58-29E-8. Dispensation of substitute prescription drug for prescribed drug. With regard to the dispensation of a substitute prescription drug for a prescribed drug to a covered individual, when the pharmacy benefits manager requests a substitution, the following provisions apply:
(1) The pharmacy benefits manager may request the substitution of a lower- priced generic and therapeutically equivalent drug for a higher-priced prescribed drug;
(2) With regard to substitutions in which the substitute drug's net cost is more for the covered individual or the covered entity than the prescribed drug, the substitution must be made only for medical reasons that benefit the covered individual. If a substitution is being requested pursuant to this subdivision, the pharmacy benefits manager shall obtain the approval of the prescribing health professional.
Nothing in this section permits the substitution of an equivalent drug product contrary to § 36-11-46.2
Source: SL 2004, ch 311, § 8.
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