Low Cost Alternative (LCA) Program
The Low Cost Alternative (LCA) program groups generic drugs that contain the same active ingredients in the same strength and formulation into categories (e.g., there is one category for acebutolol in 100 mg tablets, another for acebutolol in 200 mg tablets, etc.). PharmaCare assigns a maximum price it will cover for all the products in the category. Each category contains one or more brand name versions of the drug and all of the generic versions priced at or below the PharmaCare maximum price.
- Pharmacare fully covers drugs priced at or below the maximum price for their category.
- PharmaCare does not normally cover generic drugs that are priced above the maximum price for their category and they are not listed in the PharmaCare formulary.
- PharmaCare partially covers brand name drugs that are priced above the maximum price for their category—up to the maximum price for the category.
If a patient cannot take a low cost alternative, physicians can request Special Authority for full coverage of another drug.