March 2010

 

DMA established a Preferred Drug List (PDL) on March 15, 2010 to obtian better prices for covered outpatient drugs through supplemental rebates. Initially, there will be NO changes in the drugs that are currently covered.  In the future, selected therapeutic drug classes will be reviewed and specific drugs defined as "preferred." Generally, these drugs will not require Prior Authorization(PA) unless there are other clinical PA requirements such as step therapy or quantity limits.

"Non-preferred" drugs will be available if prior authorization criteria are met.  The PA process will be the same as it is today.  The prescriber will be responsible for initiating a PA request.  For therapeutic drug classes that do not appear on the PDL, nothing has changed.

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PAL/PHARMACY

Help the NC Medicaid prescription benefits work better for everyone.

If 50% of the prescriptions written for non-sedating antihistamines and proton pump inhibitors were prescribed as over the counter medications (OTC), NC Medicaid could save $50 million annually and maintain a strong prescription benefit program for enrollees.

 

The Prescription Advantage List (PAL) is a voluntary prescription list developed by the Community Care of NC (CCNC) Medical Directors.  The PAL ranks drugs within ten therapeutic categories according to cost (tier).

 

Tier 1 is the least expensive

 

Tier 3 is the most expensive

 

PAL pocket guides and office charts are provided to practices by 4C and the assigned case manager. 

 

View latest Prescription Advantage List

 
 

Carolina Collaborative Community Care (4C)

Phone: (910) 485-1250 Fax: (910) 485-7238