Investor Presentaiton
Specialty pharmacy
Spread pricing
Unaffiliated pharmacies
Vertical integration
Wholesale acquisition cost
Wholesalers
Specialty pharmacies are different from traditional retail pharmacies in
coordinating many aspects of patient care and disease management. They can
deliver medications with special handling, storage, and distribution
requirements with standardized processes that permit economies of scale.
Many specialty and mail order pharmacies are vertically integrated with PBMs
and insurers.
The difference between what a health plan pays the PBM and the amount that
the PBM reimbursed the pharmacy for a beneficiary's prescription.
A network pharmacy that directly or indirectly does not control, is not
controlled by, and is not under common control with, a PBM.
A business organization strategy in which all stages of production of a good or
service are controlled by one company. Example: A corporation owns a PBM
that works with outside insurers to send patients to retail, mail-order, or
specialty pharmacies that the corporation also owns.
The price the wholesaler pays the manufacturer and is generally considered
the "list" price. However, this price is not what wholesalers pay for drugs.
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In a simple distribution system, the wholesaler is the first purchaser of a drug
product direct from the manufacturer. Wholesalers buy very large quantities
and then resell either direct to provider-purchasers (like a large health system,
pharmacy or pharmacy chain), or resell to smaller, regional distributors for
regional or local distribution to retail pharmacies and hospitals.
Oregon Secretary of State | Report 2023-25 | August 2023 | page 39View entire presentation