Mail Order Pharmacy Agreement

Large shipping pharmacies are connected to various major insurers and major chains such as Walgreens, Humana, Aetna and Caremark. The three largest are Express Scripts (Cigna), OptumRx (UnitedHealthcare) and CVS Health (CVS Caremark). Historically, the majority of specialty pharmacies have contracts with Pharmacy Benefit Managers (PBM), but the number of independent shipping pharmacies specializing in certain niches or diseases is growing rapidly and these independent pharmacies are increasing exponentially, both in volume and market share. To focus more on the cause of this increase in start-ups of independent shipping pharmacies in the United States, we must first briefly address pharmacy benefit managers issues and drug repackaging. If the address matches an existing account, you`ll receive an email with instructions to reset your password. Pharmacy Benefit Managers (PBM) are third-party administrators (TPA) of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program and government plans. According to the American Pharmacists Association (APhA), « PBMs are primarily responsible for the development and maintenance of prescription, pharmacy contracts, discount negotiations and rebates with drug manufacturers, and the processing and payment of prescription fees. » Its mission is to work with government programs and self-insured companies to reduce drug costs and pharmacy costs covered by the insurance plan. The problem faced by pharmacy service managers is that many believe that PBMs prevent competition. As the National Community Pharmacists Association (NCPA) has found, pharmacy services managers actually have several incentives and monetary reasons to prevent their pharmacies from facing correspondence competition with local pharmacies. As stated in a recent NCPA publication, « the only pharmacy benefit managers to process transactions for their competitors, set prices for their competitors and determine how their competitors will compete. » It is obvious that PBM, since pharmacy service managers can manipulate contracts to pass prescriptions to their own shipping pharmacy stores, both billing rates and overcompensation rates that retail pharmacies can charge their patients.