Day 45
Occurs when a payer purchases pharmaceuticals through a specialty pharmacy, which then ships products directly to providers for administration (bypassing the wholesaler).
What is white bagging?
HEOR stands for.
What is Healthcare Economics Outcomes Research?
The key players in the pharmaceutical supply chain include the wholesaler/distributor, __, health plans, and providers.
What are PBMs?
If the PBM doesn’t cover the full cost, the patient pays the pharmacy directly, which is also known as.
What is co-insurance or a co-payment?
Initial list price set by the manufacturer for the product they make. It doesn’t include discounts or negotiations with stakeholders.
What is the wholesale acquisition cost (WAC)?
To incentivize wholesalers, pharmacies, and PBMs, to include their product on formularies, manufacturers can offer lower drug prices or money back to customers through __.
What are rebates or discounts?
Both the copay and the __ are heavily influenced by the PBM.
What is a deductible?
PBMs can cover both Part D and Part __.
What is Part B?
Providers and hospitals are responsible for buying and administering some drugs. The health plan reiumburses the cost of the drug plus up __% for administering it.
What is 6%?
Occurs when a patient acquired medication from a pharmacy and brings it directly to the provider for administration.
What is brown bagging?
PBMs and plans such a UHC and Davita, CVS and Aetna, Walgreens and Humana, and Cigna and ESI, are merging. Amazon acquired a mail order drug company called __, which brought the, into the healthcare spotlight. The aim is to lower prices and combine the negotiation power.
What is Pillpack?
A man who’s one step closer to being named “Sexiest Man Alive...”
Who is Dr. Anthony Fauci?
Upfront negotiations on drug prices between manufactures and PBMS, health plans, and wholesalers. Typically offfered by manufacturer in exchange for improved market access and formulae tiering. Negotiated and paid at the individual drug level.
What are discounts?
Up front negotiations on drug prices.
What are discounts?
The only country officially using “Immunity Passports”
What is Chile?
Provider-administered drug reimbursement (buy-and-bill) largely cuts out this part of the equation.
What are PBMs?
Wholesalers like McKesson and Cardinal, buy products from manufactures in bulk, so they can negotiate lower prices. The average price they negotiate is called the __.
What is the Average Wholesale Price (AWP)?
Payments or price concessions that are paid in the future by a manufacturer to the PBM. Can also be paid to wholesalers, pharmacies, or health plans. Manufactures offer this to customers across the supply chain to lower drug prices in exchange for improved market access.
What is a rebate?
This Pennsylvania team has a half a dozen QBs.
Who are the Philadelphia Eagles?
Price concession paid in the future by a manufacturer to a health plan, or a PBM working on the plan’s behalf. Typically offered by the manufacturer in exchange for improved market access, and often paid in aggregate (tied to purchases of multiple products).
What are rebates?
Policies created by PBMs and health plans to prohibit manufacturer copay cards from contributing to a patient’s deductible.
What are co-pay accumulators?
What candy iconic character appeared as a giant at the end of Ghostbursters?
Who is Mr. Stay Puft?
PBMs aren’t required to factor rebates and discounts, and can charge more than the NET price. The difference between what the PBM charges the employer for the prescription and what the PBM pays to the pharmacy to fill the prescription, and often a source of revenue for PBMs.
What is spread pricing?
Why city was home to the 2000 summer Olympics?
What is Sydney?
Agnetha, Bjon, Benny, and Anni-Fried are better known as this.
What is ABBA?