Pharmacy contracting has gotten incredibly complex in the past 5 years. In years past, pharmacists could just accept any contract that came along and trust that if they filled more prescriptions, they’d make more money. Those days are gone, for better or worse.
Pharmacy contracting for purchasing and for reimbursement are a game with constantly changing rules. You can’t win the game if you don’t know the rules. In this module, we’ll discuss the core concepts to understand - what’s a DIR fee and how is it computed? What is a Generic Effective Rate and how does it affect your day-to-day operations? What is a Pharmacy Services Administrative Organization (PSAO)? How do you assess if you have a good deal with the pharmacy benefit manager (PBM)? Is the PSAO getting you a good deal or can you do it better on your own?
We will also discuss how to assess your purchasing from your wholesaler. Most independents have a positive personal relationship with their wholesaler representative. But how do you go toe-to-toe with a Fortune 100 company at the negotiating table? What about rebates? What are rebates, really, and why do they exist? Remember to ask cui bono (to whom is it a benefit)?
If you’ve ever felt lost reading through a PBM contract or a deal with your wholesaler, you’re not alone and this course was designed for you.