10A NCAC 39A .1002       COVERED MEDICATIONS

(a)  Medications covered by the HIV Medication Program shall be specified on a formulary established by the Program based upon the following factors:  the medical needs of persons living with HIV disease, the cost effectiveness of the drugs, the availability of generic or other less costly alternatives, and the need to maximize the benefits to patients using finite Program dollars.  The covered medications include: antiretroviral medications used to treat HIV infection in accordance with FDA approved indications included in the official product labeling and other FDA approved medications as approved by the program, used for the prevention and treatment of the side effects of and opportunistic infections related to a diagnosis of HIV disease, or to treat the side effects and toxicities of the other covered medications.

(b)  Other medications shall be approved by the program based on:

(1)           the expert input and recommendations received from a panel of physicians in North Carolina working directly with the HIV infected community, including physicians at the tertiary care centers, in community practice, in research, and represented on the AIDS Care Advisory Committee; and

(2)           an evaluation of the availability of adequate financial resources.

(c)  A list of medications on the HIV Medications Program formulary shall be made available upon request by the Purchase of Medical Care Services or the Division of Public Health – AIDS Drug Assistance Program, 1902 Mail Service Center, Raleigh, NC 27699-1902.  Additionally, as medications are added to the program, announcements shall be made through the monthly newsletter distributed by the Purchase of Medical Care Services to participating pharmacies and through announcements mailed to HIV care consortia, tertiary care centers and other agencies serving HIV infected individuals by the Division of Public Health.

History Note:        Authority G.S. 130A‑5(3);

Eff. January 1, 1996;

Temporary Amendment Eff. July 1, 2005;

Amended Eff. November 1, 2005;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.