FAQ

/FAQ
FAQ2019-09-09T04:31:57+00:00
What expenses will our organization have?2019-09-09T02:04:53+00:00

The property where the pharmacy will exist and structural improvements required will be the responsibility of the client, as will utilities. All other aspects including planning, design, provision of furniture, On-Site Rx provides fixtures and ALL equipment necessary to run a full-service pharmacy.

Describe the model?2019-09-09T02:05:12+00:00

Your organization’s pharmacy is stocked directly from the wholesaler, bypassing the additional costs incurred by PBMs and retail pharmacies in the existing PBM setting. Our staff works with your organization to design, build and manage a full-service pharmacy on your campus. We provide this full service functionality for a fixed management fee. Because the costs to open and operate a pharmacy are somewhat fixed, and so are ours, your organization’s savings are a function of the volume of claims driven through the on-site pharmacy.

Does this threaten the PBM? ( Will we have to replace our PBM?)2019-09-09T02:05:31+00:00

The PBM remains an integral partner in this service model.

How prevalent is this model? (Who else is doing this?)2019-09-09T02:08:05+00:00

This model is unique. Other large employers have paid companies to put on-site medical clinics and the pharmacy follows as an adjunct to that. The pharmacy is the centerpiece of this model. Municipal governments along with several health systems have used our services to place pharmacies on their campus.

What work will our organization have to do?2019-09-09T02:08:40+00:00

While this is a turn-key solution, there are responsibilities that the employer should be prepared for. Most important are the facilitation with the PBM vendor and communicating to employees and dependents about the pharmacy.

Who is the target audience for this model?2019-09-09T02:09:26+00:00
  • Self-funded plan sponsors
  • Plan sponsors who currently operate an on-site clinic
  • Plan sponsors with a concentrated geography of employees
  • Plan sponsors who desire a solution to rising healthcare costs
  • Plan sponsors who wish to enrich their employee benefit without additional costs
  • Plan sponsors who value their employee’s wellness
Do your services benefit a plan sponsor who fully insures their pharmacy benefit?2019-09-09T02:10:20+00:00

Savings from our program would only benefit the insurer is this case. Our organization can help you evaluate whether self-funding the pharmacy benefit is a viable option.

What are the key challenges?2019-09-09T02:10:50+00:00

The fear of politics is often a big hurdle. PBMs who are averse to transparency may not warm up to the idea because of potential lost revenue (or exposure of the levels they’re currently making) Independent retail pharmacists may believe that their business will be threatened. (They in fact remain in the supporting network)

What is acquisition pricing?2019-09-09T02:11:27+00:00

Acquisition pricing is pricing prescription drugs for a client based on the actual cost of the goods. Traditional pricing arrangements are predicated upon average wholesale price (AWP) discounts and proprietary maximum allowable cost (MAC) schedules. These methodologies are not only higher than the acquisition cost of the drug, but they allow ambiguity relative to the true cost, meaning the vendors revenue can be manipulated.

What is AWP?2019-09-09T02:11:56+00:00

Average wholesale price or AWP is the artificial price that is set for a legend drug. It is artificial because it is inflated from the actual price the manufacturer sets for the drug. AWP is published by a few third parties (including Medispan, First Data Bank and Redbook) whose methodologies have come under legal scrutiny in the recent years. Published AWP is used to calculate discounts to third party payers including plan sponsors.

How do we promote utilization at the on-site pharmacy?2019-09-09T02:12:32+00:00

The primary motivator for most people to change behavior is money. Copay differentials are the single biggest predictor of adoption of the on-site pharmacy.

Won’t independent retail pharmacists be upset that they’re excluded?2019-09-09T02:13:05+00:00

Retail pharmacists may feel threatened by this model. Especially when adopted by larger employers. The fact is that members can still use the same retail pharmacies that were in the network. Partnerships can be developed for those desiring compounding or other special services. But the savings to the plan sponsor are far greater than the potential lost revenue to any single pharmacy.

What’s the difference between this and the traditional prescription benefit model?2019-09-09T02:13:45+00:00

The employer accesses the buying power held by a wholesaler. This buying power eliminates extraneous “middlemen” in the supply chain and lowers costs while simultaneously enhancing the benefit.

How can this integrate with our current wellness initiatives?2019-09-09T02:14:13+00:00

All chronic conditions have one thing in common. They are treated with drugs. An on-site pharmacy presents a portal to those patients who are taking medications to treat those chronic conditions. Furthermore, the pharmacy can facilitate some of the simple measurements (weight, blood pressure, etc) and counseling that are core to any wellness program.

Can our pharmacy do mail order?2019-09-09T02:14:40+00:00

The ability to send prescription drugs via mail is dictated by state pharmacy laws. Provided your state permits such distribution of drugs, accommodations can be made to facilitate sending prescriptions via a 3rd party deliverer such as UPS.