Rational Drug Therapy Program 
WVBMS Drug Therapy Guidelines 

Mandatory Generic Substitution Criteria 

 
Mandatory generic substitution is required for all Brand Medically Necessary prescriptions that have both:
  1. A Federal MAC price and
  2. An "AA" or "AB" rated generic
To get approval the physician must send a letter (FAX or mail) to RDTP explaining the request for exception.

Exemption Criteria:

  1. Allergic Reaction to excipients in the generic products.  If multiple generics are available then a history of multiple companies must exist.
  2. A therapeutic failure to the generic product.  A history of previous purchases will be reviewed to determine dosing and compliance issues.
  3. Tegretol/Depakene, and/or patients stabilized on brand name anti-psychotics
  4. Patient requests for brand will not be accepted
 
Rational Drug Therapy Program 
West Virginia University School of Pharmacy 
P.O. Box 9511 
Morgantown, WV 26506-9511 
Phone 800 847 3859 
Fax 800 531 7787