Method for Improving Pharmaceutical Selection Ratios in Pharmacy Implementation of Prescription Medication Dispensing Plans
First Claim
1. A method for improving pharmacy medication selection ratios in a prescription fulfillment plan which comprises:
- a. defining a group of related medications dispensed by a pharmacy under said plan, determining the sales price and group sales percentage of each medication within said group, determining therefrom a group-weighted sales price for each said medication, and performing a calculation of a representative price by summing said group-weighted sales prices for all medications within said group;
b. excluding from said group and representative price calculation those related medications which have price structures dissimilar to those medications within said group;
c. establishing a minimum amount at or above which said representative price will be maintained, notwithstanding any said calculation which results in a lesser amount;
d. for each prescription fulfillment of a medication within said group, paying to said pharmacy an amount equal to said representative price;
e. periodically repeating step a. to keep said representative price at an appropriate market amount; and
f. periodically assessing and when appropriate adjusting said minimum amount of step c, to keep said minimum amount at a level consistent with said representative price being within an appropriate range of market amounts;
whereby each said pharmacy receives an incentive to preferentially fulfill said prescriptions with lower costs medications with said group when consistent with medical efficacy and prescriber instruction.
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Accused Products
Abstract
A method is disclosed by which pharmacies and physicians are encouraged to select appropriate and effective medications but dissuaded from selecting higher priced medications where more economical versions are available as alternatives, but where physicians and patients can also select such higher priced medications if they so choose and are prepared to pay that higher price. Under this system a single representative price (capitation rate) is calculated by a prescription payment plan manager for a group of related medications, usually including both branded and generic, and that price is paid to a pharmacy for all prescriptions of that group of medications fulfilled under the plan. The representative prices for different groups, including their minimum levels, are periodically reviewed and updated as appropriate.
22 Citations
12 Claims
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1. A method for improving pharmacy medication selection ratios in a prescription fulfillment plan which comprises:
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a. defining a group of related medications dispensed by a pharmacy under said plan, determining the sales price and group sales percentage of each medication within said group, determining therefrom a group-weighted sales price for each said medication, and performing a calculation of a representative price by summing said group-weighted sales prices for all medications within said group; b. excluding from said group and representative price calculation those related medications which have price structures dissimilar to those medications within said group; c. establishing a minimum amount at or above which said representative price will be maintained, notwithstanding any said calculation which results in a lesser amount; d. for each prescription fulfillment of a medication within said group, paying to said pharmacy an amount equal to said representative price; e. periodically repeating step a. to keep said representative price at an appropriate market amount; and f. periodically assessing and when appropriate adjusting said minimum amount of step c, to keep said minimum amount at a level consistent with said representative price being within an appropriate range of market amounts; whereby each said pharmacy receives an incentive to preferentially fulfill said prescriptions with lower costs medications with said group when consistent with medical efficacy and prescriber instruction. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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Specification