8.6 Trial Prescription Program

General Policy Description

The intent of the Trial Prescription Program is to reduce the drug wastage that results when individuals have adverse drug reactions and cannot use the remainder of a normal prescription.

Under the program, the pharmacist can initially dispense a smaller quantity (maximum 14-day supply) than the prescription indicates for specific high-cost medications with known high incidence of side effects.

Policy Details

Pharmacy participation in the Trial Prescription Program is voluntary, but encouraged.

A small trial quantity (maximum 14-day supply) may be dispensed to individuals who are—for the first time—receiving one of a specific selection of chronic-condition medications that has a documented high incidence of side effects.

>> See the PharmaCare website for a list of the drugs eligible under the Trial Prescription Program.

The balance of the prescription may be dispensed once it has been established that the patient can tolerate the medication. That is, if the 14-day trial prescription produces no side effects, the patient returns to the pharmacy to fill the balance of the prescription.

The pharmacy can claim a second dispensing fee for filling the balance of the prescription.

Coverage of the dispensing fee (up to the PharmaCare maximum dispensing fee) and eligible drug costs for both the trial quantity and subsequent fill, if any, is subject to the patient's usual PharmaCare plan rules.

Payments the patient makes towards the eligible dispensing fee and eligible drug cost of both the trial quantity and subsequent fill, if any, will count towards the patient's Fair PharmaCare deductible.

Procedures

Procedures for pharmacies

Dispensing a trial quantity

1. Verify the medication is eligible under the Trial Prescription Program.
2. Use the intervention code MT to designate a trial prescription in PharmaNet.
3. Submit the claim in PharmaNet with the actual quantity of medication dispensed.
4. From the patient, collect any applicable contribution toward the dispensing fee and drug cost.
5. Indicate "Trial Prescription" directly on the label/receipt.
6. If unsure of a trial drug, call the PharmaNet Help Desk or use the PharmaCare Information Line to determine if a particular DIN is eligible under this program.

Dispensing the balance of a prescription

1. Put the balance of the prescription through as a normal transaction using

• The same prescription number as for the trial quantity, and
• The balance of the prescription as the quantity, and
• A blank in the Intervention and Exception Code field.

The usual rules for days' supply will be applied by PharmaNet in the adjudication.

       2. Collect any applicable co-payment from the patient. 

Completion of a form documenting the trial prescription is no longer required.