Making Sense of Pharmacy Price, Average Wholesale Price and Actual Cost
Pharmacy (Rx) costs are a major expense in a workers’ compensation claim and one of the most unpredictable line items in an overall self-insured employer’s plan. According to the Pharmaceutical Care Management Association (PCMA), Pharmacy Benefit Managers (PBMs) are projected to save self-insured employers, unions, and government programs up to 30% off the Average Wholesale Price (AWP) on drug benefit costs over the next decade. AWP provides no certain information on the price or cost of the drug. Without an accurate cost, the preferred decision is likely to go to the highest discount. Without a reference to the true cost, selecting the highest AWP may not be the proper decision.
If you don’t know the cost, how do you know if 30% is a good discount?
Introducing Transparent Pharmacy Pricing
MC Innovations has partnered with a nationally recognized PBM to offer the industry’s first Transparent Pharmacy Pricing program (TPP). With this program, prices simply are based on the amount paid by the pharmacy plus operating cost and profit. Competition brought about by pricing transparency will benefit the self-insured employer through improved service and lower cost. MC Innovations’ transparent pricing model can represent a doubling of savings compared to any client’s existing plan.
Average PBM Discount Off Average Wholesale Price (AWP) (a)
What You Have Today
What You Could Have Today
MC Innovations Negotiated w/TPA33.4%
What You're Going to Want Tomorrow
Transparent Pricing Discount55.8%
(a) Fill charges are not included in the analysis
Transparent Pharmacy Pricing = Pass through Pricing
MC Innovations Proven Program Management
Contact MC Innovationsfor improved service and to determine how much your pharmacy pricing program can save with Transparent Pricing.