1. When the more commonly used generic drugs are prescribed, average prices of such generic drugs as determined by the department will apply as to the charge to the state-not prices applicable to trade names. This will apply to the more commonly prescribed drugs such as: chloral hydrate, penicillin-G, penicillin- VK, tetracycline, ampicillin, meprobamate, reserpine, prednisone, propoxyphene and its compounds, hydrochlorthiazide, etc.2. Except as provided in sec. 17-2-99A, the charge for prescriptions shall be based on the average wholesale price per 100, pint or package, as indicated in the Red Book, plus the applicable professional fee, or the E.A.C. plus the applicable professional fee, or the usual and customary charge to the general public whichever is lower; the use of the foregoing price determination methods shall be as follows:A. For the most frequently proscribed legend drugs, reimbursement shall be made on the basis of an estimated acquisition cost or AWP which shall be the price generally and currently paid by providers and which shall be determined by the department of social services, plus the applicable professional fee, or the usual and customary charge to the general public by the provider, whichever is lower. Following final determination of the E.A.C. prices for the most frequently prescribed drugs, a list shall be compiled by the department showing the name of the drug, the procedure code for the drug and its E.A.C. price. Such lists shall be distributed to all pharmacy providers.
B. For all legend drugs for which an E.A.C. price has not been determined, reimbursement shall be made on the basis of the average wholesale price per 100, pint or package as indicated in the Red Book or their respective continuing supplements plus the applicable professional fee, or the usual and customary charge to the general public by the provider whichever is lower. In those cases where the current wholesale price in Connecticut is greater than the Red Book or AWP (e.g. controlled drugs) the Connecticut current wholesale price shall apply.C. For nonlegend drugs (OTC drugs) reimbursement shall be based on the usual and customary over the counter price. For any nonlegend drug prescribed in less than the standard package, reimbursement shall be made for the full standard package size closest to the quantity ordered. The list of items in sec. 17-2-98 represents by category, those products which are reimbursable.Conn. Agencies Regs. § 17-2-97
Effective September 26, 1978