Four axes from current statute and agency guidance. Teal bar = substitution/assistance/access in place; amber = permissive or absent.
| Generic substitution mandate | Mandatory by statute |
| State Pharmaceutical Assistance Program | No broad SPAP |
| 90-day fills permitted | Allowed |
| PMP mandatory prescriber query | Required by statute |
New Hampshire mandates generic substitution. Under RSA § 318:47-d, a pharmacist shall substitute a less expensive equivalent drug product unless the prescriber writes "medically necessary" on the prescription. The substitute must be FDA AB-rated.
New Hampshire DHHS administers NH Medicaid Care Management and maintains the NH Medicaid Preferred Drug List. Most members are enrolled in managed-care plans (AmeriHealth Caritas NH, NH Healthy Families, Well Sense Health Plan), which follow the unified PDL.
Preferred Drug List: View current PDL
Prior authorization contact: NH Medicaid Pharmacy: 1-866-675-7755
New Hampshire does not operate a Medicare-recognized broad SPAP. The NH Senior Prescription Drug Discount Program offers limited discounts but is not Medicare-creditable. Low-income New Hampshire residents use Medicare Part D Extra Help (LIS), NH Medicaid (if eligible), manufacturer Patient Assistance Programs, and ServiceLink Aging and Disability Resource Centers for Medicare enrollment counseling.
Eligibility: NH Senior Prescription Drug Discount Program (small discount card, not Medicare-creditable). No broad SPAP.
New Hampshire permits 90-day fills of non-controlled chronic medications. Out-of-state pharmacies must hold a NH Nonresident Pharmacy license. Federal CSA refill limits apply.
New Hampshire operates a Prescription Drug Monitoring Program administered by the Office of Professional Licensure and Certification. Under RSA § 318-B:31, prescribers must check the PDMP before issuing the first prescription of certain controlled substances. Dispensers must report Schedule II-V dispensing within one business day.
PMP portal: New Hampshire Prescription Drug Monitoring Program
New Hampshire hosts a 340B network including Dartmouth Health, Concord Hospital, FQHCs across the state, and Ryan White clinics.
Find a 340B clinic in New Hampshire: HRSA OPAIS database (NH filter)
Our sister site OmniRx maintains a federal-side patient assistance program directory covering manufacturer PAPs, foundation copay assistance, GoodRx-style discount cards, and 340B locators applicable nationwide.
Once the law side is clear, the next question is which pharmacy actually has the cheapest fill. Use the RxGrab Pharmacy Finder to compare CostPlus Drugs, Costco, Walmart, Amazon Pharmacy, and other discount pharmacies on your specific medication, and read our generic vs brand explainer for the bioequivalence rules behind every substitution.
Yes by default they must under RSA § 318:47-d, unless your prescriber wrote "medically necessary."
No Medicare-creditable SPAP. The NH Senior Prescription Drug Discount Program is a small discount card only. Use federal Extra Help and Medicaid.
All managed-care plans use the unified NH Medicaid PDL. Non-preferred drugs need prior auth from your prescriber.
Yes for certain controlled-substance prescriptions under RSA § 318-B:31.