I can answer that.
Again, back to the plan sponsors, they can decide how they want to handle those exceptions. In the case of government, they have a generic price policy. If a person has tried the generic and has had adverse effects or it's not working, that individual is allowed to go through the special authorization process. The individual's doctor sends in a request and asks for coverage, and if there is a legitimate need for it, then that person will be granted authorization.
On the private plan side, again, those plan sponsors have adopted that policy. There are a number of different mechanisms that can be used. One is that some plan sponsors will actually allow the pharmacist to override the prescription, so if the prescription comes into the pharmacy and it says “no substitution”, then the pharmacist can actually enter a code at the time of claim and then the brand name is paid. They also have the special authorization process as an option, if they choose to go there.