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Investor Presentaiton

National Drug Code (NDC) Oregon Prescription Drug Program Pass-through contract The unique three segment number assigned to each drug subject to commercial distribution and which is used and serves as a universal product identifier. Established in 2007, the purpose of the program is to purchase prescription drugs or reimburse pharmacies for prescription drugs to receive discounted prices and rebates, make prescription drugs available at the lowest possible cost to participants in the program and to maintain a list of prescription drugs recommended as the most effective prescription drugs available at the best possible prices. The PBM passes through the amount charged by the pharmacy to the health insurer. Typically, PBMS will charge a per claim administrative fee in this type of contract. Patient steering Pharmacy auditing Pharmacy benefit manager (PBM) Pharmacy collective groups Pharmacy network Preferred drug list Reverse auction Specialty drug Some PBMS require contracted health plan beneficiaries to visit affiliated pharmacies, or pharmacies in which they have an ownership interest including retail, mail-order, or specialty. Audits of pharmacies by PBMs to detect fraud, waste, and abuse. PBM clients are health plans. PBMs handle some or all the pharmacy benefit for health plans (formulary design, cost sharing and tiers, pharmacist networks and contracts, price concession negotiation with manufacturers). PBMs may own mail order pharmacies and/or specialty pharmacies. Unless the PBM owns a pharmacy, it is not part of the drug distribution/supply chain. This term refers to either Group Purchasing Organization or Pharmacy Services Administration Organizations. A pharmacy network is a list of pharmacies or pharmacists that a health plan or PBM has contracts with to provide prescription drug services to its members. A list of prescription drugs that are identified by a contractor's Pharmacy and Therapeutics Committee as the preferred drugs for prescriptions within a therapeutic drug class. An online, competitive bidding process states can use to select a PBM to manage prescription drug benefits. An auction starts with an opening bid and PBMS submit lower counteroffers during multiple rounds of bidding. States can achieve savings by requiring PBMs to offer the same contract terms but at a lower price than their competitors. A drug that is costly, requires special supply chain features (such as freezing or cold storage), typically indicated for a small group of patients, and where the patients may need special case management services. This is the broadest definition. There is no single agreed-upon definition, so sometimes specialty drug will only mean high-cost. For instance, specialty drugs in the Medicare Part D program are only defined by cost. Oregon Secretary of State | Report 2023-25 | August 2023 | page 38
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