NYRx, the New York Medicaid Prescription Drug Program, made the following changes to the preferred drug list. Effective February 7, the following changes will be made to the Dispense Brand Name Drug When Less Expensive Than the Generic Program: 

  1. Alphagan P® 0.1%, Forteo® and Votrient® will be ADDED to the program.
  2. Flovent® HFA and Pennsaid® pump will be REMOVED from the program. Note: Pennsaid® pump has been discontinued by the manufacturer.
  3. Diclofenac 2% topical solution will remain in non-preferred status on the NYRx Preferred Drug List. Prescribers should transition their patients to an alternative preferred product or obtain a prior authorization for the diclofenac 2% solution. 

In conformance with State Education Law, a pharmacist shall dispense a less expensive, therapeutically equivalent drug containing the same active ingredients, dosage form and strength as the drug prescribed/ordered. This includes substituting the brand name drug when NYRx has determined it to be the less expensive alternative for the patient. Brand name drugs included in this program: 

  1. Do not require “Dispense as Written” (DAW) or “Brand Medically Necessary” on the prescription.
  2. Have a generic copayment.
  3. Are paid at the Brand Name Drug reimbursement rate or usual and customary price, whichever is lower (SMAC/FUL are not applied).
  4. Do not require a new prescription if the drug is removed from this program. 

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.