Investor Presentaiton
Term
Appendix A: Glossary of Terms
340B pharmacy program
Actual acquisition cost
Administrative Fee
Average wholesale price
Brand Drug
Clawback
Coordinated Care Organization (CCO)
Department of Consumer and Business
Services (DCBS)
Definition
A federal program requiring drug manufacturers participating in Medicaid to
provide outpatient drugs to covered entities at significantly reduced prices.
State Medicaid agencies are prohibited from billing manufacturers for Medicaid
rebates for drugs dispensed to Medicaid patients that have already been
discounted under the 340B Program.
Actual acquisition cost is the state Medicaid agency's determination of
pharmacy providers' actual prices paid to acquire drug products marketed or
sold by a specific manufacturer and is the current Medicaid benchmark to set
payment for drug ingredients.
Administrative and service fees charged by pharmacy benefit managers to
manufacturers and to plan sponsors. These fees are typically a percentage of
the list (wholesale acquisition cost) price of a medicine.
The published list price for a drug sold by wholesalers to retail pharmacies and
nonretail providers. It is akin to a sticker price and used as a starting point for
negotiation for payments to retail pharmacies.
Branded products are not generic drugs or products. A brand can be an
innovator (first-in-class) or not. It is protected by a patent or has an expired
patent.
A contractual provision that reclaims money already paid out. As applied to
independent pharmacies, clawback clauses appear in many pharmacy benefit
manager contracts in the form of direct and indirect remuneration fees, as well
as generic effective rate and brand effective rate post-adjudication
recoupments.
A network of all types of health care providers (physical, behavioral, and dental
care providers) who work together in their local communities to serve people
who receive coverage under Medicaid. CCOs focus on prevention and helping
people manage chronic conditions.
Oregon's largest business regulatory and consumer protection agency. The
department administers state laws and rules to protect consumers and
workers in the areas of workers' compensation, occupational safety and health,
financial services, insurance and building codes. The department serves as an
integrated umbrella agency over most state functions affecting businesses in
order to improve efficiency and effectiveness.
Oregon Secretary of State | Report 2023-25 | August 2023 | page 36View entire presentation