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PHARMACY-IN-PHARMACY
The general concept of the PIP (Pharmacy-in-Pharmacy) maintains that one
pharmacy can acquire multiple licenses and distribute medications under the
appropriate NCPDP license. There are various reasons that this philosophy can
provide benefit to the payer.
There is "Class of Trade" price differentiations for institutional vs. traditional
or specialty pharmacy business or settings that have "closed door" pharmacy status.
This philosophy can provide significant savings to the payer of the health plan.
The overall value to the payer is the ability to negotiate and own a particular
segment of medications. Through negotiated pricing, the medications can be
adjudicated at AWP and the payer can recognize significant gross margin based
on the negotiated pricing.
By owning and maintaining their own inventory, the payer can forecast
negotiated "buys" from the manufacturer.
This work flow process does not compromise quality or accountability. Normal
process flows are not changed from traditional business, thus the same quality
standards are in place and no work flow deviation is necessary. The potential
for error is therefore diminished.
The Pharmacy-in Pharmacy concept and the relationship to inventory ownership is
an important issue. The payer has the opportunity to own the pharmaceutical
inventory. Therefore, all rebate concessions and chargeback's will be passed
through directly to the payer. The payer will be responsible for all
manufacturer contract negotiations. Administration fees, typically charged by
the larger PBM's will be absent with this concept.
DIFFERENTIATING SERVICES
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