Mail Order Pharmacy What You Don’t Know Will Hurt You!

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  • Mail Order PharmacyWhat You Dont Know Will Hurt You!

  • Mail Order PharmacyBuilds a case for savings through:Perceived Discounts Not Actual Dollars

  • Example:Brand Name PrescriptionRetail Pricing AWP 14%Mail PricingAWP 22%

    Brand PrescriptionAWP - $100.00RetailAWP 14%100.00 14.00 = $86.00Mail OrderAWP 22%100.00 22.00 = $78.00$8.00 Savings

  • Mail OrderAlters or Uses Higher AWP Products Mail OrderAWP 22%150.00 33.00 = $117.00 RetailAWP 14%100.00 14.00 = $86.00 - $31.00

  • ExampleGeneric Prescription:Retail Pricing: MAC Pricingset at $0.20 x 60 = $12.00Mail Pricing: AWP 50%AWP = $1.00 x 60 = $60.0060.00 - 50% = $30.00- $ 18.00

    DMGRetail MACMAC 1MAC 2MAC 3MAC 4MAC 5Generic Drug 1.20.30.40.50.60.70Generic Drug 2.50.751.001.101.251.35

  • Co-Pay IssueRetail co-pay

    Pfizer Study MAC co-pay

    $30.00X 3$90.00$30.00 / per one 3 month supplyPayer picks up $60.00 of cost.*If prescription is not $60.00 cheaper, then government costs go up.

  • Lipitor - Redbook

  • Repackaging Example: Lipitor 20mg #30At RetailPharmacy Paid AWP-14% + $2.00

    AWP* = $4.16/tablet30 x $4.16 = $124.80

    $124.80 - $17.47 + $2.00 = $109.33At Mail OrderPharmacy Paid AWP-22% + $0.00

    AWP* = $6.81/tablet30 x $6.81 = $ 204.30

    $204.30 - $44.95 + $0.00 = $159.35$50.02 more at Mail Order vs. Retail*2007 Red Book Pricing