Bulletin No. 40-04
September 3, 2004

Errors corrected in DWC web page pharmaceutical price calculator

DWC has corrected three errors in the pharmaceutical price calculator on the DWC web site. First, the web site calculator did not give the correct price for brand name drugs under prescriptions where the physician had written that no substitution was permitted. Second, the calculator did not implement the July 1, 2004, change in final discount in Medi-Cal prices. Finally, the calculator did not include all the steps necessary to calculate Medi-Cal pricing for compounded prescriptions. After working with Medi-Cal personnel on these issues, correct Medi-Cal pricing is now available via the calculator. The web page containing the calculator can be found at http://www.dir.ca.gov/dwc/pharmfeesched/pfs.asp.

Changes in Medi-Cal discounts and dispensing fees

The final discount taken by Medi-Cal from a calculated price, for patients not in a nursing home, was reduced from $0.50 to $0.10, for dates of service on or after July 1, 2004, through August 31, 2004.

For dates of service on or after September 1, 2004, the $0.10 final discount will be eliminated for all prescriptions. Also, for dates of service on or after September 1, 2004, the dispensing fee will be increased from $4.05 to $8.00 for patients in nursing homes, and to $7.25 for patients not in nursing homes. The DWC calculator incorporated the changes in dispensing fee and final discount on September 1, 2004. Although the dispensing fee will increase, the Medi-Cal price for most drugs will decrease by approximately 7.8%, effective September 1, 2004. The DWC calculator will incorporate the drug price changes as soon as the Department of Health Services provides the new pricing information.