R414-60B-7. Clinical and Cost-Related Factors

The P&T Committee shall base its determinations on the following factors as established by the DURB: (1) If clinical and therapeutic considerations are substantially equal, then the P&T Committee shall recommend to DIH that it consider only cost. (2) In making its recommendations to DIH, the P&T Committee may also consider whether the clinical, therapeutic effects, and medical necessity requirements justify the cost differential between drugs within a therapeutic class.