UNIQUE Rx PURCHASING MODEL
THE TRULY TRANSPARENT & PASS-THROUGH RX PROCUREMENT MODEL THAT HAS TRANSFORMED BOTH HOSPICE & PHARMACY BENEFIT MANAGEMENT.
IF YOU MAKE MEDICATION PURCHASES THROUGH A TRADITIONAL AVERAGE WHOLESALE PRICE DISCOUNT-BASED MODEL, OR A PER-DIEM ARRANGEMENT,
THEN YOU’RE SIMPLY PAYING TOO MUCH.
POSSIBLY WAY TOO MUCH.
HOSPICE TAPER VS. AWP
AVERAGE WHOLESALE PRICE MODEL (AWP)
Under average wholesale pricing, a pharmacy benefit manager gives its hospice client a discount off the average wholesale price of every medication purchased. The discount may range as high as 70–80%. It could be, and is often, much lower.
But even with the negotiated discount, the price paid by a hospice is substantially higher than what the pharmacy benefit manager actually pays the pharmacy filling the prescription—leaving a sizable markup (PBM spread) that the pharmacy benefit manager pockets as pure profit.
For example, a large hospice receives a 40% discount from its pharmacy benefit manager on the average wholesale price. For a typical hospice medication, e.g. Olanzapine 5mg tablet, the average wholesale price is approximately $370 for 30 tablets and, with its discount, the hospice pays its pharmacy benefit manager about $220. BUT the pharmacy benefit manager only pays the pharmacy filling the Olanzapine prescription $6.85—leaving a difference of more than $210 that the pharmacy benefit manager pockets as pure profit.
BUT THERE’S ANOTHER, BETTER, TRANSPARENT WAY.
Under the Delta Care Hospice Taper, Delta Care pays the pharmacy $6.85 and Delta Care passes that $6.85 cost directly through to our hospice client with no additional markup or spread.
Any genuine pass-through Rx purchasing model must include the client's ability to audit the provider at any time. If it doesn’t, then it’s not a genuine pass-through purchasing model.
Any genuine pass-through purchasing model also must identify, within the contract, what the pass-through rates are, such as maximum allowable cost (MAC), that will be paid to dispensing pharmacies or the PBM/Mail Order provider if the provider itself is doing the dispensing. If it doesn’t, then it’s not a genuine pass-through purchasing model.
When you think you have two similar pharmacy benefit offerings, be sure to have every bidder complete an apples-to-apples cost comparison to reveal what you may be missing.
FLEXIBLE PROCUREMENT OPTIONS WITH THE SAME ACCESS TO REAL BUSINESS TRANSPARENCY THROUGHOUT
COMMUNITY PHARMACY PBM SERVICES AND/OR DRAGONFLY MAIL ORDER
PBM Services. You Can...
utilize a preferred local network of pharmacies for same-day service, thus ensuring that the majority of your medication dollars are spent within the communities you serve
purchase medications at the deepest discounts available to hospices—you pay a pass-through of what we pay the pharmacy
choose medication delivery via local courier or by select local pharmacies, when necessary
utilize mail-order delivery when a patient does not qualify for local delivery or has a specialty medication need
Dragonfly Mail Order
Traditional mail order pharmacy programs DO NOT provide hospices with the formulary flexibility, business transparency, financial creativity, necessary technology or regulatory cushioning to operate effectively.
Same-Day/Next Day Emergency
Guaranteed emergency medication availability
Full access to our PBM local pharmacy network, when needed
Non-Emergency Needs & Refills?
Zero off-formulary penalties
Full transparency in both drug pricing and mailing costs
Robust medication ordering technology, complete with DEA/Surescripts certified e-Prescribing and mobile app access for any type of device
Lowest mailing rates among PBMs, with online/on-demand package tracking/order status
Inpatient Innovations™ (optional)
Think of Inpatient Innovations as a remote Delta Care pharmacy that sits in your inpatient unit or hospice house.
Hardware provided to facilitate on-site and on-demand access to most commonly used therapies
Ensured compliance with all federal and applicable state regulations
Fully integrated with the entire suite of Delta Care products and services
Customized workflow options
Unparalleled program delivery and competency