Low Cost Alternative (LCA) program
Last updated on January 31, 2024The Low Cost Alternative (LCA) program groups together categories of drugs that contain the same active ingredients in the same strength and formulation, and PharmaCare assigns a maximum price it will cover for all products in each category.
For example, one category is acebutolol 100 mg tablets, while another is acebutolol 200 mg tablets. Several versions of these drugs are available on the market. Each category typically includes one or more brand-name drugs and one or more generic drugs.
PharmaCare fully covers drugs in a category that are priced at or below the PharmaCare maximum price. These are usually generic drugs.
PharmaCare partially covers drugs priced above the maximum price—up to the maximum price. These are usually brand-name drugs.
If a patient is not able to take a fully covered drug in a category, prescribers can submit a Special Authority request for full coverage of another drug.
For more information, visit Low Cost Alternative Program — Section 5.11, PharmaCare Policy Manual.
List of LCA drugs
A spreadsheet that lists all LCA drugs, categories and coverage (full or partial) can be found on the LCA data files web page.
LCA pricing exceptions
The following exceptions can affect how an LCA price is calculated:
- If the price of a capsule, sustained-release tablet or enteric-coated tablet is significantly higher than the tablet price, the LCA price is based on the tablet price
- If a product strength is priced significantly higher (proportionally) than others, LCA prices are based on the lowest-cost strength
- If the price of a suspension is significantly higher than the price of the solution, LCA prices are based on the solution price
- For creams and ointments, if the tube's per-unit price is significantly higher than the jar's per-unit price, LCA prices are based on the jar price
| Product | Pricing |
|---|---|
| desmopressin acetate (DDAVP Melt) tablet 60 mcg | The LCA price for DDAVP Melt tablet 60 mcg is set at the LCA price of desmopressin acetate 0.1mg tablet. |
| desmopressin acetate (DDAVP Melt) tablet 120 mcg | The LCA price for DDAVP Melt tablet 120 mcg is set at the LCA price of desmopressin acetate 0.2 mg tablet. |
| desmopressin acetate (DDAVP Melt) tablet 240 mcg | The LCA price for DDAVP Melt tablet 240 mcg is set at the LCA price of two desmopressin acetate 0.2 mg tablets. |
| fenofibrate (Lipidil EZ) tablet 145 mg | The LCA price is set at the LCA price for fenofibrate FC tablet 160 mg. |
| fenofibrate (Lipidil EZ) tablet 48 mg | The LCA price is pro-rated to the LCA price for Lipidil EZ tablet 145 mg. |
| tofacitinib (tofacitinib citrate) (Xeljanz XR) 11 mg |
The LCA price for tofacitinib XR tablet 11 mg will be up to the equivalent LCA pricing for two tofacitinib 5 mg tablets. |
