Recent changes to Iowa’s Medicaid Preferred Drug List (PDL), requiring pharmacies to stock brand over generic versions of several drugs, are harming Iowa retail pharmacists’ businesses.
Last year and again in January, 2014, Iowa’s Medicaid program altered its PDL to include new brand medications and medication amounts that pharmacies must stock for their Medicaid patients. To reduce drug costs, the state Medicaid
program requires certain drugs to be dispensed in 15-day supplies only. That way, if the patient’s physician recognizes that the medication is not effective and a prescription needs to be changed, Iowa Medicaid will not pick up the extra cost of unused product.
However, some pharmacists said, they are the ones left holding the bag. One of the most challenging examples occurred in 2011. Pharmacists filling Medicaid scripts were allowed to dispense only a 15-day supply of the daily Daytrana patch prescribed for ADHD. However, the patch is sold to pharmacies in 30-day supply boxes, which expire two months* after they are opened.
“It is around $200 for a 30-day supply. We were sitting with some products that would never get used,” said Tony Beraldi, RPh, president of the Southwest Iowa Pharmacists Association in Council Bluffs, Iowa, and owner of Oard Ross Drug Inc. Fortunately, in the case of Daytrana, many pharmacists complained to Iowa Medicaid, and the 15-day requirement was rescinded.