• Brand Pricing Terms and Acronyms

    • WAC

    • AWP

    • U&C

    • PBM

  • Brand Pricing Differences Based on Dispensing Method

    • Retail

    • Mail Order

    • Specialty

  • Spread Pricing

  • Generic Pricing Terms and Acronyms

    • Authorized Generic

    • Authorized Biologic

    • MAC

    • Preferred Pharmacy Networks

  • MAC Lists 

  • NDC Codes 

  • Medically Covered Drugs 

  • Methodologies for Medical Drug Reimbursement 

"And the last definitions I'll hit are “pharmacy networks” or “preferred” and “nonpreferred pharmacy networks.” So, in the United States, there's approximately 60 to 70,000 pharmacies, and it's likely if you stand at the door of one pharmacy in your town and you turn around, there's another one within eyeshot. So, with all this competition comes the opportunity for preferred networks. So in the case of preferred networks, a payer or a PBM will negotiate to steer prescription volume to one pharmacy or pharmacy network in return for lower contract costs. Any time the customer pharmacy benefits are based on copayment level or tiers, and the preferred network has a lower cost compared to the nonpreferred network, you can only use the preferred network pharmacies."

Our Executive Clinical Pharmacy Team discusses the basics of generic and brand drug pricing and reimbursement, covering:

IPD'S DRUG & CLINICAL REVIEW:

DRUG PRICING AND REIMBURSEMENT 101

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