Lack of Transparency & Accountability in Drug Pricing Could be Costing Taxpayers Millions – Full Report

… employers to manage prescription drug plans, are expected to contain drug costs by negotiating rates for prescription drugs with drug makers and pharmacies. Instead, controversy surrounds the ways PBMs generate revenue. Practices suc …

… 14 TABLE OF CONTENTS Average Wholesale Price (AWP): The published price for prescription drugs based on a nationally recognized list of wholesale drug prices used to determine payments for medications covered by …

… s for medications covered by a prescription benefits plan. Claim: The requested financial amount due for prescription drugs and related health products and services by a plan member or pharmacy. Direct and Indirect Remuneration (DIR) Fees …

… aceutical services in addition to reimbursement for a prescription drug. Formulary: A list of approved prescription drugs a health plan will cover. Generic Drugs: Prescription drugs that are equivalents or alternatives to brand drugs and s …

… rsement for a prescription drug. Formulary: A list of approved prescription drugs a health plan will cover. Generic Drugs: Prescription drugs that are equivalents or alternatives to brand drugs and share the same active ingredient and prov …

… iption drug. Formulary: A list of approved prescription drugs a health plan will cover. Generic Drugs: Prescription drugs that are equivalents or alternatives to brand drugs and share the same active ingredient and provide the same therape …

… ption drugs a health plan will cover. Generic Drugs: Prescription drugs that are equivalents or alternatives to brand drugs and share the same active ingredient and provide the same therapeutic effect. Independent (community) pharmacy: A s …

… r sole proprietorship that could consist of more than one store owned by an individual or small group. Multisource Drugs: Prescription drugs manufactured by more than one company and have both a brand drug and generic drug equivalent. P …