Drug Pricing & Reimbursement Podcast Episode

In this episode of IPD's Drug & Clinical Review, our Executive Clinical Pharmacy Team discusses the basics of generic and brand drug pricing and reimbursement, covering:

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

And other topics:
- 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."