The trial drug program has been created to help control the costs of unused and discarded medication resulting from patients who discontinue a new drug therapy due to side effects. In these instances, it is not unusual for a second drug therapy to be prescribed and dispensed. By limiting the number of days supply of a new therapy, this program has been demonstrated to:

• Reduce wastage of medication
• Improve compliance
• Improve communications between plan members and their pharmacists
• Lower prevalence of drug-related problems as a result of early intervention
• Enhance care by reducing adverse drug reactions

The trial program is not currently offered in Quebec.

How the Program Works

When the pharmacist submits a claim for either a new medication or a new strength of an existing medication, the claim will be flagged as a trial drug claim and the following message will be returned to the pharmacist: "Invalid day supply Trial Drug Program". The pharmacist then asks the plan member if they would like to participate in the trial drug program. If both the pharmacist and the plan member choose to participate, the pharmacist will then dispense seven days supply of the medication. After five or six days have elapsed, the pharmacist will contact the plan member to determine if the medication is effective and tolerated and confirm if the remainder of the prescription is required. If yes, the balance of the prescription is dispensed and the pharmacist will receive a second dispensing fee. If the medication was ineffective or not well tolerated, the pharmacist can either redirect the plan member to the physician, or the pharmacist may call the physician for authorization to dispense an alternate medication (which may also be subject to the trial drug program).

This program is voluntary. At any stage of this program, the pharmacist can submit an override code (pdf) if the pharmacist or plan member wishes to opt out of the program. If the member opts out of this program, the claim will be subject to our standard Acute and Maintenance day supply limits as determined by the plan parameters.

Drugs Included in the Program

The trial drug program is dynamic and therefore requires no customization. The following drug families are included in the trial drug program (this is not an exhaustive list of drugs/drug classes and is subject to change):

• Angiotensin-Converting Enzyme (ACE) inhibitors (e.g. Capoten, Vasotec, Accupril, Altace, etc.)
• Angiotensin II Receptor Blockers (ARB) (e.g. Cozaar, Avapro, etc.)
• NSAIDs, excluding ASA products (e.g. Naprosyn, Motrin, Celebrex, etc.)
• Beta Blockers (e.g. Inderal, Tenorim, Betaloc, Sectral, Monocor, etc.)
• Calcium Channel Blockers (e.g. Norvasc, Cardizem, Adalat, Isoptin, etc.)
• Prokinetic Agents (e.g. Maxeran, Modulon)
• H2 Blockers (e.g. Zantac, Tagamet, Pepcid, Axid, etc.)
• Proton Pump Inhibitors (e.g. Losec, Pantoloc, Prevacid, Nexium, etc.)
• Lipid Lower Agents (e.g. Lipitor, Mevacor, Zocor, Pravacol, etc.)

The drugs most frequently flagged for trial drug prescriptions are lipid-lowering agents for high cholesterol, cardiovascular drugs, gastrointestinal drugs and non-steroidal anti-inflammatory drugs (NSAIDs).

New drugs that are normally dispensed in smaller quantities, drugs that require dispensing in original packaging, that are typically used for short duration, or that need be taken for an extended period of time to be effective are automatically excluded from the program.