§ 510B.6 — Substitute prescription drugs

Iowa § 510B.6

• Jurisdiction: Iowa
• Title XIII: COMMERCE
• Ch. 510B: REGULATION OF PHARMACY BENEFITS MANAGERS

Text

1. The following provisions shall apply if a pharmacy benefits manager requests the
dispensing of a substitute prescription drug for a drug prescribed for a covered person:
a. The pharmacy benefits manager may request the substitution of a lower priced generic
and therapeutically equivalent prescription drug for a higher priced prescription drug.
b. If the substitute prescription drug’s net cost to the covered person or to the health
carrier exceeds the cost of the prescription drug originally prescribed for the covered person,
the substitution shall be made only for medical reasons that benefit the covered person.
2. A pharmacy benefits manager shall obtain the approval of the prescribing health care
professional prior to requesting any substitution under this section.
3. A pharmacy benefits manager shall not substitute an equivalent prescription drug
contrary to a prescription drug order that prohibits a substitution.