Prior Authorizations
The state budget crisis is having a ripple effect on Pharmacy. On July 20, the N.C. Division of Medical Assistance will begin the first three of a series of prior authorization policies under the Outpatient Pharmacy Program. The change comes as a result of the State's effort to save approximately $160 million in drug costs. Twelve to fifteen new Prior Authorizations are expected to occur over the next few months. The goal of Community Care staff is to make any coverage policies that come to pass as patient- and provider-friendly as possible. As with prior efforts, Community Care staff will be engaging in a large-scale educational effort with pharmacies, practices, and enrollees.
Transitioning patients to drugs not subject to Prior Authorization can be expedited with the use of the MD Easy Forms. The MD Easy Forms are pre-populated, patient-specific forms that will identify patients affected by the Prior Authorization. Once a physician completes, signs, and faxes it to the pharmacy, it legally becomes the patient's prescription. From past experience, the forms have reduced the physician's time spent requesting prior authorizations and patient gaps in therapy. To obtain MD Easy Forms, please contact your Network Pharmacist.
E-Prescribing Project Launched
About 85 percent of the pharmacies statewide are now activated for fully integrated e-prescribing, and activity has greatly increased since the launch in July 2008 of Community Care's e-Prescribing Project, according to Surescripts data. About 36 percent of Community Care practices have at least one active prescriber in the project as of the end of February and roughly 15 percent of all non-controlled substance prescriptions are sent electronically, up from 6 percent three months prior to the beginning of the project.
More on Generics
In another pharmacy initiative, Community Care is encouraging the broader use of generics and will continue to promote increased utilization of generic prescriptions in the next two years. Under the Generics Initiative with Community Care, more patients are choosing generics. In the first quarter of 2007, 59 percent of prescriptions were generics, and in the first quarter of 2009, that rate had increased to 69 percent. To meet the state's pharmacy budget goals, roughly 80 percent of prescription fills will need to be for generics.
North Carolina Lauded for E-Prescribing
The State of North Carolina was awarded a 2008 Safe-Rx Award by Surescripts, which operates the country's largest electronic prescribing network. The award, which is presented to the top 10 e-prescribing states in the nation, was presented on June 22 at the National Press Club. North Carolina is now sixth in the nation for e-scripts. The award recognized the e-prescribing partnership between the Department of Health and Human Services, Community Care, and Blue Cross/Blue Shield in North Carolina's success.
