Magazine article Drug Topics

Reimbursement Rates Stabilized, New Study of Employers Finds

Magazine article Drug Topics

Reimbursement Rates Stabilized, New Study of Employers Finds

Article excerpt

NEWSBREAKS

The downward slope of prescription drug reimbursements to community pharmacies has leveled off, according to the latest annual Wyeth-Ayerst Prescription Drug Benefit Cost and Plan Design Survey.

Community pharmacies were reimbursed on the basis of an average wholesale price (AWP) discount of 13.1% in 1999, with an average brand-drug dispensing fee of $2.30, according to the report. Findings were based on data collected in late 1999 from 446 employers representing more than 15 million beneficiaries. When the dispensing fee was added to the AWP discount, the overall reimbursement rate was 94.6% of AWP. The numbers were little changed from 1998 when the AWP discount was 13.2% and the average dispensing fee was $2.35.

Pharmacies in the Northeast had the lowest reimbursement rates: AWP minus 13.4%, an average brand dispensing fee of $2.17, and an average generic fee of $2.26. Pharmacies in the West fared the best, with AWP minus 12.9% and fees of $2.43 for brands and $2.62 for generics.

The majority of the employers surveyed (60%) paid either 12% or 13% off AWP, although 15% paid AWP minus 15%, and 6% reported a discount higher than 15% off AWE Dispensing fees for generics averaged $3. …

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