Amount of Rebates per Claim, 2003

Slides:



Advertisements
Similar presentations
Issues and Compliance Strategies Related to Government Pricing Joseph W. Metro.
Advertisements

Adam J. Falk, Esq. FELDESMAN TUCKER LEIFER FIDELL LLP Legal issues for Medicaid Plans Under Part D in Serving Dual Eligibles MEDICAID HEALTH PLANS OF AMERICA.
Challenges of Serving Low-income Medicare Beneficiaries: Impact of Cost Sharing Cindy Parks Thomas Brandeis University Schneider Institute for Health Policy.
North Carolina AIDS Drug Assistance Program (ADAP) State Pharmaceutical Assistance Program (SPAP)
Ideas for People Losing Illinois Cares Rx Benefits July 2011.
Massachusetts,
Part D Data Sharing Harry Gamble Office of Financial Management CMS.
PBM Transactions Medicaid DRA Rule –Proposed Rule AMP includes “Discounts, rebates or other price concessions to PBMs associated with sales for drugs provided.
Rutgers Center for State Health Policy June 28, 2005 Presentation to the Academy Health Kimberley Fox, Senior Policy Analyst Rutgers Center for State Health.
Excise Taxes An indirect tax charged on the sale of a particular good (usually by UNITS of the product rather than a percentage of the cost) Thus, an excise.
1 State Perspectives on Medicare Part D: Lessons from Pharmacy Plus Programs Cindy Parks Thomas Donald Shepard Christine E. Bishop Daniel M. Gilden Brandeis.
Karmen Hanson, MA Senior Policy Specialist National Conference of State Legislatures 340B Drug Purchasing: Options for States Overview of State Rx & 340B.
Medicare Modernization Act: Impact of State Implementation Decisions Haiden Huskamp AcademyHealth June 28, 2005.
January National Medicare & You Training Program Amy Larrick, CMS NAACP April 27, 2006.
State Strategies: Expanding Prescription Drug Access Dee Mahan Families USA November 1, 2002.
 The Impact of the Medicare Prescription Drug Legislation on Pharmaceutical Revenues Presented By: Jack Rodgers PricewaterhouseCoopers February 27,
System Wide Strategies: Controlling Costs in Medicaid Brendan Krause National Governors Association Illinois Health Forum Wednesday, December 7, 2005.
New Analysis of DRE Savings for States & Federal Government September 22, 2008.
Avalere Health LLC | The intersection of business strategy and public policy The Medicare Modernization Act: The Impact on States and Low-Income Beneficiaries.
Medicare Prescription Drug, Improvement, and Modernization Act of 2003 Deirdre Duzor Director, Pharmacy Division Centers for Medicare & Medicaid Services.
1 State Options for Supplementing Medicare Part D Drug Coverage Invitational Summit on Medicare Part D Implementation Issues Jack Hoadley Georgetown University.
Managed Care Pharmacy Financials January 15, 2015.
Pharmacy Benefit Management (PBM) 101
Connecticut Pharmaceutical Forum: Access, Affordability, and Better Health Tara C. F. Ryan May 17, 2016.
Changes to AMP & Best Price: Impact on 340B Pricing February 1, 2008 Long Beach, California 4 th Annual 340B Coalition Winter Conference University of.
Top quintile (61 local areas) Second quintile (61) Third quintile (63) Fourth quintile (61) Overall performance, 2016 Bottom quintile (60) Source: Commonwealth.
BIG Pharma….the savings you can’t see
Annual Drug Expenditures per User, 2003
Pricing Strategies What’s Your Price Strategies.
Pharmaceuticals Chapter 11 Part 1.
1. Connecticut Delaware Georgia Maryland Massachusetts New Hampshire
Rate of 30-day hospital readmissions per 1,000 Medicare beneficiaries
The Basics of Pharmacy Benefit Management (PBM)
Trails Carolina
Therapy Programs Provider: Trails Carolina
Trails Carolina: Social Media Profiles
BIG Pharma….the savings you can’t see
What are Pharmacy Benefit Managers?
Pharmaceutical Pricing and Contracting: An Overview March 2006
بسم الله الرحمن الرحيم.
Most leaders support competitive bidding for medical equipment prices and negotiation of drug prices by Medicare. “Medicare is the largest payer for health.
Express Scripts Exclusions Target 25 Drug Classes
John M. Coster, Ph.D., R.Ph. Vice President, Policy and Programs
Pharmacy: Pharmacy Landscape and Uncovering the Optical Illusions
States with Mail-Order Requirement, 2003
,. . ' ;; '.. I I tI I t : /..: /.. ' : ····t I 'h I.;.; '..'.. I ' :".:".
Number of Claims per User, 2003
Brussels, June 6, 2007 Paul E. Kalb, M.D., J.D.
Prescription drug prices: Recent trends and opportunities for change
Third-Party Recovery as a Percentage of Total Drug Expenditures, 2003
Medicare Rx Legislation: Implications for PBMs
Will PBMs Participate in the New Medicare Prescription Drug Program
Pharmacy Reimbursement and Manufacturer Rebate Formulas (Part 3)
Pharmacy – Fully Insured versus Self Funding
Over-the Counter Drugs and Medical Equipment Coverage, 2003
Annual Drug Expenditures per User, 2003
Amount of Funds Budgeted and Sources of Funding by State for FY 2004
Figure 1. Three of Five Health Care Opinion Leaders Feel that Mixed Private-Public Group Insurance Is an Effective Approach to Achieving Universal Health.
Employer-Sponsored Insurance and Medicare Spending per Enrollee, Relative to U.S Median Spending for Each Population, 2014 Per-Enrollee Spending: Employer-Sponsored.
The Rx for Rx Savings Breaking the Status Quo!
Rebates as a Percentage of Total Drug Expenditures, 2003
Number of Claims per End-of-Year Enrollee, 2003
Medicare Part D Implementation Issues: Key Decisions for States
States with Generic Substitution Requirement, 2003
Pharmacy Benefit Manager
Proportion of SPAP Drug Expenditures in Five States vs
Rizzo, Fox, Trail, and Crystal, State Pharmacy Assistance Programs: A Chartbook—Updated and Revised, January 2007 Average Cost per Claim, 2003 The average.
Rizzo, Fox, Trail, and Crystal, State Pharmacy Assistance Programs: A Chartbook—Updated and Revised, January 2007 Trends in Annual Drug Expenditures per.
SeniorCare Prescription drug coverage for Wisconsin residents age 65+
Presentation transcript:

Amount of Rebates per Claim, 2003 Rizzo, Fox, Trail, and Crystal, State Pharmacy Assistance Programs: A Chartbook—Updated and Revised, January 2007 Amount of Rebates per Claim, 2003 On average, for the 11 states for which rebate and claims data were available, SPAPs recovered $9.11 per filed claim through manufacturer rebates. This ranged from $0.11 in North Carolina to $15.34 in Connecticut. The amount of rebates per claim is affected by the manufacturer rebate rate, the drug mix used by enrollees (brand-name drugs usually have higher rebate rates), and the number of days’ supply per claim allowed by a program. Massachusetts and North Carolina received the lowest amounts of rebates per claim. Massachusetts had their PBM negotiate rebates with manufacturers rather than setting the rebate amount in statute as most other states have done. This indicates that rebates that will be negotiated by PDPs will be less than those set in statutes or tied to Medicaid. THE COMMONWEALTH FUND