Four axes from current statute and agency guidance. Teal bar = substitution/assistance/access in place; amber = permissive or absent.
| Generic substitution mandate | Permissive |
| State Pharmaceutical Assistance Program | No broad SPAP |
| 90-day fills permitted | Allowed |
| PMP mandatory prescriber query | Voluntary |
South Dakota permits but does not mandate generic substitution. Under SDCL § 36-11-46.1, a pharmacist may substitute a less expensive equivalent drug product unless the prescriber has indicated "dispense as written." The substitute must be FDA AB-rated.
The South Dakota Department of Social Services administers South Dakota Medicaid pharmacy benefits and maintains the SD Medicaid PDL. SD Medicaid runs primarily as fee-for-service. Non-preferred drugs require prior authorization.
Preferred Drug List: View current PDL
Prior authorization contact: South Dakota Medicaid Pharmacy: 1-866-705-5391
South Dakota does not operate a Medicare-recognized SPAP. Low-income South Dakotans use Medicare Part D Extra Help (LIS), South Dakota Medicaid (if eligible), manufacturer Patient Assistance Programs, and SHIINE (Senior Health Information and Insurance Education) for Medicare enrollment counseling.
Eligibility: No state SPAP. SHIINE helps with Medicare enrollment.
South Dakota permits 90-day fills of non-controlled chronic medications. Out-of-state pharmacies must hold a South Dakota Nonresident Pharmacy permit. Federal CSA refill limits apply.
South Dakota operates a Prescription Drug Monitoring Program administered by the Board of Pharmacy. Prescriber query is encouraged but not universally mandated by statute. Dispensers must report Schedule II-V dispensing within one business day.
PMP portal: South Dakota Prescription Drug Monitoring Program
South Dakota hosts a 340B network including Sanford Health, Avera Health, FQHCs across Sioux Falls/Rapid City/rural counties, and Indian Health Service facilities serving multiple reservations.
Find a 340B clinic in South Dakota: HRSA OPAIS database (SD 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 unless your prescriber wrote "dispense as written." Under SDCL § 36-11-46.1 substitution is permissive.
No. Use federal Extra Help, South Dakota Medicaid if eligible, and manufacturer Patient Assistance Programs. SHIINE helps with Medicare Part D enrollment.
Yes, South Dakota expanded Medicaid in July 2023 following voter-approved Amendment D in 2022. The expansion population is covered with the same SD Medicaid PDL.
PDMP query is encouraged but not universally mandated by statute. Dispensers report Schedule II-V dispensing within one business day.