58-29E-8. Dispensation of substitute prescription drug for prescribed drug.
With regard to the dispensation of a substitute prescription drug for a prescribed drug to a covered individual, when the pharmacy benefits manager requests a substitution, the following provisions apply:
(1)The pharmacy benefits manager may request the substitution of a lower- priced generic and therapeutically equivalent drug for a higher-priced prescribed drug;
(2)With regard to substitutions in which the substitute drug's net cost is more for the covered individual or the covered entity than the prescribed drug, the substitution must be made only for medical reasons that benefit the covered individual. If a substitution is being requested pursuant to this subdivision, the pharmacy benefits manager shall obtain the approval of the prescribing health professional.
Nothing in this section permits the substitution of an equivalent drug product contrary to §36-11-46.2
Source: SL 2004, ch 311, §8.
Structure South Dakota Codified Laws
Chapter 29E - Pharmacy Benefits Management
Section 58-29E-1 - Definition of terms.
Section 58-29E-2 - Pharmacy benefits manager licensed as third party administrator.
Section 58-29E-3 - Manager to perform duties in good faith.
Section 58-29E-5 - Permission of entity required to contact covered individual--Exception.
Section 58-29E-6 - Confidentiality of information--Injunction--Damages.
Section 58-29E-7 - Audits of manager's books and records .
Section 58-29E-8 - Dispensation of substitute prescription drug for prescribed drug.
Section 58-29E-8.1 - Cost-sharing information not to be restricted.
Section 58-29E-9 - Rules--Content.
Section 58-29E-10 - Civil action--Enforcement of chapter--Damages.
Section 58-29E-11 - Application of chapter to certain contracts.
Section 58-29E-13 - Certain claims adjustments prohibited.
Section 58-29E-14 - Adjustment of claim due to error in adjudication permitted.