REFERENCE PRICE INDEX FOR PHARMACEUTICAL PRODUCTS

摘要

A pharmacy care manager (PCM) uses a reference price for a given drug that reflects the actual cost and availability of the drug in the market. The PCM determines a reference price index (RPI) using drug pricing and availability data from drug manufacturers, wholesalers, pharmacies, and the like, updated on a daily basis. Drug identification data obtained from industry publishers allow pharmaceutical products from different sources to be cross referenced. The PCM then uses the RPI as the basis for the reference price, thereby removing any arbitrariness or inconsistency in the reference price. The reference price may then be applied to pay pharmacy claims and request reimbursements from plan clients. Such an arrangement reduces or eliminates any differences between payment of claims and reimbursement.