German Pharmacies Face New Substitution Rules: AOK Sachsen-Anhalt vs. Sanicare
Pharmacies in Germany have faced new rules and clarifications regarding medication substitutions, as seen in a recent case involving AOK Sachsen-Anhalt and the Plus brand Sanicare. The pharmacy in question was found to have not followed proper procedures when substituting a medication.
From March 1, substitute funds now require only one proof of shortage, rather than two immediate availability checks. This change was clarified by the court, which also ruled that alternative forms of proof, such as manual notes or screenshots, are acceptable. However, in this case, the pharmacy failed to provide sufficient evidence of the unavailability of Palexia retard at the time of dispensing.
The pharmacy's retrospective statement and weekly availability reports were deemed insufficient. The court ruled that the pharmacy compromised the cost-effectiveness of care by not dispensing the available discounted medication. This decision comes amidst recent developments in digital shifts for nursing home medication billing and the integration of AHD into Walmart, CVS, and Walgreens pharmacies. Pharmacies now have more flexibility in choosing how to document unavailability, but it must be done at the time of dispensing and must be proven to the wholesaler.
Pharmacies are reminded to adhere to the new rules regarding medication substitutions. They must provide timely and acceptable proof of shortages to avoid compromising the cost-effectiveness of care. The case involving AOK Sachsen-Anhalt and Sanicare serves as a reminder of the importance of proper documentation and communication with wholesalers.
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