The state’s Department of Health provided notice to pharmacies that NYRx, the state Medicaid pharmacy benefit program, had changes to over the counter (OTC) drugs.
Effective April 1, NYRx will remove the following products from the List of Reimbursable Drugs:
- Cough and Cold Products: Oxymetazoline, Phenylephrine
- Gastrointestinal Products: Simethicone
- Anti-hypoglycemics: Glucose Tablets
- Dermatologicals: Neomycin, Bacitracin
- Multivitamins: For members aged 21 years and up
Impact on Providers and Patients
- Transition to Alternative Therapies: Providers are encouraged to discuss these changes with their patients. Alternative treatment options are available for medically necessary use. For example, alternatives to oxymetazoline or phenylephrine may include other decongestants or nasal corticosteroids that offer more effective management of nasal congestion.
- Patient Education: NYRx has notified members of these changes. Additionally, provider education to patients about these formulary changes is helpful and provide safer and more effective alternatives. Ensuring that patients understand the rationale behind these changes and the benefits of alternative therapies is essential for a smooth transition.
- Adjusting Prescribing Practices: Given these changes, providers may need to modify their prescribing practices. Staying informed about which medications remain covered and considering the most appropriate therapies for patients’ needs will be crucial. The New York Medicaid list of reimbursable drugs is available online.
NYRx is committed to continuously monitoring medication utilization and effectiveness to ensure that the OTC formulary remains aligned with evidence-based practices.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.