The primary care NP sees a patient covered by Medicaid, writes a prescription for a medication, and is informed by the pharmacist that the medication is "off-formulary." The NP should:
a. inform the patient that an out-of-pocket expense will be necessary.
b. write the prescription for a generic drug if it meets the patient's needs.
c. call the patient's insurance provider to advocate for this particular drug.
d. contact the pharmaceutical company to see if medication samples are available.
B
Medicaid often stipulates which medications are or are not covered. Unless the particular drug is absolutely necessary, the NP should substitute with an acceptable generic drug. Insisting that the patient pay out of pocket may mean that the prescription is not filled. If the drug is necessary, the NP may advocate for its use by contacting the third-party payer. Asking for drug samples is not a long-term solution for the problem.
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