERED DOSE
241208     NITRATES AND NITRITES /       02243588       MYLAN-NITRO           Y    NITROGLYCERIN                   DOSE           SUBLINGUAL      SPRAY                  MYP        W                           Y      0.0421    0.0421     REGULAR BENEFIT




                                                                                                                    Updated July 1, 2012                                                                                                      Page 43 of 254
                                                                                       Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                    (Regular Benefits)


                                                                                                                                                                             DISTRIBUTION   DISTRIBUTION     LCA                LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION      DIN / PIN           PRODUCT NAME        IC            GENERIC NAME             STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT    PRICE       PRICE         STATUS
                                                                                                                 0.4 MG /                       METERED DOSE
241208   NITRATES AND NITRITES /   02231441       NITROLINGUAL PUMPSPRAY   Y    NITROGLYCERIN                    DOSE        SUBLINGUAL         SPRAY                  SAV        W            7.50%          N       0.0730     0.0421     REGULAR BENEFIT
                                              3

241208   NITRATES AND NITRITES /   01926454       NITROL                   N    NITROGLYCERIN                    2%          TOPICAL            OINTMENT               PAL        B                           N       0.6390                REGULAR BENEFIT
                                              1

241208   NITRATES AND NITRITES /   01911910       NITRO-DUR 0.2            N    NITROGLYCERIN                    0.2 MG/HR   TRANSDERMAL        PATCH                  MFC        B                           N       0.5667                REGULAR BENEFIT

241208   NITRATES AND NITRITES /   02230732       TRINIPATCH 0.2           N    NITROGLYCERIN                    0.2 MG/HR   TRANSDERMAL        PATCH                  PAL        B                           N       0.5780                REGULAR BENEFIT

241208   NITRATES AND NITRITES /   02162806       MINITRAN 0.2             N    NITROGLYCERIN                    0.2 MG/HR   TRANSDERMAL        PATCH                  MEP        W            7.50%          N       0.5941                REGULAR BENEFIT

241208   NITRATES AND NITRITES /   00584223       TRANSDERM-NITRO 0.2      N    NITROGLYCERIN                    0.2 MG/HR   TRANSDERMAL        PATCH                  NOV        W            7.50%          N       0.6616                REGULAR BENEFIT
                                              4

241208   NITRATES AND NITRITES /   01911902       NITRO-DUR 0.4            N    NITROGLYCERIN                    0.4 MG/HR   TRANSDERMAL        PATCH                  MFC        B                           N       0.6400                REGULAR BENEFIT

241208   NITRATES AND NITRITES /   02230733       TRINIPATCH 0.4           N    NITROGLYCERIN                    0.4 MG/HR   TRANSDERMAL        PATCH                  PAL        B                           N       0.6528                REGULAR BENEFIT

241208   NITRATES AND NITRITES /   02163527       MINITRAN 0.4             N    NITROGLYCERIN                    0.4 MG/HR   TRANSDERMAL        PATCH                  MEP        W            7.50%          N       0.6712                REGULAR BENEFIT

241208   NITRATES AND NITRITES /   00852384       TRANSDERM-NITRO 0.4      N    NITROGLYCERIN                    0.4 MG/HR   TRANSDERMAL        PATCH                  NOV        W            7.50%          N       0.7474                REGULAR BENEFIT
                                              4

241208   NITRATES AND NITRITES /   01911929       NITRO-DUR 0.6            N    NITROGLYCERIN                    0.6 MG/HR   TRANSDERMAL        PATCH                  MFC        B                           N       0.6400                REGULAR BENEFIT

241208   NITRATES AND NITRITES /   02230734       TRINIPATCH 0.6           N    NITROGLYCERIN                    0.6 MG/HR   TRANSDERMAL        PATCH                  PAL        B                           N       0.6528                REGULAR BENEFIT

241208   NITRATES AND NITRITES /   02163535       MINITRAN 0.6             N    NITROGLYCERIN                    0.6 MG/HR   TRANSDERMAL        PATCH                  MEP        W            7.50%          N       0.6714                REGULAR BENEFIT

241208   NITRATES AND NITRITES /   02046156       TRANSDERM-NITRO 0.6      N    NITROGLYCERIN                    0.6 MG/HR   TRANSDERMAL        PATCH                  NOV        W            7.50%          N       0.7474                REGULAR BENEFIT
                                              4

241208   NITRATES AND NITRITES /   02011271       NITRO-DUR 0.8            N    NITROGLYCERIN                    0.8 MG/HR   TRANSDERMAL        PATCH                  MFC        B                           N       1.1100                REGULAR BENEFIT
                                              1
         MISCELLANEOUS
241292   VASODILATING AGENTS /     00559253       PROSTIN VR               N    ALPROSTADIL                      500 MCG / ML INJECTION                                PFI        W            7.50%          N      241.1150               REGULAR BENEFIT
                                              1
         MISCELLANEOUS
241292   VASODILATING AGENTS /     00895644       APO-DIPYRIDAMOLE (FC)    N    DIPYRIDAMOLE                     25 MG       ORAL               TABLET                 APX        B                           N       0.2633                REGULAR BENEFIT
                                              1
         MISCELLANEOUS
241292   VASODILATING AGENTS /     00895652       APO-DIPYRIDAMOLE (FC)    N    DIPYRIDAMOLE                     50 MG       ORAL               TABLET                 APX        B                           N       0.2932                REGULAR BENEFIT
                                              1
         MISCELLANEOUS
241292   VASODILATING AGENTS /     00895660       APO-DIPYRIDAMOLE (FC)    N    DIPYRIDAMOLE                     75 MG       ORAL               TABLET                 APX        B                           N       0.4397                REGULAR BENEFIT
                                              1
         MISCELLANEOUS
241292   VASODILATING AGENTS /     01926713       ARLIDIN                  N    NYLIDRIN HCL                     6 MG        ORAL               TABLET                 ERF        W            7.50%          N       0.4756                REGULAR BENEFIT




                                                                                                                  Updated July 1, 2012                                                                                                        Page 44 of 254
                                                                             Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                          (Regular Benefits)


                                                                                                                                                                   DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION   DIN / PIN          PRODUCT NAME   IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                           1

241600   SCLEROSING AGENTS /    00511234       TROMBOJECT         N    SODIUM TETRADECYL SULFATE       1%          INJECTION                                 OMG        B                           N      3.7500               REGULAR BENEFIT
                                           1
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02240588       APO-DOXAZOSIN      Y    DOXAZOSIN MESYLATE              1 MG        ORAL               TABLET                 APX        B                           Y      0.2176    0.2176     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02240498       MYLAN-DOXAZOSIN    Y    DOXAZOSIN MESYLATE              1 MG        ORAL               TABLET                 MYP        W                           Y      0.2176    0.2176     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02242728       NOVO-DOXAZOSIN     Y    DOXAZOSIN MESYLATE              1 MG        ORAL               TABLET                 TEV        B                           Y      0.2176    0.2176     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02244527       PMS-DOXAZOSIN      Y    DOXAZOSIN MESYLATE              1 MG        ORAL               TABLET                 PMS        B                           Y      0.2176    0.2176     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      01958100       CARDURA            Y    DOXAZOSIN MESYLATE              1 MG        ORAL               TABLET                 PFI        W            7.50%          N      0.5784    0.2176     REGULAR BENEFIT
                                           5
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02242729       NOVO-DOXAZOSIN     Y    DOXAZOSIN MESYLATE              2 MG        ORAL               TABLET                 TEV        B                           Y      0.2610    0.2610     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02244528       PMS-DOXAZOSIN      Y    DOXAZOSIN MESYLATE              2 MG        ORAL               TABLET                 PMS        B                           Y      0.2610    0.2610     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02240589       APO-DOXAZOSIN      Y    DOXAZOSIN MESYLATE              2 MG        ORAL               TABLET                 APX        B                           Y      0.2610    0.2610     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02240499       MYLAN-DOXAZOSIN    Y    DOXAZOSIN MESYLATE              2 MG        ORAL               TABLET                 MYP        W                           Y      0.2610    0.2610     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      01958097       CARDURA            Y    DOXAZOSIN MESYLATE              2 MG        ORAL               TABLET                 PFI        W            7.50%          N      0.6938    0.2610     REGULAR BENEFIT
                                           5
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02242730       NOVO-DOXAZOSIN     Y    DOXAZOSIN MESYLATE              4 MG        ORAL               TABLET                 TEV        B                           Y      0.3395    0.3395     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02244529       PMS-DOXAZOSIN      Y    DOXAZOSIN MESYLATE              4 MG        ORAL               TABLET                 PMS        B                           Y      0.3395    0.3395     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02240590       APO-DOXAZOSIN      Y    DOXAZOSIN MESYLATE              4 MG        ORAL               TABLET                 APX        B                           Y      0.3395    0.3395     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02240500       MYLAN-DOXAZOSIN    Y    DOXAZOSIN MESYLATE              4 MG        ORAL               TABLET                 MYP        W                           Y      0.3395    0.3395     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      01958119       CARDURA            Y    DOXAZOSIN MESYLATE              4 MG        ORAL               TABLET                 PFI        W            7.50%          N      0.9022    0.3395     REGULAR BENEFIT
                                           5
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      00882801       APO-PRAZO          Y    PRAZOSIN HCL                    1 MG        ORAL               TABLET                 APX        B                           Y      0.1371    0.1371     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      01934198       NOVO-PRAZIN        Y    PRAZOSIN HCL                    1 MG        ORAL               TABLET                 TEV        B                           Y      0.1371    0.1371     REGULAR BENEFIT
                                           2
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      01934201       NOVO-PRAZIN        Y    PRAZOSIN HCL                    2 MG        ORAL               TABLET                 TEV        B                           Y      0.1862    0.1862     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      00882828       APO-PRAZO          Y    PRAZOSIN HCL                    2 MG        ORAL               TABLET                 APX        B                           Y      0.1862    0.1862     REGULAR BENEFIT
                                           2
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      00882836       APO-PRAZO          Y    PRAZOSIN HCL                    5 MG        ORAL               TABLET                 APX        B                           Y      0.2560    0.2560     REGULAR BENEFIT




                                                                                                        Updated July 1, 2012                                                                                                      Page 45 of 254
                                                                                 Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                              (Regular Benefits)


                                                                                                                                                                       DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION   DIN / PIN          PRODUCT NAME       IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      01934228       NOVO-PRAZIN            Y    PRAZOSIN HCL                    5 MG        ORAL               TABLET                 TEV        B                           Y      0.2560    0.2560     REGULAR BENEFIT
                                           2
         ALPHA-ADRENERGIC                                                                                                                 EXTENDED-RELEASE
242000   BLOCKING AGENTS /      02340208       SANDOZ TAMSULOSIN CR   Y    TAMSULOSIN HCL                  0.4 MG      ORAL               TABLET                 SDZ        W                           Y      0.2100    0.2100     REGULAR BENEFIT
         ALPHA-ADRENERGIC                                                                                                                 EXTENDED-RELEASE
242000   BLOCKING AGENTS /      02366231       AVA-TAMSULOSIN CR      Y    TAMSULOSIN HCL                  0.4 MG      ORAL               TABLET           AVA              W                           Y      0.2100    0.2100     REGULAR BENEFIT
         ALPHA-ADRENERGIC                                                                                                                 EXTENDED-RELEASE
242000   BLOCKING AGENTS /      02368242       TEVA-TAMSULOSIN CR     Y    TAMSULOSIN HCL                  0.4 MG      ORAL               TABLET                 TEV        B                           Y      0.2100    0.2100     REGULAR BENEFIT
         ALPHA-ADRENERGIC                                                                                                                 EXTENDED-RELEASE
242000   BLOCKING AGENTS /      02362406       APO-TAMSULOSIN CR      Y    TAMSULOSIN HCL                  0.4 MG      ORAL               TABLET           APX              B                           Y      0.2100    0.2100     REGULAR BENEFIT
                                           4
         ALPHA-ADRENERGIC                                                                                                                 SUSTAINED-
242000   BLOCKING AGENTS /      02298570       MYLAN-TAMSULOSIN       Y    TAMSULOSIN HCL                  0.4 MG      ORAL               RELEASE CAPSULE        MYP        W                           Y      0.3415    0.3415     REGULAR BENEFIT
         ALPHA-ADRENERGIC                                                                                                                 SUSTAINED-
242000   BLOCKING AGENTS /      02294265       RATIO-TAMSULOSIN       Y    TAMSULOSIN HCL                  0.4 MG      ORAL               RELEASE CAPSULE        RPH        B                           Y      0.3415    0.3415     REGULAR BENEFIT
         ALPHA-ADRENERGIC                                                                                                                 SUSTAINED-
242000   BLOCKING AGENTS /      02295121       SANDOZ TAMSULOSIN      Y    TAMSULOSIN HCL                  0.4 MG      ORAL               RELEASE CAPSULE        SDZ        W                           Y      0.3415    0.3415     REGULAR BENEFIT
         ALPHA-ADRENERGIC                                                                                                                 SUSTAINED-
242000   BLOCKING AGENTS /      02281392       NOVO-TAMSULOSIN        Y    TAMSULOSIN HCL                  0.4 MG      ORAL               RELEASE CAPSULE        TEV        B                           Y      0.3415    0.3415     REGULAR BENEFIT
                                           4
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02218941       RATIO-TERAZOSIN        Y    TERAZOSIN HCL                   1 MG        ORAL               TABLET                 RPH        B                           Y      0.2563    0.2563     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02230805       TEVA-TERAZOSIN         Y    TERAZOSIN HCL                   1 MG        ORAL               TABLET                 TEV        B                           Y      0.2563    0.2563     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02243518       PMS-TERAZOSIN          Y    TERAZOSIN HCL                   1 MG        ORAL               TABLET                 PMS        B                           Y      0.2563    0.2563     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02234502       APO-TERAZOSIN          Y    TERAZOSIN HCL                   1 MG        ORAL               TABLET                 APX        B                           Y      0.2563    0.2563     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02350475       TERAZOSIN              Y    TERAZOSIN HCL                   1 MG        ORAL               TABLET                 SNS        W                           Y      0.2563    0.2563     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      00818658       HYTRIN                 Y    TERAZOSIN HCL                   1 MG        ORAL               TABLET                 ABB        B                           N      0.7323    0.2563     REGULAR BENEFIT
                                           6
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02218968       RATIO-TERAZOSIN        Y    TERAZOSIN HCL                   2 MG        ORAL               TABLET                 RPH        B                           Y      0.3258    0.3258     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02230806       TEVA-TERAZOSIN         Y    TERAZOSIN HCL                   2 MG        ORAL               TABLET                 TEV        B                           Y      0.3258    0.3258     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02243519       PMS-TERAZOSIN          Y    TERAZOSIN HCL                   2 MG        ORAL               TABLET                 PMS        B                           Y      0.3258    0.3258     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02234503       APO-TERAZOSIN          Y    TERAZOSIN HCL                   2 MG        ORAL               TABLET                 APX        B                           Y      0.3258    0.3258     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02350483       TERAZOSIN              Y    TERAZOSIN HCL                   2 MG        ORAL               TABLET                 SNS        W                           Y      0.3258    0.3258     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      00818682       HYTRIN                 Y    TERAZOSIN HCL                   2 MG        ORAL               TABLET                 ABB        B                           N      0.9309    0.3258     REGULAR BENEFIT
                                           6
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02230807       TEVA-TERAZOSIN         Y    TERAZOSIN HCL                   5 MG        ORAL               TABLET                 TEV        B                           Y      0.4425    0.4425     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /      02243520       PMS-TERAZOSIN          Y    TERAZOSIN HCL                   5 MG        ORAL               TABLET                 PMS        B                           Y      0.4425    0.4425     REGULAR BENEFIT




                                                                                                            Updated July 1, 2012                                                                                                      Page 46 of 254
                                                                                     Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                  (Regular Benefits)


                                                                                                                                                                           DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION      DIN / PIN         PRODUCT NAME         IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /        02234504       APO-TERAZOSIN            Y    TERAZOSIN HCL                   5 MG        ORAL               TABLET                 APX        B                           Y      0.4425    0.4425     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /        02350491       TERAZOSIN                Y    TERAZOSIN HCL                   5 MG        ORAL               TABLET                 SNS        W                           Y      0.4425    0.4425     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /        02218976       RATIO-TERAZOSIN          Y    TERAZOSIN HCL                   5 MG        ORAL               TABLET                 RPH        B                           Y      0.4425    0.4425     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /        00818666       HYTRIN                   Y    TERAZOSIN HCL                   5 MG        ORAL               TABLET                 ABB        B                           N      1.2642    0.4425     REGULAR BENEFIT
                                             6
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /        02218984       RATIO-TERAZOSIN          Y    TERAZOSIN HCL                   10 MG       ORAL               TABLET                 RPH        B                           Y      0.6477    0.6477     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /        02230808       TEVA-TERAZOSIN           Y    TERAZOSIN HCL                   10 MG       ORAL               TABLET                 TEV        B                           Y      0.6477    0.6477     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /        02234505       APO-TERAZOSIN            Y    TERAZOSIN HCL                   10 MG       ORAL               TABLET                 APX        B                           Y      0.6477    0.6477     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /        02243521       PMS-TERAZOSIN            Y    TERAZOSIN HCL                   10 MG       ORAL               TABLET                 PMS        B                           Y      0.6477    0.6477     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /        02350505       TERAZOSIN                Y    TERAZOSIN HCL                   10 MG       ORAL               TABLET                 SNS        W                           Y      0.6477    0.6477     REGULAR BENEFIT
         ALPHA-ADRENERGIC
242000   BLOCKING AGENTS /        00818674       HYTRIN                   Y    TERAZOSIN HCL                   10 MG       ORAL               TABLET                 ABB        B                           N      1.8506    0.6477     REGULAR BENEFIT
                                             6
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02363798       AVA-ACEBUTOLOL           Y    ACEBUTOLOL HCL                  100 MG      ORAL               TABLET                 AVA        W                           Y      0.1298    0.1298     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02286246       ACEBUTOLOL               Y    ACEBUTOLOL HCL                  100 MG      ORAL               TABLET                 SNS        W                           Y      0.1298    0.1298     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02237721       MYLAN-ACEBUTOLOL         Y    ACEBUTOLOL HCL                  100 MG      ORAL               TABLET                 MYP        W                           Y      0.1298    0.1298     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        01910140       RHOTRAL                  Y    ACEBUTOLOL HCL                  100 MG      ORAL               TABLET                 SDZ        W                           Y      0.1298    0.1298     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02204517       NOVO-ACEBUTOLOL          Y    ACEBUTOLOL HCL                  100 MG      ORAL               TABLET                 TEV        B                           Y      0.1298    0.1298     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02147602       APO-ACEBUTOLOL           Y    ACEBUTOLOL HCL                  100 MG      ORAL               TABLET                 APX        B                           Y      0.1298    0.1298     REGULAR BENEFIT
         BETA-ADRENERGIC                         MYLAN-ACEBUTOLOL (TYPE
242400   BLOCKING AGENTS /        02237885       S)                       Y    ACEBUTOLOL HCL                  100 MG      ORAL               TABLET                 MYP        W                           Y      0.1298    0.1298     REGULAR BENEFIT
         BETA-ADRENERGIC BLOCKING
242400   AGENTS /                 01926543       SECTRAL                  Y    ACEBUTOLOL HCL                  100 MG      ORAL               TABLET                 SAV        W            7.50%          N      0.3450    0.1298     REGULAR BENEFIT
                                             8
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02286254       ACEBUTOLOL               Y    ACEBUTOLOL HCL                  200 MG      ORAL               TABLET                 SNS        W                           Y      0.1947    0.1947     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02237722       MYLAN-ACEBUTOLOL         Y    ACEBUTOLOL HCL                  200 MG      ORAL               TABLET                 MYP        W                           Y      0.1947    0.1947     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        01910159       RHOTRAL                  Y    ACEBUTOLOL HCL                  200 MG      ORAL               TABLET                 SDZ        W                           Y      0.1947    0.1947     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02204525       NOVO-ACEBUTOLOL          Y    ACEBUTOLOL HCL                  200 MG      ORAL               TABLET                 TEV        B                           Y      0.1947    0.1947     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02147610       APO-ACEBUTOLOL           Y    ACEBUTOLOL HCL                  200 MG      ORAL               TABLET                 APX        B                           Y      0.1947    0.1947     REGULAR BENEFIT
         BETA-ADRENERGIC                         MYLAN-ACEBUTOLOL (TYPE
242400   BLOCKING AGENTS /        02237886       S)                       Y    ACEBUTOLOL HCL                  200 MG      ORAL               TABLET                 MYP        W                           Y      0.1947    0.1947     REGULAR BENEFIT




                                                                                                                Updated July 1, 2012                                                                                                      Page 47 of 254
                                                                                     Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                  (Regular Benefits)


                                                                                                                                                                           DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION       DIN / PIN         PRODUCT NAME         IC              GENERIC NAME          STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02363801       AVA-ACEBUTOLOL           Y    ACEBUTOLOL HCL                  200 MG      ORAL               TABLET                 AVA        W                           Y      0.1947    0.1947     REGULAR BENEFIT
         BETA-ADRENERGIC BLOCKING
242400   AGENTS /                 01926551       SECTRAL                  Y    ACEBUTOLOL HCL                  200 MG      ORAL               TABLET                 SAV        W            7.50%          N      0.5176    0.1947     REGULAR BENEFIT
                                             8
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02363828       AVA-ACEBUTOLOL           Y    ACEBUTOLOL HCL                  400 MG      ORAL               TABLET                 AVA        W                           Y      0.3875    0.3875     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02286262       ACEBUTOLOL               Y    ACEBUTOLOL HCL                  400 MG      ORAL               TABLET                 SNS        W                           Y      0.3875    0.3875     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02237723       MYLAN-ACEBUTOLOL         Y    ACEBUTOLOL HCL                  400 MG      ORAL               TABLET                 MYP        W                           Y      0.3875    0.3875     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02204533       NOVO-ACEBUTOLOL          Y    ACEBUTOLOL HCL                  400 MG      ORAL               TABLET                 TEV        B                           Y      0.3875    0.3875     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02147629       APO-ACEBUTOLOL           Y    ACEBUTOLOL HCL                  400 MG      ORAL               TABLET                 APX        B                           Y      0.3875    0.3875     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        01910167       RHOTRAL                  Y    ACEBUTOLOL HCL                  400 MG      ORAL               TABLET                 SDZ        W                           Y      0.3875    0.3875     REGULAR BENEFIT
         BETA-ADRENERGIC                         MYLAN-ACEBUTOLOL (TYPE
242400   BLOCKING AGENTS /        02237887       S)                       Y    ACEBUTOLOL HCL                  400 MG      ORAL               TABLET                 MYP        W                           Y      0.3875    0.3875     REGULAR BENEFIT
         BETA-ADRENERGIC BLOCKING
242400   AGENTS /                 01926578       SECTRAL                  Y    ACEBUTOLOL HCL                  400 MG      ORAL               TABLET                 SAV        W            7.50%          N      1.0300    0.3875     REGULAR BENEFIT
                                             8
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02303647       MYLAN-ATENOLOL           Y    ATENOLOL                        25 MG       ORAL               TABLET                 MYP        W                           Y      0.1081    0.1081     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02368013       MINT-ATENOL              Y    ATENOLOL                        25 MG       ORAL               TABLET                 MPI        B                           Y      0.1081    0.1081     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02246581       PMS-ATENOLOL             Y    ATENOLOL                        25 MG       ORAL               TABLET                 PMS        B                           Y      0.1081    0.1081     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02266660       TEVA-ATENOLOL            Y    ATENOLOL                        25 MG       ORAL               TABLET                 TEV        B                           Y      0.1081    0.1081     REGULAR BENEFIT
                                             4
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02368021       MINT-ATENOL              Y    ATENOLOL                        50 MG       ORAL               TABLET                 MPI        B                           Y      0.2246    0.2246     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02368641       SEPTA-ATENOLOL           Y    ATENOLOL                        50 MG       ORAL               TABLET                 SEP        B                           Y      0.2246    0.2246     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02371987       MAR-ATENOLOL             Y    ATENOLOL                        50 MG       ORAL               TABLET                 MAR        W                           Y      0.2246    0.2246     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02367564       JAMP-ATENOLOL            Y    ATENOLOL                        50 MG       ORAL               TABLET                 JPC        B                           Y      0.2246    0.2246     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02238316       PHL-ATENOLOL             Y    ATENOLOL                        50 MG       ORAL               TABLET                 PHH        B                           Y      0.2246    0.2246     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02237600       PMS-ATENOLOL             Y    ATENOLOL                        50 MG       ORAL               TABLET                 PMS        B                           Y      0.2246    0.2246     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02255545       CO ATENOLOL              Y    ATENOLOL                        50 MG       ORAL               TABLET                 COB        W                           Y      0.2246    0.2246     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02267985       RAN-ATENOLOL             Y    ATENOLOL                        50 MG       ORAL               TABLET                 RAN        B                           Y      0.2246    0.2246     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02171791       RATIO-ATENOLOL           Y    ATENOLOL                        50 MG       ORAL               TABLET                 RPH        B                           Y      0.2246    0.2246     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02146894       MYLAN-ATENOLOL           Y    ATENOLOL                        50 MG       ORAL               TABLET                 MYP        W                           Y      0.2246    0.2246     REGULAR BENEFIT




                                                                                                                Updated July 1, 2012                                                                                                      Page 48 of 254
                                                                                   Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                (Regular Benefits)


                                                                                                                                                                         DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION       DIN / PIN          PRODUCT NAME      IC              GENERIC NAME          STRENGTH            ROUTE              FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02231731       SANDOZ ATENOLOL        Y    ATENOLOL                        50 MG         ORAL             TABLET                 SDZ        W                           Y      0.2246    0.2246     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        01912062       TEVA-ATENOL            Y    ATENOLOL                        50 MG         ORAL             TABLET                 TEV        B                           Y      0.2246    0.2246     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00773689       APO-ATENOL             Y    ATENOLOL                        50 MG         ORAL             TABLET                 APX        B                           Y      0.2246    0.2246     REGULAR BENEFIT
         BETA-ADRENERGIC BLOCKING
242400   AGENTS /                 02039532       TENORMIN               Y    ATENOLOL                        50 MG         ORAL             TABLET                 AZC        W            7.50%          N      0.5970    0.2246     REGULAR BENEFIT
                                          14
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02368048       MINT-ATENOL            Y    ATENOLOL                        100 MG        ORAL             TABLET                 MPI        B                           Y      0.3692    0.3692     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02367572       JAMP-ATENOLOL          Y    ATENOLOL                        100 MG        ORAL             TABLET                 JPC        B                           Y      0.3692    0.3692     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02368668       SEPTA-ATENOLOL         Y    ATENOLOL                        100 MG        ORAL             TABLET                 SEP        B                           Y      0.3692    0.3692     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02371995       MAR-ATENOLOL           Y    ATENOLOL                        100 MG        ORAL             TABLET                 MAR        W                           Y      0.3692    0.3692     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02238318       PHL-ATENOLOL           Y    ATENOLOL                        100 MG        ORAL             TABLET                 PHH        B                           Y      0.3692    0.3692     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02237601       PMS-ATENOLOL           Y    ATENOLOL                        100 MG        ORAL             TABLET                 PMS        B                           Y      0.3692    0.3692     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02255553       CO ATENOLOL            Y    ATENOLOL                        100 MG        ORAL             TABLET                 COB        W                           Y      0.3692    0.3692     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02267993       RAN-ATENOLOL           Y    ATENOLOL                        100 MG        ORAL             TABLET                 RAN        B                           Y      0.3692    0.3692     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02171805       RATIO-ATENOLOL         Y    ATENOLOL                        100 MG        ORAL             TABLET                 RPH        B                           Y      0.3692    0.3692     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02147432       MYLAN-ATENOLOL         Y    ATENOLOL                        100 MG        ORAL             TABLET                 MYP        W                           Y      0.3692    0.3692     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02231733       SANDOZ ATENOLOL        Y    ATENOLOL                        100 MG        ORAL             TABLET                 SDZ        W                           Y      0.3692    0.3692     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        01912054       TEVA-ATENOL            Y    ATENOLOL                        100 MG        ORAL             TABLET                 TEV        B                           Y      0.3692    0.3692     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00773697       APO-ATENOL             Y    ATENOLOL                        100 MG        ORAL             TABLET                 APX        B                           Y      0.3692    0.3692     REGULAR BENEFIT
         BETA-ADRENERGIC BLOCKING
242400   AGENTS /                 02039540       TENORMIN               Y    ATENOLOL                        100 MG        ORAL             TABLET                 AZC        W            7.50%          N      0.9813    0.3692     REGULAR BENEFIT
                                          14
         BETA-ADRENERGIC                                                                                     50 MG * 25
242400   BLOCKING AGENTS /        02248763       APO-ATENIDONE          Y    ATENOLOL/ CHLORTHALIDONE        MG            ORAL             TABLET                 APX        B                           Y      0.3195    0.3195     REGULAR BENEFIT
         BETA-ADRENERGIC                                                                                     50 MG * 25
242400   BLOCKING AGENTS /        02302918       TEVA-ATENOLTHALIDONE   Y    ATENOLOL/ CHLORTHALIDONE        MG            ORAL             TABLET                 TEV        B                           Y      0.3195    0.3195     REGULAR BENEFIT
         BETA-ADRENERGIC BLOCKING                                                                            50 MG * 25
242400   AGENTS /                 02049961       TENORETIC 50/25        Y    ATENOLOL/ CHLORTHALIDONE        MG            ORAL             TABLET                 AZC        W            7.50%          N      0.6640    0.3195     REGULAR BENEFIT
                                             3
         BETA-ADRENERGIC                                                                                     100 MG * 25
242400   BLOCKING AGENTS /        02302926       TEVA-ATENOLTHALIDONE   Y    ATENOLOL/ CHLORTHALIDONE        MG            ORAL             TABLET                 TEV        B                           Y      0.5236    0.5236     REGULAR BENEFIT
         BETA-ADRENERGIC                                                                                     100 MG * 25
242400   BLOCKING AGENTS /        02248764       APO-ATENIDONE          Y    ATENOLOL/ CHLORTHALIDONE        MG            ORAL             TABLET                 APX        B                           Y      0.5236    0.5236     REGULAR BENEFIT
         BETA-ADRENERGIC BLOCKING                                                                            100 MG * 25
242400   AGENTS /                 02049988       TENORETIC 100/25       Y    ATENOLOL/ CHLORTHALIDONE        MG            ORAL             TABLET                 AZC        W            7.50%          N      1.0880    0.5236     REGULAR BENEFIT




                                                                                                              Updated July 1, 2012                                                                                                      Page 49 of 254
                                                                             Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                          (Regular Benefits)


                                                                                                                                                                   DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION   DIN / PIN          PRODUCT NAME    IC           GENERIC NAME             STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                          3
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02302632       PMS-BISOPROLOL      Y    BISOPROLOL FUMARATE             5 MG        ORAL               TABLET                 PMS        B                           Y      0.1378    0.1378     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02267470       NOVO-BISOPROLOL     Y    BISOPROLOL FUMARATE             5 MG        ORAL               TABLET                 TEV        B                           Y      0.1378    0.1378     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02256134       APO-BISOPROLOL      Y    BISOPROLOL FUMARATE             5 MG        ORAL               TABLET                 APX        B                           Y      0.1378    0.1378     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02247439       SANDOZ BISOPROLOL   Y    BISOPROLOL FUMARATE             5 MG        ORAL               TABLET                 SDZ        W                           Y      0.1378    0.1378     REGULAR BENEFIT
                                          4
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02302640       PMS-BISOPROLOL      Y    BISOPROLOL FUMARATE             10 MG       ORAL               TABLET                 PMS        B                           Y      0.2284    0.2284     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02363895       AVA-BISOPROLOL      Y    BISOPROLOL FUMARATE             10 MG       ORAL               TABLET                 AVA        W                           Y      0.2284    0.2284     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02247440       SANDOZ BISOPROLOL   Y    BISOPROLOL FUMARATE             10 MG       ORAL               TABLET                 SDZ        W                           Y      0.2284    0.2284     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02267489       NOVO-BISOPROLOL     Y    BISOPROLOL FUMARATE             10 MG       ORAL               TABLET                 TEV        B                           Y      0.2284    0.2284     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02256177       APO-BISOPROLOL      Y    BISOPROLOL FUMARATE             10 MG       ORAL               TABLET                 APX        B                           Y      0.2284    0.2284     REGULAR BENEFIT
                                          5
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02247933       APO-CARVEDILOL      Y    CARVEDILOL                      3.125 MG    ORAL               TABLET                 APX        B                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02252309       RATIO-CARVEDILOL    Y    CARVEDILOL                      3.125 MG    ORAL               TABLET                 RPH        B                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02268027       RAN-CARVEDILOL      Y    CARVEDILOL                      3.125 MG    ORAL               TABLET                 RAN        B                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02245914       PMS-CARVEDILOL      Y    CARVEDILOL                      3.125 MG    ORAL               TABLET                 PMS        B                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02347512       MYLAN-CARVEDILOL    Y    CARVEDILOL                      3.125 MG    ORAL               TABLET                 MYP        W                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02248752       PHL-CARVEDILOL      Y    CARVEDILOL                      3.125 MG    ORAL               TABLET                 PHH        B                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02370735       AVA-CARVEDILOL      Y    CARVEDILOL                      3.125 MG    ORAL               TABLET                 AVA        W                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02364913       CARVEDILOL          Y    CARVEDILOL                      3.125 MG    ORAL               TABLET                 SNS        W                           Y      0.4728    0.4728     REGULAR BENEFIT
                                          8
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02252317       RATIO-CARVEDILOL    Y    CARVEDILOL                      6.25 MG     ORAL               TABLET                 RPH        B                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02268035       RAN-CARVEDILOL      Y    CARVEDILOL                      6.25 MG     ORAL               TABLET                 RAN        B                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02247934       APO-CARVEDILOL      Y    CARVEDILOL                      6.25 MG     ORAL               TABLET                 APX        B                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02245915       PMS-CARVEDILOL      Y    CARVEDILOL                      6.25 MG     ORAL               TABLET                 PMS        B                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02248753       PHL-CARVEDILOL      Y    CARVEDILOL                      6.25 MG     ORAL               TABLET                 PHH        B                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /     02370743       AVA-CARVEDILOL      Y    CARVEDILOL                      6.25 MG     ORAL               TABLET                 AVA        W                           Y      0.4728    0.4728     REGULAR BENEFIT




                                                                                                        Updated July 1, 2012                                                                                                      Page 50 of 254
                                                                               Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                            (Regular Benefits)


                                                                                                                                                                     DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION       DIN / PIN         PRODUCT NAME   IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02364921       CARVEDILOL         Y    CARVEDILOL                      6.25 MG     ORAL               TABLET                 SNS        W                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02347520       MYLAN-CARVEDILOL   Y    CARVEDILOL                      6.25 MG     ORAL               TABLET                 MYP        W                           Y      0.4728    0.4728     REGULAR BENEFIT
                                             8
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02252325       RATIO-CARVEDILOL   Y    CARVEDILOL                      12.5 MG     ORAL               TABLET                 RPH        B                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02268043       RAN-CARVEDILOL     Y    CARVEDILOL                      12.5 MG     ORAL               TABLET                 RAN        B                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02247935       APO-CARVEDILOL     Y    CARVEDILOL                      12.5 MG     ORAL               TABLET                 APX        B                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02347555       MYLAN-CARVEDILOL   Y    CARVEDILOL                      12.5 MG     ORAL               TABLET                 MYP        W                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02245916       PMS-CARVEDILOL     Y    CARVEDILOL                      12.5 MG     ORAL               TABLET                 PMS        B                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02248754       PHL-CARVEDILOL     Y    CARVEDILOL                      12.5 MG     ORAL               TABLET                 PHH        B                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02370751       AVA-CARVEDILOL     Y    CARVEDILOL                      12.5 MG     ORAL               TABLET                 AVA        W                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02364948       CARVEDILOL         Y    CARVEDILOL                      12.5 MG     ORAL               TABLET                 SNS        W                           Y      0.4728    0.4728     REGULAR BENEFIT
                                             8
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02347571       MYLAN-CARVEDILOL   Y    CARVEDILOL                      25 MG       ORAL               TABLET                 MYP        W                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02247936       APO-CARVEDILOL     Y    CARVEDILOL                      25 MG       ORAL               TABLET                 APX        B                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02252333       RATIO-CARVEDILOL   Y    CARVEDILOL                      25 MG       ORAL               TABLET                 RPH        B                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02268051       RAN-CARVEDILOL     Y    CARVEDILOL                      25 MG       ORAL               TABLET                 RAN        B                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02370786       AVA-CARVEDILOL     Y    CARVEDILOL                      25 MG       ORAL               TABLET                 AVA        W                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02364956       CARVEDILOL         Y    CARVEDILOL                      25 MG       ORAL               TABLET                 SNS        W                           Y      0.4728    0.4728     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02245917       PMS-CARVEDILOL     Y    CARVEDILOL                      25 MG       ORAL               TABLET                 PMS        B                           Y      0.4728    0.4728     REGULAR BENEFIT
                                             7
         BETA-ADRENERGIC BLOCKING                LABETALOL
242400   AGENTS /                 02231689       HYDROCHLORIDE      N    LABETALOL HCL                   5 MG / ML   INJECTION                                 SDZ        W            7.50%          N      1.2930               REGULAR BENEFIT
                                             1
         BETA-ADRENERGIC BLOCKING
242400   AGENTS /                 02106272       TRANDATE           N    LABETALOL HCL                   100 MG      ORAL               TABLET                 PAL        B                           N      0.2677               REGULAR BENEFIT
                                             1
         BETA-ADRENERGIC BLOCKING
242400   AGENTS /                 02106280       TRANDATE           N    LABETALOL HCL                   200 MG      ORAL               TABLET                 PAL        B                           N      0.4733               REGULAR BENEFIT
                                             1
         BETA-ADRENERGIC BLOCKING
242400   AGENTS /                 00590819       LOPRESOR           N    METOPROLOL TARTRATE             1 MG / ML   INJECTION                                 NOV        W            7.50%          N      1.1953               REGULAR BENEFIT
                                             1




                                                                                                          Updated July 1, 2012                                                                                                      Page 51 of 254
                                                                                      Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                   (Regular Benefits)


                                                                                                                                                                            DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION       DIN / PIN         PRODUCT NAME          IC           GENERIC NAME             STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         BETA-ADRENERGIC                                                                                                                       SUSTAINED-
242400   BLOCKING AGENTS /        02285169       APO-METOPROLOL SR         Y    METOPROLOL TARTRATE             100 MG      ORAL               RELEASE TABLET         APX        B                           Y      0.1312    0.1312     REGULAR BENEFIT
         BETA-ADRENERGIC                                                                                                                       SUSTAINED-
242400   BLOCKING AGENTS /        02303396       SANDOZ METOPROLOL SR      Y    METOPROLOL TARTRATE             100 MG      ORAL               RELEASE TABLET         SDZ        W                           Y      0.1312    0.1312     REGULAR BENEFIT
         BETA-ADRENERGIC BLOCKING                                                                                                              SUSTAINED-
242400   AGENTS /                 00658855       LOPRESOR SR               Y    METOPROLOL TARTRATE             100 MG      ORAL               RELEASE TABLET         NOV        W            7.50%          N      0.3116    0.1312     REGULAR BENEFIT
                                             3
         BETA-ADRENERGIC                                                                                                                       SUSTAINED-
242400   BLOCKING AGENTS /        02285177       APO-METOPROLOL SR         Y    METOPROLOL TARTRATE             200 MG      ORAL               RELEASE TABLET         APX        B                           Y      0.2499    0.2499     REGULAR BENEFIT
         BETA-ADRENERGIC                                                                                                                       SUSTAINED-
242400   BLOCKING AGENTS /        02303418       SANDOZ METOPROLOL SR      Y    METOPROLOL TARTRATE             200 MG      ORAL               RELEASE TABLET         SDZ        W                           Y      0.2499    0.2499     REGULAR BENEFIT
         BETA-ADRENERGIC BLOCKING                                                                                                              SUSTAINED-
242400   AGENTS /                 00534560       LOPRESOR SR               Y    METOPROLOL TARTRATE             200 MG      ORAL               RELEASE TABLET         NOV        W            7.50%          N      0.5655    0.2499     REGULAR BENEFIT
                                             3
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02248855       PMS-METOPROLOL-L          Y    METOPROLOL TARTRATE             25 MG       ORAL               TABLET                 PMS        B                           Y      0.0643    0.0643     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02246010       APO-METOPROLOL            Y    METOPROLOL TARTRATE             25 MG       ORAL               TABLET                 APX        B                           Y      0.0643    0.0643     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02302055       MYLAN-METOPROLOL          Y    METOPROLOL TARTRATE             25 MG       ORAL               TABLET                 MYP        W                           Y      0.0643    0.0643     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02356813       JAMP-METOPROLOL-L         Y    METOPROLOL TARTRATE             25 MG       ORAL               TABLET                 JPC        B                           Y      0.0643    0.0643     REGULAR BENEFIT
                                             4
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00648035       TEVA-METOPROL (FC)        Y    METOPROLOL TARTRATE             50 MG       ORAL               TABLET                 TEV        B                           Y      0.1047    0.1047     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00749354       APO-METOPROLOL (TYPE L)   Y    METOPROLOL TARTRATE             50 MG       ORAL               TABLET                 APX        B                           Y      0.1047    0.1047     REGULAR BENEFIT
         BETA-ADRENERGIC                         MYLAN-METOPROLOL
242400   BLOCKING AGENTS /        02174545       (TYPE L)                  Y    METOPROLOL TARTRATE             50 MG       ORAL               TABLET                 MYP        W                           Y      0.1047    0.1047     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02230803       PMS-METOPROLOL-L          Y    METOPROLOL TARTRATE             50 MG       ORAL               TABLET                 PMS        B                           Y      0.1047    0.1047     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00618632       APO-METOPROLOL            Y    METOPROLOL TARTRATE             50 MG       ORAL               TABLET                 APX        B                           Y      0.1047    0.1047     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00842648       TEVA-METOPROL             Y    METOPROLOL TARTRATE             50 MG       ORAL               TABLET                 TEV        B                           Y      0.1047    0.1047     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02364824       AVA-METOPROLOL            Y    METOPROLOL TARTRATE             50 MG       ORAL               TABLET                 AVA        W                           Y      0.1047    0.1047     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02364840       AVA-METOPROLOL (TYPE L)   Y    METOPROLOL TARTRATE             50 MG       ORAL               TABLET                 AVA        W                           Y      0.1047    0.1047     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02350394       METOPROLOL                Y    METOPROLOL TARTRATE             50 MG       ORAL               TABLET                 SNS        W                           Y      0.1047    0.1047     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02356821       JAMP-METOPROLOL-L         Y    METOPROLOL TARTRATE             50 MG       ORAL               TABLET                 JPC        B                           Y      0.1047    0.1047     REGULAR BENEFIT
         BETA-ADRENERGIC                         SANDOZ METOPROLOL
242400   BLOCKING AGENTS /        02354187       (TYPE L)                  Y    METOPROLOL TARTRATE             50 MG       ORAL               TABLET                 SDZ        W                           Y      0.1047    0.1047     REGULAR BENEFIT
         BETA-ADRENERGIC BLOCKING
242400   AGENTS /                 00397423       LOPRESOR                  Y    METOPROLOL TARTRATE             50 MG       ORAL               TABLET                 NOV        W            7.50%          N      0.2781    0.1047     REGULAR BENEFIT
                                          12
         BETA-ADRENERGIC                         MYLAN-METOPROLOL
242400   BLOCKING AGENTS /        02174553       (TYPE L)                  Y    METOPROLOL TARTRATE             100 MG      ORAL               TABLET                 MYP        W                           Y      0.2147    0.2147     REGULAR BENEFIT




                                                                                                                 Updated July 1, 2012                                                                                                      Page 52 of 254
                                                                                      Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                   (Regular Benefits)


                                                                                                                                                                            DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION       DIN / PIN         PRODUCT NAME          IC              GENERIC NAME          STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02230804       PMS-METOPROLOL-L          Y    METOPROLOL TARTRATE             100 MG      ORAL               TABLET                 PMS        B                           Y      0.2147    0.2147     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00751170       APO-METOPROLOL (TYPE L)   Y    METOPROLOL TARTRATE             100 MG      ORAL               TABLET                 APX        B                           Y      0.2147    0.2147     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00618640       APO-METOPROLOL            Y    METOPROLOL TARTRATE             100 MG      ORAL               TABLET                 APX        B                           Y      0.2147    0.2147     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00842656       TEVA-METOPROL             Y    METOPROLOL TARTRATE             100 MG      ORAL               TABLET                 TEV        B                           Y      0.2147    0.2147     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02364832       AVA-METOPROLOL            Y    METOPROLOL TARTRATE             100 MG      ORAL               TABLET                 AVA        W                           Y      0.2147    0.2147     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02364859       AVA-METOPROLOL (TYPE L)   Y    METOPROLOL TARTRATE             100 MG      ORAL               TABLET                 AVA        W                           Y      0.2147    0.2147     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02350408       METOPROLOL                Y    METOPROLOL TARTRATE             100 MG      ORAL               TABLET                 SNS        W                           Y      0.2147    0.2147     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02356848       JAMP-METOPROLOL-L         Y    METOPROLOL TARTRATE             100 MG      ORAL               TABLET                 JPC        B                           Y      0.2147    0.2147     REGULAR BENEFIT
         BETA-ADRENERGIC                         SANDOZ METOPROLOL
242400   BLOCKING AGENTS /        02354195       (TYPE L)                  Y    METOPROLOL TARTRATE             100 MG      ORAL               TABLET                 SDZ        W                           Y      0.2147    0.2147     REGULAR BENEFIT
         BETA-ADRENERGIC                         SANDOZ METOPROLOL
242400   BLOCKING AGENTS /        02247876       (TYPE L)                  Y    METOPROLOL TARTRATE             100 MG      ORAL               TABLET                 SDZ        W                           Y      0.2147    0.2147     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00648043       TEVA-METOPROL (FC)        Y    METOPROLOL TARTRATE             100 MG      ORAL               TABLET                 TEV        B                           Y      0.2147    0.2147     REGULAR BENEFIT
         BETA-ADRENERGIC BLOCKING
242400   AGENTS /                 00397431       LOPRESOR                  Y    METOPROLOL TARTRATE             100 MG      ORAL               TABLET                 NOV        W            7.50%          N      0.5706    0.2147     REGULAR BENEFIT
                                          13
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02126753       NOVO-NADOLOL              Y    NADOLOL                         40 MG       ORAL               TABLET                 TEV        B                           Y      0.2465    0.2465     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00782505       APO-NADOL                 Y    NADOLOL                         40 MG       ORAL               TABLET                 APX        B                           Y      0.2465    0.2465     REGULAR BENEFIT
                                             2
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02126761       NOVO-NADOLOL              Y    NADOLOL                         80 MG       ORAL               TABLET                 TEV        B                           Y      0.3515    0.3515     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00782467       APO-NADOL                 Y    NADOLOL                         80 MG       ORAL               TABLET                 APX        B                           Y      0.3515    0.3515     REGULAR BENEFIT
                                             2
         BETA-ADRENERGIC BLOCKING
242400   AGENTS /                 00782475       APO-NADOL                 N    NADOLOL                         160 MG      ORAL               TABLET                 APX        B                           N      1.2046               REGULAR BENEFIT
                                             1
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02231536       PMS-PINDOLOL              Y    PINDOLOL                        5 MG        ORAL               TABLET                 PMS        B                           Y      0.2147    0.2147     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00869007       NOVO-PINDOL               Y    PINDOLOL                        5 MG        ORAL               TABLET                 TEV        B                           Y      0.2147    0.2147     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00755877       APO-PINDOL                Y    PINDOLOL                        5 MG        ORAL               TABLET                 APX        B                           Y      0.2147    0.2147     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02261782       SANDOZ PINDOLOL           Y    PINDOLOL                        5 MG        ORAL               TABLET                 SDZ        W                           Y      0.2147    0.2147     REGULAR BENEFIT
         BETA-ADRENERGIC BLOCKING
242400   AGENTS /                 00417270       VISKEN                    Y    PINDOLOL                        5 MG        ORAL               TABLET                 NOV        W            7.50%          N      0.5706    0.2147     REGULAR BENEFIT
                                             5
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00869015       NOVO-PINDOL               Y    PINDOLOL                        10 MG       ORAL               TABLET                 TEV        B                           Y      0.3666    0.3666     REGULAR BENEFIT




                                                                                                                 Updated July 1, 2012                                                                                                      Page 53 of 254
                                                                                Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                             (Regular Benefits)


                                                                                                                                                                      DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION       DIN / PIN          PRODUCT NAME   IC              GENERIC NAME          STRENGTH           ROUTE               FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02231537       PMS-PINDOLOL        Y    PINDOLOL                        10 MG        ORAL              TABLET                 PMS        B                           Y      0.3666    0.3666     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00755885       APO-PINDOL          Y    PINDOLOL                        10 MG        ORAL              TABLET                 APX        B                           Y      0.3666    0.3666     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02261790       SANDOZ PINDOLOL     Y    PINDOLOL                        10 MG        ORAL              TABLET                 SDZ        W                           Y      0.3666    0.3666     REGULAR BENEFIT
         BETA-ADRENERGIC BLOCKING
242400   AGENTS /                 00443174       VISKEN              Y    PINDOLOL                        10 MG        ORAL              TABLET                 NOV        W            7.50%          N      0.9744    0.3666     REGULAR BENEFIT
                                             5
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02231539       PMS-PINDOLOL        Y    PINDOLOL                        15 MG        ORAL              TABLET                 PMS        B                           Y      0.5318    0.5318     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00869023       NOVO-PINDOL         Y    PINDOLOL                        15 MG        ORAL              TABLET                 TEV        B                           Y      0.5318    0.5318     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00755893       APO-PINDOL          Y    PINDOLOL                        15 MG        ORAL              TABLET                 APX        B                           Y      0.5318    0.5318     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02261804       SANDOZ PINDOLOL     Y    PINDOLOL                        15 MG        ORAL              TABLET                 SDZ        W                           Y      0.5318    0.5318     REGULAR BENEFIT
         BETA-ADRENERGIC BLOCKING
242400   AGENTS /                 00417289       VISKEN              Y    PINDOLOL                        15 MG        ORAL              TABLET                 NOV        W            7.50%          N      1.4135    0.5318     REGULAR BENEFIT
                                             5
         BETA-ADRENERGIC BLOCKING                                                                         10 MG * 25
242400   AGENTS /                 00568627       VISKAZIDE 10/25     N    PINDOLOL/ HYDROCHLOROTHIAZIDE   MG           ORAL              TABLET                 NOV        W            7.50%          N      0.8746               REGULAR BENEFIT
                                             1
         BETA-ADRENERGIC BLOCKING                                                                         10 MG * 50
242400   AGENTS /                 00568635       VISKAZIDE 10/50     N    PINDOLOL/ HYDROCHLOROTHIAZIDE   MG           ORAL              TABLET                 NOV        W            7.50%          N      0.8746               REGULAR BENEFIT
                                             1
         BETA-ADRENERGIC BLOCKING                                                                                                        SUSTAINED-
242400   AGENTS /                 02042231       INDERAL-LA          N    PROPRANOLOL HCL                 60 MG        ORAL              RELEASE CAPSULE        WAY        W            7.50%          N      0.5562               REGULAR BENEFIT
                                             1
         BETA-ADRENERGIC BLOCKING                                                                                                        SUSTAINED-
242400   AGENTS /                 02042258       INDERAL-LA          N    PROPRANOLOL HCL                 80 MG        ORAL              RELEASE CAPSULE        WAY        W            7.50%          N      0.6272               REGULAR BENEFIT
                                             1
         BETA-ADRENERGIC BLOCKING                                                                                                        SUSTAINED-
242400   AGENTS /                 02042266       INDERAL-LA          N    PROPRANOLOL HCL                 120 MG       ORAL              RELEASE CAPSULE        WAY        W            7.50%          N      0.9656               REGULAR BENEFIT
                                             1
         BETA-ADRENERGIC BLOCKING                                                                                                        SUSTAINED-
242400   AGENTS /                 02042274       INDERAL-LA          N    PROPRANOLOL HCL                 160 MG       ORAL              RELEASE CAPSULE        WAY        W            7.50%          N      1.1420               REGULAR BENEFIT
                                             1
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00402788       APO-PROPRANOLOL     Y    PROPRANOLOL HCL                 10 MG        ORAL              TABLET                 APX        B                           Y      0.0192    0.0192     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00496480       NOVO-PRANOL         Y    PROPRANOLOL HCL                 10 MG        ORAL              TABLET                 TEV        B                           Y      0.0192    0.0192     REGULAR BENEFIT
                                             2
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00740675       NOVO-PRANOL         Y    PROPRANOLOL HCL                 20 MG        ORAL              TABLET                 TEV        B                           Y      0.0346    0.0346     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00663719       APO-PROPRANOLOL     Y    PROPRANOLOL HCL                 20 MG        ORAL              TABLET                 APX        B                           Y      0.0346    0.0346     REGULAR BENEFIT
                                             2
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00496499       NOVO-PRANOL         Y    PROPRANOLOL HCL                 40 MG        ORAL              TABLET                 TEV        B                           Y      0.0348    0.0348     REGULAR BENEFIT




                                                                                                           Updated July 1, 2012                                                                                                      Page 54 of 254
                                                                               Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                            (Regular Benefits)


                                                                                                                                                                     DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION       DIN / PIN         PRODUCT NAME   IC           GENERIC NAME             STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00402753       APO-PROPRANOLOL    Y    PROPRANOLOL HCL                 40 MG       ORAL               TABLET                 APX        B                           Y      0.0348    0.0348     REGULAR BENEFIT
                                             2
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00496502       NOVO-PRANOL        Y    PROPRANOLOL HCL                 80 MG       ORAL               TABLET                 TEV        B                           Y      0.0585    0.0585     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00402761       APO-PROPRANOLOL    Y    PROPRANOLOL HCL                 80 MG       ORAL               TABLET                 APX        B                           Y      0.0585    0.0585     REGULAR BENEFIT
                                             2
         BETA-ADRENERGIC BLOCKING
242400   AGENTS /                 00504335       APO-PROPRANOLOL    N    PROPRANOLOL HCL                 120 MG      ORAL               TABLET                 APX        B                           N      0.3091               REGULAR BENEFIT
                                             1
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02257831       SANDOZ SOTALOL     Y    SOTALOL HCL                     80 MG       ORAL               TABLET                 SDZ        W                           Y      0.3708    0.3708     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02210428       APO-SOTALOL        Y    SOTALOL HCL                     80 MG       ORAL               TABLET                 APX        B                           Y      0.3708    0.3708     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02084228       RATIO-SOTALOL      Y    SOTALOL HCL                     80 MG       ORAL               TABLET                 RPH        B                           Y      0.3708    0.3708     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02231181       NOVO-SOTALOL       Y    SOTALOL HCL                     80 MG       ORAL               TABLET                 TEV        B                           Y      0.3708    0.3708     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02229778       MYLAN-SOTALOL      Y    SOTALOL HCL                     80 MG       ORAL               TABLET                 MYP        W                           Y      0.3708    0.3708     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02363674       AVA-SOTALOL        Y    SOTALOL HCL                     80 MG       ORAL               TABLET                 AVA        W                           Y      0.3708    0.3708     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02238326       PMS-SOTALOL        Y    SOTALOL HCL                     80 MG       ORAL               TABLET                 PMS        B                           Y      0.3708    0.3708     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02270625       CO SOTALOL         Y    SOTALOL HCL                     80 MG       ORAL               TABLET                 COB        W                           Y      0.3708    0.3708     REGULAR BENEFIT
                                             8
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02270633       CO SOTALOL         Y    SOTALOL HCL                     160 MG      ORAL               TABLET                 COB        W                           Y      0.4058    0.4058     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02238327       PMS-SOTALOL        Y    SOTALOL HCL                     160 MG      ORAL               TABLET                 PMS        B                           Y      0.4058    0.4058     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02257858       SANDOZ SOTALOL     Y    SOTALOL HCL                     160 MG      ORAL               TABLET                 SDZ        W                           Y      0.4058    0.4058     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02084236       RATIO-SOTALOL      Y    SOTALOL HCL                     160 MG      ORAL               TABLET                 RPH        B                           Y      0.4058    0.4058     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02167794       APO-SOTALOL        Y    SOTALOL HCL                     160 MG      ORAL               TABLET                 APX        B                           Y      0.4058    0.4058     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02231182       NOVO-SOTALOL       Y    SOTALOL HCL                     160 MG      ORAL               TABLET                 TEV        B                           Y      0.4058    0.4058     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02229779       MYLAN-SOTALOL      Y    SOTALOL HCL                     160 MG      ORAL               TABLET                 MYP        W                           Y      0.4058    0.4058     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        02363682       AVA-SOTALOL        Y    SOTALOL HCL                     160 MG      ORAL               TABLET                 AVA        W                           Y      0.4058    0.4058     REGULAR BENEFIT
                                             8
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        01947796       NOVO-TIMOL         Y    TIMOLOL MALEATE                 5 MG        ORAL               TABLET                 TEV        B                           Y      0.1649    0.1649     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /        00755842       APO-TIMOL          Y    TIMOLOL MALEATE                 5 MG        ORAL               TABLET                 APX        B                           Y      0.1649    0.1649     REGULAR BENEFIT
                                             2




                                                                                                          Updated July 1, 2012                                                                                                      Page 55 of 254
                                                                              Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                           (Regular Benefits)


                                                                                                                                                                    DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION   DIN / PIN          PRODUCT NAME    IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /      01947818       NOVO-TIMOL          Y    TIMOLOL MALEATE                 10 MG       ORAL               TABLET                 TEV        B                           Y      0.2572    0.2572     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /      00755850       APO-TIMOL           Y    TIMOLOL MALEATE                 10 MG       ORAL               TABLET                 APX        B                           Y      0.2572    0.2572     REGULAR BENEFIT
                                           2
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /      00755869       APO-TIMOL           Y    TIMOLOL MALEATE                 20 MG       ORAL               TABLET                 APX        B                           Y      0.5005    0.5005     REGULAR BENEFIT
         BETA-ADRENERGIC
242400   BLOCKING AGENTS /      01947826       NOVO-TIMOL          Y    TIMOLOL MALEATE                 20 MG       ORAL               TABLET                 TEV        B                           Y      0.5005    0.5005     REGULAR BENEFIT
                                           2

242808   DIHYDROPYRIDINES /     02326760       PHL-AMLODIPINE      Y    AMLODIPINE BESYLATE             2.5 MG      ORAL               TABLET                 PHH        B                           Y      0.2684    0.2684     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02295148       PMS-AMLODIPINE      Y    AMLODIPINE BESYLATE             2.5 MG      ORAL               TABLET                 PMS        B                           Y      0.2684    0.2684     REGULAR BENEFIT
                                           2

242808   DIHYDROPYRIDINES /     02371715       MAR-AMLODIPINE      Y    AMLODIPINE BESYLATE             5 MG        ORAL               TABLET                 MAR        W                           Y      0.5052    0.5052     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02357194       JAMP-AMLODIPINE     Y    AMLODIPINE BESYLATE             5 MG        ORAL               TABLET                 JPC        B                           Y      0.5052    0.5052     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02272113       MYLAN-AMLODIPINE    Y    AMLODIPINE BESYLATE             5 MG        ORAL               TABLET                 MYP        W                           Y      0.5052    0.5052     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02284065       PMS-AMLODIPINE      Y    AMLODIPINE BESYLATE             5 MG        ORAL               TABLET                 PMS        B                           Y      0.5052    0.5052     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02259605       RATIO-AMLODIPINE    Y    AMLODIPINE BESYLATE             5 MG        ORAL               TABLET                 RPH        B                           Y      0.5052    0.5052     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02297485       CO AMLODIPINE       Y    AMLODIPINE BESYLATE             5 MG        ORAL               TABLET                 COB        W                           Y      0.5052    0.5052     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02321858       RAN-AMLODIPINE      Y    AMLODIPINE BESYLATE             5 MG        ORAL               TABLET                 RAN        B                           Y      0.5052    0.5052     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02326779       PHL-AMLODIPINE      Y    AMLODIPINE BESYLATE             5 MG        ORAL               TABLET                 PHH        B                           Y      0.5052    0.5052     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02280132       GD-AMLODIPINE       Y    AMLODIPINE BESYLATE             5 MG        ORAL               TABLET                 GMD        W                           Y      0.5052    0.5052     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02250497       TEVA-AMLODIPINE     Y    AMLODIPINE BESYLATE             5 MG        ORAL               TABLET                 TEV        B                           Y      0.5052    0.5052     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02273373       APO-AMLODIPINE      Y    AMLODIPINE BESYLATE             5 MG        ORAL               TABLET                 APX        B                           Y      0.5052    0.5052     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02284383       SANDOZ AMLODIPINE   Y    AMLODIPINE BESYLATE             5 MG        ORAL               TABLET                 SDZ        W                           Y      0.5052    0.5052     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02331284       AMLODIPINE          Y    AMLODIPINE BESYLATE             5 MG        ORAL               TABLET                 SNS        W                           Y      0.5052    0.5052     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02331934       AMLODIPINE          Y    AMLODIPINE BESYLATE             5 MG        ORAL               TABLET                 RAN        B                           Y      0.5052    0.5052     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02331071       JAMP-AMLODIPINE     Y    AMLODIPINE BESYLATE             5 MG        ORAL               TABLET                 JPC        B                           Y      0.5052    0.5052     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02357712       SEPTA-AMLODIPINE    Y    AMLODIPINE BESYLATE             5 MG        ORAL               TABLET                 SEP        B                           Y      0.5052    0.5052     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02362651       MINT-AMLODIPINE     Y    AMLODIPINE BESYLATE             5 MG        ORAL               TABLET                 MPI        B                           Y      0.5052    0.5052     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     00878928       NORVASC             Y    AMLODIPINE BESYLATE             5 MG        ORAL               TABLET                 PFI        W            7.50%          N      1.3426    0.5052     REGULAR BENEFIT




                                                                                                         Updated July 1, 2012                                                                                                      Page 56 of 254
                                                                              Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                           (Regular Benefits)


                                                                                                                                                                    DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION   DIN / PIN          PRODUCT NAME    IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                       18

242808   DIHYDROPYRIDINES /     02357208       JAMP-AMLODIPINE     Y    AMLODIPINE BESYLATE             10 MG       ORAL               TABLET                 JPC        B                           Y      0.7499    0.7499     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02259613       RATIO-AMLODIPINE    Y    AMLODIPINE BESYLATE             10 MG       ORAL               TABLET                 RPH        B                           Y      0.7499    0.7499     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02284073       PMS-AMLODIPINE      Y    AMLODIPINE BESYLATE             10 MG       ORAL               TABLET                 PMS        B                           Y      0.7499    0.7499     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02272121       MYLAN-AMLODIPINE    Y    AMLODIPINE BESYLATE             10 MG       ORAL               TABLET                 MYP        W                           Y      0.7499    0.7499     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02321866       RAN-AMLODIPINE      Y    AMLODIPINE BESYLATE             10 MG       ORAL               TABLET                 RAN        B                           Y      0.7499    0.7499     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02326787       PHL-AMLODIPINE      Y    AMLODIPINE BESYLATE             10 MG       ORAL               TABLET                 PHH        B                           Y      0.7499    0.7499     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02280140       GD-AMLODIPINE       Y    AMLODIPINE BESYLATE             10 MG       ORAL               TABLET                 GMD        W                           Y      0.7499    0.7499     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02250500       TEVA-AMLODIPINE     Y    AMLODIPINE BESYLATE             10 MG       ORAL               TABLET                 TEV        B                           Y      0.7499    0.7499     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02273381       APO-AMLODIPINE      Y    AMLODIPINE BESYLATE             10 MG       ORAL               TABLET                 APX        B                           Y      0.7499    0.7499     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02284391       SANDOZ AMLODIPINE   Y    AMLODIPINE BESYLATE             10 MG       ORAL               TABLET                 SDZ        W                           Y      0.7499    0.7499     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02331292       AMLODIPINE          Y    AMLODIPINE BESYLATE             10 MG       ORAL               TABLET                 SNS        W                           Y      0.7499    0.7499     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02331942       AMLODIPINE          Y    AMLODIPINE BESYLATE             10 MG       ORAL               TABLET                 RAN        B                           Y      0.7499    0.7499     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02331098       JAMP-AMLODIPINE     Y    AMLODIPINE BESYLATE             10 MG       ORAL               TABLET                 JPC        B                           Y      0.7499    0.7499     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02357720       SEPTA-AMLODIPINE    Y    AMLODIPINE BESYLATE             10 MG       ORAL               TABLET                 SEP        B                           Y      0.7499    0.7499     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02362678       MINT-AMLODIPINE     Y    AMLODIPINE BESYLATE             10 MG       ORAL               TABLET                 MPI        B                           Y      0.7499    0.7499     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02297493       CO AMLODIPINE       Y    AMLODIPINE BESYLATE             10 MG       ORAL               TABLET                 COB        W                           Y      0.7499    0.7499     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     02371723       MAR-AMLODIPINE      Y    AMLODIPINE BESYLATE             10 MG       ORAL               TABLET                 MAR        W                           Y      0.7499    0.7499     REGULAR BENEFIT

242808   DIHYDROPYRIDINES /     00878936       NORVASC             Y    AMLODIPINE BESYLATE             10 MG       ORAL               TABLET                 PFI        W            7.50%          N      1.9930    0.7499     REGULAR BENEFIT
                                       18
                                                                                                                                       EXTENDED-RELEASE
242808   DIHYDROPYRIDINES /     02221985       RENEDIL             Y    FELODIPINE                      2.5 MG      ORAL               TABLET                 SAV        W            7.50%          N      0.3170    0.3408     REGULAR BENEFIT
                                                                                                                                       EXTENDED-RELEASE
242808   DIHYDROPYRIDINES /     02057778       PLENDIL             Y    FELODIPINE                      2.5 MG      ORAL               TABLET                 AZC        W            7.50%          N      0.5090    0.3408     REGULAR BENEFIT
                                           2
                                                                                                                                       EXTENDED-RELEASE
242808   DIHYDROPYRIDINES /     02280264       SANDOZ FELODIPINE   Y    FELODIPINE                      5 MG        ORAL               TABLET                 SDZ        W                           Y      0.4620    0.4620     REGULAR BENEFIT
                                                                                                                                       EXTENDED-RELEASE
242808   DIHYDROPYRIDINES /     02221993       RENEDIL             Y    FELODIPINE                      5 MG        ORAL               TABLET                 SAV        W            7.50%          N      0.4633    0.4620     REGULAR BENEFIT
                                                                                                                                       EXTENDED-RELEASE
242808   DIHYDROPYRIDINES /     00851779       PLENDIL             Y    FELODIPINE                      5 MG        ORAL               TABLET                 AZC        W            7.50%          N      0.6800    0.4620     REGULAR BENEFIT
                                           3




                                                                                                         Updated July 1, 2012                                                                                                      Page 57 of 254
                                                                                    Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                 (Regular Benefits)


                                                                                                                                                                          DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION       DIN / PIN          PRODUCT NAME     IC                GENERIC NAME         STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                                                                                                                             EXTENDED-RELEASE
242808   DIHYDROPYRIDINES /        02222000       RENEDIL               Y    FELODIPINE                       10 MG       ORAL               TABLET           SAV              W            7.50%          Y      0.6733    0.6733     REGULAR BENEFIT
                                                                                                                                             EXTENDED-RELEASE
242808   DIHYDROPYRIDINES /        02280272       SANDOZ FELODIPINE     Y    FELODIPINE                       10 MG       ORAL               TABLET                 SDZ        W                           Y      0.6733    0.6733     REGULAR BENEFIT
                                                                                                                                             EXTENDED-RELEASE
242808   DIHYDROPYRIDINES /        00851787       PLENDIL               Y    FELODIPINE                       10 MG       ORAL               TABLET                 AZC        W            7.50%          N      1.0207    0.6733     REGULAR BENEFIT
                                              3

242808   DIHYDROPYRIDINES /        00725110       NIFEDIPINE            N    NIFEDIPINE                       5 MG        ORAL               CAPSULE                AAP        W            7.50%          N      0.3679               REGULAR BENEFIT
                                              1

242808   DIHYDROPYRIDINES /        00755907       NIFEDIPINE            N    NIFEDIPINE                       10 MG       ORAL               CAPSULE                AAP        W            7.50%          N      0.4877               REGULAR BENEFIT
                                              1
                                                                                                                                             EXTENDED-RELEASE
242808   DIHYDROPYRIDINES /        02237618       ADALAT XL             N    NIFEDIPINE                       20 MG       ORAL               TABLET                 BAI        W            7.50%          N      1.2487               REGULAR BENEFIT
                                              1
                                                  MYLAN-NIFEDIPINE                                                                           EXTENDED-RELEASE
242808   DIHYDROPYRIDINES /        02349167       EXTENDED RELEASE      Y    NIFEDIPINE                       30 MG       ORAL               TABLET           MYP              W                           Y      0.6171    0.6171     REGULAR BENEFIT
                                                                                                                                             EXTENDED-RELEASE
242808   DIHYDROPYRIDINES /        02155907       ADALAT XL             Y    NIFEDIPINE                       30 MG       ORAL               TABLET                 BAI        W            0.00%          N      0.7177    0.6171     REGULAR BENEFIT
                                              2
                                                  MYLAN-NIFEDIPINE                                                                           EXTENDED-RELEASE
242808   DIHYDROPYRIDINES /        02321149       EXTENDED RELEASE      Y    NIFEDIPINE                       60 MG       ORAL               TABLET           MYP              W                           Y      0.9374    0.9374     REGULAR BENEFIT
                                                                                                                                             EXTENDED-RELEASE
242808   DIHYDROPYRIDINES /        02155990       ADALAT XL             Y    NIFEDIPINE                       60 MG       ORAL               TABLET                 BAI        W            0.00%          N      1.1285    0.9374     REGULAR BENEFIT
                                              2
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02355752         PMS-DILTIAZEM CD      Y    DILTIAZEM HCL                    120 MG      ORAL               DELIVERY CAPSULE       PMS        B                           Y      0.5157    0.5157     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02370611         CO DILTIAZEM CD       Y    DILTIAZEM HCL                    120 MG      ORAL               DELIVERY CAPSULE       COB        W                           Y      0.5157    0.5157     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02229781         RATIO-DILTIAZEM CD    Y    DILTIAZEM HCL                    120 MG      ORAL               DELIVERY CAPSULE       RPH        B                           Y      0.5157    0.5157     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02230997         APO-DILTIAZ CD        Y    DILTIAZEM HCL                    120 MG      ORAL               DELIVERY CAPSULE       APX        B                           Y      0.5157    0.5157     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02242538         NOVO-DILTAZEM CD      Y    DILTIAZEM HCL                    120 MG      ORAL               DELIVERY CAPSULE       TEV        B                           Y      0.5157    0.5157     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02243338         SANDOZ DILTIAZEM CD   Y    DILTIAZEM HCL                    120 MG      ORAL               DELIVERY CAPSULE       SDZ        W                           Y      0.5157    0.5157     REGULAR BENEFIT

         MISCELLANEOUS CALCIUM-                                                                                                              CONTROLLED-
242892   CHANNEL BLOCKING AGENTS / 02097249       CARDIZEM CD           Y    DILTIAZEM HCL                    120 MG      ORAL               DELIVERY CAPSULE       VCL        B                           N      1.4734    0.5157     REGULAR BENEFIT
                                              7
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02355760         PMS-DILTIAZEM CD      Y    DILTIAZEM HCL                    180 MG      ORAL               DELIVERY CAPSULE       PMS        B                           Y      0.6846    0.6846     REGULAR BENEFIT




                                                                                                               Updated July 1, 2012                                                                                                      Page 58 of 254
                                                                                    Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                 (Regular Benefits)


                                                                                                                                                                          DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION       DIN / PIN          PRODUCT NAME     IC            GENERIC NAME             STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02370638         CO DILTIAZEM CD       Y    DILTIAZEM HCL                    180 MG      ORAL               DELIVERY CAPSULE       COB        W                           Y      0.6846    0.6846     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02229782         RATIO-DILTIAZEM CD    Y    DILTIAZEM HCL                    180 MG      ORAL               DELIVERY CAPSULE       RPH        B                           Y      0.6846    0.6846     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02230998         APO-DILTIAZ CD        Y    DILTIAZEM HCL                    180 MG      ORAL               DELIVERY CAPSULE       APX        B                           Y      0.6846    0.6846     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02242539         NOVO-DILTAZEM CD      Y    DILTIAZEM HCL                    180 MG      ORAL               DELIVERY CAPSULE       TEV        B                           Y      0.6846    0.6846     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02243339         SANDOZ DILTIAZEM CD   Y    DILTIAZEM HCL                    180 MG      ORAL               DELIVERY CAPSULE       SDZ        W                           Y      0.6846    0.6846     REGULAR BENEFIT

         MISCELLANEOUS CALCIUM-                                                                                                              CONTROLLED-
242892   CHANNEL BLOCKING AGENTS / 02097257       CARDIZEM CD           Y    DILTIAZEM HCL                    180 MG      ORAL               DELIVERY CAPSULE       VCL        B                           N      1.9559    0.6846     REGULAR BENEFIT
                                              7
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02355779         PMS-DILTIAZEM CD      Y    DILTIAZEM HCL                    240 MG      ORAL               DELIVERY CAPSULE       PMS        B                           Y      0.9080    0.9080     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02370646         CO DILTIAZEM CD       Y    DILTIAZEM HCL                    240 MG      ORAL               DELIVERY CAPSULE       COB        W                           Y      0.9080    0.9080     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02229783         RATIO-DILTIAZEM CD    Y    DILTIAZEM HCL                    240 MG      ORAL               DELIVERY CAPSULE       RPH        B                           Y      0.9080    0.9080     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02230999         APO-DILTIAZ CD        Y    DILTIAZEM HCL                    240 MG      ORAL               DELIVERY CAPSULE       APX        B                           Y      0.9080    0.9080     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02242540         NOVO-DILTAZEM CD      Y    DILTIAZEM HCL                    240 MG      ORAL               DELIVERY CAPSULE       TEV        B                           Y      0.9080    0.9080     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02243340         SANDOZ DILTIAZEM CD   Y    DILTIAZEM HCL                    240 MG      ORAL               DELIVERY CAPSULE       SDZ        W                           Y      0.9080    0.9080     REGULAR BENEFIT

         MISCELLANEOUS CALCIUM-                                                                                                              CONTROLLED-
242892   CHANNEL BLOCKING AGENTS / 02097265       CARDIZEM CD           Y    DILTIAZEM HCL                    240 MG      ORAL               DELIVERY CAPSULE       VCL        B                           N      2.5944    0.9080     REGULAR BENEFIT
                                              7
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02355787         PMS-DILTIAZEM CD      Y    DILTIAZEM HCL                    300 MG      ORAL               DELIVERY CAPSULE       PMS        B                           Y      1.1351    1.1351     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02370654         CO DILTIAZEM CD       Y    DILTIAZEM HCL                    300 MG      ORAL               DELIVERY CAPSULE       COB        W                           Y      1.1351    1.1351     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02229526         APO-DILTIAZ CD        Y    DILTIAZEM HCL                    300 MG      ORAL               DELIVERY CAPSULE       APX        B                           Y      1.1351    1.1351     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                             CONTROLLED-
242892   /                       02229784         RATIO-DILTIAZEM CD    Y    DILTIAZEM HCL                    300 MG      ORAL               DELIVERY CAPSULE       RPH        B                           Y      1.1351    1.1351     REGULAR BENEFIT




                                                                                                               Updated July 1, 2012                                                                                                      Page 59 of 254
                                                                                      Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                   (Regular Benefits)


                                                                                                                                                                            DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION       DIN / PIN          PRODUCT NAME       IC            GENERIC NAME             STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               CONTROLLED-
242892   /                       02242541         NOVO-DILTAZEM CD        Y    DILTIAZEM HCL                    300 MG      ORAL               DELIVERY CAPSULE       TEV        B                           Y      1.1351    1.1351     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               CONTROLLED-
242892   /                       02243341         SANDOZ DILTIAZEM CD     Y    DILTIAZEM HCL                    300 MG      ORAL               DELIVERY CAPSULE       SDZ        W                           Y      1.1351    1.1351     REGULAR BENEFIT

         MISCELLANEOUS CALCIUM-                                                                                                                CONTROLLED-
242892   CHANNEL BLOCKING AGENTS / 02097273       CARDIZEM CD             Y    DILTIAZEM HCL                    300 MG      ORAL               DELIVERY CAPSULE       VCL        B                           N      3.2431    1.1351     REGULAR BENEFIT
                                              7
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               EXTENDED-RELEASE
242892   /                       02291037         APO-DILTIAZ TZ          Y    DILTIAZEM HCL                    120 MG      ORAL               CAPSULE          APX              B                           Y      0.2987    0.2987     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               EXTENDED-RELEASE
242892   /                       02370441         CO DILTIAZEM T          Y    DILTIAZEM HCL                    120 MG      ORAL               CAPSULE          COB              W                           Y      0.2987    0.2987     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               EXTENDED-RELEASE
242892   /                       02271605         NOVO-DILTIAZEM HCL ER   Y    DILTIAZEM HCL                    120 MG      ORAL               CAPSULE                TEV        B                           Y      0.2987    0.2987     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               EXTENDED-RELEASE
242892   /                       02245918         SANDOZ DILTIAZEM T      Y    DILTIAZEM HCL                    120 MG      ORAL               CAPSULE                SDZ        W                           Y      0.2987    0.2987     REGULAR BENEFIT

         MISCELLANEOUS CALCIUM-                                                                                                                EXTENDED-RELEASE
242892   CHANNEL BLOCKING AGENTS / 02231150       TIAZAC                  Y    DILTIAZEM HCL                    120 MG      ORAL               CAPSULE                VCL        B                           N      0.8533    0.2987     REGULAR BENEFIT
                                              5
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               EXTENDED-RELEASE
242892   /                       02291045         APO-DILTIAZ TZ          Y    DILTIAZEM HCL                    180 MG      ORAL               CAPSULE          APX              B                           Y      0.4045    0.4045     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               EXTENDED-RELEASE
242892   /                       02370492         CO DILTIAZEM T          Y    DILTIAZEM HCL                    180 MG      ORAL               CAPSULE          COB              W                           Y      0.4045    0.4045     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               EXTENDED-RELEASE
242892   /                       02271613         NOVO-DILTIAZEM HCL ER   Y    DILTIAZEM HCL                    180 MG      ORAL               CAPSULE                TEV        B                           Y      0.4045    0.4045     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               EXTENDED-RELEASE
242892   /                       02245919         SANDOZ DILTIAZEM T      Y    DILTIAZEM HCL                    180 MG      ORAL               CAPSULE                SDZ        W                           Y      0.4045    0.4045     REGULAR BENEFIT

         MISCELLANEOUS CALCIUM-                                                                                                                EXTENDED-RELEASE
242892   CHANNEL BLOCKING AGENTS / 02231151       TIAZAC                  Y    DILTIAZEM HCL                    180 MG      ORAL               CAPSULE                VCL        B                           N      1.1556    0.4045     REGULAR BENEFIT
                                              5
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               EXTENDED-RELEASE
242892   /                       02291053         APO-DILTIAZ TZ          Y    DILTIAZEM HCL                    240 MG      ORAL               CAPSULE          APX              B                           Y      0.5365    0.5365     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               EXTENDED-RELEASE
242892   /                       02370506         CO DILTIAZEM T          Y    DILTIAZEM HCL                    240 MG      ORAL               CAPSULE          COB              W                           Y      0.5365    0.5365     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               EXTENDED-RELEASE
242892   /                       02271621         NOVO-DILTIAZEM HCL ER   Y    DILTIAZEM HCL                    240 MG      ORAL               CAPSULE                TEV        B                           Y      0.5365    0.5365     REGULAR BENEFIT




                                                                                                                 Updated July 1, 2012                                                                                                      Page 60 of 254
                                                                                      Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                   (Regular Benefits)


                                                                                                                                                                            DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION       DIN / PIN          PRODUCT NAME       IC            GENERIC NAME             STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               EXTENDED-RELEASE
242892   /                       02245920         SANDOZ DILTIAZEM T      Y    DILTIAZEM HCL                    240 MG      ORAL               CAPSULE                SDZ        W                           Y      0.5365    0.5365     REGULAR BENEFIT

         MISCELLANEOUS CALCIUM-                                                                                                                EXTENDED-RELEASE
242892   CHANNEL BLOCKING AGENTS / 02231152       TIAZAC                  Y    DILTIAZEM HCL                    240 MG      ORAL               CAPSULE                VCL        B                           N      1.5328    0.5365     REGULAR BENEFIT
                                              5
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               EXTENDED-RELEASE
242892   /                       02291061         APO-DILTIAZ TZ          Y    DILTIAZEM HCL                    300 MG      ORAL               CAPSULE          APX              B                           Y      0.6607    0.6607     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               EXTENDED-RELEASE
242892   /                       02370514         CO DILTIAZEM T          Y    DILTIAZEM HCL                    300 MG      ORAL               CAPSULE          COB              W                           Y      0.6607    0.6607     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               EXTENDED-RELEASE
242892   /                       02271648         NOVO-DILTIAZEM HCL ER   Y    DILTIAZEM HCL                    300 MG      ORAL               CAPSULE                TEV        B                           Y      0.6607    0.6607     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               EXTENDED-RELEASE
242892   /                       02245921         SANDOZ DILTIAZEM T      Y    DILTIAZEM HCL                    300 MG      ORAL               CAPSULE                SDZ        W                           Y      0.6607    0.6607     REGULAR BENEFIT

         MISCELLANEOUS CALCIUM-                                                                                                                EXTENDED-RELEASE
242892   CHANNEL BLOCKING AGENTS / 02231154       TIAZAC                  Y    DILTIAZEM HCL                    300 MG      ORAL               CAPSULE                VCL        B                           N      1.8878    0.6607     REGULAR BENEFIT
                                              5
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               EXTENDED-RELEASE
242892   /                       02291088         APO-DILTIAZ TZ          Y    DILTIAZEM HCL                    360 MG      ORAL               CAPSULE          APX              B                           Y      0.8089    0.8089     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               EXTENDED-RELEASE
242892   /                       02370522         CO DILTIAZEM T          Y    DILTIAZEM HCL                    360 MG      ORAL               CAPSULE          COB              W                           Y      0.8089    0.8089     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               EXTENDED-RELEASE
242892   /                       02245922         SANDOZ DILTIAZEM T      Y    DILTIAZEM HCL                    360 MG      ORAL               CAPSULE                SDZ        W                           Y      0.8089    0.8089     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                               EXTENDED-RELEASE
242892   /                       02271656         NOVO-DILTIAZEM HCL ER   Y    DILTIAZEM HCL                    360 MG      ORAL               CAPSULE                TEV        B                           Y      0.8089    0.8089     REGULAR BENEFIT

         MISCELLANEOUS CALCIUM-                                                                                                                EXTENDED-RELEASE
242892   CHANNEL BLOCKING AGENTS / 02231155       TIAZAC                  Y    DILTIAZEM HCL                    360 MG      ORAL               CAPSULE                VCL        B                           N      2.3112    0.8089     REGULAR BENEFIT
                                              5

         MISCELLANEOUS CALCIUM-                                                                                                                EXTENDED-RELEASE
242892   CHANNEL BLOCKING AGENTS / 02256738       TIAZAC XC               N    DILTIAZEM HCL                    120 MG      ORAL               TABLET                 VCL        B                           N      0.8194               REGULAR BENEFIT
                                              1

         MISCELLANEOUS CALCIUM-                                                                                                                EXTENDED-RELEASE
242892   CHANNEL BLOCKING AGENTS / 02256746       TIAZAC XC               N    DILTIAZEM HCL                    180 MG      ORAL               TABLET                 VCL        B                           N      1.0887               REGULAR BENEFIT
                                              1

         MISCELLANEOUS CALCIUM-                                                                                                                EXTENDED-RELEASE
242892   CHANNEL BLOCKING AGENTS / 02256754       TIAZAC XC               N    DILTIAZEM HCL                    240 MG      ORAL               TABLET                 VCL        B                           N      1.4470               REGULAR BENEFIT
                                              1




                                                                                                                 Updated July 1, 2012                                                                                                      Page 61 of 254
                                                                                   Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                (Regular Benefits)


                                                                                                                                                                         DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION       DIN / PIN          PRODUCT NAME    IC            GENERIC NAME             STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

         MISCELLANEOUS CALCIUM-                                                                                                             EXTENDED-RELEASE
242892   CHANNEL BLOCKING AGENTS / 02256762       TIAZAC XC            N    DILTIAZEM HCL                    300 MG      ORAL               TABLET                 VCL        B                           N      1.4441               REGULAR BENEFIT
                                              1

         MISCELLANEOUS CALCIUM-                                                                                                             EXTENDED-RELEASE
242892   CHANNEL BLOCKING AGENTS / 02256770       TIAZAC XC            N    DILTIAZEM HCL                    360 MG      ORAL               TABLET                 VCL        B                           N      1.4447               REGULAR BENEFIT
                                              1
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS
242892   /                       00771376         APO-DILTIAZ          Y    DILTIAZEM HCL                    30 MG       ORAL               TABLET                 APX        B                           Y      0.1866    0.1866     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS
242892   /                       00862924         NOVO-DILTAZEM        Y    DILTIAZEM HCL                    30 MG       ORAL               TABLET                 TEV        B                           Y      0.1866    0.1866     REGULAR BENEFIT
                                              2
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS
242892   /                       00771384         APO-DILTIAZ          Y    DILTIAZEM HCL                    60 MG       ORAL               TABLET                 APX        B                           Y      0.3273    0.3273     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS
242892   /                       00862932         NOVO-DILTAZEM        Y    DILTIAZEM HCL                    60 MG       ORAL               TABLET                 TEV        B                           Y      0.3273    0.3273     REGULAR BENEFIT
                                              2
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                            SUSTAINED-
242892   /                       02246893         APO-VERAP SR         Y    VERAPAMIL HCL                    120 MG      ORAL               RELEASE TABLET         APX        B                           Y      0.5078    0.5078     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                            SUSTAINED-
242892   /                       02210347         MYLAN-VERAPAMIL SR   Y    VERAPAMIL HCL                    120 MG      ORAL               RELEASE TABLET         MYP        W                           Y      0.5078    0.5078     REGULAR BENEFIT

         MISCELLANEOUS CALCIUM-                                                                                                             SUSTAINED-
242892   CHANNEL BLOCKING AGENTS / 01907123       ISOPTIN SR           Y    VERAPAMIL HCL                    120 MG      ORAL               RELEASE TABLET         ABB        B                           N      1.3448    0.5078     REGULAR BENEFIT
                                              3
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                            SUSTAINED-
242892   /                       02210355         MYLAN-VERAPAMIL SR   Y    VERAPAMIL HCL                    180 MG      ORAL               RELEASE TABLET         MYP        W                           Y      0.5315    0.5315     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                            SUSTAINED-
242892   /                       02246894         APO-VERAP SR         Y    VERAPAMIL HCL                    180 MG      ORAL               RELEASE TABLET         APX        B                           Y      0.5315    0.5315     REGULAR BENEFIT

         MISCELLANEOUS CALCIUM-                                                                                                             SUSTAINED-
242892   CHANNEL BLOCKING AGENTS / 01934317       ISOPTIN SR           Y    VERAPAMIL HCL                    180 MG      ORAL               RELEASE TABLET         ABB        B                           N      1.5186    0.5315     REGULAR BENEFIT
                                              3
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                            SUSTAINED-
242892   /                       02211920         NOVO-VERAMIL SR      Y    VERAPAMIL HCL                    240 MG      ORAL               RELEASE TABLET         TEV        B                           Y      0.7088    0.7088     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                            SUSTAINED-
242892   /                       02210363         MYLAN-VERAPAMIL SR   Y    VERAPAMIL HCL                    240 MG      ORAL               RELEASE TABLET         MYP        W                           Y      0.7088    0.7088     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                            SUSTAINED-
242892   /                       02237791         PMS-VERAPAMIL SR     Y    VERAPAMIL HCL                    240 MG      ORAL               RELEASE TABLET         PMS        B                           Y      0.7088    0.7088     REGULAR BENEFIT




                                                                                                              Updated July 1, 2012                                                                                                      Page 62 of 254
                                                                                 Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                              (Regular Benefits)


                                                                                                                                                                       DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION       DIN / PIN          PRODUCT NAME   IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS                                                                                                          SUSTAINED-
242892   /                       02246895         APO-VERAP SR        Y    VERAPAMIL HCL                   240 MG      ORAL               RELEASE TABLET         APX        B                           Y      0.7088    0.7088     REGULAR BENEFIT

         MISCELLANEOUS CALCIUM-                                                                                                           SUSTAINED-
242892   CHANNEL BLOCKING AGENTS / 00742554       ISOPTIN SR          Y    VERAPAMIL HCL                   240 MG      ORAL               RELEASE TABLET         ABB        B                           N      2.0252    0.7088     REGULAR BENEFIT
                                              5
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS
242892   /                       00782483         APO-VERAP           Y    VERAPAMIL HCL                   80 MG       ORAL               TABLET                 APX        B                           Y      0.2735    0.2735     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS
242892   /                       02237921         MYLAN-VERAPAMIL     Y    VERAPAMIL HCL                   80 MG       ORAL               TABLET                 MYP        W                           Y      0.2735    0.2735     REGULAR BENEFIT
                                              2
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS
242892   /                       02237922         MYLAN-VERAPAMIL     Y    VERAPAMIL HCL                   120 MG      ORAL               TABLET                 MYP        W                           Y      0.4250    0.4250     REGULAR BENEFIT
         MISCELLANEOUS CALCIUM-
         CHANNEL BLOCKING AGENTS
242892   /                       00782491         APO-VERAP           Y    VERAPAMIL HCL                   120 MG      ORAL               TABLET                 APX        B                           Y      0.4250    0.4250     REGULAR BENEFIT
                                              2

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /       02290332       BENAZEPRIL          Y    BENAZEPRIL HCL                  5 MG        ORAL               TABLET                 AAP        W                           Y      0.5995    0.5995     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /       00885835       LOTENSIN            Y    BENAZEPRIL HCL                  5 MG        ORAL               TABLET                 NOV        W            7.50%          N      0.7795    0.5995     REGULAR BENEFIT
                                              2
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /       02290340       BENAZEPRIL          N    BENAZEPRIL HCL                  10 MG       ORAL               TABLET                 AAP        W                           N      0.6595               REGULAR BENEFIT
                                              1

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /       02273918       BENAZEPRIL          Y    BENAZEPRIL HCL                  20 MG       ORAL               TABLET                 AAP        W                           Y      0.8135    0.8135     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /       00885851       LOTENSIN            Y    BENAZEPRIL HCL                  20 MG       ORAL               TABLET                 NOV        W            7.50%          N      1.0577    0.8135     REGULAR BENEFIT
                                              2

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /       00893595       APO-CAPTO           Y    CAPTOPRIL                       12.5 MG     ORAL               TABLET                 APX        B                           Y      0.1325    0.1325     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /       01942964       NOVO-CAPTORIL       Y    CAPTOPRIL                       12.5 MG     ORAL               TABLET                 TEV        B                           Y      0.1325    0.1325     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /       02163551       MYLAN-CAPTOPRIL     Y    CAPTOPRIL                       12.5 MG     ORAL               TABLET                 MYP        W                           Y      0.1325    0.1325     REGULAR BENEFIT
                                              3

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /       02163578       MYLAN-CAPTOPRIL     Y    CAPTOPRIL                       25 MG       ORAL               TABLET                 MYP        W                           Y      0.1875    0.1875     REGULAR BENEFIT




                                                                                                            Updated July 1, 2012                                                                                                      Page 63 of 254
                                                                                 Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                              (Regular Benefits)


                                                                                                                                                                       DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION      DIN / PIN           PRODUCT NAME   IC            GENERIC NAME             STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      01942972       NOVO-CAPTORIL       Y    CAPTOPRIL                        25 MG       ORAL               TABLET                 TEV        B                           Y      0.1875    0.1875     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      00893609       APO-CAPTO           Y    CAPTOPRIL                        25 MG       ORAL               TABLET                 APX        B                           Y      0.1875    0.1875     REGULAR BENEFIT
                                             3

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02163586       MYLAN-CAPTOPRIL     Y    CAPTOPRIL                        50 MG       ORAL               TABLET                 MYP        W                           Y      0.3494    0.3494     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      01942980       NOVO-CAPTORIL       Y    CAPTOPRIL                        50 MG       ORAL               TABLET                 TEV        B                           Y      0.3494    0.3494     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      00893617       APO-CAPTO           Y    CAPTOPRIL                        50 MG       ORAL               TABLET                 APX        B                           Y      0.3494    0.3494     REGULAR BENEFIT
                                             3

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02163594       MYLAN-CAPTOPRIL     Y    CAPTOPRIL                        100 MG      ORAL               TABLET                 MYP        W                           Y      0.6497    0.6497     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      01942999       NOVO-CAPTORIL       Y    CAPTOPRIL                        100 MG      ORAL               TABLET                 TEV        B                           Y      0.6497    0.6497     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      00893625       APO-CAPTO           Y    CAPTOPRIL                        100 MG      ORAL               TABLET                 APX        B                           Y      0.6497    0.6497     REGULAR BENEFIT
                                             3

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02283778       MYLAN-CILAZAPRIL    Y    CILAZAPRIL                       1 MG        ORAL               TABLET                 MYP        W                           Y      0.2492    0.2492     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02280442       PMS-CILAZAPRIL      Y    CILAZAPRIL                       1 MG        ORAL               TABLET                 PMS        B                           Y      0.2492    0.2492     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02291134       APO-CILAZAPRIL      Y    CILAZAPRIL                       1 MG        ORAL               TABLET                 APX        B                           Y      0.2492    0.2492     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02266350       NOVO-CILAZAPRIL     Y    CILAZAPRIL                       1 MG        ORAL               TABLET                 TEV        B                           N      0.2804    0.2492     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02350963       CILAZAPRIL          Y    CILAZAPRIL                       1 MG        ORAL               TABLET                 SNS        W                           N      0.2804    0.2492     REGULAR BENEFIT
                                             5

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02285215       CO CILAZAPRIL       Y    CILAZAPRIL                       2.5 MG      ORAL               TABLET                 COB        W                           Y      0.2755    0.2755     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02350971       CILAZAPRIL          Y    CILAZAPRIL                       2.5 MG      ORAL               TABLET                 SNS        W                           Y      0.2755    0.2755     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02283786       MYLAN-CILAZAPRIL    Y    CILAZAPRIL                       2.5 MG      ORAL               TABLET                 MYP        W                           Y      0.2755    0.2755     REGULAR BENEFIT




                                                                                                            Updated July 1, 2012                                                                                                      Page 64 of 254
                                                                                    Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                 (Regular Benefits)


                                                                                                                                                                          DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION      DIN / PIN           PRODUCT NAME      IC            GENERIC NAME             STRENGTH           ROUTE               FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02266369       NOVO-CILAZAPRIL        Y    CILAZAPRIL                       2.5 MG       ORAL              TABLET                 TEV        B                           Y      0.2755    0.2755     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02280450       PMS-CILAZAPRIL         Y    CILAZAPRIL                       2.5 MG       ORAL              TABLET                 PMS        B                           Y      0.2755    0.2755     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02291142       APO-CILAZAPRIL         Y    CILAZAPRIL                       2.5 MG       ORAL              TABLET                 APX        B                           Y      0.2755    0.2755     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      01911473       INHIBACE               Y    CILAZAPRIL                       2.5 MG       ORAL              TABLET                 HLR        W            7.50%          N      0.7323    0.2755     REGULAR BENEFIT
                                             7

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02350998       CILAZAPRIL             Y    CILAZAPRIL                       5 MG         ORAL              TABLET                 SNS        W                           Y      0.3201    0.3201     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02285223       CO CILAZAPRIL          Y    CILAZAPRIL                       5 MG         ORAL              TABLET                 COB        W                           Y      0.3201    0.3201     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02280469       PMS-CILAZAPRIL         Y    CILAZAPRIL                       5 MG         ORAL              TABLET                 PMS        B                           Y      0.3201    0.3201     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02283794       MYLAN-CILAZAPRIL       Y    CILAZAPRIL                       5 MG         ORAL              TABLET                 MYP        W                           Y      0.3201    0.3201     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02266377       NOVO-CILAZAPRIL        Y    CILAZAPRIL                       5 MG         ORAL              TABLET                 TEV        B                           Y      0.3201    0.3201     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02291150       APO-CILAZAPRIL         Y    CILAZAPRIL                       5 MG         ORAL              TABLET                 APX        B                           Y      0.3201    0.3201     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      01911481       INHIBACE               Y    CILAZAPRIL                       5 MG         ORAL              TABLET                 HLR        W            7.50%          N      0.8508    0.3201     REGULAR BENEFIT
                                             7

         ANGIOTENSIN-CONVERTING                                                                              5 MG * 12.5
243204   ENZYME INHIBITORS /      02313731       NOVO-CILAZAPRIL/HCTZ   Y    CILAZAPRIL/ HYDROCHLOROTHIAZIDE MG            ORAL              TABLET                 TEV        B                           Y      0.4170    0.4170     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING                                                                              5 MG * 12.5
243204   ENZYME INHIBITORS /      02284987       APO-CILAZAPRIL/HCTZ    Y    CILAZAPRIL/ HYDROCHLOROTHIAZIDE MG            ORAL              TABLET                 APX        B                           Y      0.4170    0.4170     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING                                                                              5 MG * 12.5
243204   ENZYME INHIBITORS /      02181479       INHIBACE PLUS          Y    CILAZAPRIL/ HYDROCHLOROTHIAZIDE MG            ORAL              TABLET                 HLR        W            7.50%          N      0.8507    0.4170     REGULAR BENEFIT
                                             3

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02020025       APO-ENALAPRIL          Y    ENALAPRIL MALEATE                2.5 MG       ORAL              TABLET                 APX        B                           Y      0.2731    0.2731     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02299933       SANDOZ ENALAPRIL       Y    ENALAPRIL MALEATE                2.5 MG       ORAL              TABLET                 SDZ        W                           Y      0.2731    0.2731     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02300680       NOVO-ENALAPRIL         Y    ENALAPRIL MALEATE                2.5 MG       ORAL              TABLET                 TEV        B                           Y      0.2731    0.2731     REGULAR BENEFIT




                                                                                                                Updated July 1, 2012                                                                                                     Page 65 of 254
                                                                               Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                            (Regular Benefits)


                                                                                                                                                                     DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION      DIN / PIN          PRODUCT NAME   IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02352230       RAN-ENALAPRIL      Y    ENALAPRIL MALEATE               2.5 MG      ORAL               TABLET                 RAN        B                           Y      0.2731    0.2731     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02300079       PMS-ENALAPRIL      Y    ENALAPRIL MALEATE               2.5 MG      ORAL               TABLET                 PMS        B                           Y      0.2731    0.2731     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02291878       CO ENALAPRIL       Y    ENALAPRIL MALEATE               2.5 MG      ORAL               TABLET                 COB        W                           Y      0.2731    0.2731     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02300036       MYLAN-ENALAPRIL    Y    ENALAPRIL MALEATE               2.5 MG      ORAL               TABLET                 MYP        W                           Y      0.2731    0.2731     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02363453       AVA-ENALAPRIL      Y    ENALAPRIL MALEATE               2.5 MG      ORAL               TABLET                 AVA        W                           Y      0.2731    0.2731     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      00851795       VASOTEC            Y    ENALAPRIL MALEATE               2.5 MG      ORAL               TABLET                 MFC        B                           N      0.7803    0.2731     REGULAR BENEFIT
                                             9

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02019884       APO-ENALAPRIL      Y    ENALAPRIL MALEATE               5 MG        ORAL               TABLET                 APX        B                           Y      0.3231    0.3231     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02300087       PMS-ENALAPRIL      Y    ENALAPRIL MALEATE               5 MG        ORAL               TABLET                 PMS        B                           Y      0.3231    0.3231     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02299941       SANDOZ ENALAPRIL   Y    ENALAPRIL MALEATE               5 MG        ORAL               TABLET                 SDZ        W                           Y      0.3231    0.3231     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02352249       RAN-ENALAPRIL      Y    ENALAPRIL MALEATE               5 MG        ORAL               TABLET                 RAN        B                           Y      0.3231    0.3231     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02291886       CO ENALAPRIL       Y    ENALAPRIL MALEATE               5 MG        ORAL               TABLET                 COB        W                           Y      0.3231    0.3231     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02300044       MYLAN-ENALAPRIL    Y    ENALAPRIL MALEATE               5 MG        ORAL               TABLET                 MYP        W                           Y      0.3231    0.3231     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02363461       AVA-ENALAPRIL      Y    ENALAPRIL MALEATE               5 MG        ORAL               TABLET                 AVA        W                           Y      0.3231    0.3231     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02233005       NOVO-ENALAPRIL     Y    ENALAPRIL MALEATE               5 MG        ORAL               TABLET                 TEV        B                           Y      0.3231    0.3231     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      00708879       VASOTEC            Y    ENALAPRIL MALEATE               5 MG        ORAL               TABLET                 MFC        B                           N      0.9231    0.3231     REGULAR BENEFIT
                                             9

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02299968       SANDOZ ENALAPRIL   Y    ENALAPRIL MALEATE               10 MG       ORAL               TABLET                 SDZ        W                           Y      0.3882    0.3882     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02019892       APO-ENALAPRIL      Y    ENALAPRIL MALEATE               10 MG       ORAL               TABLET                 APX        B                           Y      0.3882    0.3882     REGULAR BENEFIT




                                                                                                          Updated July 1, 2012                                                                                                      Page 66 of 254
                                                                                  Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                               (Regular Benefits)


                                                                                                                                                                        DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION      DIN / PIN          PRODUCT NAME      IC            GENERIC NAME            STRENGTH            ROUTE              FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02300095       PMS-ENALAPRIL         Y    ENALAPRIL MALEATE               10 MG         ORAL             TABLET                 PMS        B                           Y      0.3882    0.3882     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02352257       RAN-ENALAPRIL         Y    ENALAPRIL MALEATE               10 MG         ORAL             TABLET                 RAN        B                           Y      0.3882    0.3882     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02291894       CO ENALAPRIL          Y    ENALAPRIL MALEATE               10 MG         ORAL             TABLET                 COB        W                           Y      0.3882    0.3882     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02300052       MYLAN-ENALAPRIL       Y    ENALAPRIL MALEATE               10 MG         ORAL             TABLET                 MYP        W                           Y      0.3882    0.3882     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02363488       AVA-ENALAPRIL         Y    ENALAPRIL MALEATE               10 MG         ORAL             TABLET                 AVA        W                           Y      0.3882    0.3882     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02233006       NOVO-ENALAPRIL        Y    ENALAPRIL MALEATE               10 MG         ORAL             TABLET                 TEV        B                           Y      0.3882    0.3882     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      00670901       VASOTEC               Y    ENALAPRIL MALEATE               10 MG         ORAL             TABLET                 MFC        B                           N      1.1092    0.3882     REGULAR BENEFIT
                                             9

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02299976       SANDOZ ENALAPRIL      Y    ENALAPRIL MALEATE               20 MG         ORAL             TABLET                 SDZ        W                           Y      0.4685    0.4685     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02019906       APO-ENALAPRIL         Y    ENALAPRIL MALEATE               20 MG         ORAL             TABLET                 APX        B                           Y      0.4685    0.4685     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02233007       NOVO-ENALAPRIL        Y    ENALAPRIL MALEATE               20 MG         ORAL             TABLET                 TEV        B                           Y      0.4685    0.4685     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02352265       RAN-ENALAPRIL         Y    ENALAPRIL MALEATE               20 MG         ORAL             TABLET                 RAN        B                           Y      0.4685    0.4685     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02291908       CO ENALAPRIL          Y    ENALAPRIL MALEATE               20 MG         ORAL             TABLET                 COB        W                           Y      0.4685    0.4685     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02300060       MYLAN-ENALAPRIL       Y    ENALAPRIL MALEATE               20 MG         ORAL             TABLET                 MYP        W                           Y      0.4685    0.4685     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02363496       AVA-ENALAPRIL         Y    ENALAPRIL MALEATE               20 MG         ORAL             TABLET                 AVA        W                           Y      0.4685    0.4685     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02300109       PMS-ENALAPRIL         Y    ENALAPRIL MALEATE               20 MG         ORAL             TABLET                 PMS        B                           Y      0.4685    0.4685     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      00670928       VASOTEC               Y    ENALAPRIL MALEATE               20 MG         ORAL             TABLET                 MFC        B                           N      1.3385    0.4685     REGULAR BENEFIT
                                             9

         ANGIOTENSIN-CONVERTING                                             ENALAPRIL MALEATE/              5 MG * 12.5
243204   ENZYME INHIBITORS /      02300222       NOVO-ENALAPRIL/HCTZ   Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 TEV        B                           Y      0.4927    0.4927     REGULAR BENEFIT




                                                                                                             Updated July 1, 2012                                                                                                      Page 67 of 254
                                                                                  Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                               (Regular Benefits)


                                                                                                                                                                        DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION      DIN / PIN          PRODUCT NAME      IC            GENERIC NAME            STRENGTH            ROUTE              FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         ANGIOTENSIN-CONVERTING                  APO-ENALAPRIL              ENALAPRIL MALEATE/              5 MG * 12.5
243204   ENZYME INHIBITORS /      02352923       MALEATE/HCTZ          Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 APX        B                           N      0.4941    0.4927     REGULAR BENEFIT
                                             2

         ANGIOTENSIN-CONVERTING                  APO-ENALAPRIL              ENALAPRIL MALEATE/              10 MG * 25
243204   ENZYME INHIBITORS /      02352931       MALEATE/HCTZ          Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 APX        B                           Y      0.6108    0.6108     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING                                             ENALAPRIL MALEATE/              10 MG * 25
243204   ENZYME INHIBITORS /      02300230       NOVO-ENALAPRIL/HCTZ   Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 TEV        B                           Y      0.6108    0.6108     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING                                             ENALAPRIL MALEATE/              10 MG * 25
243204   ENZYME INHIBITORS /      00657298       VASERETIC             Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 MFC        B                           N      1.1425    0.6108     REGULAR BENEFIT
                                             3

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02262401       MYLAN-FOSINOPRIL      Y    FOSINOPRIL SODIUM               10 MG         ORAL             TABLET                 MYP        W                           Y      0.3194    0.3194     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02247802       TEVA-FOSINOPRIL       Y    FOSINOPRIL SODIUM               10 MG         ORAL             TABLET                 TEV        B                           Y      0.3194    0.3194     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02294524       RAN-FOSINOPRIL        Y    FOSINOPRIL SODIUM               10 MG         ORAL             TABLET                 RAN        B                           Y      0.3194    0.3194     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02266008       APO-FOSINOPRIL        Y    FOSINOPRIL SODIUM               10 MG         ORAL             TABLET                 APX        B                           Y      0.3194    0.3194     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02331004       JAMP-FOSINOPRIL       Y    FOSINOPRIL SODIUM               10 MG         ORAL             TABLET                 JPC        B                           Y      0.3194    0.3194     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02332566       FOSINOPRIL            Y    FOSINOPRIL SODIUM               10 MG         ORAL             TABLET                 RAN        B                           Y      0.3194    0.3194     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      01907107       MONOPRIL              Y    FOSINOPRIL SODIUM               10 MG         ORAL             TABLET                 BMS        B                           N      0.9125    0.3194     REGULAR BENEFIT
                                             7

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02262428       MYLAN-FOSINOPRIL      Y    FOSINOPRIL SODIUM               20 MG         ORAL             TABLET                 MYP        W                           Y      0.3841    0.3841     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02247803       TEVA-FOSINOPRIL       Y    FOSINOPRIL SODIUM               20 MG         ORAL             TABLET                 TEV        B                           Y      0.3841    0.3841     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02331012       JAMP-FOSINOPRIL       Y    FOSINOPRIL SODIUM               20 MG         ORAL             TABLET                 JPC        B                           Y      0.3841    0.3841     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02332574       FOSINOPRIL            Y    FOSINOPRIL SODIUM               20 MG         ORAL             TABLET                 RAN        B                           Y      0.3841    0.3841     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02294532       RAN-FOSINOPRIL        Y    FOSINOPRIL SODIUM               20 MG         ORAL             TABLET                 RAN        B                           Y      0.3841    0.3841     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02266016       APO-FOSINOPRIL        Y    FOSINOPRIL SODIUM               20 MG         ORAL             TABLET                 APX        B                           Y      0.3841    0.3841     REGULAR BENEFIT




                                                                                                             Updated July 1, 2012                                                                                                      Page 68 of 254
                                                                                        Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                     (Regular Benefits)


                                                                                                                                                                              DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION      DIN / PIN           PRODUCT NAME          IC                GENERIC NAME         STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      01907115       MONOPRIL                   Y    FOSINOPRIL SODIUM                20 MG       ORAL               TABLET                 BMS        B                           N      1.0973    0.3841     REGULAR BENEFIT
                                             7

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02217481       APO-LISINOPRIL             Y    LISINOPRIL                       5 MG        ORAL               TABLET                 APX        B                           Y      0.2094    0.2094     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02285118       NOVO-LISINOPRIL (TYPE Z)   Y    LISINOPRIL                       5 MG        ORAL               TABLET                 TEV        B                           Y      0.2094    0.2094     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02285061       TEVA-LISINOPRIL (TYPE P)   Y    LISINOPRIL                       5 MG        ORAL               TABLET                 TEV        B                           Y      0.2094    0.2094     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02274833       MYLAN-LISINOPRIL           Y    LISINOPRIL                       5 MG        ORAL               TABLET                 MYP        W                           Y      0.2094    0.2094     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02271443       CO LISINOPRIL              Y    LISINOPRIL                       5 MG        ORAL               TABLET                 COB        W                           Y      0.2094    0.2094     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02292203       PMS-LISINOPRIL             Y    LISINOPRIL                       5 MG        ORAL               TABLET                 PMS        B                           Y      0.2094    0.2094     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02256797       RATIO-LISINOPRIL P         Y    LISINOPRIL                       5 MG        ORAL               TABLET                 RPH        B                           Y      0.2094    0.2094     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02299879       RATIO-LISINOPRIL Z         Y    LISINOPRIL                       5 MG        ORAL               TABLET                 RPH        B                           Y      0.2094    0.2094     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02361531       JAMP-LISINOPRIL            Y    LISINOPRIL                       5 MG        ORAL               TABLET                 JPC        B                           Y      0.2094    0.2094     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02294230       RAN-LISINOPRIL             Y    LISINOPRIL                       5 MG        ORAL               TABLET                 RAN        B                           Y      0.2094    0.2094     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02289199       SANDOZ LISINOPRIL          Y    LISINOPRIL                       5 MG        ORAL               TABLET                 SDZ        W                           Y      0.2094    0.2094     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02332167       LISINOPRIL                 Y    LISINOPRIL                       5 MG        ORAL               TABLET                 RAN        B                           Y      0.2094    0.2094     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02049333       ZESTRIL                    Y    LISINOPRIL                       5 MG        ORAL               TABLET                 AZC        W            7.50%          N      0.5594    0.2094     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      00839388       PRINIVIL                   Y    LISINOPRIL                       5 MG        ORAL               TABLET                 MFC        B                           N      0.5983    0.2094     REGULAR BENEFIT
                                         14

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02217503       APO-LISINOPRIL             Y    LISINOPRIL                       10 MG       ORAL               TABLET                 APX        B                           Y      0.2516    0.2516     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02289202       SANDOZ LISINOPRIL          Y    LISINOPRIL                       10 MG       ORAL               TABLET                 SDZ        W                           Y      0.2516    0.2516     REGULAR BENEFIT




                                                                                                                   Updated July 1, 2012                                                                                                      Page 69 of 254
                                                                                     Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                  (Regular Benefits)


                                                                                                                                                                           DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION      DIN / PIN        PRODUCT NAME          IC                GENERIC NAME         STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02285126    NOVO-LISINOPRIL (TYPE Z)   Y    LISINOPRIL                       10 MG       ORAL               TABLET                 TEV        B                           Y      0.2516    0.2516     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02285088    TEVA-LISINOPRIL (TYPE P)   Y    LISINOPRIL                       10 MG       ORAL               TABLET                 TEV        B                           Y      0.2516    0.2516     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02274841    MYLAN-LISINOPRIL           Y    LISINOPRIL                       10 MG       ORAL               TABLET                 MYP        W                           Y      0.2516    0.2516     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02271451    CO LISINOPRIL              Y    LISINOPRIL                       10 MG       ORAL               TABLET                 COB        W                           Y      0.2516    0.2516     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02292211    PMS-LISINOPRIL             Y    LISINOPRIL                       10 MG       ORAL               TABLET                 PMS        B                           Y      0.2516    0.2516     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02256800    RATIO-LISINOPRIL P         Y    LISINOPRIL                       10 MG       ORAL               TABLET                 RPH        B                           Y      0.2516    0.2516     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02299887    RATIO-LISINOPRIL Z         Y    LISINOPRIL                       10 MG       ORAL               TABLET                 RPH        B                           Y      0.2516    0.2516     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02361558    JAMP-LISINOPRIL            Y    LISINOPRIL                       10 MG       ORAL               TABLET                 JPC        B                           Y      0.2516    0.2516     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02294249    RAN-LISINOPRIL             Y    LISINOPRIL                       10 MG       ORAL               TABLET                 RAN        B                           Y      0.2516    0.2516     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02332175    LISINOPRIL                 Y    LISINOPRIL                       10 MG       ORAL               TABLET                 RAN        B                           Y      0.2516    0.2516     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02049376    ZESTRIL                    Y    LISINOPRIL                       10 MG       ORAL               TABLET                 AZC        W            7.50%          N      0.6723    0.2516     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      00839396    PRINIVIL                   Y    LISINOPRIL                       10 MG       ORAL               TABLET                 MFC        B                           N      0.7189    0.2516     REGULAR BENEFIT
                                         14

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02217511    APO-LISINOPRIL             Y    LISINOPRIL                       20 MG       ORAL               TABLET                 APX        B                           Y      0.3026    0.3026     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02289229    SANDOZ LISINOPRIL          Y    LISINOPRIL                       20 MG       ORAL               TABLET                 SDZ        W                           Y      0.3026    0.3026     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02285134    NOVO-LISINOPRIL (TYPE Z)   Y    LISINOPRIL                       20 MG       ORAL               TABLET                 TEV        B                           Y      0.3026    0.3026     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02285096    TEVA-LISINOPRIL (TYPE P)   Y    LISINOPRIL                       20 MG       ORAL               TABLET                 TEV        B                           Y      0.3026    0.3026     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02274868    MYLAN-LISINOPRIL           Y    LISINOPRIL                       20 MG       ORAL               TABLET                 MYP        W                           Y      0.3026    0.3026     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02271478    CO LISINOPRIL              Y    LISINOPRIL                       20 MG       ORAL               TABLET                 COB        W                           Y      0.3026    0.3026     REGULAR BENEFIT




                                                                                                                Updated July 1, 2012                                                                                                      Page 70 of 254
                                                                                        Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                     (Regular Benefits)


                                                                                                                                                                              DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION      DIN / PIN           PRODUCT NAME          IC                GENERIC NAME          STRENGTH             ROUTE            FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02292238       PMS-LISINOPRIL             Y    LISINOPRIL                        20 MG          ORAL           TABLET                 PMS        B                           Y      0.3026    0.3026     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02256819       RATIO-LISINOPRIL P         Y    LISINOPRIL                        20 MG          ORAL           TABLET                 RPH        B                           Y      0.3026    0.3026     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02299895       RATIO-LISINOPRIL Z         Y    LISINOPRIL                        20 MG          ORAL           TABLET                 RPH        B                           Y      0.3026    0.3026     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02361566       JAMP-LISINOPRIL            Y    LISINOPRIL                        20 MG          ORAL           TABLET                 JPC        B                           Y      0.3026    0.3026     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02294257       RAN-LISINOPRIL             Y    LISINOPRIL                        20 MG          ORAL           TABLET                 RAN        B                           Y      0.3026    0.3026     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02332183       LISINOPRIL                 Y    LISINOPRIL                        20 MG          ORAL           TABLET                 RAN        B                           Y      0.3026    0.3026     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02049384       ZESTRIL                    Y    LISINOPRIL                        20 MG          ORAL           TABLET                 AZC        W            7.50%          N      0.8078    0.3026     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      00839418       PRINIVIL                   Y    LISINOPRIL                        20 MG          ORAL           TABLET                 MFC        B                           N      0.8645    0.3026     REGULAR BENEFIT
                                         14

         ANGIOTENSIN-CONVERTING                                                                                  10 MG * 12.5
243204   ENZYME INHIBITORS /      02297736       MYLAN-LISINOPRIL HCTZ      Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE MG               ORAL           TABLET                 MYP        W                           Y      0.3256    0.3256     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING                  TEVA-LISINOPRIL/HCTZ                                            10 MG * 12.5
243204   ENZYME INHIBITORS /      02301768       (TYPE Z)                   Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE MG               ORAL           TABLET                 TEV        B                           Y      0.3256    0.3256     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING                                                                                  10 MG * 12.5
243204   ENZYME INHIBITORS /      02261979       APO-LISINOPRIL/HCTZ        Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE MG               ORAL           TABLET                 APX        B                           Y      0.3256    0.3256     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING                                                                                  10 MG * 12.5
243204   ENZYME INHIBITORS /      02362880       AVA-LISINOPRIL HCT         Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE MG               ORAL           TABLET                 AVA        W                           Y      0.3256    0.3256     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING                                                                                  10 MG * 12.5
243204   ENZYME INHIBITORS /      02362945       LISINOPRIL/HCTZ (TYPE Z)   Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE MG               ORAL           TABLET                 SNS        W                           Y      0.3256    0.3256     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING                                                                                  10 MG * 12.5
243204   ENZYME INHIBITORS /      02302365       SANDOZ LISINOPRIL HCT      Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE MG               ORAL           TABLET                 SDZ        W                           Y      0.3256    0.3256     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING                                                                                    10 MG * 12.5
243204   ENZYME INHIBITORS /      02103729       ZESTORETIC                 Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE   MG             ORAL           TABLET                 AZC        W            7.50%          N      0.8654    0.3256     REGULAR BENEFIT
                                             7

         ANGIOTENSIN-CONVERTING                                                                                  20 MG * 12.5
243204   ENZYME INHIBITORS /      02261987       APO-LISINOPRIL/HCTZ        Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE MG               ORAL           TABLET                 APX        B                           Y      0.3913    0.3913     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING                  TEVA-LISINOPRIL/HCTZ                                            20 MG * 12.5
243204   ENZYME INHIBITORS /      02301776       (TYPE Z)                   Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE MG               ORAL           TABLET                 TEV        B                           Y      0.3913    0.3913     REGULAR BENEFIT




                                                                                                                    Updated July 1, 2012                                                                                                     Page 71 of 254
                                                                                        Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                     (Regular Benefits)


                                                                                                                                                                              DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION      DIN / PIN           PRODUCT NAME          IC            GENERIC NAME              STRENGTH             ROUTE            FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

         ANGIOTENSIN-CONVERTING                                                                                  20 MG * 12.5
243204   ENZYME INHIBITORS /      02297744       MYLAN-LISINOPRIL HCTZ      Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE MG               ORAL           TABLET                 MYP        W                           Y      0.3913    0.3913     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING                                                                                  20 MG * 12.5
243204   ENZYME INHIBITORS /      02362899       AVA-LISINOPRIL HCT         Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE MG               ORAL           TABLET                 AVA        W                           Y      0.3913    0.3913     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING                                                                                  20 MG * 12.5
243204   ENZYME INHIBITORS /      02362953       LISINOPRIL/HCTZ (TYPE Z)   Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE MG               ORAL           TABLET                 SNS        W                           Y      0.3913    0.3913     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING                                                                                  20 MG * 12.5
243204   ENZYME INHIBITORS /      02302373       SANDOZ LISINOPRIL HCT      Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE MG               ORAL           TABLET                 SDZ        W                           Y      0.3913    0.3913     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING                                                                                    20 MG * 12.5
243204   ENZYME INHIBITORS /      02045737       ZESTORETIC                 Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE   MG             ORAL           TABLET                 AZC        W            7.50%          N      1.0400    0.3913     REGULAR BENEFIT
                                             7

         ANGIOTENSIN-CONVERTING                  TEVA-LISINOPRIL/HCTZ                                            20 MG * 25
243204   ENZYME INHIBITORS /      02301784       (TYPE Z)                   Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE MG               ORAL           TABLET                 TEV        B                           Y      0.3913    0.3913     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING                                                                                  20 MG * 25
243204   ENZYME INHIBITORS /      02297752       MYLAN-LISINOPRIL HCTZ      Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE MG               ORAL           TABLET                 MYP        W                           Y      0.3913    0.3913     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING                                                                                  20 MG * 25
243204   ENZYME INHIBITORS /      02362902       AVA-LISINOPRIL HCT         Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE MG               ORAL           TABLET                 AVA        W                           Y      0.3913    0.3913     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING                                                                                  20 MG * 25
243204   ENZYME INHIBITORS /      02362961       LISINOPRIL/HCTZ (TYPE Z)   Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE MG               ORAL           TABLET                 SNS        W                           Y      0.3913    0.3913     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING                                                                                  20 MG * 25
243204   ENZYME INHIBITORS /      02302381       SANDOZ LISINOPRIL HCT      Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE MG               ORAL           TABLET                 SDZ        W                           Y      0.3913    0.3913     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING                                                                                    20 MG * 25
243204   ENZYME INHIBITORS /      02045729       ZESTORETIC                 Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE   MG             ORAL           TABLET                 AZC        W            7.50%          N      1.0400    0.3913     REGULAR BENEFIT
                                             6
         ANGIOTENSIN-CONVERTING                  NOVO-LISINOPRIL/HCTZ                                              10 MG * 12.5
243204   ENZYME INHIBITORS /      02302136       (TYPE P)                   N    LISINOPRIL/ HYDROCHLOROTHIAZIDE   MG             ORAL           TABLET                 TEV        B                           N      0.4076               REGULAR BENEFIT
                                             1

         ANGIOTENSIN-CONVERTING                  NOVO-LISINOPRIL/HCTZ                                            20 MG * 12.5
243204   ENZYME INHIBITORS /      02302144       (TYPE P)                   Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE MG               ORAL           TABLET                 TEV        B                           Y      0.3506    0.3506     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING                                                                                    20 MG * 12.5
243204   ENZYME INHIBITORS /      00884413       PRINZIDE                   Y    LISINOPRIL/ HYDROCHLOROTHIAZIDE   MG             ORAL           TABLET                 MFC        B                           N      0.8904    0.3506     REGULAR BENEFIT
                                             2
         ANGIOTENSIN-CONVERTING                  NOVO-LISINOPRIL/HCTZ                                              20 MG * 25
243204   ENZYME INHIBITORS /      02302152       (TYPE P)                   N    LISINOPRIL/ HYDROCHLOROTHIAZIDE   MG             ORAL           TABLET                 TEV        B                           N      0.6068               REGULAR BENEFIT
                                             1
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02123274       COVERSYL                   N    PERINDOPRIL ERBUMINE              2 MG           ORAL           TABLET                 SEV        W            7.50%          N      0.6526               REGULAR BENEFIT
                                             1
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02123282       COVERSYL                   N    PERINDOPRIL ERBUMINE              4 MG           ORAL           TABLET                 SEV        W            7.50%          N      0.8170               REGULAR BENEFIT
                                             1




                                                                                                                    Updated July 1, 2012                                                                                                     Page 72 of 254
                                                                                       Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                    (Regular Benefits)


                                                                                                                                                                             DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION      DIN / PIN           PRODUCT NAME         IC              GENERIC NAME            STRENGTH             ROUTE            FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02246624       COVERSYL                  N    PERINDOPRIL ERBUMINE              8 MG           ORAL           TABLET                 SEV        W            7.50%          N      1.1436               REGULAR BENEFIT
                                             1
         ANGIOTENSIN-CONVERTING                                                 PERINDOPRIL ERBUMINE/ INDAPAMIDE 4 MG * 1.25
243204   ENZYME INHIBITORS /      02246569       COVERSYL PLUS             N    HEMIHYDRATE                      MG              ORAL           TABLET                 SEV        W            7.50%          N      0.9843               REGULAR BENEFIT
                                             1
         ANGIOTENSIN-CONVERTING                                                 PERINDOPRIL ERBUMINE/ INDAPAMIDE
243204   ENZYME INHIBITORS /      02321653       COVERSYL PLUS HD          N    HEMIHYDRATE                      8 MG * 2.5 MG ORAL             TABLET                 SEV        W            7.50%          N      1.1436               REGULAR BENEFIT
                                             1
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      01947664       ACCUPRIL                  N    QUINAPRIL HCL                     5 MG           ORAL           TABLET                 PFI        W            7.50%          N      0.8976               REGULAR BENEFIT
                                             1
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      01947672       ACCUPRIL                  N    QUINAPRIL HCL                     10 MG          ORAL           TABLET                 PFI        W            7.50%          N      0.8976               REGULAR BENEFIT
                                             1
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      01947680       ACCUPRIL                  N    QUINAPRIL HCL                     20 MG          ORAL           TABLET                 PFI        W            7.50%          N      0.8976               REGULAR BENEFIT
                                             1
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      01947699       ACCUPRIL                  N    QUINAPRIL HCL                     40 MG          ORAL           TABLET                 PFI        W            7.50%          N      0.8976               REGULAR BENEFIT
                                             1
         ANGIOTENSIN-CONVERTING                                                 QUINAPRIL HCL/                    10 MG * 12.5
243204   ENZYME INHIBITORS /      02237367       ACCURETIC 10/12.5         N    HYDROCHLOROTHIAZIDE               MG             ORAL           TABLET                 PFI        W            7.50%          N      0.8974               REGULAR BENEFIT
                                             1
         ANGIOTENSIN-CONVERTING                                                 QUINAPRIL HCL/                    20 MG * 12.5
243204   ENZYME INHIBITORS /      02237368       ACCURETIC 20/12.5         N    HYDROCHLOROTHIAZIDE               MG             ORAL           TABLET                 PFI        W            7.50%          N      0.8974               REGULAR BENEFIT
                                             1
         ANGIOTENSIN-CONVERTING                                                 QUINAPRIL HCL/                    20 MG * 25
243204   ENZYME INHIBITORS /      02237369       ACCURETIC 20/25           N    HYDROCHLOROTHIAZIDE               MG             ORAL           TABLET                 PFI        W            7.50%          N      0.8682               REGULAR BENEFIT
                                             1

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02295482       CO RAMIPRIL (CAPSULE)     Y    RAMIPRIL                          1.25 MG        ORAL           CAPSULE/TABLET         COB        W                           Y      0.2663    0.2663     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02332299       RAMIPRIL (CAPSULE)        Y    RAMIPRIL                          1.25 MG        ORAL           CAPSULE/TABLET         RAN        B                           Y      0.2663    0.2663     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02331101       JAMP-RAMIPRIL (CAPSULE)   Y    RAMIPRIL                          1.25 MG        ORAL           CAPSULE/TABLET         JPC        B                           Y      0.2663    0.2663     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING                  SANDOZ RAMIPRIL
243204   ENZYME INHIBITORS /      02291398       (TABLET)                  Y    RAMIPRIL                          1.25 MG        ORAL           CAPSULE/TABLET         SDZ        W                           Y      0.2663    0.2663     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02251515       APO-RAMIPRIL (CAPSULE)    Y    RAMIPRIL                          1.25 MG        ORAL           CAPSULE/TABLET         APX        B                           Y      0.2663    0.2663     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING                  MYLAN-RAMIPRIL
243204   ENZYME INHIBITORS /      02301148       (CAPSULE)                 Y    RAMIPRIL                          1.25 MG        ORAL           CAPSULE/TABLET         MYP        W                           Y      0.2663    0.2663     REGULAR BENEFIT




                                                                                                                   Updated July 1, 2012                                                                                                     Page 73 of 254
                                                                                   Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                (Regular Benefits)


                                                                                                                                                                         DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION      DIN / PIN        PRODUCT NAME         IC              GENERIC NAME          STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02363267    AVA-RAMIPRIL (TABLET)     Y    RAMIPRIL                        1.25 MG     ORAL               CAPSULE/TABLET         AVA        W                           Y      0.2663    0.2663     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02310503    RAN-RAMIPRIL (CAPSULE)    Y    RAMIPRIL                        1.25 MG     ORAL               CAPSULE/TABLET         RAN        B                           Y      0.2663    0.2663     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02295369    PMS-RAMIPRIL (CAPSULE)    Y    RAMIPRIL                        1.25 MG     ORAL               CAPSULE/TABLET         PMS        B                           Y      0.2663    0.2663     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02221829    ALTACE (CAPSULE)          Y    RAMIPRIL                        1.25 MG     ORAL               CAPSULE/TABLET         SAV        W            7.50%          N      0.7077    0.2663     REGULAR BENEFIT
                                         10

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02295490    CO RAMIPRIL (CAPSULE)     Y    RAMIPRIL                        2.5 MG      ORAL               CAPSULE/TABLET         COB        W                           Y      0.3073    0.3073     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02332302    RAMIPRIL (CAPSULE)        Y    RAMIPRIL                        2.5 MG      ORAL               CAPSULE/TABLET         RAN        B                           Y      0.3073    0.3073     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02331128    JAMP-RAMIPRIL (CAPSULE)   Y    RAMIPRIL                        2.5 MG      ORAL               CAPSULE/TABLET         JPC        B                           Y      0.3073    0.3073     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING               SANDOZ RAMIPRIL
243204   ENZYME INHIBITORS /      02291401    (TABLET)                  Y    RAMIPRIL                        2.5 MG      ORAL               CAPSULE/TABLET         SDZ        W                           Y      0.3073    0.3073     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02251531    APO-RAMIPRIL (CAPSULE)    Y    RAMIPRIL                        2.5 MG      ORAL               CAPSULE/TABLET         APX        B                           Y      0.3073    0.3073     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02247945    TEVA-RAMIPRIL (CAPSULE)   Y    RAMIPRIL                        2.5 MG      ORAL               CAPSULE/TABLET         TEV        B                           Y      0.3073    0.3073     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING               MYLAN-RAMIPRIL
243204   ENZYME INHIBITORS /      02301156    (CAPSULE)                 Y    RAMIPRIL                        2.5 MG      ORAL               CAPSULE/TABLET         MYP        W                           Y      0.3073    0.3073     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02363275    AVA-RAMIPRIL (TABLET)     Y    RAMIPRIL                        2.5 MG      ORAL               CAPSULE/TABLET         AVA        W                           Y      0.3073    0.3073     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02374846    RAMIPRIL (CAPSULE)        Y    RAMIPRIL                        2.5 MG      ORAL               CAPSULE/TABLET         SNS        W                           Y      0.3073    0.3073     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02310511    RAN-RAMIPRIL (CAPSULE)    Y    RAMIPRIL                        2.5 MG      ORAL               CAPSULE/TABLET         RAN        B                           Y      0.3073    0.3073     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02247917    PMS-RAMIPRIL (CAPSULE)    Y    RAMIPRIL                        2.5 MG      ORAL               CAPSULE/TABLET         PMS        B                           Y      0.3073    0.3073     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02221837    ALTACE (CAPSULE)          Y    RAMIPRIL                        2.5 MG      ORAL               CAPSULE/TABLET         SAV        W            7.50%          N      0.8167    0.3073     REGULAR BENEFIT
                                         12

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02295504    CO RAMIPRIL (CAPSULE)     Y    RAMIPRIL                        5 MG        ORAL               CAPSULE/TABLET         COB        W                           Y      0.3073    0.3073     REGULAR BENEFIT




                                                                                                              Updated July 1, 2012                                                                                                      Page 74 of 254
                                                                                   Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                (Regular Benefits)


                                                                                                                                                                         DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION      DIN / PIN        PRODUCT NAME         IC              GENERIC NAME          STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02332310    RAMIPRIL (CAPSULE)        Y    RAMIPRIL                        5 MG        ORAL               CAPSULE/TABLET         RAN        B                           Y      0.3073    0.3073     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02331136    JAMP-RAMIPRIL (CAPSULE)   Y    RAMIPRIL                        5 MG        ORAL               CAPSULE/TABLET         JPC        B                           Y      0.3073    0.3073     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02247918    PMS-RAMIPRIL (CAPSULE)    Y    RAMIPRIL                        5 MG        ORAL               CAPSULE/TABLET         PMS        B                           Y      0.3073    0.3073     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING               SANDOZ RAMIPRIL
243204   ENZYME INHIBITORS /      02291428    (TABLET)                  Y    RAMIPRIL                        5 MG        ORAL               CAPSULE/TABLET         SDZ        W                           Y      0.3073    0.3073     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02251574    APO-RAMIPRIL (CAPSULE)    Y    RAMIPRIL                        5 MG        ORAL               CAPSULE/TABLET         APX        B                           Y      0.3073    0.3073     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02247946    TEVA-RAMIPRIL (CAPSULE)   Y    RAMIPRIL                        5 MG        ORAL               CAPSULE/TABLET         TEV        B                           Y      0.3073    0.3073     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING               MYLAN-RAMIPRIL
243204   ENZYME INHIBITORS /      02301164    (CAPSULE)                 Y    RAMIPRIL                        5 MG        ORAL               CAPSULE/TABLET         MYP        W                           Y      0.3073    0.3073     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02363283    AVA-RAMIPRIL (TABLET)     Y    RAMIPRIL                        5 MG        ORAL               CAPSULE/TABLET         AVA        W                           Y      0.3073    0.3073     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02374854    RAMIPRIL (CAPSULE)        Y    RAMIPRIL                        5 MG        ORAL               CAPSULE/TABLET         SNS        W                           Y      0.3073    0.3073     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02310538    RAN-RAMIPRIL (CAPSULE)    Y    RAMIPRIL                        5 MG        ORAL               CAPSULE/TABLET         RAN        B                           Y      0.3073    0.3073     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02221845    ALTACE (CAPSULE)          Y    RAMIPRIL                        5 MG        ORAL               CAPSULE/TABLET         SAV        W            7.50%          N      0.8167    0.3073     REGULAR BENEFIT
                                         12

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02332329    RAMIPRIL (CAPSULE)        Y    RAMIPRIL                        10 MG       ORAL               CAPSULE/TABLET         RAN        B                           Y      0.3892    0.3892     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02295512    CO RAMIPRIL (CAPSULE)     Y    RAMIPRIL                        10 MG       ORAL               CAPSULE/TABLET         COB        W                           Y      0.3892    0.3892     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02331144    JAMP-RAMIPRIL (CAPSULE)   Y    RAMIPRIL                        10 MG       ORAL               CAPSULE/TABLET         JPC        B                           Y      0.3892    0.3892     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02247919    PMS-RAMIPRIL (CAPSULE)    Y    RAMIPRIL                        10 MG       ORAL               CAPSULE/TABLET         PMS        B                           Y      0.3892    0.3892     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING               SANDOZ RAMIPRIL
243204   ENZYME INHIBITORS /      02291436    (TABLET)                  Y    RAMIPRIL                        10 MG       ORAL               CAPSULE/TABLET         SDZ        W                           Y      0.3892    0.3892     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02251582    APO-RAMIPRIL (CAPSULE)    Y    RAMIPRIL                        10 MG       ORAL               CAPSULE/TABLET         APX        B                           Y      0.3892    0.3892     REGULAR BENEFIT




                                                                                                              Updated July 1, 2012                                                                                                      Page 75 of 254
                                                                                      Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                   (Regular Benefits)


                                                                                                                                                                            DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION      DIN / PIN           PRODUCT NAME         IC              GENERIC NAME          STRENGTH             ROUTE             FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02247947       TEVA-RAMIPRIL (CAPSULE)   Y    RAMIPRIL                        10 MG          ORAL            CAPSULE/TABLET         TEV        B                           Y      0.3892    0.3892     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING                  MYLAN-RAMIPRIL
243204   ENZYME INHIBITORS /      02301172       (CAPSULE)                 Y    RAMIPRIL                        10 MG          ORAL            CAPSULE/TABLET         MYP        W                           Y      0.3892    0.3892     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02374862       RAMIPRIL (CAPSULE)        Y    RAMIPRIL                        10 MG          ORAL            CAPSULE/TABLET         SNS        W                           Y      0.3892    0.3892     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02363291       AVA-RAMIPRIL (TABLET)     Y    RAMIPRIL                        10 MG          ORAL            CAPSULE/TABLET         AVA        W                           Y      0.3892    0.3892     REGULAR BENEFIT

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02310546       RAN-RAMIPRIL (CAPSULE)    Y    RAMIPRIL                        10 MG          ORAL            CAPSULE/TABLET         RAN        B                           Y      0.3892    0.3892     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02221853       ALTACE (CAPSULE)          Y    RAMIPRIL                        10 MG          ORAL            CAPSULE/TABLET         SAV        W            7.50%          N      1.0343    0.3892     REGULAR BENEFIT
                                         12

         ANGIOTENSIN-CONVERTING                                                                                 2.5 MG * 12.5
243204   ENZYME INHIBITORS /      02342138       PMS-RAMIPRIL-HCTZ         Y    RAMIPRIL/ HYDROCHLOROTHIAZIDE   MG            ORAL             TABLET                 PMS        B                           Y      0.2250    0.2250     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING                                                                                 2.5 MG * 12.5
243204   ENZYME INHIBITORS /      02283131       ALTACE HCT                Y    RAMIPRIL/ HYDROCHLOROTHIAZIDE   MG            ORAL             TABLET                 SAV        W            7.50%          N      0.2989    0.2250     REGULAR BENEFIT
                                             2

         ANGIOTENSIN-CONVERTING                                                                                 5 MG * 12.5
243204   ENZYME INHIBITORS /      02342146       PMS-RAMIPRIL-HCTZ         Y    RAMIPRIL/ HYDROCHLOROTHIAZIDE   MG             ORAL            TABLET                 PMS        B                           Y      0.2263    0.2263     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING                                                                                 5 MG * 12.5
243204   ENZYME INHIBITORS /      02283158       ALTACE HCT                Y    RAMIPRIL/ HYDROCHLOROTHIAZIDE   MG             ORAL            TABLET                 SAV        W            7.50%          N      0.3829    0.2263     REGULAR BENEFIT
                                             2

         ANGIOTENSIN-CONVERTING                                                                                 10 MG * 12.5
243204   ENZYME INHIBITORS /      02342154       PMS-RAMIPRIL-HCTZ         Y    RAMIPRIL/ HYDROCHLOROTHIAZIDE   MG             ORAL            TABLET                 PMS        B                           Y      0.2865    0.2865     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING                                                                                 10 MG * 12.5
243204   ENZYME INHIBITORS /      02283166       ALTACE HCT                Y    RAMIPRIL/ HYDROCHLOROTHIAZIDE   MG             ORAL            TABLET                 SAV        W            7.50%          N      0.4875    0.2865     REGULAR BENEFIT
                                             2

         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02342162       PMS-RAMIPRIL-HCTZ         Y    RAMIPRIL/ HYDROCHLOROTHIAZIDE   5 MG * 25 MG ORAL              TABLET                 PMS        B                           Y      0.2263    0.2263     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02283174       ALTACE HCT                Y    RAMIPRIL/ HYDROCHLOROTHIAZIDE   5 MG * 25 MG ORAL              TABLET                 SAV        W            7.50%          N      0.3829    0.2263     REGULAR BENEFIT
                                             2

         ANGIOTENSIN-CONVERTING                                                                                 10 MG * 25
243204   ENZYME INHIBITORS /      02342170       PMS-RAMIPRIL-HCTZ         Y    RAMIPRIL/ HYDROCHLOROTHIAZIDE   MG             ORAL            TABLET                 PMS        B                           Y      0.2865    0.2865     REGULAR BENEFIT
         ANGIOTENSIN-CONVERTING                                                                                 10 MG * 25
243204   ENZYME INHIBITORS /      02283182       ALTACE HCT                Y    RAMIPRIL/ HYDROCHLOROTHIAZIDE   MG             ORAL            TABLET                 SAV        W            7.50%          N      0.4875    0.2865     REGULAR BENEFIT
                                             2
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /      02231457       MAVIK                     N    TRANDOLAPRIL                    0.5 MG         ORAL            CAPSULE                ABB        B                           N      0.4030               REGULAR BENEFIT
                                             1




                                                                                                                 Updated July 1, 2012                                                                                                      Page 76 of 254
                                                                                     Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                  (Regular Benefits)


                                                                                                                                                                           DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION      DIN / PIN          PRODUCT NAME        IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /       02231459       MAVIK                   N    TRANDOLAPRIL                    1 MG        ORAL               CAPSULE                ABB        B                           N      0.6901               REGULAR BENEFIT
                                              1
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /       02231460       MAVIK                   N    TRANDOLAPRIL                    2 MG        ORAL               CAPSULE                ABB        B                           N      0.7931               REGULAR BENEFIT
                                              1
         ANGIOTENSIN-CONVERTING
243204   ENZYME INHIBITORS /       02239267       MAVIK                   N    TRANDOLAPRIL                    4 MG        ORAL               CAPSULE                ABB        B                           N      0.9785               REGULAR BENEFIT
                                              1
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02379279       CANDESARTAN CILEXETIL   Y    CANDESARTAN CILEXETIL           8 MG        ORAL               TABLET                 AHI        B                           Y      0.4455    0.4455     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02379139       MYLAN-CANDESARTAN       Y    CANDESARTAN CILEXETIL           8 MG        ORAL               TABLET                 MYP        W                           Y      0.4455    0.4455     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02376539       CO CANDESARTAN          Y    CANDESARTAN CILEXETIL           8 MG        ORAL               TABLET                 COB        W                           Y      0.4455    0.4455     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02366312       TEVA-CANDESARTAN        Y    CANDESARTAN CILEXETIL           8 MG        ORAL               TABLET                 TEV        B                           Y      0.4455    0.4455     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02326965       SANDOZ CANDESARTAN      Y    CANDESARTAN CILEXETIL           8 MG        ORAL               TABLET                 SDZ        W                           Y      0.4455    0.4455     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02365359       APO-CANDESARTAN         Y    CANDESARTAN CILEXETIL           8 MG        ORAL               TABLET                 APX        B                           Y      0.4455    0.4455     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02239091       ATACAND                 Y    CANDESARTAN CILEXETIL           8 MG        ORAL               TABLET                 AZC        W            7.50%          N      1.1840    0.4455     REGULAR BENEFIT
                                              7
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02379147       MYLAN-CANDESARTAN       Y    CANDESARTAN CILEXETIL           16 MG       ORAL               TABLET                 MYP        W                           Y      0.4455    0.4455     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02376547       CO CANDESARTAN          Y    CANDESARTAN CILEXETIL           16 MG       ORAL               TABLET                 COB        W                           Y      0.4455    0.4455     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02366320       TEVA-CANDESARTAN        Y    CANDESARTAN CILEXETIL           16 MG       ORAL               TABLET                 TEV        B                           Y      0.4455    0.4455     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02379287       CANDESARTAN CILEXETIL   Y    CANDESARTAN CILEXETIL           16 MG       ORAL               TABLET                 AHI        B                           Y      0.4455    0.4455     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02326973       SANDOZ CANDESARTAN      Y    CANDESARTAN CILEXETIL           16 MG       ORAL               TABLET                 SDZ        W                           Y      0.4455    0.4455     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02365367       APO-CANDESARTAN         Y    CANDESARTAN CILEXETIL           16 MG       ORAL               TABLET                 APX        B                           Y      0.4455    0.4455     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02239092       ATACAND                 Y    CANDESARTAN CILEXETIL           16 MG       ORAL               TABLET                 AZC        W            7.50%          N      1.1840    0.4455     REGULAR BENEFIT
                                              7
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02379295       CANDESARTAN CILEXETIL   Y    CANDESARTAN CILEXETIL           32 MG       ORAL               TABLET                 AHI        B                           Y      0.4455    0.4455     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02379155       MYLAN-CANDESARTAN       Y    CANDESARTAN CILEXETIL           32 MG       ORAL               TABLET                 MYP        W                           Y      0.4455    0.4455     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02376555       CO CANDESARTAN          Y    CANDESARTAN CILEXETIL           32 MG       ORAL               TABLET                 COB        W                           Y      0.4455    0.4455     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02366339       TEVA-CANDESARTAN        Y    CANDESARTAN CILEXETIL           32 MG       ORAL               TABLET                 TEV        B                           Y      0.4455    0.4455     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02311658       ATACAND                 Y    CANDESARTAN CILEXETIL           32 MG       ORAL               TABLET                 AZC        W            7.50%          N      1.1840    0.4455     REGULAR BENEFIT
                                              5




                                                                                                                Updated July 1, 2012                                                                                                      Page 77 of 254
                                                                                 Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                              (Regular Benefits)


                                                                                                                                                                       DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION      DIN / PIN          PRODUCT NAME    IC            GENERIC NAME            STRENGTH             ROUTE             FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         ANGIOTENSIN II RECEPTOR                                           CANDESARTAN CILEXETIL/          16 MG * 12.5
243208   ANTAGONISTS /             02244021       ATACAND PLUS        N    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 AZC        W            7.50%          N      1.1700               REGULAR BENEFIT
                                              1
         ANGIOTENSIN II RECEPTOR                                           CANDESARTAN CILEXETIL/          32 MG * 12.5
243208   ANTAGONISTS /             02332922       ATACAND PLUS        N    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 AZC        W            7.50%          N      1.1700               REGULAR BENEFIT
                                              1
         ANGIOTENSIN II RECEPTOR                                           CANDESARTAN CILEXETIL/          32 MG * 25
243208   ANTAGONISTS /             02332957       ATACAND PLUS        N    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 AZC        W            7.50%          N      1.1700               REGULAR BENEFIT
                                              1
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02240432       TEVETEN             N    EPROSARTAN MESYLATE             400 MG         ORAL            TABLET                 ABB        B                           N      0.7075               REGULAR BENEFIT
                                              1
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02243942       TEVETEN             N    EPROSARTAN MESYLATE             600 MG         ORAL            TABLET                 ABB        B                           N      1.0836               REGULAR BENEFIT
                                              1
         ANGIOTENSIN II RECEPTOR                                           EPROSARTAN MESYLATE/            600 MG * 12.5
243208   ANTAGONISTS /             02253631       TEVETEN PLUS        N    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 ABB        B                           N      1.0836               REGULAR BENEFIT
                                              1
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02328070       CO IRBESARTAN       Y    IRBESARTAN                      75 MG          ORAL            TABLET                 COB        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02317060       PMS-IRBESARTAN      Y    IRBESARTAN                      75 MG          ORAL            TABLET                 PMS        B                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02315971       TEVA-IRBESARTAN     Y    IRBESARTAN                      75 MG          ORAL            TABLET                 TEV        B                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02328461       SANDOZ IRBESARTAN   Y    IRBESARTAN                      75 MG          ORAL            TABLET                 SDZ        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02373319       AVA-IRBESARTAN      Y    IRBESARTAN                      75 MG          ORAL            TABLET                 AVA        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02316390       RATIO-IRBESARTAN    Y    IRBESARTAN                      75 MG          ORAL            TABLET                 RPH        B                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02347296       MYLAN-IRBESARTAN    Y    IRBESARTAN                      75 MG          ORAL            TABLET                 MYP        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02372347       IRBESARTAN          Y    IRBESARTAN                      75 MG          ORAL            TABLET                 SNS        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02237923       AVAPRO              Y    IRBESARTAN                      75 MG          ORAL            TABLET                 SAV        B                           N      1.2633    0.4422     REGULAR BENEFIT
                                              9
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02328089       CO IRBESARTAN       Y    IRBESARTAN                      150 MG         ORAL            TABLET                 COB        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02317079       PMS-IRBESARTAN      Y    IRBESARTAN                      150 MG         ORAL            TABLET                 PMS        B                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02315998       TEVA-IRBESARTAN     Y    IRBESARTAN                      150 MG         ORAL            TABLET                 TEV        B                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02328488       SANDOZ IRBESARTAN   Y    IRBESARTAN                      150 MG         ORAL            TABLET                 SDZ        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02372371       IRBESARTAN          Y    IRBESARTAN                      150 MG         ORAL            TABLET                 SNS        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02373327       AVA-IRBESARTAN      Y    IRBESARTAN                      150 MG         ORAL            TABLET                 AVA        W                           Y      0.4422    0.4422     REGULAR BENEFIT




                                                                                                            Updated July 1, 2012                                                                                                      Page 78 of 254
                                                                                     Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                  (Regular Benefits)


                                                                                                                                                                           DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION      DIN / PIN           PRODUCT NAME       IC           GENERIC NAME             STRENGTH            ROUTE              FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02347318       MYLAN-IRBESARTAN        Y    IRBESARTAN                      150 MG       ORAL              TABLET                 MYP        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02316404       RATIO-IRBESARTAN        Y    IRBESARTAN                      150 MG       ORAL              TABLET                 RPH        B                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02237924       AVAPRO                  Y    IRBESARTAN                      150 MG       ORAL              TABLET                 SAV        B                           N      1.2633    0.4422     REGULAR BENEFIT
                                              9
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02328100       CO IRBESARTAN           Y    IRBESARTAN                      300 MG       ORAL              TABLET                 COB        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02317087       PMS-IRBESARTAN          Y    IRBESARTAN                      300 MG       ORAL              TABLET                 PMS        B                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02316005       TEVA-IRBESARTAN         Y    IRBESARTAN                      300 MG       ORAL              TABLET                 TEV        B                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02328496       SANDOZ IRBESARTAN       Y    IRBESARTAN                      300 MG       ORAL              TABLET                 SDZ        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02373335       AVA-IRBESARTAN          Y    IRBESARTAN                      300 MG       ORAL              TABLET                 AVA        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02347326       MYLAN-IRBESARTAN        Y    IRBESARTAN                      300 MG       ORAL              TABLET                 MYP        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02316412       RATIO-IRBESARTAN        Y    IRBESARTAN                      300 MG       ORAL              TABLET                 RPH        B                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02372398       IRBESARTAN              Y    IRBESARTAN                      300 MG       ORAL              TABLET                 SNS        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02237925       AVAPRO                  Y    IRBESARTAN                      300 MG       ORAL              TABLET                 SAV        B                           N      1.2633    0.4422     REGULAR BENEFIT
                                              9
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     150 MG * 12.5
243208   ANTAGONISTS /             02372886       IRBESARTAN/HCTZ         Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 SNS        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     150 MG * 12.5
243208   ANTAGONISTS /             02373343       AVA-IRBESARTAN/HCTZ     Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 AVA        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     150 MG * 12.5
243208   ANTAGONISTS /             02363208       RAN-IRBESARTAN HCTZ     Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 RAN        B                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     150 MG * 12.5
243208   ANTAGONISTS /             02328518       PMS-IRBESARTAN-HCTZ     Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 PMS        B                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     150 MG * 12.5
243208   ANTAGONISTS /             02330512       RATIO-IRBESARTAN HCTZ   Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 RPH        B                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     150 MG * 12.5
243208   ANTAGONISTS /             02316013       TEVA-IRBESARTAN/HCTZ    Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 TEV        B                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     150 MG * 12.5
243208   ANTAGONISTS /             02357399       CO IRBESARTAN/HCT       Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 COB        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     150 MG * 12.5
243208   ANTAGONISTS /             02337428       SANDOZ IRBESARTAN HCT   Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 SDZ        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     150 MG * 12.5
243208   ANTAGONISTS /             02241818       AVALIDE 150/12.5        Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 SAV        B                           N      1.2633    0.4422     REGULAR BENEFIT
                                              9
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     300 MG * 12.5
243208   ANTAGONISTS /             02372894       IRBESARTAN/HCTZ         Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 SNS        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     300 MG * 12.5
243208   ANTAGONISTS /             02373351       AVA-IRBESARTAN/HCTZ     Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 AVA        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     300 MG * 12.5
243208   ANTAGONISTS /             02363216       RAN-IRBESARTAN HCTZ     Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 RAN        B                           Y      0.4422    0.4422     REGULAR BENEFIT




                                                                                                                Updated July 1, 2012                                                                                                      Page 79 of 254
                                                                                     Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                  (Regular Benefits)


                                                                                                                                                                           DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION      DIN / PIN           PRODUCT NAME       IC           GENERIC NAME             STRENGTH            ROUTE              FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     300 MG * 12.5
243208   ANTAGONISTS /             02328526       PMS-IRBESARTAN-HCTZ     Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 PMS        B                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     300 MG * 12.5
243208   ANTAGONISTS /             02330520       RATIO-IRBESARTAN HCTZ   Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 RPH        B                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     300 MG * 12.5
243208   ANTAGONISTS /             02316021       TEVA-IRBESARTAN/HCTZ    Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 TEV        B                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     300 MG * 12.5
243208   ANTAGONISTS /             02357402       CO IRBESARTAN/HCT       Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 COB        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     300 MG * 12.5
243208   ANTAGONISTS /             02337436       SANDOZ IRBESARTAN HCT   Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 SDZ        W                           Y      0.4422    0.4422     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     300 MG * 12.5
243208   ANTAGONISTS /             02241819       AVALIDE 300/12.5        Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 SAV        B                           N      1.2633    0.4422     REGULAR BENEFIT
                                              9
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     300 MG * 25
243208   ANTAGONISTS /             02328534       PMS-IRBESARTAN-HCTZ     Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 PMS        B                           Y      0.4205    0.4205     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     300 MG * 25
243208   ANTAGONISTS /             02372908       IRBESARTAN/HCTZ         Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 SNS        W                           N      0.4206    0.4205     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     300 MG * 25
243208   ANTAGONISTS /             02373378       AVA-IRBESARTAN/HCTZ     Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 AVA        W                           N      0.4206    0.4205     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     300 MG * 25
243208   ANTAGONISTS /             02363224       RAN-IRBESARTAN HCTZ     Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 RAN        B                           N      0.4206    0.4205     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     300 MG * 25
243208   ANTAGONISTS /             02330539       RATIO-IRBESARTAN HCTZ   Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 RPH        B                           N      0.4206    0.4205     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     300 MG * 25
243208   ANTAGONISTS /             02316048       TEVA-IRBESARTAN/HCTZ    Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 TEV        B                           N      0.4206    0.4205     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     300 MG * 25
243208   ANTAGONISTS /             02357410       CO IRBESARTAN/HCT       Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 COB        W                           N      0.4206    0.4205     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                               IRBESARTAN/                     300 MG * 25
243208   ANTAGONISTS /             02337444       SANDOZ IRBESARTAN HCT   Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 SDZ        W                           N      0.4206    0.4205     REGULAR BENEFIT
                                              8
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02379058       APO-LOSARTAN            Y    LOSARTAN POTASSIUM              25 MG         ORAL             TABLET                 APX        B                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02380838       TEVA-LOSARTAN           Y    LOSARTAN POTASSIUM              25 MG         ORAL             TABLET                 TEV        B                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02313332       SANDOZ LOSARTAN         Y    LOSARTAN POTASSIUM              25 MG         ORAL             TABLET                 SDZ        W                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02309750       PMS-LOSARTAN            Y    LOSARTAN POTASSIUM              25 MG         ORAL             TABLET                 PMS        B                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02368277       MYLAN-LOSARTAN          Y    LOSARTAN POTASSIUM              25 MG         ORAL             TABLET                 MYP        W                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02354829       CO LOSARTAN             Y    LOSARTAN POTASSIUM              25 MG         ORAL             TABLET                 COB        W                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02182815       COZAAR                  Y    LOSARTAN POTASSIUM              25 MG         ORAL             TABLET                 MFC        B                           N      1.2590    0.4407     REGULAR BENEFIT
                                              7
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02309769       PMS-LOSARTAN            Y    LOSARTAN POTASSIUM              50 MG         ORAL             TABLET                 PMS        B                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02353504       APO-LOSARTAN            Y    LOSARTAN POTASSIUM              50 MG         ORAL             TABLET                 APX        B                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02357968       TEVA-LOSARTAN           Y    LOSARTAN POTASSIUM              50 MG         ORAL             TABLET                 TEV        B                           Y      0.4407    0.4407     REGULAR BENEFIT




                                                                                                                Updated July 1, 2012                                                                                                      Page 80 of 254
                                                                                      Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                   (Regular Benefits)


                                                                                                                                                                            DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION      DIN / PIN          PRODUCT NAME         IC           GENERIC NAME             STRENGTH             ROUTE             FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02313340       SANDOZ LOSARTAN          Y    LOSARTAN POTASSIUM              50 MG          ORAL            TABLET                 SDZ        W                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02368285       MYLAN-LOSARTAN           Y    LOSARTAN POTASSIUM              50 MG          ORAL            TABLET                 MYP        W                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02354837       CO LOSARTAN              Y    LOSARTAN POTASSIUM              50 MG          ORAL            TABLET                 COB        W                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02182874       COZAAR                   Y    LOSARTAN POTASSIUM              50 MG          ORAL            TABLET                 MFC        B                           N      1.2590    0.4407     REGULAR BENEFIT
                                              7
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02357976       TEVA-LOSARTAN            Y    LOSARTAN POTASSIUM              100 MG         ORAL            TABLET                 TEV        B                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02313359       SANDOZ LOSARTAN          Y    LOSARTAN POTASSIUM              100 MG         ORAL            TABLET                 SDZ        W                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02309777       PMS-LOSARTAN             Y    LOSARTAN POTASSIUM              100 MG         ORAL            TABLET                 PMS        B                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02353512       APO-LOSARTAN             Y    LOSARTAN POTASSIUM              100 MG         ORAL            TABLET                 APX        B                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02368293       MYLAN-LOSARTAN           Y    LOSARTAN POTASSIUM              100 MG         ORAL            TABLET                 MYP        W                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02354845       CO LOSARTAN              Y    LOSARTAN POTASSIUM              100 MG         ORAL            TABLET                 COB        W                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02182882       COZAAR                   Y    LOSARTAN POTASSIUM              100 MG         ORAL            TABLET                 MFC        B                           N      1.2590    0.4407     REGULAR BENEFIT
                                              7
         ANGIOTENSIN II RECEPTOR                                                LOSARTAN POTASSIUM/             50 MG * 12.5
243208   ANTAGONISTS /             02378078       MYLAN-LOSARTAN HCTZ      Y    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 MYP        W                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                                LOSARTAN POTASSIUM/             50 MG * 12.5
243208   ANTAGONISTS /             02358263       TEVA-LOSARTAN/HCTZ       Y    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 TEV        B                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                                LOSARTAN POTASSIUM/             50 MG * 12.5
243208   ANTAGONISTS /             02313375       SANDOZ LOSARTAN HCT      Y    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 SDZ        W                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                                LOSARTAN POTASSIUM/             50 MG * 12.5
243208   ANTAGONISTS /             02371235       APO-LOSARTAN/HCTZ        Y    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 APX        B                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                                LOSARTAN POTASSIUM/             50 MG * 12.5
243208   ANTAGONISTS /             02230047       HYZAAR                   Y    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 MFC        B                           N      1.2590    0.4407     REGULAR BENEFIT
                                              5
         ANGIOTENSIN II RECEPTOR                                                LOSARTAN POTASSIUM/             100 MG * 12.5
243208   ANTAGONISTS /             02371243       APO-LOSARTAN/HCTZ        Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 APX        B                           Y      0.4314    0.4314     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                                LOSARTAN POTASSIUM/             100 MG * 12.5
243208   ANTAGONISTS /             02362449       SANDOZ LOSARTAN HCT      Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 SDZ        W                           Y      0.4314    0.4314     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                                LOSARTAN POTASSIUM/             100 MG * 12.5
243208   ANTAGONISTS /             02378086       MYLAN-LOSARTAN HCTZ      Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 MYP        W                           Y      0.4314    0.4314     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                                LOSARTAN POTASSIUM/             100 MG * 12.5
243208   ANTAGONISTS /             02377144       TEVA-LOSARTAN/HCTZ       Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 TEV        B                           Y      0.4314    0.4314     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                                LOSARTAN POTASSIUM/             100 MG * 12.5
243208   ANTAGONISTS /             02297841       HYZAAR                   Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 MFC        B                           N      1.2327    0.4314     REGULAR BENEFIT
                                              5
         ANGIOTENSIN II RECEPTOR                                                LOSARTAN POTASSIUM/             100 MG * 25
243208   ANTAGONISTS /             02313383       SANDOZ LOSARTAN HCT DS   Y    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 SDZ        W                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                                LOSARTAN POTASSIUM/             100 MG * 25
243208   ANTAGONISTS /             02371251       APO-LOSARTAN/HCTZ        Y    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 APX        B                           Y      0.4407    0.4407     REGULAR BENEFIT




                                                                                                                 Updated July 1, 2012                                                                                                      Page 81 of 254
                                                                                      Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                   (Regular Benefits)


                                                                                                                                                                            DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION      DIN / PIN          PRODUCT NAME         IC            GENERIC NAME            STRENGTH             ROUTE             FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         ANGIOTENSIN II RECEPTOR                                                LOSARTAN POTASSIUM/             100 MG * 25
243208   ANTAGONISTS /             02378094       MYLAN-LOSARTAN HCTZ      Y    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 MYP        W                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                                LOSARTAN POTASSIUM/             100 MG * 25
243208   ANTAGONISTS /             02377152       TEVA-LOSARTAN/HCTZ       Y    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 TEV        B                           Y      0.4407    0.4407     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                                LOSARTAN POTASSIUM/             100 MG * 25
243208   ANTAGONISTS /             02241007       HYZAAR DS                Y    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 MFC        B                           N      1.2590    0.4407     REGULAR BENEFIT
                                              5
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02320177       TEVA-TELMISARTAN         Y    TELMISARTAN                     40 MG          ORAL            TABLET                 TEV        B                           Y      0.4080    0.4080     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02375958       SANDOZ TELMISARTAN       Y    TELMISARTAN                     40 MG          ORAL            TABLET                 SDZ        W                           Y      0.4080    0.4080     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02376717       MYLAN-TELMISARTAN        Y    TELMISARTAN                     40 MG          ORAL            TABLET                 MYP        W                           Y      0.4080    0.4080     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02240769       MICARDIS                 Y    TELMISARTAN                     40 MG          ORAL            TABLET                 BOE        B                           N      1.1657    0.4080     REGULAR BENEFIT
                                              4
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02375966       SANDOZ TELMISARTAN       Y    TELMISARTAN                     80 MG          ORAL            TABLET                 SDZ        W                           Y      0.4080    0.4080     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02376725       MYLAN-TELMISARTAN        Y    TELMISARTAN                     80 MG          ORAL            TABLET                 MYP        W                           Y      0.4080    0.4080     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02320185       TEVA-TELMISARTAN         Y    TELMISARTAN                     80 MG          ORAL            TABLET                 TEV        B                           Y      0.4080    0.4080     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02240770       MICARDIS                 Y    TELMISARTAN                     80 MG          ORAL            TABLET                 BOE        B                           N      1.1657    0.4080     REGULAR BENEFIT
                                              4
         ANGIOTENSIN II RECEPTOR                                                TELMISARTAN/ AMLODIPINE
243208   ANTAGONISTS /             02371022       TWYNSTA                  N    BESYLATE                        40 MG * 5 MG ORAL              TABLET                 BOE        B                           N      0.6818               REGULAR BENEFIT
                                              1
         ANGIOTENSIN II RECEPTOR                                                TELMISARTAN/ AMLODIPINE         40 MG * 10
243208   ANTAGONISTS /             02371030       TWYNSTA                  N    BESYLATE                        MG             ORAL            TABLET                 BOE        B                           N      0.6818               REGULAR BENEFIT
                                              1
         ANGIOTENSIN II RECEPTOR                                                TELMISARTAN/ AMLODIPINE
243208   ANTAGONISTS /             02371049       TWYNSTA                  N    BESYLATE                        80 MG * 5 MG ORAL              TABLET                 BOE        B                           N      0.6818               REGULAR BENEFIT
                                              1
         ANGIOTENSIN II RECEPTOR                                                TELMISARTAN/ AMLODIPINE         80 MG * 10
243208   ANTAGONISTS /             02371057       TWYNSTA                  N    BESYLATE                        MG             ORAL            TABLET                 BOE        B                           N      0.6818               REGULAR BENEFIT
                                              1
         ANGIOTENSIN II RECEPTOR                                                TELMISARTAN/                    80 MG * 12.5
243208   ANTAGONISTS /             02330288       TEVA-TELMISARTAN HCTZ    Y    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 TEV        B                           Y      0.4080    0.4080     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                                TELMISARTAN/                    80 MG * 12.5
243208   ANTAGONISTS /             02373564       MYLAN-TELMISARTAN HCTZ   Y    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 MYP        W                           Y      0.4080    0.4080     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                                TELMISARTAN/                    80 MG * 12.5
243208   ANTAGONISTS /             02244344       MICARDIS PLUS            Y    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 BOE        B                           N      1.1657    0.4080     REGULAR BENEFIT
                                              3
         ANGIOTENSIN II RECEPTOR                                                TELMISARTAN/                    80 MG * 25
243208   ANTAGONISTS /             02379252       TEVA-TELMISARTAN HCTZ    Y    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 TEV        B                           Y      0.4080    0.4080     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                                TELMISARTAN/                    80 MG * 25
243208   ANTAGONISTS /             02373572       MYLAN-TELMISARTAN HCTZ   Y    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 MYP        W                           Y      0.4080    0.4080     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                                TELMISARTAN/                    80 MG * 25
243208   ANTAGONISTS /             02318709       MICARDIS PLUS            Y    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 BOE        B                           N      1.1657    0.4080     REGULAR BENEFIT




                                                                                                                 Updated July 1, 2012                                                                                                      Page 82 of 254
                                                                                    Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                 (Regular Benefits)


                                                                                                                                                                          DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION      DIN / PIN          PRODUCT NAME       IC           GENERIC NAME             STRENGTH             ROUTE             FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                              3
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02363100       RAN-VALSARTAN          Y    VALSARTAN                       80 MG          ORAL            TABLET                 RAN        B                           Y      0.4514    0.4514     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02356759       SANDOZ VALSARTAN       Y    VALSARTAN                       80 MG          ORAL            TABLET                 SDZ        W                           Y      0.4514    0.4514     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02367122       AVA-VALSARTAN          Y    VALSARTAN                       80 MG          ORAL            TABLET                 AVA        W                           Y      0.4514    0.4514     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02356651       TEVA-VALSARTAN         Y    VALSARTAN                       80 MG          ORAL            TABLET                 TEV        B                           Y      0.4514    0.4514     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02337495       CO VALSARTAN           Y    VALSARTAN                       80 MG          ORAL            TABLET                 COB        W                           Y      0.4514    0.4514     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02371529       APO-VALSARTAN          Y    VALSARTAN                       80 MG          ORAL            TABLET                 APX        B                           Y      0.4514    0.4514     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02244781       DIOVAN                 Y    VALSARTAN                       80 MG          ORAL            TABLET                 NOV        W            7.50%          N      1.1996    0.4514     REGULAR BENEFIT
                                              7
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02363119       RAN-VALSARTAN          Y    VALSARTAN                       160 MG         ORAL            TABLET                 RAN        B                           Y      0.4512    0.4512     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02356767       SANDOZ VALSARTAN       Y    VALSARTAN                       160 MG         ORAL            TABLET                 SDZ        W                           Y      0.4512    0.4512     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02367130       AVA-VALSARTAN          Y    VALSARTAN                       160 MG         ORAL            TABLET                 AVA        W                           Y      0.4512    0.4512     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02356678       TEVA-VALSARTAN         Y    VALSARTAN                       160 MG         ORAL            TABLET                 TEV        B                           Y      0.4512    0.4512     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02337509       CO VALSARTAN           Y    VALSARTAN                       160 MG         ORAL            TABLET                 COB        W                           Y      0.4512    0.4512     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02371537       APO-VALSARTAN          Y    VALSARTAN                       160 MG         ORAL            TABLET                 APX        B                           Y      0.4512    0.4512     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02244782       DIOVAN                 Y    VALSARTAN                       160 MG         ORAL            TABLET                 NOV        W            7.50%          N      1.1993    0.4512     REGULAR BENEFIT
                                              7
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02367149       AVA-VALSARTAN          Y    VALSARTAN                       320 MG         ORAL            TABLET                 AVA        W                           Y      0.4347    0.4347     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02356686       TEVA-VALSARTAN         Y    VALSARTAN                       320 MG         ORAL            TABLET                 TEV        B                           Y      0.4347    0.4347     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02337517       CO VALSARTAN           Y    VALSARTAN                       320 MG         ORAL            TABLET                 COB        W                           Y      0.4347    0.4347     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02371545       APO-VALSARTAN          Y    VALSARTAN                       320 MG         ORAL            TABLET                 APX        B                           Y      0.4347    0.4347     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02356775       SANDOZ VALSARTAN       Y    VALSARTAN                       320 MG         ORAL            TABLET                 SDZ        W                           Y      0.4347    0.4347     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR
243208   ANTAGONISTS /             02289504       DIOVAN                 Y    VALSARTAN                       320 MG         ORAL            TABLET                 NOV        W            7.50%          N      1.1554    0.4347     REGULAR BENEFIT
                                              6
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                      80 MG * 12.5
243208   ANTAGONISTS /             02373734       MYLAN-VALSARTAN HCTZ   Y    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 MYP        W                           Y      0.4492    0.4492     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                      80 MG * 12.5
243208   ANTAGONISTS /             02356694       SANDOZ VALSARTAN HCT   Y    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 SDZ        W                           Y      0.4492    0.4492     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                      80 MG * 12.5
243208   ANTAGONISTS /             02367068       AVA-VALSARTAN HCT      Y    HYDROCHLOROTHIAZIDE             MG             ORAL            TABLET                 AVA        W                           Y      0.4492    0.4492     REGULAR BENEFIT




                                                                                                               Updated July 1, 2012                                                                                                      Page 83 of 254
                                                                                    Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                 (Regular Benefits)


                                                                                                                                                                          DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION      DIN / PIN          PRODUCT NAME       IC            GENERIC NAME             STRENGTH             ROUTE            FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                       80 MG * 12.5
243208   ANTAGONISTS /             02356996       TEVA-VALSARTAN/HCTZ    Y    HYDROCHLOROTHIAZIDE              MG             ORAL           TABLET                 TEV        B                           Y      0.4492    0.4492     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                       80 MG * 12.5
243208   ANTAGONISTS /             02382547       APO-VALSARTAN/HCTZ     Y    HYDROCHLOROTHIAZIDE              MG             ORAL           TABLET                 APX        B                           Y      0.4492    0.4492     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                                                             80 MG * 12.5
243208   ANTAGONISTS /             02241900       DIOVAN-HCT             Y    VALSARTAN/ HYDROCHLOROTHIAZIDE MG               ORAL           TABLET                 NOV        W            7.50%          N      1.1939    0.4492     REGULAR BENEFIT
                                              6
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                       160 MG * 12.5
243208   ANTAGONISTS /             02373742       MYLAN-VALSARTAN HCTZ   Y    HYDROCHLOROTHIAZIDE              MG            ORAL            TABLET                 MYP        W                           Y      0.4504    0.4504     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                       160 MG * 12.5
243208   ANTAGONISTS /             02367076       AVA-VALSARTAN HCT      Y    HYDROCHLOROTHIAZIDE              MG            ORAL            TABLET                 AVA        W                           Y      0.4504    0.4504     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                       160 MG * 12.5
243208   ANTAGONISTS /             02356708       SANDOZ VALSARTAN HCT   Y    HYDROCHLOROTHIAZIDE              MG            ORAL            TABLET                 SDZ        W                           Y      0.4504    0.4504     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                       160 MG * 12.5
243208   ANTAGONISTS /             02357003       TEVA-VALSARTAN/HCTZ    Y    HYDROCHLOROTHIAZIDE              MG            ORAL            TABLET                 TEV        B                           Y      0.4504    0.4504     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                       160 MG * 12.5
243208   ANTAGONISTS /             02382555       APO-VALSARTAN/HCTZ     Y    HYDROCHLOROTHIAZIDE              MG            ORAL            TABLET                 APX        B                           Y      0.4504    0.4504     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                                                             160 MG * 12.5
243208   ANTAGONISTS /             02241901       DIOVAN-HCT             Y    VALSARTAN/ HYDROCHLOROTHIAZIDE MG            ORAL              TABLET                 NOV        W            7.50%          N      1.1971    0.4504     REGULAR BENEFIT
                                              6
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                       160 MG * 25
243208   ANTAGONISTS /             02373750       MYLAN-VALSARTAN HCTZ   Y    HYDROCHLOROTHIAZIDE              MG             ORAL           TABLET                 MYP        W                           Y      0.4519    0.4519     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                       160 MG * 25
243208   ANTAGONISTS /             02382563       APO-VALSARTAN/HCTZ     Y    HYDROCHLOROTHIAZIDE              MG             ORAL           TABLET                 APX        B                           Y      0.4519    0.4519     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                       160 MG * 25
243208   ANTAGONISTS /             02356716       SANDOZ VALSARTAN HCT   Y    HYDROCHLOROTHIAZIDE              MG             ORAL           TABLET                 SDZ        W                           Y      0.4519    0.4519     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                       160 MG * 25
243208   ANTAGONISTS /             02357011       TEVA-VALSARTAN/HCTZ    Y    HYDROCHLOROTHIAZIDE              MG             ORAL           TABLET                 TEV        B                           Y      0.4519    0.4519     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                       160 MG * 25
243208   ANTAGONISTS /             02367084       AVA-VALSARTAN HCT      Y    HYDROCHLOROTHIAZIDE              MG             ORAL           TABLET                 AVA        W                           Y      0.4519    0.4519     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                                                             160 MG * 25
243208   ANTAGONISTS /             02246955       DIOVAN-HCT             Y    VALSARTAN/ HYDROCHLOROTHIAZIDE MG               ORAL           TABLET                 NOV        W            7.50%          N      1.2011    0.4519     REGULAR BENEFIT
                                              6
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                       320 MG * 12.5
243208   ANTAGONISTS /             02367092       AVA-VALSARTAN HCT      Y    HYDROCHLOROTHIAZIDE              MG            ORAL            TABLET                 AVA        W                           Y      0.4452    0.4452     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                       320 MG * 12.5
243208   ANTAGONISTS /             02373769       MYLAN-VALSARTAN HCTZ   Y    HYDROCHLOROTHIAZIDE              MG            ORAL            TABLET                 MYP        W                           Y      0.4452    0.4452     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                       320 MG * 12.5
243208   ANTAGONISTS /             02382571       APO-VALSARTAN/HCTZ     Y    HYDROCHLOROTHIAZIDE              MG            ORAL            TABLET                 APX        B                           Y      0.4452    0.4452     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                       320 MG * 12.5
243208   ANTAGONISTS /             02356724       SANDOZ VALSARTAN HCT   Y    HYDROCHLOROTHIAZIDE              MG            ORAL            TABLET                 SDZ        W                           Y      0.4452    0.4452     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                       320 MG * 12.5
243208   ANTAGONISTS /             02357038       TEVA-VALSARTAN/HCTZ    Y    HYDROCHLOROTHIAZIDE              MG            ORAL            TABLET                 TEV        B                           Y      0.4452    0.4452     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                                                             320 MG * 12.5
243208   ANTAGONISTS /             02308908       DIOVAN-HCT             Y    VALSARTAN/ HYDROCHLOROTHIAZIDE MG            ORAL              TABLET                 NOV        W            7.50%          N      1.1832    0.4452     REGULAR BENEFIT
                                              6
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                       320 MG * 25
243208   ANTAGONISTS /             02367106       AVA-VALSARTAN HCT      Y    HYDROCHLOROTHIAZIDE              MG             ORAL           TABLET                 AVA        W                           Y      0.4452    0.4452     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                       320 MG * 25
243208   ANTAGONISTS /             02373777       MYLAN-VALSARTAN HCTZ   Y    HYDROCHLOROTHIAZIDE              MG             ORAL           TABLET                 MYP        W                           Y      0.4452    0.4452     REGULAR BENEFIT




                                                                                                                Updated July 1, 2012                                                                                                     Page 84 of 254
                                                                                    Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                 (Regular Benefits)


                                                                                                                                                                          DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION      DIN / PIN           PRODUCT NAME      IC            GENERIC NAME            STRENGTH            ROUTE              FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                      320 MG * 25
243208   ANTAGONISTS /             02382598       APO-VALSARTAN/HCTZ     Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 APX        B                           Y      0.4452    0.4452     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                      320 MG * 25
243208   ANTAGONISTS /             02356732       SANDOZ VALSARTAN HCT   Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 SDZ        W                           Y      0.4452    0.4452     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                              VALSARTAN/                      320 MG * 25
243208   ANTAGONISTS /             02357046       TEVA-VALSARTAN/HCTZ    Y    HYDROCHLOROTHIAZIDE             MG            ORAL             TABLET                 TEV        B                           Y      0.4452    0.4452     REGULAR BENEFIT
         ANGIOTENSIN II RECEPTOR                                                                             320 MG * 25
243208   ANTAGONISTS /             02308916       DIOVAN-HCT             Y    VALSARTAN/ HYDROCHLOROTHIAZIDE MG             ORAL             TABLET                 NOV        W            7.50%          N      1.1832    0.4452     REGULAR BENEFIT
                                              6
         MINERALOCORTICOID
         (ALDOSTERONE) RECEPTOR                                               HYDROCHLOROTHIAZIDE/            25 MG * 25
243220   ANTAGONISTS /             00613231       NOVO-SPIROZINE         Y    SPIRONOLACTONE                  MG            ORAL             TABLET                 TEV        B                           Y      0.1216    0.1216     REGULAR BENEFIT
         MINERALOCORTICOID
         (ALDOSTERONE) RECEPTOR                                               HYDROCHLOROTHIAZIDE/            25 MG * 25
243220   ANTAGONISTS /             00180408       ALDACTAZIDE 25         Y    SPIRONOLACTONE                  MG            ORAL             TABLET                 PFI        W            7.50%          N      0.1307    0.1216     REGULAR BENEFIT
                                              2
         MINERALOCORTICOID
         (ALDOSTERONE) RECEPTOR                                               HYDROCHLOROTHIAZIDE/            50 MG * 50
243220   ANTAGONISTS /             00657182       NOVO-SPIROZINE         Y    SPIRONOLACTONE                  MG            ORAL             TABLET                 TEV        B                           Y      0.2571    0.2571     REGULAR BENEFIT
         MINERALOCORTICOID
         (ALDOSTERONE) RECEPTOR                                               HYDROCHLOROTHIAZIDE/            50 MG * 50
243220   ANTAGONISTS /             00594377       ALDACTAZIDE 50         Y    SPIRONOLACTONE                  MG            ORAL             TABLET                 PFI        W            7.50%          N      0.2771    0.2571     REGULAR BENEFIT
                                              2
         MINERALOCORTICOID
         (ALDOSTERONE) RECEPTOR
243220   ANTAGONISTS /             00613215       NOVO-SPIROTON          Y    SPIRONOLACTONE                  25 MG         ORAL             TABLET                 TEV        B                           Y      0.1194    0.1194     REGULAR BENEFIT
         MINERALOCORTICOID
         (ALDOSTERONE) RECEPTOR
243220   ANTAGONISTS /             00028606       ALDACTONE              Y    SPIRONOLACTONE                  25 MG         ORAL             TABLET                 PFI        W            7.50%          N      0.1307    0.1194     REGULAR BENEFIT
                                              2
         MINERALOCORTICOID
         (ALDOSTERONE) RECEPTOR
243220   ANTAGONISTS /             00613223       NOVO-SPIROTON          Y    SPIRONOLACTONE                  100 MG        ORAL             TABLET                 TEV        B                           Y      0.2780    0.2780     REGULAR BENEFIT
         MINERALOCORTICOID
         (ALDOSTERONE) RECEPTOR
243220   ANTAGONISTS /             00285455       ALDACTONE              Y    SPIRONOLACTONE                  100 MG        ORAL             TABLET                 PFI        W            7.50%          N      0.3080    0.2780     REGULAR BENEFIT
                                              2
                                                  COMPD-NSAID/
                                                  ANALG/MUSCLE RELAX
         ANALGESICS AND                           (NOT DICLOFENAC)-
280800   ANTIPYRETICS /            00999205       TOPICAL                Y    COMPOUND PRESCRIPTION                         TOPICAL                                 XXX        B                           Y      0.0000               REGULAR BENEFIT
                                              1
                                                  COMPD- NSAID/
                                                  ANALG/MUSCLE RELAX
         ANALGESICS AND                           (NOT DICLOFENAC)-
280800   ANTIPYRETICS /            00999105       TOPICAL                Y    COMPOUND PRESCRIPTION                         TOPICAL                                 XXX        B                           Y      0.0000               REGULAR BENEFIT
                                              1
         NONSTEROIDAL ANTI-                       COMPOUND- DICLOFENAC
280804   INFLAMMATORY AGENTS /     00999202       (TOPICAL)              Y    COMPOUND PRESCRIPTION                         TOPICAL                                 XXX        B                           Y      0.0000               REGULAR BENEFIT
                                              1




                                                                                                               Updated July 1, 2012                                                                                                      Page 85 of 254
                                                                                     Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                  (Regular Benefits)


                                                                                                                                                                           DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION       DIN / PIN          PRODUCT NAME     IC             GENERIC NAME            STRENGTH            ROUTE              FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           NONSTEROIDAL ANTI-                      COMPOUND-DICLOFENAC
280804     INFLAMMATORY AGENTS /    00999102       (TOPICAL)             Y    COMPOUND PRESCRIPTION                          TOPICAL                                 XXX        B                           Y      0.0000               REGULAR BENEFIT
                                               1
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /                                                                                                              ENTERIC-COATED
28080424   SALICYLATES              00010340       ENTROPHEN 10          N    ASA                              650 MG        ORAL             TABLET                 PPH        W            7.50%          N      0.0818               REGULAR BENEFIT
                                               1
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /                                                                               50 MG * 40
28080424   SALICYLATES              00608238       RATIO-TECNAL          Y    BUTALBITAL/ CAFFEINE/ ASA        MG * 330 MG ORAL               CAPSULE                RPH        B                           Y      1.0304    1.0304     REGULAR BENEFIT
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /                                                                               50 MG * 40
28080424   SALICYLATES              00226327       FIORINAL              Y    BUTALBITAL/ CAFFEINE/ ASA        MG * 330 MG   ORAL             CAPSULE                NOV        W            7.50%          N      1.5175    1.0304     REGULAR BENEFIT
                                               2
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /                                                                               50 MG * 40
28080424   SALICYLATES              00608211       RATIO-TECNAL          N    BUTALBITAL/ CAFFEINE/ ASA        MG * 330 MG   ORAL             TABLET                 RPH        B                           N      0.6265               REGULAR BENEFIT
                                               1

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02261952       SANDOZ DICLOFENAC     Y    DICLOFENAC SODIUM                25 MG         ORAL             TABLET                 SDZ        W                           Y      0.1189    0.1189     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      00808539       NOVO-DIFENAC          Y    DICLOFENAC SODIUM                25 MG         ORAL             TABLET                 TEV        B                           Y      0.1189    0.1189     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      00839175       APO-DICLO             Y    DICLOFENAC SODIUM                25 MG         ORAL             TABLET                 APX        B                           Y      0.1189    0.1189     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02302616       PMS-DICLOFENAC        Y    DICLOFENAC SODIUM                25 MG         ORAL             TABLET                 PMS        B                           Y      0.1189    0.1189     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02366665       AVA-DICLOFENAC        Y    DICLOFENAC SODIUM                25 MG         ORAL             TABLET                 AVA        W                           Y      0.1189    0.1189     REGULAR BENEFIT
                                               5

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02261960       SANDOZ DICLOFENAC     Y    DICLOFENAC SODIUM                50 MG         ORAL             TABLET                 SDZ        W                           Y      0.3257    0.2378     REGULAR BENEFIT




                                                                                                                Updated July 1, 2012                                                                                                      Page 86 of 254
                                                                                     Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                  (Regular Benefits)


                                                                                                                                                                           DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION       DIN / PIN         PRODUCT NAME       IC            GENERIC NAME            STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      00808547       NOVO-DIFENAC           Y    DICLOFENAC SODIUM               50 MG       ORAL               TABLET                 TEV        B                           Y      0.3257    0.2378     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      00839183       APO-DICLO              Y    DICLOFENAC SODIUM               50 MG       ORAL               TABLET                 APX        B                           Y      0.3257    0.2378     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02302624       PMS-DICLOFENAC         Y    DICLOFENAC SODIUM               50 MG       ORAL               TABLET                 PMS        B                           Y      0.3257    0.2378     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02352397       DICLOFENAC SODIUM      Y    DICLOFENAC SODIUM               50 MG       ORAL               TABLET                 SNS        W                           Y      0.3257    0.2378     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02366673       AVA-DICLOFENAC         Y    DICLOFENAC SODIUM               50 MG       ORAL               TABLET                 AVA        W                           Y      0.3257    0.2378     REGULAR BENEFIT
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      00514012       VOLTAREN               Y    DICLOFENAC SODIUM               50 MG       ORAL               TABLET                 NOV        W            7.50%          N      0.8656    0.2378     REGULAR BENEFIT
                                               7

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           SUSTAINED-
28080492   INFLAMMATORY AGENTS      02261901       SANDOZ DICLOFENAC SR   Y    DICLOFENAC SODIUM               75 MG       ORAL               RELEASE TABLET         SDZ        W                           Y      0.4491    0.3567     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           SUSTAINED-
28080492   INFLAMMATORY AGENTS      02231504       PMS-DICLOFENAC-SR      Y    DICLOFENAC SODIUM               75 MG       ORAL               RELEASE TABLET         PMS        B                           Y      0.4491    0.3567     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           SUSTAINED-
28080492   INFLAMMATORY AGENTS      02158582       NOVO-DIFENAC SR        Y    DICLOFENAC SODIUM               75 MG       ORAL               RELEASE TABLET         TEV        B                           Y      0.4491    0.3567     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           SUSTAINED-
28080492   INFLAMMATORY AGENTS      02162814       APO-DICLO SR           Y    DICLOFENAC SODIUM               75 MG       ORAL               RELEASE TABLET         APX        B                           Y      0.4491    0.3567     REGULAR BENEFIT




                                                                                                                Updated July 1, 2012                                                                                                      Page 87 of 254
                                                                                     Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                  (Regular Benefits)


                                                                                                                                                                           DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION       DIN / PIN         PRODUCT NAME       IC            GENERIC NAME            STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           SUSTAINED-
28080492   INFLAMMATORY AGENTS      02352400       DICLOFENAC SODIUM SR   Y    DICLOFENAC SODIUM               75 MG       ORAL               RELEASE TABLET         SNS        W                           Y      0.4491    0.3567     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           SUSTAINED-
28080492   INFLAMMATORY AGENTS      02366681       AVA-DICLOFENAC SR      Y    DICLOFENAC SODIUM               75 MG       ORAL               RELEASE TABLET         AVA        W                           Y      0.4491    0.3567     REGULAR BENEFIT
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           SUSTAINED-
28080492   INFLAMMATORY AGENTS      00782459       VOLTAREN SR            Y    DICLOFENAC SODIUM               75 MG       ORAL               RELEASE TABLET         NOV        W            7.50%          N      1.1937    0.3567     REGULAR BENEFIT
                                               7

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           SUSTAINED-
28080492   INFLAMMATORY AGENTS      02261944       SANDOZ DICLOFENAC SR   Y    DICLOFENAC SODIUM               100 MG      ORAL               RELEASE TABLET         SDZ        W                           Y      0.6402    0.4756     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           SUSTAINED-
28080492   INFLAMMATORY AGENTS      02231505       PMS-DICLOFENAC-SR      Y    DICLOFENAC SODIUM               100 MG      ORAL               RELEASE TABLET         PMS        B                           Y      0.6402    0.4756     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           SUSTAINED-
28080492   INFLAMMATORY AGENTS      02048698       NOVO-DIFENAC SR        Y    DICLOFENAC SODIUM               100 MG      ORAL               RELEASE TABLET         TEV        B                           Y      0.6402    0.4756     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           SUSTAINED-
28080492   INFLAMMATORY AGENTS      02091194       APO-DICLO SR           Y    DICLOFENAC SODIUM               100 MG      ORAL               RELEASE TABLET         APX        B                           Y      0.6402    0.4756     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           SUSTAINED-
28080492   INFLAMMATORY AGENTS      02366703       AVA-DICLOFENAC SR      Y    DICLOFENAC SODIUM               100 MG      ORAL               RELEASE TABLET         AVA        W                           Y      0.6402    0.4756     REGULAR BENEFIT
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                           SUSTAINED-
28080492   INFLAMMATORY AGENTS      00590827       VOLTAREN SR            Y    DICLOFENAC SODIUM               100 MG      ORAL               RELEASE TABLET         NOV        W            7.50%          N      1.7016    0.4756     REGULAR BENEFIT
                                               6

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02241224       SANDOZ DICLOFENAC      Y    DICLOFENAC SODIUM               50 MG       RECTAL             SUPPOSITORY            SDZ        W                           Y      0.4891    0.4891     REGULAR BENEFIT




                                                                                                                Updated July 1, 2012                                                                                                      Page 88 of 254
                                                                                    Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                 (Regular Benefits)


                                                                                                                                                                          DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION       DIN / PIN          PRODUCT NAME    IC            GENERIC NAME             STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02231506       PMS-DICLOFENAC       Y    DICLOFENAC SODIUM                50 MG       RECTAL             SUPPOSITORY            PMS        B                           Y      0.4891    0.4891     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02261928       SANDOZ DICLOFENAC    Y    DICLOFENAC SODIUM                50 MG       RECTAL             SUPPOSITORY            SDZ        W                           Y      0.4891    0.4891     REGULAR BENEFIT
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00632724       VOLTAREN             Y    DICLOFENAC SODIUM                50 MG       RECTAL             SUPPOSITORY            NOV        W            7.50%          N      1.2999    0.4891     REGULAR BENEFIT
                                               4

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02261936       SANDOZ DICLOFENAC    Y    DICLOFENAC SODIUM                100 MG      RECTAL             SUPPOSITORY            SDZ        W                           Y      0.6583    0.6583     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02231508       PMS-DICLOFENAC       Y    DICLOFENAC SODIUM                100 MG      RECTAL             SUPPOSITORY            PMS        B                           Y      0.6583    0.6583     REGULAR BENEFIT
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00632732       VOLTAREN             Y    DICLOFENAC SODIUM                100 MG      RECTAL             SUPPOSITORY            NOV        W            7.50%          N      1.7496    0.6583     REGULAR BENEFIT
                                               3
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                         50 MG * 200
28080492   INFLAMMATORY AGENTS      01917056       ARTHROTEC-50         N    DICLOFENAC SODIUM/ MISOPROSTOL MCG           ORAL               TABLET                 PFI        W            7.50%          N      0.6053               REGULAR BENEFIT
                                               1
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                         75 MG * 200
28080492   INFLAMMATORY AGENTS      02229837       ARTHROTEC-75         N    DICLOFENAC SODIUM/ MISOPROSTOL MCG           ORAL               TABLET                 PFI        W            7.50%          N      0.8239               REGULAR BENEFIT
                                               1

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02048493       NOVO-DIFLUNISAL FC   Y    DIFLUNISAL                       250 MG      ORAL               TABLET                 TEV        B                           Y      0.5366    0.5366     REGULAR BENEFIT
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02039486       APO-DIFLUNISAL       Y    DIFLUNISAL                       250 MG      ORAL               TABLET                 APX        B                           N      0.5646    0.5366     REGULAR BENEFIT
                                               2




                                                                                                               Updated July 1, 2012                                                                                                      Page 89 of 254
                                                                                   Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                (Regular Benefits)


                                                                                                                                                                         DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION       DIN / PIN          PRODUCT NAME   IC              GENERIC NAME           STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02039494       APO-DIFLUNISAL      N    DIFLUNISAL                       500 MG      ORAL               TABLET                 APX        B                           N      0.7150               REGULAR BENEFIT
                                               1
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02232317       ETODOLAC            N    ETODOLAC                         200 MG      ORAL               CAPSULE                AAP        W            7.50%          N      0.7600               REGULAR BENEFIT
                                               1
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02232318       ETODOLAC            N    ETODOLAC                         300 MG      ORAL               CAPSULE                AAP        W            7.50%          N      0.7600               REGULAR BENEFIT
                                               1
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02244680       FLOCTAFENINE        N    FLOCTAFENINE                     200 MG      ORAL               TABLET                 AAP        W            7.50%          N      0.4175               REGULAR BENEFIT
                                               1
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02244681       FLOCTAFENINE        N    FLOCTAFENINE                     400 MG      ORAL               TABLET                 AAP        W            7.50%          N      0.8123               REGULAR BENEFIT
                                               1

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      01912046       APO-FLURBIPROFEN    Y    FLURBIPROFEN                     50 MG       ORAL               TABLET                 APX        B                           Y      0.2221    0.2221     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02100509       NOVO-FLURPROFEN     Y    FLURBIPROFEN                     50 MG       ORAL               TABLET                 TEV        B                           Y      0.2221    0.2221     REGULAR BENEFIT
                                               2

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      01912038       APO-FLURBIPROFEN    Y    FLURBIPROFEN                     100 MG      ORAL               TABLET                 APX        B                           Y      0.3039    0.3039     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02100517       NOVO-FLURPROFEN     Y    FLURBIPROFEN                     100 MG      ORAL               TABLET                 TEV        B                           Y      0.3039    0.3039     REGULAR BENEFIT
                                               2
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00441651       APO-IBUPROFEN       N    IBUPROFEN                        300 MG      ORAL               TABLET                 APX        B                           N      0.1087               REGULAR BENEFIT




                                                                                                              Updated July 1, 2012                                                                                                      Page 90 of 254
                                                                                    Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                 (Regular Benefits)


                                                                                                                                                                          DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION       DIN / PIN         PRODUCT NAME      IC           GENERIC NAME             STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                               1

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00629340       NOVO-PROFEN           Y    IBUPROFEN                       400 MG      ORAL               TABLET                 TEV        B                           Y      0.0474    0.0474     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00506052       APO-IBUPROFEN         Y    IBUPROFEN                       400 MG      ORAL               TABLET                 APX        B                           Y      0.0474    0.0474     REGULAR BENEFIT
                                               2

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00585114       APO-IBUPROFEN         Y    IBUPROFEN                       600 MG      ORAL               TABLET                 APX        B                           Y      0.1313    0.1313     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00629359       NOVO-PROFEN           Y    IBUPROFEN                       600 MG      ORAL               TABLET                 TEV        B                           Y      0.1313    0.1313     REGULAR BENEFIT
                                               2

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00337420       NOVO-METHACIN         N    INDOMETHACIN                    25 MG       ORAL               CAPSULE                TEV        B                           Y      0.0871    0.0871     REGULAR BENEFIT
                                               1

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00337439       NOVO-METHACIN         N    INDOMETHACIN                    50 MG       ORAL               CAPSULE                TEV        B                           Y      0.1511    0.1511     REGULAR BENEFIT
                                               1
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02231799       SANDOZ INDOMETHACIN   N    INDOMETHACIN                    50 MG       RECTAL             SUPPOSITORY            SDZ        W            7.50%          N      0.8225               REGULAR BENEFIT
                                               1

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02231800       SANDOZ INDOMETHACIN   Y    INDOMETHACIN                    100 MG      RECTAL             SUPPOSITORY            SDZ        W                           Y      0.8910    0.8910     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      01934139       RATIO-INDOMETHACIN    Y    INDOMETHACIN                    100 MG      RECTAL             SUPPOSITORY            RPH        B                           Y      0.8910    0.8910     REGULAR BENEFIT
                                               2




                                                                                                               Updated July 1, 2012                                                                                                      Page 91 of 254
                                                                                 Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                              (Regular Benefits)


                                                                                                                                                                       DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION       DIN / PIN         PRODUCT NAME   IC           GENERIC NAME             STRENGTH           ROUTE               FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00790427       KETOPROFEN         N    KETOPROFEN                      50 MG        ORAL              CAPSULE                AAP        W            7.50%          N      0.3373               REGULAR BENEFIT
                                               1
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                       ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      00790435       KETOPROFEN-E       N    KETOPROFEN                      50 MG        ORAL              TABLET                 AAP        W            7.50%          N      0.3373               REGULAR BENEFIT
                                               1
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                       ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      00842664       KETOPROFEN-E       N    KETOPROFEN                      100 MG       ORAL              TABLET                 AAP        W            7.50%          N      0.6823               REGULAR BENEFIT
                                               1
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                       SUSTAINED-
28080492   INFLAMMATORY AGENTS      02172577       KETOPROFEN SR      N    KETOPROFEN                      200 MG       ORAL              RELEASE TABLET         AAP        W            7.50%          N      1.3890    1.4670     REGULAR BENEFIT
                                               1
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02015951       PMS-KETOPROFEN     N    KETOPROFEN                      100 MG       RECTAL            SUPPOSITORY            PMS        B                           N      1.1453               REGULAR BENEFIT
                                               1
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02162644       TORADOL            N    KETOROLAC TROMETHAMINE          10 MG / ML   INJECTION                                HLR        W            7.50%          N      2.2380               REGULAR BENEFIT
                                               1
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                KETOROLAC
28080492   INFLAMMATORY AGENTS      02239944       TROMETHAMINE       N    KETOROLAC TROMETHAMINE          30 MG / ML   INJECTION                                SDZ        W            7.50%          N      4.0000               REGULAR BENEFIT
                                               1

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02230201       NOVO-KETOROLAC     Y    KETOROLAC TROMETHAMINE          10 MG        ORAL              TABLET                 TEV        B                           Y      0.4085    0.4085     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02229080       APO-KETOROLAC      Y    KETOROLAC TROMETHAMINE          10 MG        ORAL              TABLET                 APX        B                           Y      0.4085    0.4085     REGULAR BENEFIT
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02162660       TORADOL            Y    KETOROLAC TROMETHAMINE          10 MG        ORAL              TABLET                 HLR        W            7.50%          N      0.6922    0.4085     REGULAR BENEFIT
                                               3




                                                                                                            Updated July 1, 2012                                                                                                      Page 92 of 254
                                                                                 Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                              (Regular Benefits)


                                                                                                                                                                       DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION       DIN / PIN         PRODUCT NAME   IC              GENERIC NAME          STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02229452       MEFENAMIC          N    MEFENAMIC ACID                  250 MG      ORAL               CAPSULE                AAP        W            7.50%          N      0.4988               REGULAR BENEFIT
                                               1

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02343282       NABUMETONE         Y    NABUMETONE                      500 MG      ORAL               TABLET                 SNS        W                           Y      0.3625    0.3625     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02244563       MYLAN-NABUMETONE   Y    NABUMETONE                      500 MG      ORAL               TABLET                 MYP        W                           Y      0.3625    0.3625     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02240867       NOVO-NABUMETONE    Y    NABUMETONE                      500 MG      ORAL               TABLET                 TEV        B                           Y      0.3625    0.3625     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02238639       APO-NABUMETONE     Y    NABUMETONE                      500 MG      ORAL               TABLET                 APX        B                           Y      0.3625    0.3625     REGULAR BENEFIT
                                               4

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                       ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02365847       AVA-NAPROXEN EC    Y    NAPROXEN                        250 MG      ORAL               TABLET                 AVA        W                           Y      0.1570    0.1570     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                       ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02350785       NAPROXEN EC        Y    NAPROXEN                        250 MG      ORAL               TABLET                 SNS        W                           Y      0.1570    0.1570     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                       ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02243312       TEVA-NAPROX EC     Y    NAPROXEN                        250 MG      ORAL               TABLET                 TEV        B                           Y      0.1570    0.1570     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                       ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02246699       APO-NAPROXEN EC    Y    NAPROXEN                        250 MG      ORAL               TABLET                 APX        B                           Y      0.1570    0.1570     REGULAR BENEFIT
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                       ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02162792       NAPROSYN E         Y    NAPROXEN                        250 MG      ORAL               TABLET                 HLR        W            7.50%          N      0.4174    0.1570     REGULAR BENEFIT
                                               5




                                                                                                            Updated July 1, 2012                                                                                                      Page 93 of 254
                                                                                 Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                              (Regular Benefits)


                                                                                                                                                                       DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION       DIN / PIN         PRODUCT NAME    IC              GENERIC NAME         STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                       ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02365855       AVA-NAPROXEN EC     Y    NAPROXEN                       375 MG      ORAL               TABLET                 AVA        W                           Y      0.2062    0.1458     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                       ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02350793       NAPROXEN EC         Y    NAPROXEN                       375 MG      ORAL               TABLET                 SNS        W                           Y      0.2062    0.1458     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                       ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02243432       MYLAN-NAPROXEN EC   Y    NAPROXEN                       375 MG      ORAL               TABLET                 MYP        W                           Y      0.2062    0.1458     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                       ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02243313       TEVA-NAPROX EC      Y    NAPROXEN                       375 MG      ORAL               TABLET                 TEV        B                           Y      0.2062    0.1458     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                       ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02246700       APO-NAPROXEN EC     Y    NAPROXEN                       375 MG      ORAL               TABLET                 APX        B                           Y      0.2062    0.1458     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                       ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02294702       PMS-NAPROXEN EC     Y    NAPROXEN                       375 MG      ORAL               TABLET                 PMS        B                           Y      0.2062    0.1458     REGULAR BENEFIT
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                       ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02162415       NAPROSYN E          Y    NAPROXEN                       375 MG      ORAL               TABLET                 HLR        W            7.50%          N      0.5479    0.1458     REGULAR BENEFIT
                                               7

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                       ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02365863       AVA-NAPROXEN EC     Y    NAPROXEN                       500 MG      ORAL               TABLET                 AVA        W                           Y      0.3718    0.2110     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                       ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02350807       NAPROXEN EC         Y    NAPROXEN                       500 MG      ORAL               TABLET                 SNS        W                           Y      0.3718    0.2110     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                       ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02241024       MYLAN-NAPROXEN EC   Y    NAPROXEN                       500 MG      ORAL               TABLET                 MYP        W                           Y      0.3718    0.2110     REGULAR BENEFIT




                                                                                                            Updated July 1, 2012                                                                                                      Page 94 of 254
                                                                                Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                             (Regular Benefits)


                                                                                                                                                                      DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION       DIN / PIN         PRODUCT NAME   IC              GENERIC NAME         STRENGTH           ROUTE               FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                      ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02243314       TEVA-NAPROX EC     Y    NAPROXEN                       500 MG       ORAL              TABLET                 TEV        B                           Y      0.3718    0.2110     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                      ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02294710       PMS-NAPROXEN EC    Y    NAPROXEN                       500 MG       ORAL              TABLET                 PMS        B                           Y      0.3718    0.2110     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                      ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02246701       APO-NAPROXEN EC    Y    NAPROXEN                       500 MG       ORAL              TABLET                 APX        B                           Y      0.3718    0.2110     REGULAR BENEFIT
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                      ENTERIC-COATED
28080492   INFLAMMATORY AGENTS      02162423       NAPROSYN E         Y    NAPROXEN                       500 MG       ORAL              TABLET                 HLR        W            7.50%          N      0.9882    0.2110     REGULAR BENEFIT
                                               7
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-                                                                                                      SUSTAINED-
28080492   INFLAMMATORY AGENTS      02162466       NAPROSYN SR        N    NAPROXEN                       750 MG       ORAL              RELEASE TABLET         HLR        W            7.50%          N      1.3211    0.2916     REGULAR BENEFIT
                                               1
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02162431       NAPROSYN           N    NAPROXEN                       25 MG / ML   ORAL              SUSPENSION             HLR        W            7.50%          N      0.0626               REGULAR BENEFIT
                                               1
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00522678       APO-NAPROXEN       N    NAPROXEN                       125 MG       ORAL              TABLET                 APX        B                           N      0.0781               REGULAR BENEFIT
                                               1

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02350750       NAPROXEN           Y    NAPROXEN                       250 MG       ORAL              TABLET                 SNS        W                           Y      0.1068    0.1068     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00522651       APO-NAPROXEN       Y    NAPROXEN                       250 MG       ORAL              TABLET                 APX        B                           Y      0.1068    0.1068     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00565350       TEVA-NAPROX        Y    NAPROXEN                       250 MG       ORAL              TABLET                 TEV        B                           Y      0.1068    0.1068     REGULAR BENEFIT
                                               3




                                                                                                           Updated July 1, 2012                                                                                                      Page 95 of 254
                                                                                 Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                              (Regular Benefits)


                                                                                                                                                                       DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION       DIN / PIN         PRODUCT NAME   IC              GENERIC NAME          STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02365820       AVA-NAPROXEN       Y    NAPROXEN                        375 MG      ORAL               TABLET                 AVA        W                           Y      0.1458    0.1458     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02350769       NAPROXEN           Y    NAPROXEN                        375 MG      ORAL               TABLET                 SNS        W                           Y      0.1458    0.1458     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00600806       APO-NAPROXEN       Y    NAPROXEN                        375 MG      ORAL               TABLET                 APX        B                           Y      0.1458    0.1458     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00627097       TEVA-NAPROX        Y    NAPROXEN                        375 MG      ORAL               TABLET                 TEV        B                           Y      0.1458    0.1458     REGULAR BENEFIT
                                               4

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02365839       AVA-NAPROXEN       Y    NAPROXEN                        500 MG      ORAL               TABLET                 AVA        W                           Y      0.2110    0.2110     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02350777       NAPROXEN           Y    NAPROXEN                        500 MG      ORAL               TABLET                 SNS        W                           Y      0.2110    0.2110     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00589861       TEVA-NAPROX        Y    NAPROXEN                        500 MG      ORAL               TABLET                 TEV        B                           Y      0.2110    0.2110     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00592277       APO-NAPROXEN       Y    NAPROXEN                        500 MG      ORAL               TABLET                 APX        B                           Y      0.2110    0.2110     REGULAR BENEFIT
                                               4
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02017237       PMS-NAPROXEN       N    NAPROXEN                        500 MG      RECTAL             SUPPOSITORY            PMS        B                           N      0.8883               REGULAR BENEFIT
                                               1

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00784354       APO-NAPRO-NA       Y    NAPROXEN SODIUM                 275 MG      ORAL               TABLET                 APX        B                           Y      0.3422    0.3422     REGULAR BENEFIT




                                                                                                            Updated July 1, 2012                                                                                                      Page 96 of 254
                                                                                      Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                   (Regular Benefits)


                                                                                                                                                                            DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION       DIN / PIN         PRODUCT NAME        IC               GENERIC NAME         STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00778389       TEVA-NAPROX SODIUM      Y    NAPROXEN SODIUM                 275 MG      ORAL               TABLET                 TEV        B                           Y      0.3422    0.3422     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02351013       NAPROXEN SODIUM         Y    NAPROXEN SODIUM                 275 MG      ORAL               TABLET                 SNS        W                           Y      0.3422    0.3422     REGULAR BENEFIT
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02162725       ANAPROX                 Y    NAPROXEN SODIUM                 275 MG      ORAL               TABLET                 HLR        W            7.50%          N      0.6239    0.3422     REGULAR BENEFIT
                                               4

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02026600       TEVA-NAPROX SODIUM DS   Y    NAPROXEN SODIUM                 550 MG      ORAL               TABLET                 TEV        B                           Y      0.6667    0.6667     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      01940309       APO-NAPRO-NA DS         Y    NAPROXEN SODIUM                 550 MG      ORAL               TABLET                 APX        B                           Y      0.6667    0.6667     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02351021       NAPROXEN SODIUM DS      Y    NAPROXEN SODIUM                 550 MG      ORAL               TABLET                 SNS        W                           Y      0.6667    0.6667     REGULAR BENEFIT
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02162717       ANAPROX DS              Y    NAPROXEN SODIUM                 550 MG      ORAL               TABLET                 HLR        W            7.50%          N      1.2012    0.6667     REGULAR BENEFIT
                                               4

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00642886       APO-PIROXICAM           Y    PIROXICAM                       10 MG       ORAL               CAPSULE                APX        B                           Y      0.3210    0.3210     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00695718       NOVO-PIROCAM            Y    PIROXICAM                       10 MG       ORAL               CAPSULE                TEV        B                           Y      0.3210    0.3210     REGULAR BENEFIT
                                               2

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00642894       APO-PIROXICAM           Y    PIROXICAM                       20 MG       ORAL               CAPSULE                APX        B                           Y      0.5195    0.5195     REGULAR BENEFIT




                                                                                                                 Updated July 1, 2012                                                                                                      Page 97 of 254
                                                                                 Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                              (Regular Benefits)


                                                                                                                                                                       DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION       DIN / PIN         PRODUCT NAME   IC               GENERIC NAME         STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00695696       NOVO-PIROCAM       Y    PIROXICAM                       20 MG       ORAL               CAPSULE                TEV        B                           Y      0.5195    0.5195     REGULAR BENEFIT
                                               2
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02154463       PMS-PIROXICAM      N    PIROXICAM                       20 MG       RECTAL             SUPPOSITORY            PMS        B                           N      2.0580               REGULAR BENEFIT
                                               1

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00745588       NOVO-SUNDAC        Y    SULINDAC                        150 MG      ORAL               TABLET                 TEV        B                           Y      0.3824    0.3824     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00778354       APO-SULIN          Y    SULINDAC                        150 MG      ORAL               TABLET                 APX        B                           Y      0.3824    0.3824     REGULAR BENEFIT
                                               2

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00778362       APO-SULIN          Y    SULINDAC                        200 MG      ORAL               TABLET                 APX        B                           Y      0.3920    0.3920     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      00745596       NOVO-SUNDAC        Y    SULINDAC                        200 MG      ORAL               TABLET                 TEV        B                           Y      0.3920    0.3920     REGULAR BENEFIT
                                               2
           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02230661       TENOXICAM          N    TENOXICAM                       20 MG       ORAL               TABLET                 AAP        W            7.50%          N      1.1552               REGULAR BENEFIT
                                               1

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02136112       APO-TIAPROFENIC    Y    TIAPROFENIC ACID                200 MG      ORAL               TABLET                 APX        B                           Y      0.3437    0.3437     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02179679       NOVO-TIAPROFENIC   Y    TIAPROFENIC ACID                200 MG      ORAL               TABLET                 TEV        B                           Y      0.3437    0.3437     REGULAR BENEFIT
                                               2




                                                                                                            Updated July 1, 2012                                                                                                      Page 98 of 254
                                                                                      Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                   (Regular Benefits)


                                                                                                                                                                            DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC           PTC DESCRIPTION      DIN / PIN           PRODUCT NAME     IC            GENERIC NAME              STRENGTH            ROUTE             FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02136120       APO-TIAPROFENIC        Y    TIAPROFENIC ACID                  300 MG        ORAL            TABLET                 APX        B                           Y      0.3257    0.3257     REGULAR BENEFIT

           NONSTEROIDAL ANTI-
           INFLAMMATORY AGENTS /
           OTHER NONSTEROIDAL ANTI-
28080492   INFLAMMATORY AGENTS      02179687       NOVO-TIAPROFENIC       Y    TIAPROFENIC ACID                  300 MG        ORAL            TABLET                 TEV        B                           Y      0.3257    0.3257     REGULAR BENEFIT
                                               2
                                                                               ASA/ CODEINE PHOSPHATE/ CAFFEINE 375 MG * 15
280808     OPIATE AGONISTS /        02234510       282                    N    CITRATE                          MG * 30 MG     ORAL            TABLET                 PPH        W            7.50%          N      0.0683               REGULAR BENEFIT
                                               1
                                                                                                                 50 MG * 15
                                                                               BUTALBITAL/ CODEINE PHOSPHATE/    MG * 330 MG
280808     OPIATE AGONISTS /        00608203       RATIO-TECNAL-C 1/4     Y    ASA/ CAFFEINE                     * 40 MG     ORAL              CAPSULE                RPH        B                           Y      1.1051    1.1051     REGULAR BENEFIT
                                                                                                                 50 MG * 15
                                                                               BUTALBITAL/ CODEINE PHOSPHATE/    MG * 330 MG
280808     OPIATE AGONISTS /        00176192       FIORINAL-C 1/4         Y    ASA/ CAFFEINE                     * 40 MG       ORAL            CAPSULE                NOV        W            7.50%          N      1.6274    1.1051     REGULAR BENEFIT
                                               2
                                                                                                                 50 MG * 30
                                                                               BUTALBITAL/ CODEINE PHOSPHATE/    MG * 330 MG
280808     OPIATE AGONISTS /        00608181       RATIO-TECNAL-C 1/2     Y    ASA/ CAFFEINE                     * 40 MG     ORAL              CAPSULE                RPH        B                           Y      1.3532    1.3532     REGULAR BENEFIT
                                                                                                                 50 MG * 30
                                                                               BUTALBITAL/ CODEINE PHOSPHATE/    MG * 330 MG
280808     OPIATE AGONISTS /        00176206       FIORINAL-C 1/2         Y    ASA/ CAFFEINE                     * 40 MG       ORAL            CAPSULE                NOV        W            7.50%          N      1.9928    1.3532     REGULAR BENEFIT
                                               2

280808     OPIATE AGONISTS /        00544884       CODEINE PHOSPHATE      N    CODEINE PHOSPHATE                 30 MG / ML    INJECTION                              SDZ        W            7.50%          N      1.3116               REGULAR BENEFIT
                                               1

280808     OPIATE AGONISTS /        00593435       RATIO-CODEINE          N    CODEINE PHOSPHATE                 15 MG         ORAL            TABLET                 RPH        B                           N      0.0765               REGULAR BENEFIT
                                               1

280808     OPIATE AGONISTS /        00593451       RATIO-CODEINE          N    CODEINE PHOSPHATE                 30 MG         ORAL            TABLET                 RPH        B                           N      0.1284               REGULAR BENEFIT
                                               1
                                                                               CODEINE PHOSPHATE/                1.6 MG / ML *
280808     OPIATE AGONISTS /        02163942       TYLENOL WITH CODEINE   N    ACETAMINOPHEN                     32 MG / ML    ORAL            ELIXIR                 JAI        W            7.50%          N      0.1043               REGULAR BENEFIT
                                               1
                                                                               CODEINE PHOSPHATE/                30 MG * 300
280808     OPIATE AGONISTS /        00608882       RATIO-EMTEC-30         N    ACETAMINOPHEN                     MG            ORAL            TABLET                 RPH        B                           N      0.1616               REGULAR BENEFIT
                                               1
                                                                               CODEINE PHOSPHATE/                60 MG * 300
280808     OPIATE AGONISTS /        00621463       RATIO-LENOLTEC NO.4    Y    ACETAMINOPHEN                     MG            ORAL            TABLET                 RPH        B                           Y      0.1685    0.1685     REGULAR BENEFIT
                                                                               CODEINE PHOSPHATE/                60 MG * 300
280808     OPIATE AGONISTS /        02163918       TYLENOL NO. 4          Y    ACETAMINOPHEN                     MG            ORAL            TABLET                 JAI        W            7.50%          N      0.1877    0.1685     REGULAR BENEFIT
                                               2
                                                                               CODEINE PHOSPHATE/                15 MG * 300
280808     OPIATE AGONISTS /        00653241       RATIO-LENOLTEC NO.2    Y    ACETAMINOPHEN/ CAFFEINE           MG * 15 MG    ORAL            TABLET                 RPH        B                           Y      0.0807    0.0807     REGULAR BENEFIT




                                                                                                                  Updated July 1, 2012                                                                                                     Page 99 of 254
                                                                                     Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                  (Regular Benefits)


                                                                                                                                                                           DISTRIBUTION   DISTRIBUTION     LCA               LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION   DIN / PIN            PRODUCT NAME        IC            GENERIC NAME              STRENGTH            ROUTE             FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE       PRICE         STATUS
                                                                              CODEINE PHOSPHATE/                15 MG * 300
280808   OPIATE AGONISTS /      02163934       TYLENOL NO. 2             Y    ACETAMINOPHEN/ CAFFEINE           MG * 15 MG    ORAL            TABLET                 JAI        W            7.50%          Y      0.0807     0.0807     REGULAR BENEFIT
                                           2
                                                                              CODEINE PHOSPHATE/                30 MG * 300
280808   OPIATE AGONISTS /      00653276       RATIO-LENOLTEC NO.3       Y    ACETAMINOPHEN/ CAFFEINE           MG * 15 MG    ORAL            TABLET                 RPH        B                           Y      0.0798     0.0798     REGULAR BENEFIT
                                                                              CODEINE PHOSPHATE/                30 MG * 300
280808   OPIATE AGONISTS /      02163926       TYLENOL NO. 3             Y    ACETAMINOPHEN/ CAFFEINE           MG * 15 MG    ORAL            TABLET                 JAI        W            7.50%          N      0.0888     0.0798     REGULAR BENEFIT
                                           2
                                                                              CODEINE PHOSPHATE/ ASA/ CAFFEINE 30 MG * 375
280808   OPIATE AGONISTS /      02238645       292                       N    CITRATE                          MG * 30 MG     ORAL            TABLET                 PPH        W            7.50%          N      0.1766                REGULAR BENEFIT
                                           1
                                                                                                                15 MG * 350
                                                                              CODEINE PHOSPHATE/ ASA/           MG * 200 MG
280808   OPIATE AGONISTS /      02238646       282 MEP                   N    MEPROBAMATE/ CAFFEINE CITRATE     * 30 MG       ORAL            TABLET                 PPH        W            7.50%          N      0.2205                REGULAR BENEFIT
                                           1
                                               COMPOUND NARCOTIC
                                               MIXTURES - ORAL AND
280808   OPIATE AGONISTS /      00999208       INJECTION                 Y    COMPOUND PRESCRIPTION                                                                  XXX        B                           Y      0.0000                REGULAR BENEFIT
                                           1
                                               COMPOUND NARCOTIC
                                               MIXTURES - ORAL AND
280808   OPIATE AGONISTS /      00999108       INJECTION                 Y    COMPOUND PRESCRIPTION                                                                  XXX        B                           Y      0.0000                REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      02085895       DILAUDID STERILE POWDER   N    HYDROMORPHONE HCL                 250 MG / VIAL INJECTION                              PUR        W            7.50%          N      70.1425               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      02145901       HYDROMORPHONE             Y    HYDROMORPHONE HCL                 2 MG / ML     INJECTION                              SDZ        W                           Y      0.9450     0.9450     REGULAR BENEFIT

280808   OPIATE AGONISTS /      00627100       DILAUDID                  Y    HYDROMORPHONE HCL                 2 MG / ML     INJECTION                              PUR        W            7.50%          N      1.1400     0.9450     REGULAR BENEFIT
                                           2

280808   OPIATE AGONISTS /      02145928       HYDROMORPHONE HP          Y    HYDROMORPHONE HCL                 10 MG / ML    INJECTION                              SDZ        B                           Y      2.3380     2.3380     REGULAR BENEFIT

280808   OPIATE AGONISTS /      00622133       DILAUDID-HP               Y    HYDROMORPHONE HCL                 10 MG / ML    INJECTION                              PUR        W            7.50%          N      2.7900     2.3380     REGULAR BENEFIT
                                           2

280808   OPIATE AGONISTS /      02145936       HYDROMORPHONE HP 20       N    HYDROMORPHONE HCL                 20 MG / ML    INJECTION                              SDZ        W                           N      4.5100                REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      02146126       HYDROMORPHONE HP 50       N    HYDROMORPHONE HCL                 50 MG / ML    INJECTION                              SDZ        W                           N      13.1500               REGULAR BENEFIT
                                           1
                                                                                                                                              CONTROLLED-
280808   OPIATE AGONISTS /      02125323       HYDROMORPH CONTIN         N    HYDROMORPHONE HCL                 3 MG          ORAL            RELEASE CAPSULE        PUR        W            7.50%          N      0.6745                REGULAR BENEFIT
                                           1
                                                                                                                                              CONTROLLED-
280808   OPIATE AGONISTS /      02359502       HYDROMORPH CONTIN         N    HYDROMORPHONE HCL                 4.5 MG        ORAL            RELEASE CAPSULE        PUR        W            7.50%          N      0.8140                REGULAR BENEFIT
                                           1




                                                                                                                 Updated July 1, 2012                                                                                                     Page 100 of 254
                                                                              Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                           (Regular Benefits)


                                                                                                                                                                    DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION   DIN / PIN           PRODUCT NAME    IC           GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                                                                                                                       CONTROLLED-
280808   OPIATE AGONISTS /      02125331       HYDROMORPH CONTIN    N    HYDROMORPHONE HCL              6 MG        ORAL               RELEASE CAPSULE        PUR        W            7.50%          N      1.0115               REGULAR BENEFIT
                                           1
                                                                                                                                       CONTROLLED-
280808   OPIATE AGONISTS /      02359510       HYDROMORPH CONTIN    N    HYDROMORPHONE HCL              9 MG        ORAL               RELEASE CAPSULE        PUR        W            7.50%          N      1.3340               REGULAR BENEFIT
                                           1
                                                                                                                                       CONTROLLED-
280808   OPIATE AGONISTS /      02125366       HYDROMORPH CONTIN    N    HYDROMORPHONE HCL              12 MG       ORAL               RELEASE CAPSULE        PUR        W            7.50%          N      1.7530               REGULAR BENEFIT
                                           1
                                                                                                                                       CONTROLLED-
280808   OPIATE AGONISTS /      02243562       HYDROMORPH CONTIN    N    HYDROMORPHONE HCL              18 MG       ORAL               RELEASE CAPSULE        PUR        W            7.50%          N      2.5290               REGULAR BENEFIT
                                           1
                                                                                                                                       CONTROLLED-
280808   OPIATE AGONISTS /      02125382       HYDROMORPH CONTIN    N    HYDROMORPHONE HCL              24 MG       ORAL               RELEASE CAPSULE        PUR        W            7.50%          N      3.2365               REGULAR BENEFIT
                                           1
                                                                                                                                       CONTROLLED-
280808   OPIATE AGONISTS /      02125390       HYDROMORPH CONTIN    N    HYDROMORPHONE HCL              30 MG       ORAL               RELEASE CAPSULE        PUR        W            7.50%          N      3.8775               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      01916386       PMS-HYDROMORPHONE    Y    HYDROMORPHONE HCL              1 MG / ML   ORAL               LIQUID                 PMS        B                           Y      0.0665    0.0665     REGULAR BENEFIT

280808   OPIATE AGONISTS /      00786535       DILAUDID             Y    HYDROMORPHONE HCL              1 MG / ML   ORAL               LIQUID                 PUR        W            7.50%          N      0.0792    0.0665     REGULAR BENEFIT
                                           2

280808   OPIATE AGONISTS /      00885444       PMS-HYDROMORPHONE    Y    HYDROMORPHONE HCL              1 MG        ORAL               TABLET                 PMS        B                           Y      0.0959    0.0959     REGULAR BENEFIT

280808   OPIATE AGONISTS /      02319403       TEVA-HYDROMORPHONE   Y    HYDROMORPHONE HCL              1 MG        ORAL               TABLET                 TEV        B                           Y      0.0959    0.0959     REGULAR BENEFIT

280808   OPIATE AGONISTS /      02364115       APO-HYDROMORPHONE    Y    HYDROMORPHONE HCL              1 MG        ORAL               TABLET                 APX        B                           Y      0.0959    0.0959     REGULAR BENEFIT

280808   OPIATE AGONISTS /      00705438       DILAUDID             Y    HYDROMORPHONE HCL              1 MG        ORAL               TABLET                 PUR        W            7.50%          Y      0.0959    0.0959     REGULAR BENEFIT
                                           4

280808   OPIATE AGONISTS /      02319411       TEVA-HYDROMORPHONE   Y    HYDROMORPHONE HCL              2 MG        ORAL               TABLET                 TEV        B                           Y      0.1416    0.1416     REGULAR BENEFIT

280808   OPIATE AGONISTS /      02364123       APO-HYDROMORPHONE    Y    HYDROMORPHONE HCL              2 MG        ORAL               TABLET                 APX        B                           N      0.1417    0.1416     REGULAR BENEFIT

280808   OPIATE AGONISTS /      00125083       DILAUDID             Y    HYDROMORPHONE HCL              2 MG        ORAL               TABLET                 PUR        W            7.50%          N      0.1417    0.1416     REGULAR BENEFIT

280808   OPIATE AGONISTS /      00885436       PMS-HYDROMORPHONE    Y    HYDROMORPHONE HCL              2 MG        ORAL               TABLET                 PMS        B                           N      0.1417    0.1416     REGULAR BENEFIT
                                           4

280808   OPIATE AGONISTS /      02319438       TEVA-HYDROMORPHONE   Y    HYDROMORPHONE HCL              4 MG        ORAL               TABLET                 TEV        B                           Y      0.2240    0.2240     REGULAR BENEFIT

280808   OPIATE AGONISTS /      02364131       APO-HYDROMORPHONE    Y    HYDROMORPHONE HCL              4 MG        ORAL               TABLET                 APX        B                           Y      0.2240    0.2240     REGULAR BENEFIT

280808   OPIATE AGONISTS /      00125121       DILAUDID             Y    HYDROMORPHONE HCL              4 MG        ORAL               TABLET                 PUR        W            7.50%          Y      0.2240    0.2240     REGULAR BENEFIT

280808   OPIATE AGONISTS /      00885401       PMS-HYDROMORPHONE    Y    HYDROMORPHONE HCL              4 MG        ORAL               TABLET                 PMS        B                           Y      0.2240    0.2240     REGULAR BENEFIT
                                           4




                                                                                                         Updated July 1, 2012                                                                                                     Page 101 of 254
                                                                                Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                             (Regular Benefits)


                                                                                                                                                                      DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION   DIN / PIN           PRODUCT NAME     IC            GENERIC NAME            STRENGTH            ROUTE              FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

280808   OPIATE AGONISTS /      00786543       DILAUDID              Y    HYDROMORPHONE HCL               8 MG          ORAL             TABLET                 PUR        W            7.50%          Y      0.3528    0.3528     REGULAR BENEFIT

280808   OPIATE AGONISTS /      02319446       TEVA-HYDROMORPHONE    Y    HYDROMORPHONE HCL               8 MG          ORAL             TABLET                 TEV        B                           Y      0.3528    0.3528     REGULAR BENEFIT

280808   OPIATE AGONISTS /      02364158       APO-HYDROMORPHONE     Y    HYDROMORPHONE HCL               8 MG          ORAL             TABLET                 APX        B                           Y      0.3528    0.3528     REGULAR BENEFIT

280808   OPIATE AGONISTS /      00885428       PMS-HYDROMORPHONE     Y    HYDROMORPHONE HCL               8 MG          ORAL             TABLET                 PMS        B                           Y      0.3528    0.3528     REGULAR BENEFIT
                                           4

280808   OPIATE AGONISTS /      01916394       PMS-HYDROMORPHONE     N    HYDROMORPHONE HCL               3 MG          RECTAL           SUPPOSITORY            PMS        B                           N      2.9640               REGULAR BENEFIT
                                           1
                                               MEPERIDINE
280808   OPIATE AGONISTS /      00725765       HYDROCHLORIDE         N    MEPERIDINE HCL                  50 MG / ML    INJECTION                               SDZ        W            7.50%          N      0.8930               REGULAR BENEFIT
                                           1
                                               MEPERIDINE
280808   OPIATE AGONISTS /      00725757       HYDROCHLORIDE         N    MEPERIDINE HCL                  75 MG / ML    INJECTION                               SDZ        W            7.50%          N      0.9395               REGULAR BENEFIT
                                           1
                                               MEPERIDINE
280808   OPIATE AGONISTS /      00725749       HYDROCHLORIDE         N    MEPERIDINE HCL                  100 MG / ML   INJECTION                               SDZ        W            7.50%          N      0.9953               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      02138018       DEMEROL               N    MEPERIDINE HCL                  50 MG         ORAL             TABLET                 SAV        W            7.50%          N      0.1503               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      00999995       METHADONE             N    METHADONE COMPOUND                            ORAL             LIQUID                 XXX        B                           Y      0.0000               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      02241377       METADOL CONCENTRATE   N    METHADONE HCL                   10 MG / ML    ORAL             LIQUID                 PAL        B                           N      0.3676               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      02247694       METADOL               N    METHADONE HCL                   1 MG / ML     ORAL             SOLUTION               PAL        B                           N      0.1017               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      02247698       METADOL               N    METHADONE HCL                   1 MG          ORAL             TABLET                 PAL        B                           N      0.1689               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      02247699       METADOL               N    METHADONE HCL                   5 MG          ORAL             TABLET                 PAL        B                           N      0.5627               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      02247700       METADOL               N    METHADONE HCL                   10 MG         ORAL             TABLET                 PAL        B                           N      0.9003               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      02247701       METADOL               N    METHADONE HCL                   25 MG         ORAL             TABLET                 PAL        B                           N      1.6879               REGULAR BENEFIT
                                           1
                                                                                                                                         SUSTAINED-
280808   OPIATE AGONISTS /      00776181       M.O.S.-SR             N    MORPHINE HCL                    30 MG         ORAL             RELEASE TABLET         VCL        W            7.50%          N      0.4614               REGULAR BENEFIT
                                           1




                                                                                                           Updated July 1, 2012                                                                                                     Page 102 of 254
                                                                                 Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                              (Regular Benefits)


                                                                                                                                                                       DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION   DIN / PIN           PRODUCT NAME      IC           GENERIC NAME             STRENGTH            ROUTE             FORM           MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                                                                                                                          SUSTAINED-
280808   OPIATE AGONISTS /      00776203       M.O.S.-SR              N    MORPHINE HCL                    60 MG         ORAL             RELEASE TABLET         VCL        W            7.50%          N      0.8134               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      00607762       RATIO-MORPHINE         N    MORPHINE HCL                    1 MG / ML     ORAL             SYRUP                  RPH        B                           N      0.0151               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      00607770       RATIO-MORPHINE         N    MORPHINE HCL                    5 MG / ML     ORAL             SYRUP                  RPH        B                           N      0.0602               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      00690783       RATIO-MORPHINE         N    MORPHINE HCL                    10 MG / ML    ORAL             SYRUP                  RPH        B                           N      0.1931               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      00690791       RATIO-MORPHINE         N    MORPHINE HCL                    20 MG / ML    ORAL             SYRUP                  RPH        B                           N      0.5489               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      02021056       MORPHINE LP EPIDURAL   N    MORPHINE SULFATE                0.5 MG / ML   INJECTION                               SDZ        W            7.50%          N      1.0623               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      02021048       MORPHINE LP EPIDURAL   N    MORPHINE SULFATE                1 MG / ML     INJECTION                               SDZ        W            7.50%          N      2.1247               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      00392588       MORPHINE SULFATE       N    MORPHINE SULFATE                10 MG / ML    INJECTION                               SDZ        W            7.50%          N      0.9209               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      00392561       MORPHINE SULFATE       N    MORPHINE SULFATE                15 MG / ML    INJECTION                               SDZ        W            7.50%          N      0.9349               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      00676411       MORPHINE HP 25         N    MORPHINE SULFATE                25 MG / ML    INJECTION                               SDZ        W            7.50%          N      2.6884               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      00617288       MORPHINE HP 50         N    MORPHINE SULFATE                50 MG / ML    INJECTION                               SDZ        W            7.50%          N      3.7116               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      00621935       STATEX                 N    MORPHINE SULFATE                20 MG / ML    ORAL             DROPS                  PAL        B                           N      0.4980               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      00705799       STATEX                 N    MORPHINE SULFATE                50 MG / ML    ORAL             DROPS                  PAL        B                           N      0.9464               REGULAR BENEFIT
                                           1
                                                                                                                                          EXTENDED-RELEASE
280808   OPIATE AGONISTS /      02019930       M-ESLON                N    MORPHINE SULFATE                10 MG         ORAL             CAPSULE                ETP        W            7.50%          N      0.2984               REGULAR BENEFIT
                                           1
                                                                                                                                          EXTENDED-RELEASE
280808   OPIATE AGONISTS /      02177749       M-ESLON                N    MORPHINE SULFATE                15 MG         ORAL             CAPSULE                ETP        W            7.50%          N      0.3447               REGULAR BENEFIT
                                           1
                                                                                                                                          EXTENDED-RELEASE
280808   OPIATE AGONISTS /      02019949       M-ESLON                N    MORPHINE SULFATE                30 MG         ORAL             CAPSULE                ETP        W            7.50%          N      0.5145               REGULAR BENEFIT
                                           1




                                                                                                            Updated July 1, 2012                                                                                                     Page 103 of 254
                                                                               Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                            (Regular Benefits)


                                                                                                                                                                     DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION   DIN / PIN          PRODUCT NAME     IC           GENERIC NAME             STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                                                                                                                        EXTENDED-RELEASE
280808   OPIATE AGONISTS /      02019957       M-ESLON              N    MORPHINE SULFATE                60 MG       ORAL               CAPSULE                ETP        W            7.50%          N      0.9132               REGULAR BENEFIT
                                           1
                                                                                                                                        EXTENDED-RELEASE
280808   OPIATE AGONISTS /      02019965       M-ESLON              N    MORPHINE SULFATE                100 MG      ORAL               CAPSULE                ETP        W            7.50%          N      1.9654               REGULAR BENEFIT
                                           1
                                                                                                                                        EXTENDED-RELEASE
280808   OPIATE AGONISTS /      02177757       M-ESLON              N    MORPHINE SULFATE                200 MG      ORAL               CAPSULE                ETP        W            7.50%          N      3.9306               REGULAR BENEFIT
                                           1
                                                                                                                                        SUSTAINED-
280808   OPIATE AGONISTS /      02242163       KADIAN               N    MORPHINE SULFATE                10 MG       ORAL               RELEASE CAPSULE        ABB        B                           N      0.3680               REGULAR BENEFIT
                                           1
                                                                                                                                        SUSTAINED-
280808   OPIATE AGONISTS /      02184435       KADIAN               N    MORPHINE SULFATE                20 MG       ORAL               RELEASE CAPSULE        ABB        B                           N      0.7151               REGULAR BENEFIT
                                           1
                                                                                                                                        SUSTAINED-
280808   OPIATE AGONISTS /      02184443       KADIAN               N    MORPHINE SULFATE                50 MG       ORAL               RELEASE CAPSULE        ABB        B                           N      1.3145               REGULAR BENEFIT
                                           1
                                                                                                                                        SUSTAINED-
280808   OPIATE AGONISTS /      02184451       KADIAN               N    MORPHINE SULFATE                100 MG      ORAL               RELEASE CAPSULE        ABB        B                           N      2.2926               REGULAR BENEFIT
                                           1
                                                                                                                                        SUSTAINED-
280808   OPIATE AGONISTS /      02244790       SANDOZ MORPHINE SR   Y    MORPHINE SULFATE                15 MG       ORAL               RELEASE TABLET         SDZ        W                           Y      0.2559    0.2559     REGULAR BENEFIT
                                                                                                                                        SUSTAINED-
280808   OPIATE AGONISTS /      02350815       MORPHINE SR          Y    MORPHINE SULFATE                15 MG       ORAL               RELEASE TABLET         SNS        W                           Y      0.2559    0.2559     REGULAR BENEFIT
                                                                                                                                        SUSTAINED-
280808   OPIATE AGONISTS /      02302764       NOVO-MORPHINE SR     Y    MORPHINE SULFATE                15 MG       ORAL               RELEASE TABLET         TEV        B                           Y      0.2559    0.2559     REGULAR BENEFIT
                                                                                                                                        SUSTAINED-
280808   OPIATE AGONISTS /      02015439       MS CONTIN            Y    MORPHINE SULFATE                15 MG       ORAL               RELEASE TABLET         PUR        W            7.50%          N      0.6800    0.2559     REGULAR BENEFIT
                                           4
                                                                                                                                        SUSTAINED-
280808   OPIATE AGONISTS /      02244791       SANDOZ MORPHINE SR   Y    MORPHINE SULFATE                30 MG       ORAL               RELEASE TABLET         SDZ        W                           Y      0.3872    0.3872     REGULAR BENEFIT
                                                                                                                                        SUSTAINED-
280808   OPIATE AGONISTS /      02350890       MORPHINE SR          Y    MORPHINE SULFATE                30 MG       ORAL               RELEASE TABLET         SNS        W                           Y      0.3872    0.3872     REGULAR BENEFIT
                                                                                                                                        SUSTAINED-
280808   OPIATE AGONISTS /      02302772       NOVO-MORPHINE SR     Y    MORPHINE SULFATE                30 MG       ORAL               RELEASE TABLET         TEV        B                           Y      0.3872    0.3872     REGULAR BENEFIT
                                                                                                                                        SUSTAINED-
280808   OPIATE AGONISTS /      02014297       MS CONTIN            Y    MORPHINE SULFATE                30 MG       ORAL               RELEASE TABLET         PUR        W            7.50%          N      1.0290    0.3872     REGULAR BENEFIT
                                           4
                                                                                                                                        SUSTAINED-
280808   OPIATE AGONISTS /      02244792       SANDOZ MORPHINE SR   Y    MORPHINE SULFATE                60 MG       ORAL               RELEASE TABLET         SDZ        W                           Y      0.6822    0.6822     REGULAR BENEFIT
                                                                                                                                        SUSTAINED-
280808   OPIATE AGONISTS /      02350912       MORPHINE SR          Y    MORPHINE SULFATE                60 MG       ORAL               RELEASE TABLET         SNS        W                           Y      0.6822    0.6822     REGULAR BENEFIT
                                                                                                                                        SUSTAINED-
280808   OPIATE AGONISTS /      02302780       NOVO-MORPHINE SR     Y    MORPHINE SULFATE                60 MG       ORAL               RELEASE TABLET         TEV        B                           Y      0.6822    0.6822     REGULAR BENEFIT
                                                                                                                                        SUSTAINED-
280808   OPIATE AGONISTS /      02014300       MS CONTIN            Y    MORPHINE SULFATE                60 MG       ORAL               RELEASE TABLET         PUR        W            7.50%          N      1.8130    0.6822     REGULAR BENEFIT
                                           4
                                                                                                                                        SUSTAINED-
280808   OPIATE AGONISTS /      02350920       MORPHINE SR          Y    MORPHINE SULFATE                100 MG      ORAL               RELEASE TABLET         SNS        W                           Y      1.0400    1.0400     REGULAR BENEFIT




                                                                                                          Updated July 1, 2012                                                                                                     Page 104 of 254
                                                                                 Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                              (Regular Benefits)


                                                                                                                                                                       DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION   DIN / PIN              PRODUCT NAME   IC           GENERIC NAME             STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                                                                                                                          SUSTAINED-
280808   OPIATE AGONISTS /      02302799       NOVO-MORPHINE SR       Y    MORPHINE SULFATE                100 MG      ORAL               RELEASE TABLET         TEV        B                           Y      1.0400    1.0400     REGULAR BENEFIT
                                                                                                                                          SUSTAINED-
280808   OPIATE AGONISTS /      02014319       MS CONTIN              Y    MORPHINE SULFATE                100 MG      ORAL               RELEASE TABLET         PUR        W            7.50%          N      2.7640    1.0400     REGULAR BENEFIT
                                           3
                                                                                                                                          SUSTAINED-
280808   OPIATE AGONISTS /      02350947       MORPHINE SR            Y    MORPHINE SULFATE                200 MG      ORAL               RELEASE TABLET         SNS        W                           Y      1.9335    1.9335     REGULAR BENEFIT
                                                                                                                                          SUSTAINED-
280808   OPIATE AGONISTS /      02302802       NOVO-MORPHINE SR       Y    MORPHINE SULFATE                200 MG      ORAL               RELEASE TABLET         TEV        B                           Y      1.9335    1.9335     REGULAR BENEFIT
                                                                                                                                          SUSTAINED-
280808   OPIATE AGONISTS /      02014327       MS CONTIN              Y    MORPHINE SULFATE                200 MG      ORAL               RELEASE TABLET         PUR        W            7.50%          N      5.1390    1.9335     REGULAR BENEFIT
                                           3

280808   OPIATE AGONISTS /      00591467       STATEX                 N    MORPHINE SULFATE                1 MG / ML   ORAL               SYRUP                  PAL        B                           N      0.0200               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      00591475       STATEX                 N    MORPHINE SULFATE                5 MG / ML   ORAL               SYRUP                  PAL        B                           N      0.0803               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      00594652       STATEX                 Y    MORPHINE SULFATE                5 MG        ORAL               TABLET                 PAL        W            7.50%          N      0.1100    0.1182     REGULAR BENEFIT

280808   OPIATE AGONISTS /      02009773       M.O.S. SULFATE         Y    MORPHINE SULFATE                5 MG        ORAL               TABLET                 VCL        W            7.50%          N      0.1129    0.1182     REGULAR BENEFIT

280808   OPIATE AGONISTS /      02014203       MS.IR                  Y    MORPHINE SULFATE                5 MG        ORAL               TABLET                 PUR        W            7.50%          N      0.1240    0.1182     REGULAR BENEFIT
                                           3

280808   OPIATE AGONISTS /      00594644       STATEX                 Y    MORPHINE SULFATE                10 MG       ORAL               TABLET                 PAL        W            7.50%          N      0.1700    0.1828     REGULAR BENEFIT

280808   OPIATE AGONISTS /      02009765       M.O.S. SULFATE         Y    MORPHINE SULFATE                10 MG       ORAL               TABLET                 VCL        W            7.50%          N      0.1745    0.1828     REGULAR BENEFIT

280808   OPIATE AGONISTS /      02014211       MS.IR                  Y    MORPHINE SULFATE                10 MG       ORAL               TABLET                 PUR        W            7.50%          N      0.1930    0.1828     REGULAR BENEFIT
                                           3

280808   OPIATE AGONISTS /      02014238       MS.IR                  N    MORPHINE SULFATE                20 MG       ORAL               TABLET                 PUR        W            7.50%          N      0.3440               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      00594636       STATEX                 Y    MORPHINE SULFATE                25 MG       ORAL               TABLET                 PAL        W            7.50%          N      0.2250    0.2419     REGULAR BENEFIT

280808   OPIATE AGONISTS /      02009749       M.O.S. SULFATE         Y    MORPHINE SULFATE                25 MG       ORAL               TABLET                 VCL        W            7.50%          N      0.2309    0.2419     REGULAR BENEFIT
                                           2

280808   OPIATE AGONISTS /      02014254       MS.IR                  N    MORPHINE SULFATE                30 MG       ORAL               TABLET                 PUR        W            7.50%          N      0.4410               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      00675962       STATEX                 Y    MORPHINE SULFATE                50 MG       ORAL               TABLET                 PAL        W            7.50%          N      0.3450    0.3709     REGULAR BENEFIT

280808   OPIATE AGONISTS /      02009706       M.O.S. SULFATE         Y    MORPHINE SULFATE                50 MG       ORAL               TABLET                 VCL        W            7.50%          N      0.3541    0.3709     REGULAR BENEFIT
                                           2

280808   OPIATE AGONISTS /      00632228       STATEX                 N    MORPHINE SULFATE                5 MG        RECTAL             SUPPOSITORY            PAL        B                           N      1.6690               REGULAR BENEFIT




                                                                                                            Updated July 1, 2012                                                                                                     Page 105 of 254
                                                                             Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                          (Regular Benefits)


                                                                                                                                                                   DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION   DIN / PIN          PRODUCT NAME   IC            GENERIC NAME            STRENGTH           ROUTE             FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                           1

280808   OPIATE AGONISTS /      00632201       STATEX             N    MORPHINE SULFATE                10 MG        RECTAL            SUPPOSITORY            PAL        B                           N      1.8640               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      00596965       STATEX             N    MORPHINE SULFATE                20 MG        RECTAL            SUPPOSITORY            PAL        B                           N      2.2190               REGULAR BENEFIT
                                           1

280808   OPIATE AGONISTS /      00639389       STATEX             N    MORPHINE SULFATE                30 MG        RECTAL            SUPPOSITORY            PAL        B                           N      2.4340               REGULAR BENEFIT
                                           1
                                               SANDOZ OPIUM &                                          65 MG * 15
280808   OPIATE AGONISTS /      01901869       BELLADONNA         N    OPIUM/ BELLADONNA               MG           RECTAL            SUPPOSITORY            SDZ        W            7.50%          N      2.6791               REGULAR BENEFIT
                                           1
                                                                                                                                      CONTROLLED-
280808   OPIATE AGONISTS /      02258129       OXYCONTIN          N    OXYCODONE HCL                   5 MG         ORAL              RELEASE TABLET         PUR        W            7.50%          N      0.6300               REGULAR BENEFIT
                                           1
                                                                                                                                      CONTROLLED-
280808   OPIATE AGONISTS /      02202441       OXYCONTIN          Y    OXYCODONE HCL                   10 MG        ORAL              RELEASE TABLET         PUR        W            7.50%          N      0.8780    0.9438     REGULAR BENEFIT
                                                                                                                                      CONTROLLED-
280808   OPIATE AGONISTS /      02372525       OXYNEO             Y    OXYCODONE HCL                   10 MG        ORAL              RELEASE TABLET         PUR        W            7.50%          N      0.8780    0.9438     REGULAR BENEFIT
                                           2
                                                                                                                                      CONTROLLED-
280808   OPIATE AGONISTS /      02372797       OXYNEO             Y    OXYCODONE HCL                   20 MG        ORAL              RELEASE TABLET         PUR        W            7.50%          N      1.3170    1.4158     REGULAR BENEFIT
                                                                                                                                      CONTROLLED-
280808   OPIATE AGONISTS /      02202468       OXYCONTIN          Y    OXYCODONE HCL                   20 MG        ORAL              RELEASE TABLET         PUR        W            7.50%          N      1.3190    1.4158     REGULAR BENEFIT
                                           2
                                                                                                                                      CONTROLLED-
280808   OPIATE AGONISTS /      02372568       OXYNEO             Y    OXYCODONE HCL                   40 MG        ORAL              RELEASE TABLET         PUR        W            7.50%          N      2.2825    2.4537     REGULAR BENEFIT
                                                                                                                                      CONTROLLED-
280808   OPIATE AGONISTS /      02202476       OXYCONTIN          Y    OXYCODONE HCL                   40 MG        ORAL              RELEASE TABLET         PUR        W            7.50%          N      2.2900    2.4537     REGULAR BENEFIT
                                           2
                                                                                                                                      CONTROLLED-
280808   OPIATE AGONISTS /      02372584       OXYNEO             Y    OXYCODONE HCL                   80 MG        ORAL              RELEASE TABLET         PUR        W            7.50%          N      4.2160    4.5322     REGULAR BENEFIT
                                                                                                                                      CONTROLLED-
280808   OPIATE AGONISTS /      02202484       OXYCONTIN          Y    OXYCODONE HCL                   80 MG        ORAL              RELEASE TABLET         PUR        W            7.50%          N      4.2300    4.5322     REGULAR BENEFIT
                                           2
                                                                                                                                      CONTROLLED-
280808   OPIATE AGONISTS /      02372533       OXYNEO             Y    OXYCODONE HCL                   15 MG        ORAL              RELEASE TABLET         PUR        W            7.50%          N      1.0600    1.1395     REGULAR BENEFIT
                                                                                                                                      CONTROLLED-
280808   OPIATE AGONISTS /      02323192       OXYCONTIN          Y    OXYCODONE HCL                   15 MG        ORAL              RELEASE TABLET         PUR        W            7.50%          N      1.0600    1.1395     REGULAR BENEFIT
                                           2
                                                                                                                                      CONTROLLED-
280808   OPIATE AGONISTS /      02372541       OXYNEO             Y    OXYCODONE HCL                   30 MG        ORAL              RELEASE TABLET         PUR        W            7.50%          N      1.7400    1.8705     REGULAR BENEFIT
                                                                                                                                      CONTROLLED-
280808   OPIATE AGONISTS /      02323206       OXYCONTIN          Y    OXYCODONE HCL                   30 MG        ORAL              RELEASE TABLET         PUR        W            7.50%          N      1.7400    1.8705     REGULAR BENEFIT
                                           2
                                                                                                                                      CONTROLLED-
280808   OPIATE AGONISTS /      02372576       OXYNEO             Y    OXYCODONE HCL                   60 MG        ORAL              RELEASE TABLET         PUR        W            7.50%          N      3.1500    3.3862     REGULAR BENEFIT




                                                                                                        Updated July 1, 2012                                                                                                     Page 106 of 254
                                                                                       Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                    (Regular Benefits)


                                                                                                                                                                             DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION        DIN / PIN           PRODUCT NAME       IC            GENERIC NAME            STRENGTH             ROUTE             FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                                                                                                                                CONTROLLED-
280808   OPIATE AGONISTS /           02323214       OXYCONTIN               Y    OXYCODONE HCL                   60 MG          ORAL            RELEASE TABLET         PUR        W            7.50%          N      3.1500    3.3862     REGULAR BENEFIT
                                                2

280808   OPIATE AGONISTS /           02319977       PMS-OXYCODONE           Y    OXYCODONE HCL                   5 MG           ORAL            TABLET                 PMS        B                           Y      0.1287    0.1287     REGULAR BENEFIT

280808   OPIATE AGONISTS /           00789739       SUPEUDOL                Y    OXYCODONE HCL                   5 MG           ORAL            TABLET                 SDZ        W            0.00%          N      0.1332    0.1287     REGULAR BENEFIT
                                                2

280808   OPIATE AGONISTS /           02319985       PMS-OXYCODONE           Y    OXYCODONE HCL                   10 MG          ORAL            TABLET                 PMS        B                           Y      0.1896    0.1896     REGULAR BENEFIT

280808   OPIATE AGONISTS /           00443948       SUPEUDOL                Y    OXYCODONE HCL                   10 MG          ORAL            TABLET                 SDZ        W            0.00%          N      0.2283    0.1896     REGULAR BENEFIT

280808   OPIATE AGONISTS /           02240131       OXY-IR                  Y    OXYCODONE HCL                   10 MG          ORAL            TABLET                 PUR        W            7.50%          N      0.3860    0.1896     REGULAR BENEFIT
                                                3

280808   OPIATE AGONISTS /           02319993       PMS-OXYCODONE           Y    OXYCODONE HCL                   20 MG          ORAL            TABLET                 PMS        B                           Y      0.2964    0.2964     REGULAR BENEFIT

280808   OPIATE AGONISTS /           02262983       SUPEUDOL                Y    OXYCODONE HCL                   20 MG          ORAL            TABLET                 SDZ        W            0.00%          N      0.3965    0.2964     REGULAR BENEFIT

280808   OPIATE AGONISTS /           02240132       OXY-IR                  Y    OXYCODONE HCL                   20 MG          ORAL            TABLET                 PUR        W            7.50%          N      0.6710    0.2964     REGULAR BENEFIT
                                                3

280808   OPIATE AGONISTS /           00392480       SUPEUDOL                N    OXYCODONE HCL                   10 MG          RECTAL          SUPPOSITORY            SDZ        W            7.50%          N      2.1034               REGULAR BENEFIT
                                                1

280808   OPIATE AGONISTS /           00392472       SUPEUDOL                N    OXYCODONE HCL                   20 MG          RECTAL          SUPPOSITORY            SDZ        W            7.50%          N      2.6698               REGULAR BENEFIT
                                                1
                                                                                                                 2.5 MG * 325
280808   OPIATE AGONISTS /           01916491       PERCOCET DEMI           N    OXYCODONE HCL/ ACETAMINOPHEN    MG             ORAL            TABLET                 BMS        B                           N      0.6299               REGULAR BENEFIT
                                                1
                                                                                                                 5 MG * 325
280808   OPIATE AGONISTS /           01916548       ENDOCET                 Y    OXYCODONE HCL/ ACETAMINOPHEN    MG             ORAL            TABLET                 BMS        B                           Y      0.1285    0.1285     REGULAR BENEFIT
                                                                                                                 5 MG * 325
280808   OPIATE AGONISTS /           02307898       SANDOZ-OXYCODONE ACET   Y    OXYCODONE HCL/ ACETAMINOPHEN    MG             ORAL            TABLET                 SDZ        W                           Y      0.1285    0.1285     REGULAR BENEFIT
                                                                                                                 5 MG * 325
280808   OPIATE AGONISTS /           02324628       APO-OXYCODONE           Y    OXYCODONE HCL/ ACETAMINOPHEN    MG             ORAL            TABLET                 APX        B                           Y      0.1285    0.1285     REGULAR BENEFIT
                                                                                                                 5 MG * 325
280808   OPIATE AGONISTS /           02361361       OXYCODONE/ACET          Y    OXYCODONE HCL/ ACETAMINOPHEN    MG             ORAL            TABLET                 SNS        W                           Y      0.1285    0.1285     REGULAR BENEFIT
                                                                                                                 5 MG * 325
280808   OPIATE AGONISTS /           00608165       RATIO-OXYCOCET          Y    OXYCODONE HCL/ ACETAMINOPHEN    MG             ORAL            TABLET                 RPH        B                           Y      0.1285    0.1285     REGULAR BENEFIT
                                                                                                                 5 MG * 325
280808   OPIATE AGONISTS /           01916475       PERCOCET                Y    OXYCODONE HCL/ ACETAMINOPHEN    MG             ORAL            TABLET                 BMS        B                           N      0.7706    0.1285     REGULAR BENEFIT
                                                6
                                                                                                                 5 MG * 325
280808   OPIATE AGONISTS /           00608157       RATIO-OXYCODAN          N    OXYCODONE HCL/ ASA              MG             ORAL            TABLET                 RPH        B                           N      0.3879               REGULAR BENEFIT
                                                1
                                                                                 BUPRENORPHINE HCL/ NALOXONE
280812   OPIATE PARTIAL AGONISTS /   02295695       SUBOXONE                N    HYDROCHLORIDE DIHYDRATE         2 MG * 0.5 MG ORAL             SUBLINGUAL TABLET      RBC        B                           N      2.6700               REGULAR BENEFIT
                                                1




                                                                                                                  Updated July 1, 2012                                                                                                     Page 107 of 254
                                                                                   Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                (Regular Benefits)


                                                                                                                                                                         DISTRIBUTION   DISTRIBUTION     LCA               LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION        DIN / PIN           PRODUCT NAME   IC               GENERIC NAME         STRENGTH            ROUTE              FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE       PRICE         STATUS
                                                                             BUPRENORPHINE HCL/ NALOXONE
280812   OPIATE PARTIAL AGONISTS /   02295709       SUBOXONE            N    HYDROCHLORIDE DIHYDRATE         8 MG * 2 MG   ORAL             SUBLINGUAL TABLET      RBC        B                           N      4.7300                REGULAR BENEFIT
                                                1

280812   OPIATE PARTIAL AGONISTS /   02137984       TALWIN              N    PENTAZOCINE HCL                 50 MG         ORAL             TABLET                 SAV        W            7.50%          N      0.4337                REGULAR BENEFIT
                                                1

280812   OPIATE PARTIAL AGONISTS /   02241976       TALWIN              N    PENTAZOCINE LACTATE             30 MG / ML    INJECTION                               HSP        W            7.50%          N      11.9700               REGULAR BENEFIT
                                                1

281204   BARBITURATES /              00399310       PRIMIDONE           N    PRIMIDONE                       125 MG        ORAL             TABLET                 AAP        W            7.50%          N      0.0553                REGULAR BENEFIT
                                                1

281204   BARBITURATES /              00396761       PRIMIDONE           N    PRIMIDONE                       250 MG        ORAL             TABLET                 AAP        W            7.50%          N      0.0870                REGULAR BENEFIT
                                                1

281208   BENZODIAZEPINES /           02244474       PMS-CLOBAZAM        Y    CLOBAZAM                        10 MG         ORAL             TABLET                 PMS        B                           Y      0.1537     0.1537     REGULAR BENEFIT

281208   BENZODIAZEPINES /           02238334       NOVO-CLOBAZAM       Y    CLOBAZAM                        10 MG         ORAL             TABLET                 TEV        B                           Y      0.1537     0.1537     REGULAR BENEFIT

281208   BENZODIAZEPINES /           02244638       APO-CLOBAZAM        Y    CLOBAZAM                        10 MG         ORAL             TABLET                 APX        B                           Y      0.1537     0.1537     REGULAR BENEFIT
                                                3

281208   BENZODIAZEPINES /           02179660       PMS-CLONAZEPAM      N    CLONAZEPAM                      0.25 MG       ORAL             TABLET                 PMS        B                           N      0.0719                REGULAR BENEFIT
                                                1

281208   BENZODIAZEPINES /           02236948       PHL-CLONAZEPAM-R    Y    CLONAZEPAM                      0.5 MG        ORAL             TABLET                 PHH        B                           Y      0.0746     0.0746     REGULAR BENEFIT

281208   BENZODIAZEPINES /           02233960       SANDOZ CLONAZEPAM   Y    CLONAZEPAM                      0.5 MG        ORAL             TABLET                 SDZ        W                           Y      0.0746     0.0746     REGULAR BENEFIT

281208   BENZODIAZEPINES /           02048701       PMS-CLONAZEPAM      Y    CLONAZEPAM                      0.5 MG        ORAL             TABLET                 PMS        B                           Y      0.0746     0.0746     REGULAR BENEFIT

281208   BENZODIAZEPINES /           02103656       RATIO-CLONAZEPAM    Y    CLONAZEPAM                      0.5 MG        ORAL             TABLET                 RPH        B                           Y      0.0746     0.0746     REGULAR BENEFIT

281208   BENZODIAZEPINES /           02230950       MYLAN-CLONAZEPAM    Y    CLONAZEPAM                      0.5 MG        ORAL             TABLET                 MYP        W                           Y      0.0746     0.0746     REGULAR BENEFIT

281208   BENZODIAZEPINES /           02207818       PMS-CLONAZEPAM-R    Y    CLONAZEPAM                      0.5 MG        ORAL             TABLET                 PMS        B                           Y      0.0746     0.0746     REGULAR BENEFIT

281208   BENZODIAZEPINES /           02177889       APO-CLONAZEPAM      Y    CLONAZEPAM                      0.5 MG        ORAL             TABLET                 APX        B                           Y      0.0746     0.0746     REGULAR BENEFIT

281208   BENZODIAZEPINES /           02239024       NOVO-CLONAZEPAM     Y    CLONAZEPAM                      0.5 MG        ORAL             TABLET                 TEV        B                           Y      0.0746     0.0746     REGULAR BENEFIT

281208   BENZODIAZEPINES /           02145227       PHL-CLONAZEPAM      Y    CLONAZEPAM                      0.5 MG        ORAL             TABLET                 PHH        B                           Y      0.0746     0.0746     REGULAR BENEFIT

281208   BENZODIAZEPINES /           02270641       CO CLONAZEPAM       Y    CLONAZEPAM                      0.5 MG        ORAL             TABLET                 COB        W                           Y      0.0746     0.0746     REGULAR BENEFIT

281208   BENZODIAZEPINES /           00382825       RIVOTRIL            Y    CLONAZEPAM                      0.5 MG        ORAL             TABLET                 HLR        W            7.50%          N      0.1982     0.0746     REGULAR BENEFIT
                                            11

281208   BENZODIAZEPINES /           02233982       SANDOZ CLONAZEPAM   Y    CLONAZEPAM                      1 MG          ORAL             TABLET                 SDZ        W                           Y      0.1487     0.1487     REGULAR BENEFIT




                                                                                                              Updated July 1, 2012                                                                                                      Page 108 of 254
                                                                              Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                           (Regular Benefits)


                                                                                                                                                                    DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION   DIN / PIN           PRODUCT NAME   IC            GENERIC NAME            STRENGTH           ROUTE               FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

281208   BENZODIAZEPINES /      02048728       PMS-CLONAZEPAM      Y    CLONAZEPAM                      1 MG         ORAL              TABLET                 PMS        B                           Y      0.1487    0.1487     REGULAR BENEFIT

281208   BENZODIAZEPINES /      02145235       PHL-CLONAZEPAM      Y    CLONAZEPAM                      1 MG         ORAL              TABLET                 PHH        B                           Y      0.1487    0.1487     REGULAR BENEFIT

281208   BENZODIAZEPINES /      02270668       CO CLONAZEPAM       Y    CLONAZEPAM                      1 MG         ORAL              TABLET                 COB        W                           Y      0.1487    0.1487     REGULAR BENEFIT
                                           4

281208   BENZODIAZEPINES /      02233985       SANDOZ CLONAZEPAM   Y    CLONAZEPAM                      2 MG         ORAL              TABLET                 SDZ        W                           Y      0.1286    0.1286     REGULAR BENEFIT

281208   BENZODIAZEPINES /      02048736       PMS-CLONAZEPAM      Y    CLONAZEPAM                      2 MG         ORAL              TABLET                 PMS        B                           Y      0.1286    0.1286     REGULAR BENEFIT

281208   BENZODIAZEPINES /      02103737       RATIO-CLONAZEPAM    Y    CLONAZEPAM                      2 MG         ORAL              TABLET                 RPH        B                           Y      0.1286    0.1286     REGULAR BENEFIT

281208   BENZODIAZEPINES /      02230951       MYLAN-CLONAZEPAM    Y    CLONAZEPAM                      2 MG         ORAL              TABLET                 MYP        W                           Y      0.1286    0.1286     REGULAR BENEFIT

281208   BENZODIAZEPINES /      02177897       APO-CLONAZEPAM      Y    CLONAZEPAM                      2 MG         ORAL              TABLET                 APX        B                           Y      0.1286    0.1286     REGULAR BENEFIT

281208   BENZODIAZEPINES /      02239025       NOVO-CLONAZEPAM     Y    CLONAZEPAM                      2 MG         ORAL              TABLET                 TEV        B                           Y      0.1286    0.1286     REGULAR BENEFIT

281208   BENZODIAZEPINES /      02145243       PHL-CLONAZEPAM      Y    CLONAZEPAM                      2 MG         ORAL              TABLET                 PHH        B                           Y      0.1286    0.1286     REGULAR BENEFIT

281208   BENZODIAZEPINES /      02270676       CO CLONAZEPAM       Y    CLONAZEPAM                      2 MG         ORAL              TABLET                 COB        W                           Y      0.1286    0.1286     REGULAR BENEFIT

281208   BENZODIAZEPINES /      00382841       RIVOTRIL            Y    CLONAZEPAM                      2 MG         ORAL              TABLET                 HLR        W            7.50%          N      0.3417    0.1286     REGULAR BENEFIT
                                           9

281212   HYDANTOINS /           00023698       DILANTIN INFATABS   N    PHENYTOIN                       50 MG        ORAL              CHEWABLE TABLET        PFI        W            7.50%          N      0.0724               REGULAR BENEFIT
                                           1

281212   HYDANTOINS /           00023442       DILANTIN-30         N    PHENYTOIN                       6 MG / ML    ORAL              SUSPENSION             PFI        W            7.50%          N      0.0399               REGULAR BENEFIT
                                           1

281212   HYDANTOINS /           02250896       TARO-PHENYTOIN      Y    PHENYTOIN                       25 MG / ML   ORAL              SUSPENSION             TAR        W                           Y      0.0311    0.0311     REGULAR BENEFIT

281212   HYDANTOINS /           00023450       DILANTIN-125        Y    PHENYTOIN                       25 MG / ML   ORAL              SUSPENSION             PFI        W            7.50%          N      0.0470    0.0311     REGULAR BENEFIT
                                           2

281212   HYDANTOINS /           00780626       PHENYTOIN SODIUM    N    PHENYTOIN SODIUM                50 MG / ML   INJECTION                                SDZ        W            7.50%          N      2.4465               REGULAR BENEFIT
                                           1

281212   HYDANTOINS /           00022772       DILANTIN            N    PHENYTOIN SODIUM                30 MG        ORAL              CAPSULE                PFI        W            7.50%          N      0.0528               REGULAR BENEFIT
                                           1

281212   HYDANTOINS /           00022780       DILANTIN            N    PHENYTOIN SODIUM                100 MG       ORAL              CAPSULE                PFI        W            7.50%          N      0.0734               REGULAR BENEFIT
                                           1

281220   SUCCINIMIDES /         00022799       ZARONTIN            N    ETHOSUXIMIDE                    250 MG       ORAL              CAPSULE                ERF        W            7.50%          N      0.3203               REGULAR BENEFIT
                                           1




                                                                                                         Updated July 1, 2012                                                                                                     Page 109 of 254
                                                                                 Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                              (Regular Benefits)


                                                                                                                                                                       DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC         PTC DESCRIPTION   DIN / PIN          PRODUCT NAME       IC            GENERIC NAME            STRENGTH           ROUTE              FORM           MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS

281220   SUCCINIMIDES /         00023485       ZARONTIN               N    ETHOSUXIMIDE                    50 MG / ML   ORAL              SYRUP                  ERF        W            7.50%          N      0.0640               REGULAR BENEFIT
                                           1

281220   SUCCINIMIDES /         00022802       CELONTIN               N    METHSUXIMIDE                    300 MG       ORAL              CAPSULE                ERF        W            7.50%          N      0.5933               REGULAR BENEFIT
                                           1
         MISCELLANEOUS
281292   ANTICONVULSANTS /      02244403       TARO-CARBAMAZEPINE     Y    CARBAMAZEPINE                   100 MG       ORAL              CHEWABLE TABLET        TAR        W                           Y      0.0599    0.0599     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /      02231542       PMS-CARBAMAZEPINE      Y    CARBAMAZEPINE                   100 MG       ORAL              CHEWABLE TABLET        PMS        B                           Y      0.0599    0.0599     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /      02261855       SANDOZ CARBAMAZEPINE   Y    CARBAMAZEPINE                   100 MG       ORAL              CHEWABLE TABLET        SDZ        W                           Y      0.0599    0.0599     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /      00369810       TEGRETOL               Y    CARBAMAZEPINE                   100 MG       ORAL              CHEWABLE TABLET        NOV        W            7.50%          N      0.1591    0.0599     REGULAR BENEFIT
                                           4
         MISCELLANEOUS
281292   ANTICONVULSANTS /      02261863       SANDOZ CARBAMAZEPINE   Y    CARBAMAZEPINE                   200 MG       ORAL              CHEWABLE TABLET        SDZ        W                           Y      0.1181    0.1181     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /      02244404       TARO-CARBAMAZEPINE     Y    CARBAMAZEPINE                   200 MG       ORAL              CHEWABLE TABLET        TAR        W                           Y      0.1181    0.1181     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /      02231540       PMS-CARBAMAZEPINE      Y    CARBAMAZEPINE                   200 MG       ORAL              CHEWABLE TABLET        PMS        B                           Y      0.1181    0.1181     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /      00665088       TEGRETOL               Y    CARBAMAZEPINE                   200 MG       ORAL              CHEWABLE TABLET        NOV        W            7.50%          N      0.3139    0.1181     REGULAR BENEFIT
                                           4
         MISCELLANEOUS                                                                                                                    SUSTAINED-
281292   ANTICONVULSANTS /      02231543       PMS-CARBAMAZEPINE-CR   Y    CARBAMAZEPINE                   200 MG       ORAL              RELEASE TABLET         PMS        B                           Y      0.1467    0.1467     REGULAR BENEFIT
         MISCELLANEOUS                         MYLAN-CARBAMAZEPINE                                                                        SUSTAINED-
281292   ANTICONVULSANTS /      02241882       CR                     Y    CARBAMAZEPINE                   200 MG       ORAL              RELEASE TABLET         MYP        W                           Y      0.1467    0.1467     REGULAR BENEFIT
         MISCELLANEOUS                         SANDOZ CARBAMAZEPINE                                                                       SUSTAINED-
281292   ANTICONVULSANTS /      02261839       CR                     Y    CARBAMAZEPINE                   200 MG       ORAL              RELEASE TABLET         SDZ        W                           Y      0.1467    0.1467     REGULAR BENEFIT
         MISCELLANEOUS                                                                                                                    SUSTAINED-
281292   ANTICONVULSANTS /      00773611       TEGRETOL CR            Y    CARBAMAZEPINE                   200 MG       ORAL              RELEASE TABLET         NOV        W            7.50%          N      0.3899    0.1467     REGULAR BENEFIT
                                           4
         MISCELLANEOUS                         MYLAN-CARBAMAZEPINE                                                                        SUSTAINED-
281292   ANTICONVULSANTS /      02241883       CR                     Y    CARBAMAZEPINE                   400 MG       ORAL              RELEASE TABLET         MYP        W                           Y      0.2933    0.2933     REGULAR BENEFIT
         MISCELLANEOUS                         SANDOZ CARBAMAZEPINE                                                                       SUSTAINED-
281292   ANTICONVULSANTS /      02261847       CR                     Y    CARBAMAZEPINE                   400 MG       ORAL              RELEASE TABLET         SDZ        W                           Y      0.2933    0.2933     REGULAR BENEFIT
         MISCELLANEOUS                                                                                                                    SUSTAINED-
281292   ANTICONVULSANTS /      02231544       PMS-CARBAMAZEPINE-CR   Y    CARBAMAZEPINE                   400 MG       ORAL              RELEASE TABLET         PMS        B                           Y      0.2933    0.2933     REGULAR BENEFIT
         MISCELLANEOUS                                                                                                                    SUSTAINED-
281292   ANTICONVULSANTS /      00755583       TEGRETOL CR            Y    CARBAMAZEPINE                   400 MG       ORAL              RELEASE TABLET         NOV        W            7.50%          N      0.7796    0.2933     REGULAR BENEFIT
                                           4
         MISCELLANEOUS
281292   ANTICONVULSANTS /      02367394       TARO-CARBAMAZEPINE     Y    CARBAMAZEPINE                   20 MG / ML   ORAL              SUSPENSION             TAR        W                           Y      0.0541    0.0541     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /      02194333       TEGRETOL               Y    CARBAMAZEPINE                   20 MG / ML   ORAL              SUSPENSION             NOV        W            7.50%          N      0.0751    0.0541     REGULAR BENEFIT
                                           2
         MISCELLANEOUS
281292   ANTICONVULSANTS /      00782718       TEVA-CARBAMAZ          Y    CARBAMAZEPINE                   200 MG       ORAL              TABLET                 TEV        B                           Y      0.0795    0.0795     REGULAR BENEFIT




                                                                                                            Updated July 1, 2012                                                                                                     Page 110 of 254
                                                                             Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                          (Regular Benefits)


                                                                                                                                                                   DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION   DIN / PIN           PRODUCT NAME   IC            GENERIC NAME             STRENGTH          ROUTE               FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         MISCELLANEOUS
281292   ANTICONVULSANTS /     00010405       TEGRETOL            Y    CARBAMAZEPINE                    200 MG      ORAL              TABLET                 NOV        W            7.50%          N      0.3867    0.0795     REGULAR BENEFIT
                                          2
         MISCELLANEOUS                                                 DIVALPROEX SODIUM (VALPROIC                                    ENTERIC-COATED
281292   ANTICONVULSANTS /     02239698       APO-DIVALPROEX      Y    ACID EQUIV.)                     125 MG      ORAL              TABLET                 APX        B                           Y      0.1011    0.1011     REGULAR BENEFIT
         MISCELLANEOUS                                                 DIVALPROEX SODIUM (VALPROIC                                    ENTERIC-COATED
281292   ANTICONVULSANTS /     02239701       NOVO-DIVALPROEX     Y    ACID EQUIV.)                     125 MG      ORAL              TABLET                 TEV        B                           Y      0.1011    0.1011     REGULAR BENEFIT
         MISCELLANEOUS                                                 DIVALPROEX SODIUM (VALPROIC ACID                               ENTERIC-COATED
281292   ANTICONVULSANTS /     00596418       EPIVAL              Y    EQUIV.)                          125 MG      ORAL              TABLET                 ABB        B                           N      0.2889    0.1011     REGULAR BENEFIT
                                          3
         MISCELLANEOUS                                                 DIVALPROEX SODIUM (VALPROIC                                    ENTERIC-COATED
281292   ANTICONVULSANTS /     02239699       APO-DIVALPROEX      Y    ACID EQUIV.)                     250 MG      ORAL              TABLET                 APX        B                           Y      0.1817    0.1817     REGULAR BENEFIT
         MISCELLANEOUS                                                 DIVALPROEX SODIUM (VALPROIC                                    ENTERIC-COATED
281292   ANTICONVULSANTS /     02239702       NOVO-DIVALPROEX     Y    ACID EQUIV.)                     250 MG      ORAL              TABLET                 TEV        B                           Y      0.1817    0.1817     REGULAR BENEFIT
         MISCELLANEOUS                                                 DIVALPROEX SODIUM (VALPROIC ACID                               ENTERIC-COATED
281292   ANTICONVULSANTS /     00596426       EPIVAL              Y    EQUIV.)                          250 MG      ORAL              TABLET                 ABB        B                           N      0.5192    0.1817     REGULAR BENEFIT
                                          3
         MISCELLANEOUS                                                 DIVALPROEX SODIUM (VALPROIC                                    ENTERIC-COATED
281292   ANTICONVULSANTS /     02239703       NOVO-DIVALPROEX     Y    ACID EQUIV.)                     500 MG      ORAL              TABLET                 TEV        B                           Y      0.3637    0.3637     REGULAR BENEFIT
         MISCELLANEOUS                                                 DIVALPROEX SODIUM (VALPROIC                                    ENTERIC-COATED
281292   ANTICONVULSANTS /     02239700       APO-DIVALPROEX      Y    ACID EQUIV.)                     500 MG      ORAL              TABLET                 APX        B                           Y      0.3637    0.3637     REGULAR BENEFIT
         MISCELLANEOUS                                                 DIVALPROEX SODIUM (VALPROIC ACID                               ENTERIC-COATED
281292   ANTICONVULSANTS /     00596434       EPIVAL              Y    EQUIV.)                          500 MG      ORAL              TABLET                 ABB        B                           N      1.0392    0.3637     REGULAR BENEFIT
                                          3
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02361469       JAMP-GABAPENTIN     Y    GABAPENTIN                       100 MG      ORAL              CAPSULE                JPC        B                           Y      0.1598    0.1598     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02260883       RATIO-GABAPENTIN    Y    GABAPENTIN                       100 MG      ORAL              CAPSULE                RPH        B                           Y      0.1598    0.1598     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02246314       GABAPENTIN          Y    GABAPENTIN                       100 MG      ORAL              CAPSULE                MEL        B                           Y      0.1598    0.1598     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02332582       GABAPENTIN          Y    GABAPENTIN                       100 MG      ORAL              CAPSULE                RAN        B                           Y      0.1598    0.1598     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02319055       RAN-GABAPENTIN      Y    GABAPENTIN                       100 MG      ORAL              CAPSULE                RAN        B                           Y      0.1598    0.1598     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02321203       AURO-GABAPENTIN     Y    GABAPENTIN                       100 MG      ORAL              CAPSULE                AUR        B                           Y      0.1598    0.1598     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02353245       GABAPENTIN          Y    GABAPENTIN                       100 MG      ORAL              CAPSULE                SNS        W                           Y      0.1598    0.1598     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02285819       GD-GABAPENTIN       Y    GABAPENTIN                       100 MG      ORAL              CAPSULE                GMD        W                           Y      0.1598    0.1598     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02244304       APO-GABAPENTIN      Y    GABAPENTIN                       100 MG      ORAL              CAPSULE                APX        B                           Y      0.1598    0.1598     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02244513       TEVA-GABAPENTIN     Y    GABAPENTIN                       100 MG      ORAL              CAPSULE                TEV        B                           Y      0.1598    0.1598     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02243446       PMS-GABAPENTIN      Y    GABAPENTIN                       100 MG      ORAL              CAPSULE                PMS        B                           Y      0.1598    0.1598     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02256142       CO GABAPENTIN       Y    GABAPENTIN                       100 MG      ORAL              CAPSULE                COB        W                           Y      0.1598    0.1598     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02248259       MYLAN-GABAPENTIN    Y    GABAPENTIN                       100 MG      ORAL              CAPSULE                MYP        W                           Y      0.1598    0.1598     REGULAR BENEFIT




                                                                                                         Updated July 1, 2012                                                                                                    Page 111 of 254
                                                                         Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                      (Regular Benefits)


                                                                                                                                                               DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION   DIN / PIN       PRODUCT NAME   IC           GENERIC NAME             STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02084260    NEURONTIN          Y    GABAPENTIN                      100 MG      ORAL               CAPSULE                PFI        W            7.50%          N      0.4247    0.1598     REGULAR BENEFIT
                                      14
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02361485    JAMP-GABAPENTIN    Y    GABAPENTIN                      300 MG      ORAL               CAPSULE                JPC        B                           Y      0.3887    0.3887     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02246315    GABAPENTIN         Y    GABAPENTIN                      300 MG      ORAL               CAPSULE                MEL        B                           Y      0.3887    0.3887     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02332590    GABAPENTIN         Y    GABAPENTIN                      300 MG      ORAL               CAPSULE                RAN        B                           Y      0.3887    0.3887     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02319063    RAN-GABAPENTIN     Y    GABAPENTIN                      300 MG      ORAL               CAPSULE                RAN        B                           Y      0.3887    0.3887     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02321211    AURO-GABAPENTIN    Y    GABAPENTIN                      300 MG      ORAL               CAPSULE                AUR        B                           Y      0.3887    0.3887     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02353253    GABAPENTIN         Y    GABAPENTIN                      300 MG      ORAL               CAPSULE                SNS        W                           Y      0.3887    0.3887     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02285827    GD-GABAPENTIN      Y    GABAPENTIN                      300 MG      ORAL               CAPSULE                GMD        W                           Y      0.3887    0.3887     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02244305    APO-GABAPENTIN     Y    GABAPENTIN                      300 MG      ORAL               CAPSULE                APX        B                           Y      0.3887    0.3887     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02244514    TEVA-GABAPENTIN    Y    GABAPENTIN                      300 MG      ORAL               CAPSULE                TEV        B                           Y      0.3887    0.3887     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02243447    PMS-GABAPENTIN     Y    GABAPENTIN                      300 MG      ORAL               CAPSULE                PMS        B                           Y      0.3887    0.3887     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02256150    CO GABAPENTIN      Y    GABAPENTIN                      300 MG      ORAL               CAPSULE                COB        W                           Y      0.3887    0.3887     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02248260    MYLAN-GABAPENTIN   Y    GABAPENTIN                      300 MG      ORAL               CAPSULE                MYP        W                           Y      0.3887    0.3887     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02084279    NEURONTIN          Y    GABAPENTIN                      300 MG      ORAL               CAPSULE                PFI        W            7.50%          N      1.0332    0.3887     REGULAR BENEFIT
                                      13
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02361493    JAMP-GABAPENTIN    Y    GABAPENTIN                      400 MG      ORAL               CAPSULE                JPC        B                           Y      0.4633    0.4633     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02260905    RATIO-GABAPENTIN   Y    GABAPENTIN                      400 MG      ORAL               CAPSULE                RPH        B                           Y      0.4633    0.4633     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02246316    GABAPENTIN         Y    GABAPENTIN                      400 MG      ORAL               CAPSULE                MEL        B                           Y      0.4633    0.4633     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02332604    GABAPENTIN         Y    GABAPENTIN                      400 MG      ORAL               CAPSULE                RAN        B                           Y      0.4633    0.4633     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02319071    RAN-GABAPENTIN     Y    GABAPENTIN                      400 MG      ORAL               CAPSULE                RAN        B                           Y      0.4633    0.4633     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02321238    AURO-GABAPENTIN    Y    GABAPENTIN                      400 MG      ORAL               CAPSULE                AUR        B                           Y      0.4633    0.4633     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02353261    GABAPENTIN         Y    GABAPENTIN                      400 MG      ORAL               CAPSULE                SNS        W                           Y      0.4633    0.4633     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02285835    GD-GABAPENTIN      Y    GABAPENTIN                      400 MG      ORAL               CAPSULE                GMD        W                           Y      0.4633    0.4633     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02244306    APO-GABAPENTIN     Y    GABAPENTIN                      400 MG      ORAL               CAPSULE                APX        B                           Y      0.4633    0.4633     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02244515    TEVA-GABAPENTIN    Y    GABAPENTIN                      400 MG      ORAL               CAPSULE                TEV        B                           Y      0.4633    0.4633     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02243448    PMS-GABAPENTIN     Y    GABAPENTIN                      400 MG      ORAL               CAPSULE                PMS        B                           Y      0.4633    0.4633     REGULAR BENEFIT




                                                                                                    Updated July 1, 2012                                                                                                     Page 112 of 254
                                                                             Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                          (Regular Benefits)


                                                                                                                                                                   DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION   DIN / PIN          PRODUCT NAME    IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02248261       MYLAN-GABAPENTIN    Y    GABAPENTIN                      400 MG      ORAL               CAPSULE                MYP        W                           Y      0.4633    0.4633     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02256169       CO GABAPENTIN       Y    GABAPENTIN                      400 MG      ORAL               CAPSULE                COB        W                           Y      0.4633    0.4633     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02084287       NEURONTIN           Y    GABAPENTIN                      400 MG      ORAL               CAPSULE                PFI        W            7.50%          N      1.2313    0.4633     REGULAR BENEFIT
                                      14
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02240115       LAMICTAL            N    LAMOTRIGINE                     5 MG        ORAL               CHEWABLE TABLET        GSK        W            7.50%          N      0.1630               REGULAR BENEFIT
                                          1
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02243352       RATIO-LAMOTRIGINE   Y    LAMOTRIGINE                     25 MG       ORAL               TABLET                 RPH        B                           Y      0.1438    0.1438     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02248232       NOVO-LAMOTRIGINE    Y    LAMOTRIGINE                     25 MG       ORAL               TABLET                 TEV        B                           Y      0.1438    0.1438     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02245208       APO-LAMOTRIGINE     Y    LAMOTRIGINE                     25 MG       ORAL               TABLET                 APX        B                           Y      0.1438    0.1438     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02246897       PMS-LAMOTRIGINE     Y    LAMOTRIGINE                     25 MG       ORAL               TABLET                 PMS        B                           Y      0.1438    0.1438     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02343010       LAMOTRIGINE         Y    LAMOTRIGINE                     25 MG       ORAL               TABLET                 SNS        W                           Y      0.1438    0.1438     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02265494       MYLAN-LAMOTRIGINE   Y    LAMOTRIGINE                     25 MG       ORAL               TABLET                 MYP        W                           Y      0.1438    0.1438     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02142082       LAMICTAL            Y    LAMOTRIGINE                     25 MG       ORAL               TABLET                 GSK        W            7.50%          N      0.3821    0.1438     REGULAR BENEFIT
                                          7
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02246898       PMS-LAMOTRIGINE     Y    LAMOTRIGINE                     100 MG      ORAL               TABLET                 PMS        B                           Y      0.5739    0.5739     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02243353       RATIO-LAMOTRIGINE   Y    LAMOTRIGINE                     100 MG      ORAL               TABLET                 RPH        B                           Y      0.5739    0.5739     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02248233       NOVO-LAMOTRIGINE    Y    LAMOTRIGINE                     100 MG      ORAL               TABLET                 TEV        B                           Y      0.5739    0.5739     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02245209       APO-LAMOTRIGINE     Y    LAMOTRIGINE                     100 MG      ORAL               TABLET                 APX        B                           Y      0.5739    0.5739     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02343029       LAMOTRIGINE         Y    LAMOTRIGINE                     100 MG      ORAL               TABLET                 SNS        W                           Y      0.5739    0.5739     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02265508       MYLAN-LAMOTRIGINE   Y    LAMOTRIGINE                     100 MG      ORAL               TABLET                 MYP        W                           Y      0.5739    0.5739     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02142104       LAMICTAL            Y    LAMOTRIGINE                     100 MG      ORAL               TABLET                 GSK        W            7.50%          N      1.5254    0.5739     REGULAR BENEFIT
                                          7
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02265516       MYLAN-LAMOTRIGINE   Y    LAMOTRIGINE                     150 MG      ORAL               TABLET                 MYP        W                           Y      0.8458    0.8458     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02246963       RATIO-LAMOTRIGINE   Y    LAMOTRIGINE                     150 MG      ORAL               TABLET                 RPH        B                           Y      0.8458    0.8458     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02248234       NOVO-LAMOTRIGINE    Y    LAMOTRIGINE                     150 MG      ORAL               TABLET                 TEV        B                           Y      0.8458    0.8458     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02245210       APO-LAMOTRIGINE     Y    LAMOTRIGINE                     150 MG      ORAL               TABLET                 APX        B                           Y      0.8458    0.8458     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02246899       PMS-LAMOTRIGINE     Y    LAMOTRIGINE                     150 MG      ORAL               TABLET                 PMS        B                           Y      0.8458    0.8458     REGULAR BENEFIT




                                                                                                        Updated July 1, 2012                                                                                                     Page 113 of 254
                                                                              Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                           (Regular Benefits)


                                                                                                                                                                    DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION   DIN / PIN          PRODUCT NAME     IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02343037       LAMOTRIGINE          Y    LAMOTRIGINE                     150 MG      ORAL               TABLET                 SNS        W                           Y      0.8458    0.8458     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02142112       LAMICTAL             Y    LAMOTRIGINE                     150 MG      ORAL               TABLET                 GSK        W            7.50%          N      2.2481    0.8458     REGULAR BENEFIT
                                          7
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02353350       LEVETIRACETAM        Y    LEVETIRACETAM                   500 MG      ORAL               TABLET                 SNS        W                           Y      0.9750    0.9750     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02285932       APO-LEVETIRACETAM    Y    LEVETIRACETAM                   500 MG      ORAL               TABLET                 APX        B                           Y      0.9750    0.9750     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02296128       PMS-LEVETIRACETAM    Y    LEVETIRACETAM                   500 MG      ORAL               TABLET                 PMS        B                           Y      0.9750    0.9750     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02274191       CO LEVETIRACETAM     Y    LEVETIRACETAM                   500 MG      ORAL               TABLET                 COB        W                           Y      0.9750    0.9750     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02371685       AVA-LEVETIRACETAM    Y    LEVETIRACETAM                   500 MG      ORAL               TABLET                 AVA        W                           Y      0.9750    0.9750     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02375257       AURO-LEVETIRACETAM   Y    LEVETIRACETAM                   500 MG      ORAL               TABLET                 AUR        B                           Y      0.9750    0.9750     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02247028       KEPPRA               Y    LEVETIRACETAM                   500 MG      ORAL               TABLET                 UCB        W            7.50%          N      2.0427    0.9750     REGULAR BENEFIT
                                          7
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02375265       AURO-LEVETIRACETAM   Y    LEVETIRACETAM                   750 MG      ORAL               TABLET                 AUR        B                           Y      1.3500    1.3500     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02353369       LEVETIRACETAM        Y    LEVETIRACETAM                   750 MG      ORAL               TABLET                 SNS        W                           Y      1.3500    1.3500     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02285940       APO-LEVETIRACETAM    Y    LEVETIRACETAM                   750 MG      ORAL               TABLET                 APX        B                           Y      1.3500    1.3500     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02296136       PMS-LEVETIRACETAM    Y    LEVETIRACETAM                   750 MG      ORAL               TABLET                 PMS        B                           Y      1.3500    1.3500     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02274205       CO LEVETIRACETAM     Y    LEVETIRACETAM                   750 MG      ORAL               TABLET                 COB        W                           Y      1.3500    1.3500     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02371693       AVA-LEVETIRACETAM    Y    LEVETIRACETAM                   750 MG      ORAL               TABLET                 AVA        W                           Y      1.3500    1.3500     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02247029       KEPPRA               Y    LEVETIRACETAM                   750 MG      ORAL               TABLET                 UCB        W            7.50%          N      2.8283    1.3500     REGULAR BENEFIT
                                          7
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02274183       CO LEVETIRACETAM     Y    LEVETIRACETAM                   250 MG      ORAL               TABLET                 COB        W                           Y      0.8000    0.8000     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02375249       AURO-LEVETIRACETAM   Y    LEVETIRACETAM                   250 MG      ORAL               TABLET                 AUR        B                           Y      0.8000    0.8000     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02353342       LEVETIRACETAM        Y    LEVETIRACETAM                   250 MG      ORAL               TABLET                 SNS        W                           Y      0.8000    0.8000     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02285924       APO-LEVETIRACETAM    Y    LEVETIRACETAM                   250 MG      ORAL               TABLET                 APX        B                           Y      0.8000    0.8000     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02296101       PMS-LEVETIRACETAM    Y    LEVETIRACETAM                   250 MG      ORAL               TABLET                 PMS        B                           Y      0.8000    0.8000     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02371677       AVA-LEVETIRACETAM    Y    LEVETIRACETAM                   250 MG      ORAL               TABLET                 AVA        W                           Y      0.8000    0.8000     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02247027       KEPPRA               Y    LEVETIRACETAM                   250 MG      ORAL               TABLET                 UCB        W            7.50%          N      1.6613    0.8000     REGULAR BENEFIT
                                          7




                                                                                                         Updated July 1, 2012                                                                                                     Page 114 of 254
                                                                             Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                          (Regular Benefits)


                                                                                                                                                                   DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION   DIN / PIN          PRODUCT NAME    IC           GENERIC NAME             STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02239907       TOPAMAX SPRINKLE    N    TOPIRAMATE                      15 MG       ORAL               CAPSULE                JAI        W            7.50%          N      1.1675               REGULAR BENEFIT
                                          1
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02239908       TOPAMAX SPRINKLE    N    TOPIRAMATE                      25 MG       ORAL               CAPSULE                JAI        W            7.50%          N      1.2255               REGULAR BENEFIT
                                          1
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02370972       AVA-TOPIRAMATE      Y    TOPIRAMATE                      25 MG       ORAL               TABLET                 AVA        W                           Y      0.4811    0.4811     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02345803       AURO-TOPIRAMATE     Y    TOPIRAMATE                      25 MG       ORAL               TABLET                 AUR        B                           Y      0.4811    0.4811     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02260050       SANDOZ TOPIRAMATE   Y    TOPIRAMATE                      25 MG       ORAL               TABLET                 SDZ        W                           Y      0.4811    0.4811     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02248860       NOVO-TOPIRAMATE     Y    TOPIRAMATE                      25 MG       ORAL               TABLET                 TEV        B                           Y      0.4811    0.4811     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02287765       CO TOPIRAMATE       Y    TOPIRAMATE                      25 MG       ORAL               TABLET                 COB        W                           Y      0.4811    0.4811     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02315645       MINT-TOPIRAMATE     Y    TOPIRAMATE                      25 MG       ORAL               TABLET                 MPI        B                           Y      0.4811    0.4811     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02271184       PHL-TOPIRAMATE      Y    TOPIRAMATE                      25 MG       ORAL               TABLET                 PHH        B                           Y      0.4811    0.4811     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02356856       TOPIRAMATE          Y    TOPIRAMATE                      25 MG       ORAL               TABLET                 SNS        W                           Y      0.4811    0.4811     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02263351       MYLAN-TOPIRAMATE    Y    TOPIRAMATE                      25 MG       ORAL               TABLET                 MYP        W                           Y      0.4811    0.4811     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02262991       PMS-TOPIRAMATE      Y    TOPIRAMATE                      25 MG       ORAL               TABLET                 PMS        B                           Y      0.4811    0.4811     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02279614       APO-TOPIRAMATE      Y    TOPIRAMATE                      25 MG       ORAL               TABLET                 APX        B                           Y      0.4811    0.4811     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02230893       TOPAMAX             Y    TOPIRAMATE                      25 MG       ORAL               TABLET                 JAI        W            7.50%          N      1.2787    0.4811     REGULAR BENEFIT
                                      12
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02312085       PMS-TOPIRAMATE      N    TOPIRAMATE                      50 MG       ORAL               TABLET                 PMS        B                           N      1.0674               REGULAR BENEFIT
                                          1
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02345838       AURO-TOPIRAMATE     Y    TOPIRAMATE                      100 MG      ORAL               TABLET                 AUR        B                           Y      0.9119    0.9119     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02260069       SANDOZ TOPIRAMATE   Y    TOPIRAMATE                      100 MG      ORAL               TABLET                 SDZ        W                           Y      0.9119    0.9119     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02248861       NOVO-TOPIRAMATE     Y    TOPIRAMATE                      100 MG      ORAL               TABLET                 TEV        B                           Y      0.9119    0.9119     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02287773       CO TOPIRAMATE       Y    TOPIRAMATE                      100 MG      ORAL               TABLET                 COB        W                           Y      0.9119    0.9119     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02315653       MINT-TOPIRAMATE     Y    TOPIRAMATE                      100 MG      ORAL               TABLET                 MPI        B                           Y      0.9119    0.9119     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02271192       PHL-TOPIRAMATE      Y    TOPIRAMATE                      100 MG      ORAL               TABLET                 PHH        B                           Y      0.9119    0.9119     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02356864       TOPIRAMATE          Y    TOPIRAMATE                      100 MG      ORAL               TABLET                 SNS        W                           Y      0.9119    0.9119     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02263378       MYLAN-TOPIRAMATE    Y    TOPIRAMATE                      100 MG      ORAL               TABLET                 MYP        W                           Y      0.9119    0.9119     REGULAR BENEFIT




                                                                                                        Updated July 1, 2012                                                                                                     Page 115 of 254
                                                                                  Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                               (Regular Benefits)


                                                                                                                                                                        DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC        PTC DESCRIPTION   DIN / PIN           PRODUCT NAME        IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02263009       PMS-TOPIRAMATE           Y    TOPIRAMATE                      100 MG      ORAL               TABLET                 PMS        B                           Y      0.9119    0.9119     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02279630       APO-TOPIRAMATE           Y    TOPIRAMATE                      100 MG      ORAL               TABLET                 APX        B                           Y      0.9119    0.9119     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02370980       AVA-TOPIRAMATE           Y    TOPIRAMATE                      100 MG      ORAL               TABLET                 AVA        W                           Y      0.9119    0.9119     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02230894       TOPAMAX                  Y    TOPIRAMATE                      100 MG      ORAL               TABLET                 JAI        W            7.50%          N      2.4235    0.9119     REGULAR BENEFIT
                                      12
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02370999       AVA-TOPIRAMATE           Y    TOPIRAMATE                      200 MG      ORAL               TABLET                 AVA        W                           Y      1.3616    1.3616     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02345846       AURO-TOPIRAMATE          Y    TOPIRAMATE                      200 MG      ORAL               TABLET                 AUR        B                           Y      1.3616    1.3616     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02267837       SANDOZ TOPIRAMATE        Y    TOPIRAMATE                      200 MG      ORAL               TABLET                 SDZ        W                           Y      1.3616    1.3616     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02248862       NOVO-TOPIRAMATE          Y    TOPIRAMATE                      200 MG      ORAL               TABLET                 TEV        B                           Y      1.3616    1.3616     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02287781       CO TOPIRAMATE            Y    TOPIRAMATE                      200 MG      ORAL               TABLET                 COB        W                           Y      1.3616    1.3616     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02279649       APO-TOPIRAMATE           Y    TOPIRAMATE                      200 MG      ORAL               TABLET                 APX        B                           Y      1.3616    1.3616     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02315661       MINT-TOPIRAMATE          Y    TOPIRAMATE                      200 MG      ORAL               TABLET                 MPI        B                           Y      1.3616    1.3616     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02271206       PHL-TOPIRAMATE           Y    TOPIRAMATE                      200 MG      ORAL               TABLET                 PHH        B                           Y      1.3616    1.3616     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02356872       TOPIRAMATE               Y    TOPIRAMATE                      200 MG      ORAL               TABLET                 SNS        W                           Y      1.3616    1.3616     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02263386       MYLAN-TOPIRAMATE         Y    TOPIRAMATE                      200 MG      ORAL               TABLET                 MYP        W                           Y      1.3616    1.3616     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02263017       PMS-TOPIRAMATE           Y    TOPIRAMATE                      200 MG      ORAL               TABLET                 PMS        B                           Y      1.3616    1.3616     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02230896       TOPAMAX                  Y    TOPIRAMATE                      200 MG      ORAL               TABLET                 JAI        W            7.50%          N      3.6190    1.3616     REGULAR BENEFIT
                                      12
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02230768       PMS-VALPROIC ACID        Y    VALPROIC ACID                   250 MG      ORAL               CAPSULE                PMS        B                           Y      0.1908    0.1908     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02184648       MYLAN-VALPROIC           Y    VALPROIC ACID                   250 MG      ORAL               CAPSULE                MYP        W                           Y      0.1908    0.1908     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02100630       NOVO-VALPROIC            Y    VALPROIC ACID                   250 MG      ORAL               CAPSULE                TEV        B                           Y      0.1908    0.1908     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02239714       SANDOZ VALPROIC          Y    VALPROIC ACID                   250 MG      ORAL               CAPSULE                SDZ        W                           Y      0.1908    0.1908     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     02238048       APO-VALPROIC             Y    VALPROIC ACID                   250 MG      ORAL               CAPSULE                APX        B                           Y      0.1908    0.1908     REGULAR BENEFIT
         MISCELLANEOUS
281292   ANTICONVULSANTS /     00443840       DEPAKENE                 Y    VALPROIC ACID                   250 MG      ORAL               CAPSULE                ABB        B                           N      0.5452    0.1908     REGULAR BENEFIT
                                          6
         MISCELLANEOUS                                                                                                                     ENTERIC-COATED
281292   ANTICONVULSANTS /     02229628       PMS-VALPROIC ACID E.C.   Y    VALPROIC ACID                   500 MG      ORAL               CAPSULE                PMS        B                           Y      0.5197    0.5197     REGULAR BENEFIT
         MISCELLANEOUS                                                                                                                     ENTERIC-COATED
281292   ANTICONVULSANTS /     02218321       NOVO-VALPROIC            Y    VALPROIC ACID                   500 MG      ORAL               CAPSULE                TEV        B                           Y      0.5197    0.5197     REGULAR BENEFIT




                                                                                                             Updated July 1, 2012                                                                                                     Page 116 of 254
                                                                                  Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                               (Regular Benefits)


                                                                                                                                                                        DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION       DIN / PIN         PRODUCT NAME    IC            GENERIC NAME            STRENGTH           ROUTE               FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
                                               2
           MISCELLANEOUS
281292     ANTICONVULSANTS /        02236807       PMS-VALPROIC ACID   Y    VALPROIC ACID                   50 MG / ML   ORAL              SYRUP                  PMS        B                           Y      0.0398    0.0398     REGULAR BENEFIT
           MISCELLANEOUS
281292     ANTICONVULSANTS /        02140063       RATIO-VALPROIC      Y    VALPROIC ACID                   50 MG / ML   ORAL              SYRUP                  RPH        B                           Y      0.0398    0.0398     REGULAR BENEFIT
           MISCELLANEOUS
281292     ANTICONVULSANTS /        02238370       APO-VALPROIC        Y    VALPROIC ACID                   50 MG / ML   ORAL              SYRUP                  APX        B                           Y      0.0398    0.0398     REGULAR BENEFIT
           MISCELLANEOUS
281292     ANTICONVULSANTS /        00443832       DEPAKENE            Y    VALPROIC ACID                   50 MG / ML   ORAL              SYRUP                  ABB        B                           N      0.1136    0.0398     REGULAR BENEFIT
                                               4
           MISCELLANEOUS
281292     ANTICONVULSANTS /        02068036       SABRIL              N    VIGABATRIN                      500 MG       ORAL              POWDER PACKET          LUI        B                           N      0.9110               REGULAR BENEFIT
                                               1
           MISCELLANEOUS
281292     ANTICONVULSANTS /        02065819       SABRIL              N    VIGABATRIN                      500 MG       ORAL              TABLET                 LUI        B                           N      0.9110               REGULAR BENEFIT
                                               1
           ANTIDEPRESSANTS /
           MONOAMINE OXIDASE
28160412   INHIBITORS               02232148       APO-MOCLOBEMIDE     Y    MOCLOBEMIDE                     100 MG       ORAL              TABLET                 APX        B                           Y      0.2520    0.2520     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           MONOAMINE OXIDASE
28160412   INHIBITORS               02239746       NOVO-MOCLOBEMIDE    Y    MOCLOBEMIDE                     100 MG       ORAL              TABLET                 TEV        B                           Y      0.2520    0.2520     REGULAR BENEFIT
                                               2
           ANTIDEPRESSANTS /
           MONOAMINE OXIDASE
28160412   INHIBITORS               02239747       NOVO-MOCLOBEMIDE    Y    MOCLOBEMIDE                     150 MG       ORAL              TABLET                 TEV        B                           Y      0.2279    0.2279     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           MONOAMINE OXIDASE
28160412   INHIBITORS               02232150       APO-MOCLOBEMIDE     Y    MOCLOBEMIDE                     150 MG       ORAL              TABLET                 APX        B                           Y      0.2279    0.2279     REGULAR BENEFIT
                                               2
           ANTIDEPRESSANTS /
           MONOAMINE OXIDASE
28160412   INHIBITORS               02239748       NOVO-MOCLOBEMIDE    Y    MOCLOBEMIDE                     300 MG       ORAL              TABLET                 TEV        B                           Y      0.4476    0.4476     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           MONOAMINE OXIDASE
28160412   INHIBITORS               02240456       APO-MOCLOBEMIDE     Y    MOCLOBEMIDE                     300 MG       ORAL              TABLET                 APX        B                           Y      0.4476    0.4476     REGULAR BENEFIT
                                               2
           ANTIDEPRESSANTS /
           MONOAMINE OXIDASE
28160412   INHIBITORS               00476552       NARDIL              N    PHENELZINE SULFATE              15 MG        ORAL              TABLET                 ERF        W            7.50%          N      0.3561               REGULAR BENEFIT
                                               1
           ANTIDEPRESSANTS /
           MONOAMINE OXIDASE
28160412   INHIBITORS               01919598       PARNATE             N    TRANYLCYPROMINE SULFATE         10 MG        ORAL              TABLET                 GSK        W            7.50%          N      0.3759               REGULAR BENEFIT
                                               1
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                         DELAYED RELEASE
28160416   INHIBITORS               02301482       CYMBALTA            N    DULOXETINE HYDROCHLORIDE        30 MG        ORAL              CAPSULE                LIL        W            7.50%          N      1.8766               REGULAR BENEFIT
                                               1




                                                                                                             Updated July 1, 2012                                                                                                     Page 117 of 254
                                                                                      Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                   (Regular Benefits)


                                                                                                                                                                            DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION       DIN / PIN         PRODUCT NAME        IC            GENERIC NAME            STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             DELAYED RELEASE
28160416   INHIBITORS               02301490       CYMBALTA                N    DULOXETINE HYDROCHLORIDE        60 MG       ORAL               CAPSULE                LIL        W            7.50%          N      3.7536               REGULAR BENEFIT
                                               1
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             EXTENDED-RELEASE
28160416   INHIBITORS               02275023       TEVA-VENLAFAXINE XR     Y    VENLAFAXINE HCL                 37.5 MG     ORAL               CAPSULE                TEV        B                           Y      0.3477    0.3477     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             EXTENDED-RELEASE
28160416   INHIBITORS               02304317       CO VENLAFAXINE XR       Y    VENLAFAXINE HCL                 37.5 MG     ORAL               CAPSULE          COB              W                           Y      0.3477    0.3477     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             EXTENDED-RELEASE
28160416   INHIBITORS               02310317       SANDOZ VENLAFAXINE XR   Y    VENLAFAXINE HCL                 37.5 MG     ORAL               CAPSULE                SDZ        W                           Y      0.3477    0.3477     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             EXTENDED-RELEASE
28160416   INHIBITORS               02273969       RATIO-VENLAFAXINE XR    Y    VENLAFAXINE HCL                 37.5 MG     ORAL               CAPSULE          RPH              B                           Y      0.3477    0.3477     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             EXTENDED-RELEASE
28160416   INHIBITORS               02278545       PMS-VENLAFAXINE XR      Y    VENLAFAXINE HCL                 37.5 MG     ORAL               CAPSULE          PMS              B                           Y      0.3477    0.3477     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             EXTENDED-RELEASE
28160416   INHIBITORS               02310279       MYLAN-VENLAFAXINE XR    Y    VENLAFAXINE HCL                 37.5 MG     ORAL               CAPSULE          MYP              W                           Y      0.3477    0.3477     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             EXTENDED-RELEASE
28160416   INHIBITORS               02360020       GD-VENLAFAXINE XR       Y    VENLAFAXINE HCL                 37.5 MG     ORAL               CAPSULE          GMD              W                           Y      0.3477    0.3477     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             EXTENDED-RELEASE
28160416   INHIBITORS               02380072       RAN-VENLAFAXINE XR      Y    VENLAFAXINE HCL                 37.5 MG     ORAL               CAPSULE          RAN              B                           Y      0.3477    0.3477     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             EXTENDED-RELEASE
28160416   INHIBITORS               02354713       VENLAFAXINE XR          Y    VENLAFAXINE HCL                 37.5 MG     ORAL               CAPSULE          SNS              W                           Y      0.3477    0.3477     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             EXTENDED-RELEASE
28160416   INHIBITORS               02331683       APO-VENLAFAXINE XR      Y    VENLAFAXINE HCL                 37.5 MG     ORAL               CAPSULE          APX              B                           Y      0.3477    0.3477     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             EXTENDED-RELEASE
28160416   INHIBITORS               02237279       EFFEXOR XR              Y    VENLAFAXINE HCL                 37.5 MG     ORAL               CAPSULE          WAY              W            7.50%          N      0.9242    0.3477     REGULAR BENEFIT
                                            11




                                                                                                                 Updated July 1, 2012                                                                                                     Page 118 of 254
                                                                                    Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                 (Regular Benefits)


                                                                                                                                                                          DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION       DIN / PIN       PRODUCT NAME        IC            GENERIC NAME            STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                           EXTENDED-RELEASE
28160416   INHIBITORS               02360039     GD-VENLAFAXINE XR       Y    VENLAFAXINE HCL                 75 MG       ORAL               CAPSULE          GMD              W                           Y      0.6956    0.6956     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                           EXTENDED-RELEASE
28160416   INHIBITORS               02275031     TEVA-VENLAFAXINE XR     Y    VENLAFAXINE HCL                 75 MG       ORAL               CAPSULE                TEV        B                           Y      0.6956    0.6956     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                           EXTENDED-RELEASE
28160416   INHIBITORS               02304325     CO VENLAFAXINE XR       Y    VENLAFAXINE HCL                 75 MG       ORAL               CAPSULE          COB              W                           Y      0.6956    0.6956     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                           EXTENDED-RELEASE
28160416   INHIBITORS               02310325     SANDOZ VENLAFAXINE XR   Y    VENLAFAXINE HCL                 75 MG       ORAL               CAPSULE                SDZ        W                           Y      0.6956    0.6956     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                           EXTENDED-RELEASE
28160416   INHIBITORS               02273977     RATIO-VENLAFAXINE XR    Y    VENLAFAXINE HCL                 75 MG       ORAL               CAPSULE          RPH              B                           Y      0.6956    0.6956     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                           EXTENDED-RELEASE
28160416   INHIBITORS               02278553     PMS-VENLAFAXINE XR      Y    VENLAFAXINE HCL                 75 MG       ORAL               CAPSULE          PMS              B                           Y      0.6956    0.6956     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                           EXTENDED-RELEASE
28160416   INHIBITORS               02310287     MYLAN-VENLAFAXINE XR    Y    VENLAFAXINE HCL                 75 MG       ORAL               CAPSULE          MYP              W                           Y      0.6956    0.6956     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                           EXTENDED-RELEASE
28160416   INHIBITORS               02380080     RAN-VENLAFAXINE XR      Y    VENLAFAXINE HCL                 75 MG       ORAL               CAPSULE          RAN              B                           Y      0.6956    0.6956     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                           EXTENDED-RELEASE
28160416   INHIBITORS               02354721     VENLAFAXINE XR          Y    VENLAFAXINE HCL                 75 MG       ORAL               CAPSULE          SNS              W                           Y      0.6956    0.6956     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                           EXTENDED-RELEASE
28160416   INHIBITORS               02331691     APO-VENLAFAXINE XR      Y    VENLAFAXINE HCL                 75 MG       ORAL               CAPSULE          APX              B                           Y      0.6956    0.6956     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                           EXTENDED-RELEASE
28160416   INHIBITORS               02237280     EFFEXOR XR              Y    VENLAFAXINE HCL                 75 MG       ORAL               CAPSULE          WAY              W            7.50%          N      1.8488    0.6956     REGULAR BENEFIT
                                            11
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                           EXTENDED-RELEASE
28160416   INHIBITORS               02360047     GD-VENLAFAXINE XR       Y    VENLAFAXINE HCL                 150 MG      ORAL               CAPSULE          GMD              W                           Y      0.7343    0.7343     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                           EXTENDED-RELEASE
28160416   INHIBITORS               02275058     TEVA-VENLAFAXINE XR     Y    VENLAFAXINE HCL                 150 MG      ORAL               CAPSULE                TEV        B                           Y      0.7343    0.7343     REGULAR BENEFIT




                                                                                                               Updated July 1, 2012                                                                                                     Page 119 of 254
                                                                                      Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                   (Regular Benefits)


                                                                                                                                                                            DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION       DIN / PIN         PRODUCT NAME        IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             EXTENDED-RELEASE
28160416   INHIBITORS               02304333       CO VENLAFAXINE XR       Y    VENLAFAXINE HCL                 150 MG      ORAL               CAPSULE          COB              W                           Y      0.7343    0.7343     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             EXTENDED-RELEASE
28160416   INHIBITORS               02310333       SANDOZ VENLAFAXINE XR   Y    VENLAFAXINE HCL                 150 MG      ORAL               CAPSULE                SDZ        W                           Y      0.7343    0.7343     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             EXTENDED-RELEASE
28160416   INHIBITORS               02273985       RATIO-VENLAFAXINE XR    Y    VENLAFAXINE HCL                 150 MG      ORAL               CAPSULE          RPH              B                           Y      0.7343    0.7343     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             EXTENDED-RELEASE
28160416   INHIBITORS               02278561       PMS-VENLAFAXINE XR      Y    VENLAFAXINE HCL                 150 MG      ORAL               CAPSULE          PMS              B                           Y      0.7343    0.7343     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             EXTENDED-RELEASE
28160416   INHIBITORS               02310295       MYLAN-VENLAFAXINE XR    Y    VENLAFAXINE HCL                 150 MG      ORAL               CAPSULE          MYP              W                           Y      0.7343    0.7343     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             EXTENDED-RELEASE
28160416   INHIBITORS               02380099       RAN-VENLAFAXINE XR      Y    VENLAFAXINE HCL                 150 MG      ORAL               CAPSULE          RAN              B                           Y      0.7343    0.7343     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             EXTENDED-RELEASE
28160416   INHIBITORS               02354748       VENLAFAXINE XR          Y    VENLAFAXINE HCL                 150 MG      ORAL               CAPSULE          SNS              W                           Y      0.7343    0.7343     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             EXTENDED-RELEASE
28160416   INHIBITORS               02331705       APO-VENLAFAXINE XR      Y    VENLAFAXINE HCL                 150 MG      ORAL               CAPSULE          APX              B                           Y      0.7343    0.7343     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE SEROTONIN- AND
           NOREPINEPHRINE-REUPTAKE                                                                                                             EXTENDED-RELEASE
28160416   INHIBITORS               02237282       EFFEXOR XR              Y    VENLAFAXINE HCL                 150 MG      ORAL               CAPSULE          WAY              W            7.50%          N      1.9517    0.7343     REGULAR BENEFIT
                                            11
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS      02370077       MINT-CITALOPRAM         N    CITALOPRAM HYDROBROMIDE         10 MG       ORAL               TABLET                 MPI        B                           N      0.2790               REGULAR BENEFIT
                                               1
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS      02252112       RATIO-CITALOPRAM        Y    CITALOPRAM HYDROBROMIDE         20 MG       ORAL               TABLET                 RPH        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS      02331950       CITALOPRAM              Y    CITALOPRAM HYDROBROMIDE         20 MG       ORAL               TABLET                 RAN        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS      02355272       SEPTA-CITALOPRAM        Y    CITALOPRAM HYDROBROMIDE         20 MG       ORAL               TABLET                 SEP        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS      02353660       CITALOPRAM              Y    CITALOPRAM HYDROBROMIDE         20 MG       ORAL               TABLET                 SNS        W                           Y      0.5011    0.5011     REGULAR BENEFIT




                                                                                                                 Updated July 1, 2012                                                                                                     Page 120 of 254
                                                                               Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                            (Regular Benefits)


                                                                                                                                                                     DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION   DIN / PIN           PRODUCT NAME   IC           GENERIC NAME             STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02371898       MAR-CITALOPRAM      Y    CITALOPRAM HYDROBROMIDE         20 MG       ORAL               TABLET                 MAR        W                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02246594       MYLAN-CITALOPRAM    Y    CITALOPRAM HYDROBROMIDE         20 MG       ORAL               TABLET                 MYP        W                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02246056       APO-CITALOPRAM      Y    CITALOPRAM HYDROBROMIDE         20 MG       ORAL               TABLET                 APX        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02248010       PMS-CITALOPRAM      Y    CITALOPRAM HYDROBROMIDE         20 MG       ORAL               TABLET                 PMS        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02248050       CO CITALOPRAM       Y    CITALOPRAM HYDROBROMIDE         20 MG       ORAL               TABLET                 COB        W                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02248170       SANDOZ CITALOPRAM   Y    CITALOPRAM HYDROBROMIDE         20 MG       ORAL               TABLET                 SDZ        W                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02285622       RAN-CITALO          Y    CITALOPRAM HYDROBROMIDE         20 MG       ORAL               TABLET                 RAN        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02306239       CITALOPRAM-ODAN     Y    CITALOPRAM HYDROBROMIDE         20 MG       ORAL               TABLET                 ODN        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02293218       NOVO-CITALOPRAM     Y    CITALOPRAM HYDROBROMIDE         20 MG       ORAL               TABLET                 TEV        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02248944       PHL-CITALOPRAM      Y    CITALOPRAM HYDROBROMIDE         20 MG       ORAL               TABLET                 PHH        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02304686       MINT-CITALOPRAM     Y    CITALOPRAM HYDROBROMIDE         20 MG       ORAL               TABLET                 MPI        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02313405       JAMP-CITALOPRAM     Y    CITALOPRAM HYDROBROMIDE         20 MG       ORAL               TABLET                 JPC        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02239607       CELEXA              Y    CITALOPRAM HYDROBROMIDE         20 MG       ORAL               TABLET                 LBC        W            7.50%          N      1.3317    0.5011     REGULAR BENEFIT
                                        17
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02296152       CTP 30              N    CITALOPRAM HYDROBROMIDE         30 MG       ORAL               TABLET                 SUN        W            7.50%          N      0.8750               REGULAR BENEFIT
                                            1
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02313413       JAMP-CITALOPRAM     Y    CITALOPRAM HYDROBROMIDE         40 MG       ORAL               TABLET                 JPC        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02293226       NOVO-CITALOPRAM     Y    CITALOPRAM HYDROBROMIDE         40 MG       ORAL               TABLET                 TEV        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02331977       CITALOPRAM          Y    CITALOPRAM HYDROBROMIDE         40 MG       ORAL               TABLET                 RAN        B                           Y      0.5011    0.5011     REGULAR BENEFIT




                                                                                                          Updated July 1, 2012                                                                                                     Page 121 of 254
                                                                               Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                            (Regular Benefits)


                                                                                                                                                                     DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION   DIN / PIN          PRODUCT NAME    IC           GENERIC NAME             STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02355280       SEPTA-CITALOPRAM    Y    CITALOPRAM HYDROBROMIDE         40 MG       ORAL               TABLET                 SEP        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02353679       CITALOPRAM          Y    CITALOPRAM HYDROBROMIDE         40 MG       ORAL               TABLET                 SNS        W                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02371901       MAR-CITALOPRAM      Y    CITALOPRAM HYDROBROMIDE         40 MG       ORAL               TABLET                 MAR        W                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02246595       MYLAN-CITALOPRAM    Y    CITALOPRAM HYDROBROMIDE         40 MG       ORAL               TABLET                 MYP        W                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02246057       APO-CITALOPRAM      Y    CITALOPRAM HYDROBROMIDE         40 MG       ORAL               TABLET                 APX        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02248011       PMS-CITALOPRAM      Y    CITALOPRAM HYDROBROMIDE         40 MG       ORAL               TABLET                 PMS        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02248051       CO CITALOPRAM       Y    CITALOPRAM HYDROBROMIDE         40 MG       ORAL               TABLET                 COB        W                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02248171       SANDOZ CITALOPRAM   Y    CITALOPRAM HYDROBROMIDE         40 MG       ORAL               TABLET                 SDZ        W                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02285630       RAN-CITALO          Y    CITALOPRAM HYDROBROMIDE         40 MG       ORAL               TABLET                 RAN        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02252120       RATIO-CITALOPRAM    Y    CITALOPRAM HYDROBROMIDE         40 MG       ORAL               TABLET                 RPH        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02306247       CITALOPRAM-ODAN     Y    CITALOPRAM HYDROBROMIDE         40 MG       ORAL               TABLET                 ODN        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02248945       PHL-CITALOPRAM      Y    CITALOPRAM HYDROBROMIDE         40 MG       ORAL               TABLET                 PHH        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02304694       MINT-CITALOPRAM     Y    CITALOPRAM HYDROBROMIDE         40 MG       ORAL               TABLET                 MPI        B                           Y      0.5011    0.5011     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02239608       CELEXA              Y    CITALOPRAM HYDROBROMIDE         40 MG       ORAL               TABLET                 LBC        W            7.50%          N      1.3317    0.5011     REGULAR BENEFIT
                                        17
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02263238       CIPRALEX            N    ESCITALOPRAM OXALATE            10 MG       ORAL               TABLET                 LBC        W            7.50%          N      1.6933               REGULAR BENEFIT
                                            1
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02263254       CIPRALEX            N    ESCITALOPRAM OXALATE            20 MG       ORAL               TABLET                 LBC        W            7.50%          N      1.8027               REGULAR BENEFIT
                                            1




                                                                                                          Updated July 1, 2012                                                                                                     Page 122 of 254
                                                                            Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                         (Regular Benefits)


                                                                                                                                                                  DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION   DIN / PIN       PRODUCT NAME    IC            GENERIC NAME            STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02286068    FLUOXETINE          Y    FLUOXETINE HCL                  10 MG       ORAL               CAPSULE                SNS        W                           Y      0.8650    0.8650     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02380560    MINT-FLUOXETINE     Y    FLUOXETINE HCL                  10 MG       ORAL               CAPSULE                MPI        B                           Y      0.8650    0.8650     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02223481    PHL-FLUOXETINE      Y    FLUOXETINE HCL                  10 MG       ORAL               CAPSULE                PHH        B                           Y      0.8650    0.8650     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN               RATIO-FLUOXETINE
28160420   REUPTAKE INHIBITORS   02241371    HYDROCHLORIDE       Y    FLUOXETINE HCL                  10 MG       ORAL               CAPSULE                RPH        B                           Y      0.8650    0.8650     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02237813    MYLAN-FLUOXETINE    Y    FLUOXETINE HCL                  10 MG       ORAL               CAPSULE                MYP        W                           Y      0.8650    0.8650     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02242177    CO FLUOXETINE       Y    FLUOXETINE HCL                  10 MG       ORAL               CAPSULE                COB        W                           Y      0.8650    0.8650     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02243486    SANDOZ FLUOXETINE   Y    FLUOXETINE HCL                  10 MG       ORAL               CAPSULE                SDZ        W                           Y      0.8650    0.8650     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02177579    PMS-FLUOXETINE      Y    FLUOXETINE HCL                  10 MG       ORAL               CAPSULE                PMS        B                           Y      0.8650    0.8650     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02216582    TEVA-FLUOXETINE     Y    FLUOXETINE HCL                  10 MG       ORAL               CAPSULE                TEV        B                           Y      0.8650    0.8650     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02216353    APO-FLUOXETINE      Y    FLUOXETINE HCL                  10 MG       ORAL               CAPSULE                APX        B                           Y      0.8650    0.8650     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02018985    PROZAC              Y    FLUOXETINE HCL                  10 MG       ORAL               CAPSULE                LIL        W            7.50%          N      1.8379    0.8650     REGULAR BENEFIT
                                        11
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02286076    FLUOXETINE          Y    FLUOXETINE HCL                  20 MG       ORAL               CAPSULE                SNS        W                           Y      0.6920    0.6920     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02380579    MINT-FLUOXETINE     Y    FLUOXETINE HCL                  20 MG       ORAL               CAPSULE                MPI        B                           Y      0.6920    0.6920     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02364530    AVA-FLUOXETINE      Y    FLUOXETINE HCL                  20 MG       ORAL               CAPSULE                AVA        W                           Y      0.6920    0.6920     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02223503    PHL-FLUOXETINE      Y    FLUOXETINE HCL                  20 MG       ORAL               CAPSULE                PHH        B                           Y      0.6920    0.6920     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02177587    PMS-FLUOXETINE      Y    FLUOXETINE HCL                  20 MG       ORAL               CAPSULE                PMS        B                           Y      0.6920    0.6920     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN               RATIO-FLUOXETINE
28160420   REUPTAKE INHIBITORS   02241374    HYDROCHLORIDE       Y    FLUOXETINE HCL                  20 MG       ORAL               CAPSULE                RPH        B                           Y      0.6920    0.6920     REGULAR BENEFIT




                                                                                                       Updated July 1, 2012                                                                                                     Page 123 of 254
                                                                                Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                             (Regular Benefits)


                                                                                                                                                                      DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION   DIN / PIN          PRODUCT NAME     IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02237814       MYLAN-FLUOXETINE     Y    FLUOXETINE HCL                  20 MG       ORAL               CAPSULE                MYP        W                           Y      0.6920    0.6920     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02242178       CO FLUOXETINE        Y    FLUOXETINE HCL                  20 MG       ORAL               CAPSULE                COB        W                           Y      0.6920    0.6920     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02243487       SANDOZ FLUOXETINE    Y    FLUOXETINE HCL                  20 MG       ORAL               CAPSULE                SDZ        W                           Y      0.6920    0.6920     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02216590       TEVA-FLUOXETINE      Y    FLUOXETINE HCL                  20 MG       ORAL               CAPSULE                TEV        B                           Y      0.6920    0.6920     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02216361       APO-FLUOXETINE       Y    FLUOXETINE HCL                  20 MG       ORAL               CAPSULE                APX        B                           Y      0.6920    0.6920     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   00636622       PROZAC               Y    FLUOXETINE HCL                  20 MG       ORAL               CAPSULE                LIL        W            7.50%          N      1.8393    0.6920     REGULAR BENEFIT
                                        12
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02231328       APO-FLUOXETINE       N    FLUOXETINE HCL                  4 MG / ML   ORAL               LIQUID                 APX        B                           N      0.5859               REGULAR BENEFIT
                                            1
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02218453       RATIO-FLUVOXAMINE    Y    FLUVOXAMINE MALEATE             50 MG       ORAL               TABLET                 RPH        B                           Y      0.3063    0.3063     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02363763       AVA-FLUVOXAMINE      Y    FLUVOXAMINE MALEATE             50 MG       ORAL               TABLET                 AVA        W                           Y      0.3063    0.3063     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02240682       PMS-FLUVOXAMINE      Y    FLUVOXAMINE MALEATE             50 MG       ORAL               TABLET                 PMS        B                           Y      0.3063    0.3063     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02239953       NOVO-FLUVOXAMINE     Y    FLUVOXAMINE MALEATE             50 MG       ORAL               TABLET                 TEV        B                           Y      0.3063    0.3063     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02231329       APO-FLUVOXAMINE      Y    FLUVOXAMINE MALEATE             50 MG       ORAL               TABLET                 APX        B                           Y      0.3063    0.3063     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02247054       SANDOZ FLUVOXAMINE   Y    FLUVOXAMINE MALEATE             50 MG       ORAL               TABLET                 SDZ        W                           Y      0.3063    0.3063     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02255529       CO FLUVOXAMINE       Y    FLUVOXAMINE MALEATE             50 MG       ORAL               TABLET                 COB        W                           Y      0.3063    0.3063     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   01919342       LUVOX                Y    FLUVOXAMINE MALEATE             50 MG       ORAL               TABLET                 ABB        B                           N      0.8750    0.3063     REGULAR BENEFIT
                                            8
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02255537       CO FLUVOXAMINE       Y    FLUVOXAMINE MALEATE             100 MG      ORAL               TABLET                 COB        W                           Y      0.5506    0.5506     REGULAR BENEFIT




                                                                                                           Updated July 1, 2012                                                                                                     Page 124 of 254
                                                                                  Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                               (Regular Benefits)


                                                                                                                                                                        DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION   DIN / PIN              PRODUCT NAME   IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02218461       RATIO-FLUVOXAMINE      Y    FLUVOXAMINE MALEATE             100 MG      ORAL               TABLET                 RPH        B                           Y      0.5506    0.5506     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02363771       AVA-FLUVOXAMINE        Y    FLUVOXAMINE MALEATE             100 MG      ORAL               TABLET                 AVA        W                           Y      0.5506    0.5506     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02240683       PMS-FLUVOXAMINE        Y    FLUVOXAMINE MALEATE             100 MG      ORAL               TABLET                 PMS        B                           Y      0.5506    0.5506     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02239954       NOVO-FLUVOXAMINE       Y    FLUVOXAMINE MALEATE             100 MG      ORAL               TABLET                 TEV        B                           Y      0.5506    0.5506     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02231330       APO-FLUVOXAMINE        Y    FLUVOXAMINE MALEATE             100 MG      ORAL               TABLET                 APX        B                           Y      0.5506    0.5506     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02247055       SANDOZ FLUVOXAMINE     Y    FLUVOXAMINE MALEATE             100 MG      ORAL               TABLET                 SDZ        W                           Y      0.5506    0.5506     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   01919369       LUVOX                  Y    FLUVOXAMINE MALEATE             100 MG      ORAL               TABLET                 ABB        B                           N      1.5730    0.5506     REGULAR BENEFIT
                                            8
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02282852       PAROXETINE             Y    PAROXETINE HCL                  20 MG       ORAL               TABLET                 SNS        W                           Y      0.6794    0.6794     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02248451       PAROXETINE             Y    PAROXETINE HCL                  20 MG       ORAL               TABLET                 MEL        B                           Y      0.6794    0.6794     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02248013       MYLAN-PAROXETINE       Y    PAROXETINE HCL                  20 MG       ORAL               TABLET                 MYP        W                           Y      0.6794    0.6794     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02247811       RATIO-PAROXETINE       Y    PAROXETINE HCL                  20 MG       ORAL               TABLET                 RPH        B                           Y      0.6794    0.6794     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02247751       PMS-PAROXETINE         Y    PAROXETINE HCL                  20 MG       ORAL               TABLET                 PMS        B                           Y      0.6794    0.6794     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02240908       APO-PAROXETINE         Y    PAROXETINE HCL                  20 MG       ORAL               TABLET                 APX        B                           Y      0.6794    0.6794     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02248557       TEVA-PAROXETINE        Y    PAROXETINE HCL                  20 MG       ORAL               TABLET                 TEV        B                           Y      0.6794    0.6794     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02262754       CO PAROXETINE          Y    PAROXETINE HCL                  20 MG       ORAL               TABLET                 COB        W                           Y      0.6794    0.6794     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02269430       SANDOZ PAROXETINE      Y    PAROXETINE HCL                  20 MG       ORAL               TABLET                 SDZ        W                           Y      0.6794    0.6794     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   01940481       PAXIL                  Y    PAROXETINE HCL                  20 MG       ORAL               TABLET                 GSK        W            7.50%          N      1.8056    0.6794     REGULAR BENEFIT
                                        10




                                                                                                             Updated July 1, 2012                                                                                                     Page 125 of 254
                                                                                  Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                               (Regular Benefits)


                                                                                                                                                                        DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION   DIN / PIN              PRODUCT NAME   IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02282860       PAROXETINE             Y    PAROXETINE HCL                  30 MG       ORAL               TABLET                 SNS        W                           Y      0.7218    0.7218     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02248452       PAROXETINE             Y    PAROXETINE HCL                  30 MG       ORAL               TABLET                 MEL        B                           Y      0.7218    0.7218     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02248014       MYLAN-PAROXETINE       Y    PAROXETINE HCL                  30 MG       ORAL               TABLET                 MYP        W                           Y      0.7218    0.7218     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02247812       RATIO-PAROXETINE       Y    PAROXETINE HCL                  30 MG       ORAL               TABLET                 RPH        B                           Y      0.7218    0.7218     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02247752       PMS-PAROXETINE         Y    PAROXETINE HCL                  30 MG       ORAL               TABLET                 PMS        B                           Y      0.7218    0.7218     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02240909       APO-PAROXETINE         Y    PAROXETINE HCL                  30 MG       ORAL               TABLET                 APX        B                           Y      0.7218    0.7218     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02248558       TEVA-PAROXETINE        Y    PAROXETINE HCL                  30 MG       ORAL               TABLET                 TEV        B                           Y      0.7218    0.7218     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02262762       CO PAROXETINE          Y    PAROXETINE HCL                  30 MG       ORAL               TABLET                 COB        W                           Y      0.7218    0.7218     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02269449       SANDOZ PAROXETINE      Y    PAROXETINE HCL                  30 MG       ORAL               TABLET                 SDZ        W                           Y      0.7218    0.7218     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02254778       SANDOZ PAROXETINE      Y    PAROXETINE HCL                  30 MG       ORAL               TABLET                 SDZ        W                           Y      0.7218    0.7218     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   01940473       PAXIL                  Y    PAROXETINE HCL                  30 MG       ORAL               TABLET                 GSK        W            7.50%          N      1.9183    0.7218     REGULAR BENEFIT
                                        11
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02293749       PMS-PAROXETINE         N    PAROXETINE HCL                  40 MG       ORAL               TABLET                 PMS        B                           N      2.2454               REGULAR BENEFIT
                                            1
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02240485       TEVA-SERTRALINE        Y    SERTRALINE HCL                  25 MG       ORAL               CAPSULE                TEV        B                           Y      0.3169    0.3169     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02353520       SERTRALINE             Y    SERTRALINE HCL                  25 MG       ORAL               CAPSULE                SNS        W                           Y      0.3169    0.3169     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02245824       PHL-SERTRALINE         Y    SERTRALINE HCL                  25 MG       ORAL               CAPSULE                PHH        B                           Y      0.3169    0.3169     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02273683       GD-SERTRALINE          Y    SERTRALINE HCL                  25 MG       ORAL               CAPSULE                GMD        W                           Y      0.3169    0.3169     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02374552       RAN-SERTRALINE         Y    SERTRALINE HCL                  25 MG       ORAL               CAPSULE                RAN        B                           Y      0.3169    0.3169     REGULAR BENEFIT




                                                                                                             Updated July 1, 2012                                                                                                     Page 126 of 254
                                                                            Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                         (Regular Benefits)


                                                                                                                                                                  DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION   DIN / PIN       PRODUCT NAME    IC            GENERIC NAME            STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02287390    CO SERTRALINE       Y    SERTRALINE HCL                  25 MG       ORAL               CAPSULE                COB        W                           Y      0.3169    0.3169     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02238280    APO-SERTRALINE      Y    SERTRALINE HCL                  25 MG       ORAL               CAPSULE                APX        B                           Y      0.3169    0.3169     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02245159    SANDOZ SERTRALINE   Y    SERTRALINE HCL                  25 MG       ORAL               CAPSULE                SDZ        W                           Y      0.3169    0.3169     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02244838    PMS-SERTRALINE      Y    SERTRALINE HCL                  25 MG       ORAL               CAPSULE                PMS        B                           Y      0.3169    0.3169     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02242519    MYLAN-SERTRALINE    Y    SERTRALINE HCL                  25 MG       ORAL               CAPSULE                MYP        W                           Y      0.3169    0.3169     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02132702    ZOLOFT              Y    SERTRALINE HCL                  25 MG       ORAL               CAPSULE                PFI        W            7.50%          N      0.8422    0.3169     REGULAR BENEFIT
                                        11
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02353539    SERTRALINE          Y    SERTRALINE HCL                  50 MG       ORAL               CAPSULE                SNS        W                           Y      0.6337    0.6337     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02245825    PHL-SERTRALINE      Y    SERTRALINE HCL                  50 MG       ORAL               CAPSULE                PHH        B                           Y      0.6337    0.6337     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02273691    GD-SERTRALINE       Y    SERTRALINE HCL                  50 MG       ORAL               CAPSULE                GMD        W                           Y      0.6337    0.6337     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02374560    RAN-SERTRALINE      Y    SERTRALINE HCL                  50 MG       ORAL               CAPSULE                RAN        B                           Y      0.6337    0.6337     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02287404    CO SERTRALINE       Y    SERTRALINE HCL                  50 MG       ORAL               CAPSULE                COB        W                           Y      0.6337    0.6337     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02238281    APO-SERTRALINE      Y    SERTRALINE HCL                  50 MG       ORAL               CAPSULE                APX        B                           Y      0.6337    0.6337     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02245160    SANDOZ SERTRALINE   Y    SERTRALINE HCL                  50 MG       ORAL               CAPSULE                SDZ        W                           Y      0.6337    0.6337     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02244839    PMS-SERTRALINE      Y    SERTRALINE HCL                  50 MG       ORAL               CAPSULE                PMS        B                           Y      0.6337    0.6337     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02242520    MYLAN-SERTRALINE    Y    SERTRALINE HCL                  50 MG       ORAL               CAPSULE                MYP        W                           Y      0.6337    0.6337     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   02240484    TEVA-SERTRALINE     Y    SERTRALINE HCL                  50 MG       ORAL               CAPSULE                TEV        B                           Y      0.6337    0.6337     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS   01962817    ZOLOFT              Y    SERTRALINE HCL                  50 MG       ORAL               CAPSULE                PFI        W            7.50%          N      1.6844    0.6337     REGULAR BENEFIT
                                        11




                                                                                                       Updated July 1, 2012                                                                                                     Page 127 of 254
                                                                                Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                             (Regular Benefits)


                                                                                                                                                                      DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION    DIN / PIN          PRODUCT NAME    IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS    02353547       SERTRALINE          Y    SERTRALINE HCL                  100 MG      ORAL               CAPSULE                SNS        W                           Y      0.6641    0.6641     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS    02245826       PHL-SERTRALINE      Y    SERTRALINE HCL                  100 MG      ORAL               CAPSULE                PHH        B                           Y      0.6641    0.6641     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS    02273705       GD-SERTRALINE       Y    SERTRALINE HCL                  100 MG      ORAL               CAPSULE                GMD        W                           Y      0.6641    0.6641     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS    02374579       RAN-SERTRALINE      Y    SERTRALINE HCL                  100 MG      ORAL               CAPSULE                RAN        B                           Y      0.6641    0.6641     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS    02287412       CO SERTRALINE       Y    SERTRALINE HCL                  100 MG      ORAL               CAPSULE                COB        W                           Y      0.6641    0.6641     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS    02238282       APO-SERTRALINE      Y    SERTRALINE HCL                  100 MG      ORAL               CAPSULE                APX        B                           Y      0.6641    0.6641     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS    02245161       SANDOZ SERTRALINE   Y    SERTRALINE HCL                  100 MG      ORAL               CAPSULE                SDZ        W                           Y      0.6641    0.6641     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS    02244840       PMS-SERTRALINE      Y    SERTRALINE HCL                  100 MG      ORAL               CAPSULE                PMS        B                           Y      0.6641    0.6641     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS    02242521       MYLAN-SERTRALINE    Y    SERTRALINE HCL                  100 MG      ORAL               CAPSULE                MYP        W                           Y      0.6641    0.6641     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS    02240481       TEVA-SERTRALINE     Y    SERTRALINE HCL                  100 MG      ORAL               CAPSULE                TEV        B                           Y      0.6641    0.6641     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           SELECTIVE-SEROTONIN
28160420   REUPTAKE INHIBITORS    01962779       ZOLOFT              Y    SERTRALINE HCL                  100 MG      ORAL               CAPSULE                PFI        W            7.50%          N      1.7650    0.6641     REGULAR BENEFIT
                                         11
           ANTIDEPRESSANTS /
28160424   SEROTONIN MODULATORS   02348772       TRAZODONE           Y    TRAZODONE HCL                   50 MG       ORAL               TABLET                 SNS        W                           Y      0.1384    0.1384     REGULAR BENEFIT
           ANTIDEPRESSANTS /
28160424   SEROTONIN MODULATORS   02147637       APO-TRAZODONE       Y    TRAZODONE HCL                   50 MG       ORAL               TABLET                 APX        B                           Y      0.1384    0.1384     REGULAR BENEFIT
           ANTIDEPRESSANTS /
28160424   SEROTONIN MODULATORS   02144263       TEVA-TRAZODONE      Y    TRAZODONE HCL                   50 MG       ORAL               TABLET                 TEV        B                           Y      0.1384    0.1384     REGULAR BENEFIT
           ANTIDEPRESSANTS /
28160424   SEROTONIN MODULATORS   01937227       PMS-TRAZODONE       Y    TRAZODONE HCL                   50 MG       ORAL               TABLET                 PMS        B                           Y      0.1384    0.1384     REGULAR BENEFIT
           ANTIDEPRESSANTS /
28160424   SEROTONIN MODULATORS   02231683       MYLAN-TRAZODONE     Y    TRAZODONE HCL                   50 MG       ORAL               TABLET                 MYP        W                           Y      0.1384    0.1384     REGULAR BENEFIT
                                             5
           ANTIDEPRESSANTS /
28160424   SEROTONIN MODULATORS   02237339       PMS-TRAZODONE       N    TRAZODONE HCL                   75 MG       ORAL               TABLET                 PMS        B                           N      0.3506               REGULAR BENEFIT
                                             1
           ANTIDEPRESSANTS /
28160424   SEROTONIN MODULATORS   02348780       TRAZODONE           Y    TRAZODONE HCL                   100 MG      ORAL               TABLET                 SNS        W                           Y      0.2473    0.2473     REGULAR BENEFIT
           ANTIDEPRESSANTS /
28160424   SEROTONIN MODULATORS   02147645       APO-TRAZODONE       Y    TRAZODONE HCL                   100 MG      ORAL               TABLET                 APX        B                           Y      0.2473    0.2473     REGULAR BENEFIT




                                                                                                           Updated July 1, 2012                                                                                                     Page 128 of 254
                                                                                  Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                               (Regular Benefits)


                                                                                                                                                                        DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION      DIN / PIN          PRODUCT NAME   IC            GENERIC NAME             STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           ANTIDEPRESSANTS /
28160424   SEROTONIN MODULATORS    02231684       MYLAN-TRAZODONE     Y    TRAZODONE HCL                    100 MG      ORAL               TABLET                 MYP        W                           Y      0.2473    0.2473     REGULAR BENEFIT
           ANTIDEPRESSANTS /
28160424   SEROTONIN MODULATORS    01937235       PMS-TRAZODONE       Y    TRAZODONE HCL                    100 MG      ORAL               TABLET                 PMS        B                           Y      0.2473    0.2473     REGULAR BENEFIT
           ANTIDEPRESSANTS /
28160424   SEROTONIN MODULATORS    02144271       TEVA-TRAZODONE      Y    TRAZODONE HCL                    100 MG      ORAL               TABLET                 TEV        B                           Y      0.2473    0.2473     REGULAR BENEFIT
                                              5
           ANTIDEPRESSANTS /
28160424   SEROTONIN MODULATORS    02348799       TRAZODONE           Y    TRAZODONE HCL                    150 MG      ORAL               TABLET                 SNS        W                           Y      0.3633    0.3633     REGULAR BENEFIT
           ANTIDEPRESSANTS /
28160424   SEROTONIN MODULATORS    02147653       APO-TRAZODONE D     Y    TRAZODONE HCL                    150 MG      ORAL               TABLET                 APX        B                           Y      0.3633    0.3633     REGULAR BENEFIT
           ANTIDEPRESSANTS /
28160424   SEROTONIN MODULATORS    02144298       TEVA-TRAZODONE      Y    TRAZODONE HCL                    150 MG      ORAL               TABLET                 TEV        B                           Y      0.3633    0.3633     REGULAR BENEFIT
                                              3
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00335053       ELAVIL              N    AMITRIPTYLINE HCL                10 MG       ORAL               TABLET                 AAP        W            7.50%          N      0.0664               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00335061       ELAVIL              N    AMITRIPTYLINE HCL                25 MG       ORAL               TABLET                 AAP        W            7.50%          N      0.1211               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00335088       ELAVIL              N    AMITRIPTYLINE HCL                50 MG       ORAL               TABLET                 AAP        W            7.50%          N      0.2347               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00754129       ELAVIL              N    AMITRIPTYLINE HCL                75 MG       ORAL               TABLET                 AAP        W            7.50%          N      0.3634               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02040786       APO-CLOMIPRAMINE    Y    CLOMIPRAMINE HCL                 10 MG       ORAL               TABLET                 APX        B                           Y      0.1290    0.1290     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02244816       CO CLOMIPRAMINE     Y    CLOMIPRAMINE HCL                 10 MG       ORAL               TABLET                 COB        W                           Y      0.1290    0.1290     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00330566       ANAFRANIL           Y    CLOMIPRAMINE HCL                 10 MG       ORAL               TABLET                 SUN        W            7.50%          N      0.2766    0.1290     REGULAR BENEFIT
                                              3
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02040778       APO-CLOMIPRAMINE    Y    CLOMIPRAMINE HCL                 25 MG       ORAL               TABLET                 APX        B                           Y      0.1758    0.1758     REGULAR BENEFIT




                                                                                                             Updated July 1, 2012                                                                                                     Page 129 of 254
                                                                                Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                             (Regular Benefits)


                                                                                                                                                                      DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION      DIN / PIN         PRODUCT NAME   IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02244817       CO CLOMIPRAMINE    Y    CLOMIPRAMINE HCL                25 MG       ORAL               TABLET                 COB        W                           Y      0.1758    0.1758     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00324019       ANAFRANIL          Y    CLOMIPRAMINE HCL                25 MG       ORAL               TABLET                 SUN        W            7.50%          N      0.3769    0.1758     REGULAR BENEFIT
                                              3
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02040751       APO-CLOMIPRAMINE   Y    CLOMIPRAMINE HCL                50 MG       ORAL               TABLET                 APX        B                           Y      0.3237    0.3237     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02244818       CO CLOMIPRAMINE    Y    CLOMIPRAMINE HCL                50 MG       ORAL               TABLET                 COB        W                           Y      0.3237    0.3237     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00402591       ANAFRANIL          Y    CLOMIPRAMINE HCL                50 MG       ORAL               TABLET                 SUN        W            7.50%          N      0.6940    0.3237     REGULAR BENEFIT
                                              3
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02216248       APO-DESIPRAMINE    N    DESIPRAMINE HCL                 10 MG       ORAL               TABLET                 APX        B                           N      0.3804               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02216256       APO-DESIPRAMINE    N    DESIPRAMINE HCL                 25 MG       ORAL               TABLET                 APX        B                           N      0.3804               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02216264       APO-DESIPRAMINE    N    DESIPRAMINE HCL                 50 MG       ORAL               TABLET                 APX        B                           N      0.6704               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02216272       APO-DESIPRAMINE    N    DESIPRAMINE HCL                 75 MG       ORAL               TABLET                 APX        B                           N      0.8915               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02049996       APO-DOXEPIN        Y    DOXEPIN HCL                     10 MG       ORAL               CAPSULE                APX        B                           Y      0.1889    0.1889     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00024325       SINEQUAN           Y    DOXEPIN HCL                     10 MG       ORAL               CAPSULE                ERF        W            7.50%          N      0.2575    0.1889     REGULAR BENEFIT
                                              2




                                                                                                           Updated July 1, 2012                                                                                                     Page 130 of 254
                                                                                Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                             (Regular Benefits)


                                                                                                                                                                      DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION      DIN / PIN         PRODUCT NAME   IC            GENERIC NAME            STRENGTH          ROUTE              FORM            MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              01913425       NOVO-DOXEPIN       Y    DOXEPIN HCL                     25 MG       ORAL               CAPSULE                TEV        B                           Y      0.1576    0.1576     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02050005       APO-DOXEPIN        Y    DOXEPIN HCL                     25 MG       ORAL               CAPSULE                APX        B                           N      0.1860    0.1576     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00024333       SINEQUAN           Y    DOXEPIN HCL                     25 MG       ORAL               CAPSULE                ERF        W            7.50%          N      0.3141    0.1576     REGULAR BENEFIT
                                              3
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              01913433       NOVO-DOXEPIN       Y    DOXEPIN HCL                     50 MG       ORAL               CAPSULE                TEV        B                           Y      0.2923    0.2923     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02050013       APO-DOXEPIN        Y    DOXEPIN HCL                     50 MG       ORAL               CAPSULE                APX        B                           N      0.3450    0.2923     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00024341       SINEQUAN           Y    DOXEPIN HCL                     50 MG       ORAL               CAPSULE                ERF        W            7.50%          N      0.5814    0.2923     REGULAR BENEFIT
                                              3
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              01913441       NOVO-DOXEPIN       Y    DOXEPIN HCL                     75 MG       ORAL               CAPSULE                TEV        B                           Y      0.3916    0.3916     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02050021       APO-DOXEPIN        Y    DOXEPIN HCL                     75 MG       ORAL               CAPSULE                APX        B                           N      0.4953    0.3916     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00400750       SINEQUAN           Y    DOXEPIN HCL                     75 MG       ORAL               CAPSULE                ERF        W            7.50%          N      0.8416    0.3916     REGULAR BENEFIT
                                              3
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              01913468       NOVO-DOXEPIN       Y    DOXEPIN HCL                     100 MG      ORAL               CAPSULE                TEV        B                           Y      0.5160    0.5160     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02050048       APO-DOXEPIN        Y    DOXEPIN HCL                     100 MG      ORAL               CAPSULE                APX        B                           N      0.6526    0.5160     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00326925       SINEQUAN           Y    DOXEPIN HCL                     100 MG      ORAL               CAPSULE                ERF        W            7.50%          N      1.1089    0.5160     REGULAR BENEFIT
                                              3




                                                                                                           Updated July 1, 2012                                                                                                     Page 131 of 254
                                                                                  Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                               (Regular Benefits)


                                                                                                                                                                        DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION      DIN / PIN         PRODUCT NAME     IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              01913476       NOVO-DOXEPIN         N    DOXEPIN HCL                     150 MG      ORAL               CAPSULE                TEV        B                           N      1.1841               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00360201       IMIPRAMINE           N    IMIPRAMINE HCL                  10 MG       ORAL               TABLET                 AAP        W            7.50%          N      0.1370               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00312797       IMIPRAMINE           N    IMIPRAMINE HCL                  25 MG       ORAL               TABLET                 AAP        W            7.50%          N      0.2471               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00326852       IMIPRAMINE           N    IMIPRAMINE HCL                  50 MG       ORAL               TABLET                 AAP        W            7.50%          N      0.4822               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00644579       IMIPRAMINE           N    IMIPRAMINE HCL                  75 MG       ORAL               TABLET                 AAP        W            7.50%          N      0.6308               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02158612       NOVO-MAPROTILINE     N    MAPROTILINE HCL                 25 MG       ORAL               TABLET                 TEV        B                           N      0.5957               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02158620       NOVO-MAPROTILINE     N    MAPROTILINE HCL                 50 MG       ORAL               TABLET                 TEV        B                           N      1.1281               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02158639       NOVO-MAPROTILINE     N    MAPROTILINE HCL                 75 MG       ORAL               TABLET                 TEV        B                           N      1.5406               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02231781       NOVO-NORTRIPTYLINE   Y    NORTRIPTYLINE HCL               10 MG       ORAL               CAPSULE                TEV        B                           Y      0.0893    0.0893     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02364301       AVA-NORTRIPTYLINE    Y    NORTRIPTYLINE HCL               10 MG       ORAL               CAPSULE                AVA        W                           Y      0.0893    0.0893     REGULAR BENEFIT




                                                                                                             Updated July 1, 2012                                                                                                     Page 132 of 254
                                                                                  Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                               (Regular Benefits)


                                                                                                                                                                        DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION      DIN / PIN         PRODUCT NAME     IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02223511       APO-NORTRIPTYLINE    Y    NORTRIPTYLINE HCL               10 MG       ORAL               CAPSULE                APX        B                           Y      0.0893    0.0893     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02177692       PMS-NORTRIPTYLINE    Y    NORTRIPTYLINE HCL               10 MG       ORAL               CAPSULE                PMS        B                           Y      0.0893    0.0893     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00015229       AVENTYL              Y    NORTRIPTYLINE HCL               10 MG       ORAL               CAPSULE                PPH        W            7.50%          N      0.2373    0.0893     REGULAR BENEFIT
                                              5
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02231782       NOVO-NORTRIPTYLINE   Y    NORTRIPTYLINE HCL               25 MG       ORAL               CAPSULE                TEV        B                           Y      0.1804    0.1804     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02223538       APO-NORTRIPTYLINE    Y    NORTRIPTYLINE HCL               25 MG       ORAL               CAPSULE                APX        B                           Y      0.1804    0.1804     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02364328       AVA-NORTRIPTYLINE    Y    NORTRIPTYLINE HCL               25 MG       ORAL               CAPSULE                AVA        W                           Y      0.1804    0.1804     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02177706       PMS-NORTRIPTYLINE    Y    NORTRIPTYLINE HCL               25 MG       ORAL               CAPSULE                PMS        B                           Y      0.1804    0.1804     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00015237       AVENTYL              Y    NORTRIPTYLINE HCL               25 MG       ORAL               CAPSULE                PPH        W            7.50%          N      0.4794    0.1804     REGULAR BENEFIT
                                              5
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              02070987       TRIMIPRAMINE         N    TRIMIPRAMINE MALEATE            75 MG       ORAL               CAPSULE                AAP        W            7.50%          N      0.7314               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00740799       TRIMIPRAMINE         N    TRIMIPRAMINE MALEATE            12.5 MG     ORAL               TABLET                 AAP        W            7.50%          N      0.2156               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00740802       TRIMIPRAMINE         N    TRIMIPRAMINE MALEATE            25 MG       ORAL               TABLET                 AAP        W            7.50%          N      0.2776               REGULAR BENEFIT
                                              1




                                                                                                             Updated July 1, 2012                                                                                                     Page 133 of 254
                                                                                   Alberta Health and Wellness Drug Benefit List (AHWDBL) Effective July 1, 2012
                                                                                                                (Regular Benefits)


                                                                                                                                                                         DISTRIBUTION   DISTRIBUTION     LCA              LCA / MAC      COVERAGE
  PTC          PTC DESCRIPTION      DIN / PIN         PRODUCT NAME      IC            GENERIC NAME            STRENGTH          ROUTE                FORM          MFG      METHOD       ALLOWANCE     PRODUCT   PRICE      PRICE         STATUS
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00740810       TRIMIPRAMINE          N    TRIMIPRAMINE MALEATE            50 MG       ORAL               TABLET                 AAP        W            7.50%          N      0.5434               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           TRICYCLICS AND OTHER
           NOREPINEPHRINE-REUPTAKE
28160428   INHIBITORS              00740829       TRIMIPRAMINE          N    TRIMIPRAMINE MALEATE            100 MG      ORAL               TABLET                 AAP        W            7.50%          N      0.9273               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           MISCELLANEOUS                                                                                                                    EXTENDED-RELEASE
28160492   ANTIDEPRESSANTS         02275090       WELLBUTRIN XL         N    BUPROPION HCL                   150 MG      ORAL               TABLET                 VCL        B                           N      0.5573               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           MISCELLANEOUS                                                                                                                    EXTENDED-RELEASE
28160492   ANTIDEPRESSANTS         02275104       WELLBUTRIN XL         N    BUPROPION HCL                   300 MG      ORAL               TABLET                 VCL        B                           N      1.1150               REGULAR BENEFIT
                                              1
           ANTIDEPRESSANTS /
           MISCELLANEOUS                                                                                                                    SUSTAINED-
28160492   ANTIDEPRESSANTS         02275074       SANDOZ BUPROPION SR   Y    BUPROPION HCL                   100 MG      ORAL               RELEASE TABLET         SDZ        W                           Y      0.2103    0.2103     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           MISCELLANEOUS                                                                                                                    SUSTAINED-
28160492   ANTIDEPRESSANTS         02285657       RATIO-BUPROPION SR    Y    BUPROPION HCL                   100 MG      ORAL               RELEASE TABLET         RPH        B                           Y      0.2103    0.2103     REGULAR BENEFIT
                                              2
           ANTIDEPRESSANTS /
           MISCELLANEOUS                                                                                                                    SUSTAINED-
28160492   ANTIDEPRESSANTS         02275082       SANDOZ BUPROPION SR   Y    BUPROPION HCL                   150 MG      ORAL               RELEASE TABLET         SDZ        W                           Y      0.3275    0.3275     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           MISCELLANEOUS                                                                                                                    SUSTAINED-
28160492   ANTIDEPRESSANTS         02285665       RATIO-BUPROPION SR    Y    BUPROPION HCL                   150 MG      ORAL               RELEASE TABLET         RPH        B                           Y      0.3275    0.3275     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           MISCELLANEOUS                                                                                                                    SUSTAINED-
28160492   ANTIDEPRESSANTS         02313421       PMS-BUPROPION SR      Y    BUPROPION HCL                   150 MG      ORAL               RELEASE TABLET         PMS        B                           Y      0.3275    0.3275     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           MISCELLANEOUS                                                                                                                    SUSTAINED-
28160492   ANTIDEPRESSANTS         02363402       AVA-BUPROPION SR      Y    BUPROPION HCL                   150 MG      ORAL               RELEASE TABLET         AVA        W                           Y      0.3275    0.3275     REGULAR BENEFIT
           ANTIDEPRESSANTS /
           MISCELLANEOUS                                                                                                                    SUSTAINED-
28160492   ANTIDEPRESSANTS         02237825       WELLBUTRIN SR         Y    BUPROPION HCL                   150 MG      ORAL               RELEASE TABLET         VCL        B                           N      0.9356    0.3275     REGULAR BENEFIT