Which of the following medications is exempt from the mandatory Medicaid Generic Program?

The medication that is exempt from the mandatory Medicaid Generic Program is Clozaril. This medication, known generically as clozapine, is a unique antipsychotic used primarily for treatment-resistant schizophrenia. Though several medications may have generic equivalents, Clozaril is not considered interchangeable with other antipsychotic drugs due to its specific indications, side effect profile, and the necessity for ongoing blood monitoring to manage potential risks, such as agranulocytosis.

Medicaid policy allows for certain drugs to be exempt from the generic substitution mandate in order to ensure patients have access to necessary medications where generics may not provide the same therapeutic benefit or safety. In this case, Clozaril's unique clinical considerations and the importance of adherence to therapy make it necessary for it to remain available as the brand name drug without mandatory generic substitution.

In contrast, ibuprofen, amoxicillin, and lisinopril all have established generic versions that are widely used and considered therapeutically equivalent. These medications generally fall under the mandatory generic program, which emphasizes cost savings through the use of generics whenever possible. Thus, their lack of exemption from this program stands in contrast to the situation with Clozaril.