Acts and Regulations

2013-41 - Prescription Drug Payment Act

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NEW BRUNSWICK
REGULATION 2013-41
under the
Prescription Drug Payment Act
(O.C. 2013-158)
Filed May 30, 2013
1Subsection 12.1(3) of New Brunswick Regulation 84-170 under the Prescription Drug Payment Act is repealed and the following is substituted:
12.1(3)For the purposes of subsection (1), the price per unit of an interchangeable pharmaceutical product is the price fixed as follows:
(a) 35% of the manufacturer’s list price of the original product as of January 1, 2010;
(b) despite paragraph (a), if the interchangeable pharmaceutical product is in solid oral dosage form, 25% of the manufacturer’s list price of the original product as of January 1, 2010;
(c) if there is no interchangeable pharmaceutical product, other than the original product, with a notice of compliance on June 1, 2013, 35% of the manufacturer’s list price of the original product as of the date a notice of compliance is issued for the first product in a category of interchangeable pharmaceutical products, other than the original product; or
(d) despite paragraph (c), if there is no interchangeable pharmaceutical product, other than the original product, with a notice of compliance on June 1, 2013, and the original product is in solid oral dosage form, 25% of the manufacturer’s list price of the original product as of the date a notice of compliance is issued for the first product in a category of interchangeable pharmaceutical products, other than the original product.
2Section 12.2 of the Regulation is amended
(a) in paragraph (1)(b) by striking out “the manufacturer and the wholesaler sell” and substituting “the manufacturer sells”;
(b) in paragraph (2)(e) by striking out “and costs” and substituting “or costs”.
3Section 16 of the Regulation is amended
(a) in subsection (1)
(i) in the portion preceding paragraph (a) by striking out “subsections (2) and (3)” and substituting “subsection (3)”;
(ii) in paragraph (a) by striking out “actual acquisition cost; and” and substituting “manufacturer’s list price;”;
(iii) by repealing paragraph (b) and substituting the following:
(b) a dispensing fee of up to $10.50; and
(iv) by adding after paragraph (b) the following:
(c) up to 8% of the manufacturer’s list price.
(b) by repealing subsection (2);
(c) in subsection (3)
(i) in paragraph (b) by striking out “$10.40” and substituting “up to $10.50”;
(ii) by repealing paragraph (c) and substituting the following:
(c) up to 8% of the maximum allowable price.
(d) by adding after subsection (3) the following:
16(4)Despite subsections (1) and (3),
(a) if the entitled service rendered by a pharmacy is a drug specified by the Minister and used to treat opioid dependence, the payment for the service is the sum of the following amounts:
(i) an amount that is equal to or less than 100% of the maximum allowable price; and
(ii) a dispensing fee of up to $9.50; or
(b) if the entitled service rendered by a pharmacy is an extemporaneous preparation, the payment for the service is the sum of the following amounts:
(i) an amount that is equal to or less than 100% of the actual acquisition cost of each ingredient; and
(ii) a dispensing fee of up to $15.75.
16(5)Subject to subsection (6), a dispensing fee under this section shall be paid to a pharmacy in the following circumstances:
(a) the amount of the drug supplied to a beneficiary is a continuous 28 day supply; or
(b) the amount of the drug supplied to a beneficiary is at least a one day supply and, either,
(i) the Director authorizes the payment of the dispensing fee, or
(ii) the drug is specified by the Minister and used to treat opioid dependence.
16(6)In the case of a drug specified by the Minister that is classified according to the anatomical therapeutic chemical classification system, a dispensing fee shall be paid to a pharmacy in the following circumstances:
(a) the amount of the drug supplied to a beneficiary is a continuous 60 or 90 day supply according to the drug’s classification;
(b) the amount of the drug supplied to a beneficiary is a continuous 30 day supply and the beneficiary has not received the drug in the past 12 months; or
(c) the amount of the drug supplied to a beneficiary is at least a one day supply and the Director authorizes the payment of the dispensing fee.
4Section 22 of the Regulation is amended
(a) in subsection (1)
(i) in the portion preceding paragraph (a) by striking out “paragraphs (2) and (3)” and substituting “subsection (3)”;
(ii) in paragraph (a) by striking out “actual acquisition cost; and” and substituting “manufacturer’s list price;”;
(iii) by repealing paragraph (b) and substituting the following:
(b) a dispensing fee of up to $8.40; and
(iv) by adding after paragraph (b) the following:
(c) up to 8% of the manufacturer’s list price.
(b) by repealing subsection (2);
(c) in subsection (3)
(i) in paragraph (b) by striking out “$8.32” and substituting “up to $8.40”;
(ii) by repealing paragraph (c) and substituting the following:
(c) up to 8% of the maximum allowable price.
(d) by adding after subsection (3) the following:
22(4)Despite subsections (1) and (3), if the entitled service rendered by a dispensing physician is an extemporaneous preparation, the payment for the service is the sum of the following amounts:
(a) an amount that is equal to or less than 100% of the actual acquisition cost of each ingredient; and
(b) a dispensing fee of up to $12.60.
22(5)Subject to subsection (6), a dispensing fee under this section shall be paid to a dispensing physician in the following circumstances:
(a) the amount of the drug supplied to a beneficiary is a continuous 28 day supply; or
(b) the amount of the drug supplied to a beneficiary is at least a one day supply and the Director authorizes the payment of the dispensing fee.
22(6)In the case of a drug specified by the Minister that is classified according to the anatomical therapeutic chemical classification system, a dispensing fee shall be paid to a dispensing physician in the following circumstances:
(a) the amount of the drug supplied to a beneficiary is a continuous 60 or 90 day supply according to the drug’s classification;
(b) the amount of the drug supplied to a beneficiary is a continuous 30 day supply and the beneficiary has not received the drug in the past 12 months; or
(c) the amount of the drug supplied to a beneficiary is at least a one day supply and the Director authorizes the payment of the dispensing fee.
5Schedule 3 of the Regulation is repealed.
6(1)Subject to subsections (2) and (3), this Regulation comes into force on June 1, 2013.
6(2)Paragraph 2(b) of this Regulation shall be deemed to have come into force on April 1, 2013.
6(3)Paragraph 16(5)(a) as enacted by paragraph 3(d) of this Regulation and paragraph 22(5)(a) as enacted by paragraph 4(d) of this Regulation, as those paragraphs apply to a beneficiary who is a resident, as defined in the Nursing Homes Act, of a nursing home, shall be deemed to have come into force on September 10, 2009.