IVR CHANGES

Effective September 2, 1999, changes were made to PharmaCare's IVR application. If you enquire about a blood glucose certificate, the IVR application will return to you the latest expiry date on file for the patient. Remember, the coverage expires at midnight the day prior to the expiry date quoted.

SUBMITTING INVOICES

When submitting invoices for Methadone or Plan B beds, please mail to the following address:
PharmaCare
Ministry of Health Services
PO Box 9655 Stn Prov Govt
Victoria BC V8W 9P2

RDP PRICING CHANGES

Effective November 1, 1999 the following RDP pricing changes will be implemented:

HUMALOG^® (INSULIN LISPRO)

Effective November 1, 1999, the new Max Price for Humalog^® (Insulin Lispro) will be $1.9625 per ml.

PROCYTOX

Effective Friday, August 20, 1999, the price in PharmaNet for DIN 13552 (Procytox) vial 1000mg is calculated by the price of a vial.

LCA POLICY CHANGES - NOVEMBER 1, 1999

REINTRODUCTION OF FULL AND PARTIAL BENEFIT STATUS
In response to concerns raised by the BCPhA and the pharmaceutical industry in February 1999, PharmaCare modified its policy of identifying specific products that would be fully covered under the LCA program. As you are aware, effective March 1, 1999, all products within an LCA category were limited to the lesser of AAC, the maximum price or the LCA price, eliminating the designation of full and partial benefit status.
It was hoped that the best interest of all stakeholders, including patients, would be met with this new approach. Since March, however, PharmaCare has received numerous requests from patients, as well as pharmacists, to identify at least one product in each LCA category as a full benefit under the LCA program.
As a result, effective November 1, 1999 those products within an LCA category that have the LOWEST price will be designated as FULL LCA benefits. PharmaCare will set the LCA price at the cost of the alternative with the lowest average PharmaCare claimed price of all the alternatives within an LCA category. Full LCA benefit status will generally be limited to a single product and manufacturer, while the remaining products will be partial benefits. Although many of these products have identical manufacturer list prices, PharmaCare cost experience can vary significantly among the available low cost alternatives. Because the LCA price is based on PharmaCare payment data, drugs with the same list price do not automatically have the same LCA benefit status.

LCA POLICY CHANGES (cont'd)

Claims received for drugs that are designated as partial benefits will be fully reimbursed only if the submitted drug cost is less than or equal to the LCA price. If the drug cost is higher than the LCA price, the claim will be reduced to the LCA price and the client required to pay the difference in cost. Only those drugs which are designated as full benefits will be adjudicated at the lesser of Actual Acquisition Cost (AAC) or the Maximum Price, as defined by the Maximum Price Policy.
The LCA/RDP book should not be considered an endorsement of the interchangeability of any products identified. In those situations where the products are not legally interchangeable, pharmacists are advised to consult with the prescriber and obtain the appropriate legal authority to dispense a low cost alternative or reference-drug product. For the purposes of LCA, pricing is based on the same chemical entity, recognizing the strength and dosage form that provides the best value.
PharmaCare is committed to ensuring the accessibility and affordability of its broad coverage programs and appreciates and is responsive to positive feedback from the pharmacist community.

LCA UPDATES

Please be advised that the following drugs will be include as new LCA categories effective November 1, 1999:
Betaxolol Solution 0.5%
Betaxolol Suspension 0.25%
Doxazosin Mesylate 1mg
Doxazosin Mesylate 2mg
Doxazosin Mesylate 4mg
Ipratropium Nasal Spray 0.03%
Testosterone Cypionate Injection 100mg/ml
Tobramycin Drops 3mg/ml
· Betaxolol solution and suspension, although not interchangeable, are considered bioequivalent. The LCA price for the suspension will be set at the LCA price for the solution.
· Chloral hydrate 500mg capsules and syrup have been removed from LCA due to the lack of more than one low cost alternative.


· The LCA price for Penicillin V 250 mg tablets will now be set at the LCA price for the 300 mg tablets.

BENEFITS

The following new drugs have been included
as eligible PharmaCare benefits on Plans A, B, C, E and F

NEW PRODUCTS CATEGORIZED TO LCA and/or RDP

The following new products will be included as benefits
under the LCA/RDP Program for Benefit Groups A, B, C, E, & F

NON BENEFITS

The following new drugs have not been included as benefits under any plans

NEW DRUGS UNDER REVIEW

The following new drug submissions are currently under review by the Therapeutics Initiative, Pharmacoeconomics Initiative and the Drug Benefit Committee of PharmaCare.
hydromorphone (HYDROMORPH CONTIN^® SR) controlled release capsules, resubmission
terbinafine 1% (LAMISIL^®) topical spray and cream
oxycodone long acting tablets (OXYCONTIN^®), resubmission

NEW DRUGS UNDER REVIEW (cont'd)

modafinil (ALERTEC^®) somatropin (HUMATROPE^®)
lamivudine (HEPTOVIR^®) raloxifene (EVISTA^®)
ciprofloxacin (CIPROFLOXACIN^®) ophth.oint. becaplermin gel (REGRANEX^®)
donepezil HCl (ARICEPT^®), resubmission citalopram hydrobromide (CELEXA^®)
interferon alfa-2b/ribavirin (REBETRON^®) grepafloxacin (RAXAR^®)
nadroparin (FRAXIPARINE^®) zafirlukast (ACCOLATE^®), resubmission
topiramate (TOPAMAX^®), 15 & 25mg Sprinkle Caps sildenafil citrate (VIAGRA^®)
celecoxib (CELEBREX^®) acarbose (PRANDASE^®), resubmission
tobramycin (TOBI^®) granisetron (KYTRIL^®), resubmission
repaglinide (GLUCONORM^®) cefprozil (CEFZIL^®), resubmission