New Rules for “Do Not Substitute” Prescriptions

 

As of April 24th, all persons diagnosed with ALS who are prescribed Rilutek® (brand-name) will be switched to the generic form riluzole as per a RAMQ mandate, even if the medical Doctor’s prescription mentions “Do Not Substitute”.  In addition, renewed Rilutek® prescriptions already bearing the instruction “Do Not Substitute” will only be reimbursed until June 1, 2015. This switch to a generic option may present a profound financial impact.

Those who wish to continue to use Rilutek® will need to pay all out-of-pocket costs related to the Co-Pay requirement to their Private Drug Plan.  This is typically 20% of the cost of the drug (ex. $219.57/month) plus the pharmacist’s mark-up and dispensing fees (ex. $16).  This would result in patients needing to pay approximately $546/yr for their co-pay requirements. Medicum’s Rilutek® Patient Assistance Program helps lessen the resulting financial burden by paying for all co-pay costs, so that people with ALS will pay no out-of-pocket costs.

For individuals with ALS who have a RAMQ drug benefit eligibility and who prefer to continue to stay with Rilutek®, the Medicum payee assistance program will pay for the difference between what RAMQ would be willing to reimburse (the generic price) and the branded price.  This results inpaying nothing out of pocket for staying with Rilutek®, provided they are enrolled into the Rilutek® program via Medicum.

For further information about the Medicum Rilutek® Patient Assistance Program , please contact Catherine Boucher or France Martinelli at at 1-866-474-5883 or by e-mail to [email protected]

To know more about the RAMQ new reimbursement rules, please visit their website by clicking here.

 

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