[Provider] 15-day limit on first-time prescriptions for certain drugs

[Provider Notification]

MaineCare has begun instituting measures to ensure cost effectiveness
through the use of Drug Benefit Management, Drug-Drug editing to ensure
education and patient safety, recent PPI limitations and Intensive
Benefit Management with controlled substances. 

 

For a number of years in Maine, research from the Maine Benzodiazepine
Study Group, The University of Maine Center on Aging, and in part funded
by the only Federal Grant in the US on unused drug return mail back
programming has suggested that adherence to medication and other
variables may lead to large amounts of unused and discarded medication.
Closer evaluation of side effects and efficacy may lead to better
patient outcome and better safety for patients with closer evaluation of
initial response.

 

With that, MaineCare will institute new 15 day limits on initial
prescriptions for various medication that have been identified with high
side effect profiles, high discontinuation rates, or frequent dose
adjustments to ensure cost effectiveness without "wasting" or
"discarding" of used medications.  Effective 8/6/09 MaineCare will begin
limiting initial prescriptions on the following medications, Suboxone,
Subutex, Chantix and Nicotine replacement products to 15 day supplies.
Initial prescriptions for preferred products over the initial 15 day
supply will require prior authorization. Subsequent refills of these
products will be allowed at the usual MaineCare allowable days supply.

 

For further questions please contact Goold Health Systems at
1-888-4450497.

 

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time.  Call Provider Enrollment at 1-800-321-5557 Option #6.  

 

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This is a one-way communication.  Do not reply to this e-mail.  Your
e-mail will not receive response.  If you have questions, please call
1-800-321-5557.  

 

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