Systems and Methods for Shifting Prescription Market Share by Presenting Pricing Differentials for Therapeutic Alternatives

• US 20070162303A1
• Filed: 12/07/2006
• Published: 07/12/2007
• Est. Priority Date: 12/08/2005
• Status: Abandoned Application

• Current Assignee: NDCHealth Corp. (McKesson Corp.)
• Original Assignee: NDCHealth Corp. (McKesson Corp.)
• Inventors: Wiley, Joseph, Burkett, Kenneth
• Application Number:
  US11/608,068
• Publication Number:
  US 20070162303A1
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/0206 Price or cost determination based on market factors
• CPC Class Codes: G06Q 30/0283 Price estimation or determination
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients

Abstract

While a pharmacist may know of other medications approved by the FDA for the same medical condition, the pharmacist typically does not know what the therapeutically equivalent dose of those products is when compared to the originally prescribed item In addition to this lack of equivalent dosage information, the pharmacist also is unable to determine if any of those other FDA approved items will save the consumer any money. Accordingly, embodiments of the invention can provide pharmacists and/or consumers with equivalent dosage information as well as pricing information for the equivalent dosage. Accordingly, based at least in part on this information, consumers may have an incentive to and may decide to purchase to another prescription drug, thereby shifting market share to a preferred prescription drug or pharmaceutical manufacturer or provider.

Claims

1. A method for facilitating a shift in drug market share, comprising:

receiving prescription drug information associated with a consumer;

based at least in part on the prescription drug information, determining at least one alternative drug and cost savings information associated with purchasing the alternative drug in lieu of a prescription drug associated with the prescription drug information;

providing, for review by an entity, the identity of the alternative drug and cost savings information; and

receiving decision information associated with the consumer, wherein the decision information includes a decision to switch from the prescription drug to the alternative drug.

2. The method of claim 1, further comprising:

providing at least a portion of the decision information to at least one provider associated with the alternative drug; and

receiving new pricing information associated with the alternative drug.

3. The method of claim 1, further comprising:

providing, to a third party, at least a portion of the decision information, wherein at least one provider associated with the alternative drug receives the portion of decision information; and

receiving new pricing information associated with the alternative drug.

4. The method of claim 1, further comprising:

based at least in part on a portion of the decision information, receiving a rebate revenue from at least one provider.

5. The method of claim 3, wherein the third party comprises at least one of the following:

a pharmaceutical benefits manager.

6. The method of claim 1, wherein determining at least one alternative drug and cost savings information associated with purchasing the alternative drug in lieu of a prescription drug associated with the prescription drug information comprises:

accessing a data storage device comprising a list of a plurality of alternative drugs, dosage information associated with each of the plurality of alternative drugs, and pricing information associated with each of the plurality of alternative drugs;

comparing a dosage associated with the prescription drug with a portion of information stored in the data storage device; and

determining whether one or more alternative drugs that have substantially similar therapeutic effects as the prescription drug exist.

7. The method of claim 1, wherein determining at least one alternative drug comprises receiving alternative drug information from a third party.

8. The method of claim 1, wherein determining at least one alternative drug and cost savings information associated with purchasing the alternative drug in lieu of a prescription drug associated with the prescription drug information comprises:

determining a price associated with the alternative drug;

determining a price associated with the prescription drug;

determining a difference between the price associated with the alternative drug and the price associated with the prescription drug.

9. The method of claim 1, wherein determining at least one alternative drug and cost savings information associated with purchasing the alternative drug in lieu of a prescription drug associated with the prescription drug information comprises:

based at least in part on at least one predefined discount rule, determining a true price associated with the alternative drug;

based at least in part on at least one predefined discount rule, determining a true price associated with the prescription drug;

determining a difference between the true price associated with the alternative drug and the true price associated with the prescription drug.

10. The method of claim 9, wherein at least one predefined discount rule is defined by a therapeutic alternative program, a therapeutic alternative program module, a pharmaceutical benefits manager, a pharmaceutical manufacturer or provider, a physician, or a pharmacist.

11. The method of claim 1, wherein providing, for review by an entity, the identity of the alternative drug and cost savings information comprises:

transmitting a message to an entity regarding a cost savings associated with an alternative drug, and requesting approval to switch from the prescription drug to the alternative drug.

12. The method of claim 1, wherein the entity comprises at least one of the following:

a consumer, a patient, a guardian, a pharmacy, a physician, a pharmaceutical benefits manager, a health care provider, a health medical organization, an insurance company, or a benefits plan manager.

13. A computer-implemented method for facilitating a shift in drug market share, comprising:

receiving, at a switch provider, a message from a pharmacy, wherein the message includes information identifying a requested drug;

identifying one or more alternative drugs for the requested drug, wherein the alternative drugs have substantially similar therapeutic effects as the requested drug;

determining that at least one of the identified alternative drugs are priced at lower price than the requested drug; and

transmitting, to the pharmacy, an indication of availability of at least one alternative drug and pricing information associated with the at least one alternative drug.

14. The method of claim 13, further comprising:

receiving decision information associated with a selection of at least one alternative drug;

providing at least a portion of the decision information to at least one provider associated with the at least one alternative drug; and

receiving new pricing information associated with the at least one alternative drug.

15. The method of claim 13, further comprising:

providing decision information associated with a plurality of alternative drugs to at least one provider associated with at least one alternative drug; and

receiving new pricing information associated with the at least one alternative drug.

16. The method of claim 13, further comprising:

based at least in part on a portion of the decision information, receiving a rebate revenue from at least one provider.

17. The method of claim 13, wherein identifying one or more alternative drugs for the requested drug comprises:

accessing a data storage device comprising a list of a plurality of alternative drugs, dosage information associated with each of the plurality of alternative drugs, and pricing information associated with each of the plurality of alternative drugs; and

comparing a dosage associated with the requested drug with a portion of information stored in the data storage device.

18. The method of claim 13, wherein identifying one or more alternative drugs for the requested drug comprises receiving alternative drug information from a third party.

19. The method of claim 13, wherein determining that at least one of the identified alternative drugs are priced at lower price than the requested drug comprises:

determining a price associated with an alternative drug;

determining a price associated with the requested drug;

determining a difference between the price associated with the alternative drug and the price associated with the requested drug.

20. The method of claim 13, wherein determining that at least one of the identified alternative drugs are priced at lower price than the requested drug comprises:

based at least in part on at least one discount rule, determining a true price associated with the alternative drug;

based at least in part on at least one discount rule, determining a true price associated with the requested drug;

determining a difference between the true price associated with the alternative drug and the true price associated with the requested drug.

21. The method of claim 13, wherein transmitting, to the pharmacy, an indication of availability of at least one alternative drug and pricing information associated with the at least one alternative drug comprises transmitting a message to an entity regarding a cost savings associated with an alternative drug, and requesting approval of a switch to the alternative drug.

22. The method of claim 13, wherein the entity comprises at least one of the following:

a consumer, a patient, a guardian, a pharmacy, a physician, a health care provider, a health medical organization, an insurance company, or a benefits plan manager

23. A computer-implemented method for obtaining an alternative to a prescription drug from a pharmacy, comprising:

requesting a prescription drug from a therapeutic alternative program;

receiving, from the therapeutic alternative program, information identifying one or more alternative drugs, wherein each of the alternative drugs has substantially similar therapeutic effects as the prescription drug;

receiving, from the therapeutic alternative program, information associated with a price savings, wherein one or more of the alternative drugs is priced lower than the requested prescription drug; and

transmitting a switch request to the therapeutic alternative program, wherein the switch request comprises a request for at least one alternative drug in lieu of the initially requested prescription drug.

24. A system for facilitating a shift in drug market share, comprising:

a therapeutic alternative program module operable to;

receive prescription drug information associated with a consumer;

based at least in part on the prescription drug information, determine at least one alternative drug and cost savings information associated with purchasing the alternative drug in lieu of a prescription drug associated with the prescription drug information;

provide, for review by an entity, the identity of the alternative drug and cost savings information; and

receive decision information associated with the consumer, wherein the decision information includes a decision to switch from the prescription drug to the alternative drug.

25. A system for facilitating a shift in drug market share, comprising:

a therapeutic alternative program module operable to;

receive, at a switch provider, a message from a pharmacy, wherein the message includes information identifying a requested drug;

identify one or more alternative drugs for the requested drug, wherein the alternative drugs have substantially similar therapeutic effects as the requested drug;

determine that at least one of the identified alternative drugs are priced at lower price than the requested drug; and

transmit, to the pharmacy, an indication of availability of at least one alternative drug and pricing information associated with the at least one alternative drug.

26. A system for obtaining an alternative to a prescription drug from a pharmacy, comprising:

a computer program module operable to;

request a prescription drug from a therapeutic alternative program;

receive, from the therapeutic alterative program, information identifying one or more alternative drugs, wherein each of the alternative drugs has substantially similar therapeutic effects as the prescription drug;

receive, from the therapeutic alternative program, information associated with a price savings, wherein one or more of the alternative drugs is priced lower than the requested prescription drug; and

transmit a switch request to the therapeutic alternative program, wherein the switch request comprises a request for at least one alternative drug in lieu of the initially requested prescription drug.

27. A method for facilitating a shift in drug market share, comprising:

offering one or more drugs to a pharmacy at an initial price, wherein the drugs can be used to fill prescriptions associated with consumers;

establishing a rebate program with the pharmacy to provide a price reduction for a prescribed drug based on a predefined shift in market share for the prescribed drug;

receiving, from a therapeutic alternative program, information associated with a shift in market share for one of the drugs;

based at least in part on the shift in market share, determining whether the drug is eligible for a price reduction; and

if the drug is eligible for a price a reduction, offering the drug to the pharmacy at a reduced price, wherein the drug can be used to fill a prescription requested by a consumer

28. A method for enhancing revenues of a pharmacy, comprising:

establishing a customer program at a pharmacy for cash customers;

providing one or more program rules for the customer program, wherein at least one program rule specifies at least an amount of a discount for one or more drugs;

receiving at least one drug order from a cash customer at the pharmacy;

providing the drug order to a switch provider;

identifying, via the switch provider, one or more alternative drugs for the drug associated with the drug order, wherein the alternative drugs have substantially similar therapeutic effects as the drug associated with the drug order;

determining that one or more of the identified alternative drugs are priced at a lower price than the drug associated with the drug order, wherein the prices for the alternative drugs are based at least in part on one or more of the program rules; and

transmitting, to the pharmacy, an indication of availability of one or more alternative drugs and pricing information associated with the one or more alternative drugs.