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These include: my organization, the employer as my client, the employees of the client as plan participants, the pharmacists dispensing the medications, and the pharmaceutical manufacturers and/or distributors. My job is to develop a plan that is profitable for my organization. I must also develop a plan that is cost-effective for the employer. The employees of the client must find the plan valuable and beneficial in the maintenance of their healthcare. The pharmacists must be compensated fairly for their time, and the pharmaceutical manufacturers and/or distributors must be able to make a profit in an increasingly competitive, rapidly changing industry. Developing a pricing strategy to meet these competing stakeholder needs is challenging and will require looking at each employer's unique pharmaceutical needs to determine the best pricing plan possible.
The MAC pricing strategy meets the needs of my organization, in that it limits our costs and therefore enhances profitability; however, for this type of strategy to meet the needs of both the employer and their employees, AWP needs to be utilized to determine the MAC values. This can be used for both generic and branded pharmaceuticals. In fact, most states, as of 2009, use AWP to determine their MAC values.
For brand drugs with no generic equivalent, reimbursement varies from state to state, but it is usually based on AWP minus 5% to 15%. This formula recognizes that the AWP,
published in the Red Book, is usually higher than the actual cost a pharmacy pays to acquire a pharmaceutical. When a generic pharmaceutical is available, pharmacists often reimbursed...
This can then be enhanced by looking at each individual employer to determine if rebate contracts for certain pharmaceuticals can help further offset costs to the employer and provide even more benefits to the employees, while also helping the pharmaceutical companies garner more market share.
Although it may be tempting to hide administrative and dispensing fees within other portions of the pricing strategy, to make the client think they are getting a better deal than they really are, in the long-run, this will become evident and the client will likely feel like they've been taken advantage of. An unhappy client often equates to a lost client and lost referral business. For this reason, the pricing strategy I recommend would include denotation of reasonable administrative and dispensing fees, along with an explanation to the client about how other pharmaceutical benefit managers may try to hide these fees, so they can compare apples to apples.
References
Jones, J.D. (2003). "Developing an effective generic prescription drug program." Benefits Quarterly, 19(1), p. 14-18.
Maximum allowable cost. (17 Feb 2009). Retrieved February 24, 2011, from http://www.gphaonline.org/resources/2009/maximum-allowable-cost-mac.
McClurg, J. (Jan 2009). "Understanding the Rx financial trail: Who pays what, when, where, and why." Employee Benefit News, 23(1). p. 41-42.
Usually, both physical and psychological components need to be addressed. Byrd (2001) explains, the function of brain cells (neurons) is affected when a drug is used repeatedly over a long period of time. Each neuron produces and releases chemicals called neurotransmitters. These neurotransmitters can impact the function of the nerve cell, making it produce and release hormones. "The neurotransmitters that have been associated with addiction include serotonin, dopamine, norepinephrine,
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Drug Courts The Department of Justice of the United States of America, in order to cope with heavy work pressure, had to introduce a separate court for the sole purpose of dealing with criminal offenses committed by drug abusers and drug dependants. This concept has proved to be so successful that other countries of the world, including Australia, are now contemplating the introduction of a separate court for dealing with the
309). The abbreviated approval process authorized by Hatch-Waxman lets generic drug manufacturers use the same clinical data that the original manufacturer used to obtain FDA approval, thereby avoiding these expenses. In this regard, Greene emphasizes that, "Whereas the pioneer drug manufacturer must incur great expense and undergo rigorous scrutiny when it files an new drug application (NDA) to secure FDA approval, a generic manufacturer may file an Abbreviated New Drug
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Vancomycin should be given for at least 60 minutes. The initial dosage for pediatrics with renal impairment is not less than 15 mg/kg per day or 15 times the GFR in mL/min. Premature infants should have longer dosing intervals. PO administration should be 40 mg/kg/day in 3-4 divided doses for 7-10 days. The maximum is 2,000 mg/day, which may be diluted in 1 oz of water or administered through