Transcript find price

drug cost
•self payments--full price unless senior discount,
ect
•3rd party payer----ins company, gov plan,
employee benefit plan, unions.
•deductible---pt pays x amount then ins starts to
pay
•copay---pt pays x% and ins co pays the rest
•ins co want to pay for generic unless dr gets
preauth for brand name.
find selling price
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pharmacies choose one of these
cost plus markup method-cost+(cost*markup)+dispensing fee=shelf price
expenses per month /# rx per month=dispense fee
• other way---AWP+/-percentage+dispensing fee
• ins co wants this since pharmacy maybe got a bulk
discount. pharmacy has contract with ins co.
• AWP=average wholesale price
• AWP+/-(AWP x %)+dispensing fee=ins pays