The state is proposing to stop covering brand-name drugs for RIte Care enrollees, except in limited circumstances.

Under the proposal, patients in the state’s health plan for the poor would automatically get lower-cost generic drugs unless there is no generic version of the drug they need. This tightening of prescription-drug coverage has spurred protests from advocates for the poor, who gathered at the State House yesterday to decry the change.

Currently, if a doctor specifies that a RIte Care patient should receive the brand-name version of drug, the patient can get it. The new policy “takes the brand off the table,” said Amy Kempe, spokeswoman for Governor Carcieri. But there will be exceptions and opportunities for appeal, under terms that have yet to be hammered out, she said.

The change was originally to take effect on Nov. 1, but Kempe said it has been postponed to an undetermined date.

Meanwhile, a public hearing on the plan will be held today from 3 to 6 p.m. at the DaVinci Center for Community Progress, 470 Charles St., Providence.

The proposal was approved in principle by the General Assembly during discussions of the current year’s budget, Kempe said. She described it as a cost-saving measure offered as an alternative to cutting people from the RIte Care rolls.

Kempe did not have a figure for the amount of money the plan was expected to save. But she noted that the anticipated savings would not be realized because more than a quarter of the fiscal year has already passed by.

Stephen Evangelista, president and chief executive officer of the Arthritis Foundation of Northern and Southern New England, said patients taking more than one drug may have problems if one of the drugs is switched to a generic because of interactions among them. People on RIte Care won’t be able afford a brand-name drug, he said. “You’re putting the onus on the people who can least afford it,” he said.

Dr. John Bossian, a family practitioner in Wakefield, said generic drugs sometimes don’t work as well as brand-name drugs because they can vary in both their active and inactive ingredients. He told of a patient who was controlling her high blood pressure on a brand-name drug. When her insurer switched her to a generic, her blood pressure went “sky high.” Some of her pills were coming from a manufacturer in Puerto Rico and some from Japan, and the different versions were not equally effective.

Bossian said that while most commercial insurers encourage use of generic drugs, the RIte Care proposal is more stringent than the private sector.

“If I try someone on a generic and it doesn’t work, I don’t want my hands to be tied,” Bossian said. He said that if drugs don’t work properly it could end up costing more in sickness and doctor’s visits. “There might be savings up front. On the other end their might be a loss,” he said. “I don’t want it to be a loss of life.”

ffreyer@projo.com