The State Department of Health shared the following reminder:
NYRx, the Medicaid Pharmacy Program would like to remind stakeholders, including prescribers, pharmacists, members and other caregivers, that 90-day supplies of most maintenance medications and over the counter (OTC) drugs are covered by NYRx. This benefit applies, but is not limited to, NYRx covered OTC medications such as aspirin, acetaminophen, ibuprofen, antihistamines and covered vitamins and minerals, such as prenatal vitamins, vitamin B, vitamin D, calcium, fluoride and iron preparations. For a complete list of medications covered by NYRx, see the Medicaid pharmacy list of reimbursable drugs. 90-day supplies offer numerous benefits:
- For patients, cost savings with less copays, convenience of less trips to the pharmacy, improved medication adherence and reduced risk of missing refills.
- For prescribers, increased patient adherence equals easier monitoring, reduced administrative burden, increased patient satisfaction and a more streamlined process for chronic disease management.
- For pharmacies, increased patient adherence, improved operational efficiency leading to more time for additional services such as immunizations and medication therapy management (MTM) and enhanced customer satisfaction resulting in a stronger patient-pharmacy relationship.
Prescribers should consider writing for a 90-day supply and pharmacists should work with prescribers to switch to a 90-day supply, once it is determined the patient is on a stable dose of a maintenance medication or OTC drug.
Furthermore, pharmacists may also submit for package size quantities that closely represent the prescriber's fiscal order. For instance, if a prescriber writes for a quantity of 90 tablets and the closest package size is 100 tablets, that can be utilized.
For questions on this policy, contact NYRx@health.ny.gov or 518-486-3209.
Also in New York, NYRx Education and Outreach team shared an NYRx Brand Less Than Generic Program Update, effective August 21.
- Complera® will be ADDED to the program.
- Pradaxa®, Sandostatin LAR®, and Sprycel® will be REMOVED from the program.
For more information related to the Brand Less Than Generic (BLTG) Program, please review the BLTG YouTube webinar, NYRx, the Brand Less Than Generic (BLTG) Program – YouTube.
The NYRx Education & Outreach Call Center is available by phone at 1-833-967-7310 or by email at NYRxEO@primetherapeutics.com from 8:00 am to 5:00 pm ET, Monday through Friday, excluding holidays.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
