Pharmacy

Prescription Advantage List (PAL)

The Prescription Advantage List (PAL) was developed by the North Carolina Physicians' Advisory Group (NCPAG) and Community Care of North Carolina, in cooperation with the state's Division of Medical Assistance, as an effort to control rising pharmacy costs in North Carolina Medicaid. The voluntary list is a guide for physicians to prescribe less expensive medications whenever possible and clinically appropriate. By evaluating the actual net cost of each medication to North Carolina Medicaid (including rebates), the medications in each class are ranked in order from least expensive to most expensive, as determined by the NCPAG. No judgment as to efficacy is implied by this list; rather, it is intended as an educational tool based on cost alone.

The PAL Pocket Card was developed to assist physicians change prescribing behaviors for select commonly prescribed high cost, high utilization drugs when good generic alternatives are available. The complete, Interactive PAL is available online and allows users to compare pricing tiers between medications and classes.

Pharmacist Referral Program

In 2003, AccessCare began its PolyPharmacy initiative to address the high costs of drugs used by nursing home patients.  Pharmacy consultants reviewed prescription regimens of all Medicaid and dual eligible nursing home patients and made recommendations to physicians in order to optimize overall drug management and reduce costs where appropriate.  These efforts led to not only millions of dollars in reduced drug costs, but improved patient health care due to the reduction of duplicate drugs and fewer adverse drug-drug interactions.  The initiative continues with annual drug review efforts in nursing homes in order to maintain cost effective and high-quality drug regimen solutions for patients. Read more...

Pharmacy Links

Community Care of North Carolina Pharmacy Initiatives

Community Care of North Carolina (CCNC) Clinical Directors chose pharmacy as a quality improvement and cost containment effort in 2002 as a response to continuously increasing Medicaid pharmacy expenditures and patients on eight or more medications. The pharmacy initiative provides an opportunity to improve patient health outcomes.

NC Division of Medical Assistance: Outpatient Pharmacy Services

The Division of Medical Assistance's Outpatient Pharmacy Services website provides the most up-to-date policies and procedures for Medicaid pharmacy related services. The site provides pharmacy newsletters, over-the-counter and prescription drug policies, billing guidelines, and prior authorization policies and forms.

North Carolina Controlled Substances Reporting System

This statewide reporting system was established by North Carolina law to improve the state's ability to identify people who abuse and misuse prescription drugs classified as Schedule II-V controlled substances. It is also meant to assist clinicians in identifying and referring for treatment patients misusing controlled substances.