email print share Twitter Digg Yahoo Facebook Delicious Google LinkedIn Reddit StumbleUpon

Avalere Finds States Have Varying Patient Consent and Notification Strategies When Dispensing Generic vs. Brand Name Drugs

Contact: Lindsey Spindle, 202.207.1337, lspindle@avalerehealth.net

06.07.10

Washington, DC – Eight states allow pharmacists to dispense generic medication to Medicaid beneficiaries without obtaining consent or notifying the patient, found Avalere Health in its new review of state-based policies regarding generic substitution.  Avalere released its findings today at the National Medicaid Congress, post healthcare reform when Medicaid expansion and its effects are increasingly the focus of the healthcare community.

Avalere studied all fifty states and the District of Columbia’s generic dispensing policies to determine the flexibility afforded to pharmacists in determining whether a patient receives a brand-name drug or a generic.   Researchers found that 16 states require pharmacists to dispense generics if a prescription does not specify that brand is necessary.  Nearly every state – 49 out of 50 – allow prescribers to require a brand name drug.  Ten states mandate that prescribers sign a special signature line that specifies their order for a brand-name drug. 

• Oklahoma is the only state that actively prohibits pharmacists from dispensing a generic unless the prescriber or purchaser specifically authorizes it.
• Several states, including Connecticut and Indiana, have implemented policies that are more “generics-friendly” for patients in government health programs such as Medicaid.
• For Maine patients paying for the prescription with their own resources, pharmacists must ask whether the patient prefers to receive the brand or the generic.

“Some states have given pharmacists an enormous amount of authority and latitude in how they dispense prescriptions to patients,” said Lisa Murphy, a senior manager at Avalere Health and lead analyst for this research project.  “As health plans and government payers continue to look for ways to control costs, it will be important to observe if these trends continue to shift toward more restrictive access to branded drugs for patients.’

Avalere Health is an advisory services company whose core purpose is to create innovative solutions to complex healthcare problems. Based in Washington DC, the firm delivers research, analysis, insight, and strategy for leaders in healthcare business and policy. Avalere's experts span 125 staff drawn from the federal government (e.g., CMS, OMB, CBO, and the Congress), Fortune 500 healthcare companies, top consultancies, and nonprofits. The firm offers deep substance in areas ranging from healthcare coverage and financing to the changing role of evidence in healthcare decision-making. Its focus on strategy is supported by a rigorous, in-house analytic research group that uses public and private data to generate quantitative insight. Through events, publications, and interactive programs, Avalere also translates real-time healthcare developments into actionable information.

Learn more at www.avalerehealth.net.

Return to the News Room.