Prescription costs

The information in the Prescription Cost Analysis System and the Base de Datos de Especialidades Farmaceuticas (Pharmaceutical Product Database) is compiled according to accounting criteria. We processed the information and created two structured databases in order to obtain the statistics that will show us the competition and the structure of the pharmaceutical markets of each of the countries studied. 

Finally, the cost of medication as experienced by the family can have distinct meaning for the child or adolescent patient, because of their dependent status. When kids overhear, or directly encounter, their family s discussion about prescription costs, especially in the face of spotty coverage by hugely uneven insurance plans, the child can feel like a further burden to the family. To avoid this further complication of compliance, cost is best discussed privately and preemptively with the parents. 

Pharmacies have third-party patients and private-pay patients. Private-pay patients, sometimes referred to as cash patients, are people who do not have any health insurance coverage or people who have health insurance that does not cover prescription drugs. From the pharmacy s perspective, patients who pay the pharmacy directly for their prescriptions and later are reimbursed by their insurance company often are indistinguishable from private-pay patients. This type of prescription drug insurance, called indemnity insurance, used to be common, but it now has been replaced largely by service benefit plans. Under a service benefit plan, the patient may pay the pharmacy a predetermined portion of the prescription cost, but the pharmacy is reimbursed directly by the third party for most of the prescription cost. 

Table 6 Experiments in Managed Care US, UK, Germany, and France— Constraints on Growth of Prescription Costs...

PBMs are also characterized by a series of relationships among many stakeholders payers, providers, consumers, and pharmaceutical companies. Payers include employers, employer coalitions, insurers, managed care organizations, Medicare, and Medicaid. Typically, they pay the net prescription cost and a per claim or transaction fee to the PBM for claim processing. Money and information flow back to the payers in the form of rebates and a variety of utilization reports. 

In cases where prescription costs are part of the major medical deductible, an employer must pay two administrative service fees one to the PBM for claims adjudication and another to the medical carrier for claims reimbursement and reporting. 

Pharmaceutical companies and government used to the two major drivers for Rx-to-OTC switches and they will continue to be the maior drivers for the switches. The former conducts switches for lifestyle management of prescription drugs while the latter promotes switches to reduce national prescription costs. In future, manage care providers will also be a major driver to petition for switches as in the case of second-generation antihistamines. 

Oxycodone CR is supplied in 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 60 mg, 80 mg, and 160 mg tablet strengths for oral administration. A 40 mg tablet of OxyContin by prescription costs approximately 4 - 400 for a 100-tablet bottle in a retail pharmacy. Street prices vary depending on geographic location, but generally OxyContin sells for between 50 cents and 1 per milligram. 

Table H Survey of Prescription Costs per Dose from Internet Sources...

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