Specialty Drugs
The first human recombinant biological on the US market in 1982.
What is insulin?
The 3 largest PBMs control this percentage of the US prescription market.
What is 80%?
A local patient advocacy 3rd party service for pharmaceuticals in Indianapolis.
What is Rx Help Centers?
#1 prescription drug by revenue in 2019, and it goes off patent in 2023.
What is Humira (adalimumab)?
The price benchmark in which PBMs contract discounts.
What is the Average Wholesale Price?
The most expensive gene therapy on the US market, and treats this disorder.
What are Zolgensma and spinal muscular atrophy?
The number one reason why self-funded healthcare plans switched PBMs in 2021.
What are Patient advocacy and assistance programs? (This is according to the programs in our book of business.)
The ____ Act set up HRSA to administer this discount drug program for covered entities, called ______.
What is the Public Health Services Act, and 340B? 340B is the actual section of the PHSA.
Name a nonprofit generic pharmaceutical company founded by Intermountain Healthcare, now joined by 800 hospitals.
What is CivicaRx?
The price benchmark at which pharmacies purchase drugs from pharmacy wholesalers.
What is Wholesale Acquisition Cost (WAC)?
Orphan diseases consist of less than ____ patients in the US.
What is 200,000?
Currently, the only PBM that allows GoodRx pricing in lesser of logic at point of sale.
What is MagellanRx?
The historic case by the US Supreme Court decided in December 2020 that allows states to regulate PBMs.
What is Rutledge vs. PCMA?
A standard the British Realm (CAN, AUS, UK) uses to benchmark how much extra it costs for a drug to give a patient an additional year of high-quality life.
What is QALY, or Quality-adjusted life year?
The most common pricing benchmark for medical (J code) drugs.
What is Average Sales Price (ASP)?
The first biosimilar to the US market under the BPCIA in 2015.
What is Zarxio? (Filgrastim-sndz - biosimilar to Neupogen)
The PBM with the lowest in house patient assistance program advocacy fees.
What is CapitalRx? (They charge a flat fee, no % of savings recovered.)
M-O-N in Medispan.
What is the best definition for "brand drugs" in a PBM contract?
The drug "PharmaBro" Martin Shkreli was sentenced to securities fraud for spiking the price of, along with the parasite it treats.
What is Daraprim (pyrimethamine) and toxoplasma gondii, or toxoplasmosis.
A newer price benchmark for pharmacy prescription drugs closer to the real cost of brand drugs for pharmacies.
What is NADAC, or national average drug acquisition cost?
The highest number of gene and cellular therapies already approved, and used for this.
What are cord blood products, used for organ transplants?
The site to quickly determine coupons and patient advocacy programs by drug.
What is needymeds.com?
The Most Favored Nations and international pricing index POTUS executive order and CMS interim final rule during 4Q20 covered what category of drugs?
What are the top 50 Medicare Part B (J code) drugs by highest spend?
This diabetes drug was derived from saliva of the gila monster.
What is Byetta (exenatide)?
What quantities are used to bill J code (medical) drugs, set by whom?
What are units, set by CMS?