Journal of managed care pharmacy: JMCP (J MANAGE CARE PHARM )
JMCP publishes peer-reviewed original research manuscripts, subject reviews, and other content intended to advance the use of the scientific method, including the interpretation of research findings in managed care pharmacy. JMCP is dedicated to improving the quality of care delivered to patients served by managed care pharmacy by providing its readers with the results of scientific investigation and evaluation of clinical, health, service, and economic outcomes of pharmacy services and pharmaceutical interventions, including formulary management. JMCP strives to engage and serve professionals in pharmacy, medicine, nursing, and related fields to optimize the value of pharmaceutical products and pharmacy services delivered to patients. The Journal of Managed Care Pharmacy is a peer-reviewed journal, with 9 publication dates per year: separate issues for the months of March, April, May, June, September, and October and combined issues for January/February, July/August, and November/December.
- Impact factor2.41Show impact factor historyHide impact factor history
- 5-year impact2.51
- Cited half-life4.70
- Immediacy index0.58
- Article influence0.72
- WebsiteJournal of Managed Care Pharmacy website
- Other titlesJournal of managed care pharmacy, JMCP
- Material typePeriodical, Internet resource
- Document typeJournal / Magazine / Newspaper, Internet Resource
Publications in this journal
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ABSTRACT: BACKGROUND: Contraceptives vary by effectiveness, duration of effect, and the total costs related to the method used and unintended pregnancies (UP). Health care payers and women incur higher initial costs for long-acting reversible contraceptives, such as intrauterine contraceptives and implants, than for short-acting reversible contraceptives, such as oral contraceptives (OC). When making coverage decisions for contraceptives, health care payers should take into consideration both product and pregnancy-related costs over the entire time of contraceptive use. OBJECTIVE: To estimate the impact on the cost to a U.S. health care plan over 3 years when switching women from OCs to a low dose levonorgestrel-intrauterine system (LNG-IUS-12). METHODS: A budget impact model was designed to estimate the cost before and after the availability of LNG-IUS-12, over a 3-year time horizon, among females 15-44 years at risk of UP, covered by a health plan. U.S. Census and National Survey of Family Growth data were used to determine the number of women aged 15-44 currently using or requiring contraception. Pregnancy outcomes (i.e., live births, induced and spontaneous abortion, ectopic pregnancy), risk of UP, discontinuation rates, and typical failure rates were estimated using published literature. It was assumed that LNG-IUS-12 garnered 0.5% of the contraceptive market in the first year, an additional 0.3% in the second year, and 0.2% in the third year, resulting in 1% of the contraceptive market at year 3, with LNG-IUS-12 taking direct market share from branded and generic OCs. The model incorporated costs for contraceptives, related physician visits, and pregnancy outcomes from method failures. Pharmacy costs were derived from Wolters Kluwers Health-MediSpan Master Drug Database; medical care costs were gathered from Medicare Reimbursement Rate for physicians; and the pregnancy costs were obtained from the Health Care Utilization Project. Model outputs were reported as cost per plan, per member, per patient, or per member per month (PMPM), as well as the number of UP. All costs accrued in years 2 and 3 were discounted at 3%. A scenario analysis assessed the impact of potential first-year discontinuation rates for LNG-IUS-12, allowing for a 20% switch from LNG-IUS-12 back to OC. RESULTS: In a hypothetical cohort of 1 million plan members, the base case model, with no allowance for discontinuation, estimated a reduction in total costs of $516,166, in PMPM costs of $0.04, and in UP 153. When first-year discontinuation of LNG-IUS-12 was considered, the model estimated a decrease in total costs of $381,032, in PMPM costs of $0.03, and in UP of 134. These results were based on an estimated LNG-IUS-12 uptake of 1% of the total contraceptive market taken from OC users over a 3-year time horizon in women at risk for pregnancy. CONCLUSIONS: Switching contraceptive users from OC to LNG-IUS-12 in a U.S. health care plan may result in less UP and an overall cost savings to the plan.Journal of managed care pharmacy: JMCP 01/2013; 19(2):153.
- Journal of managed care pharmacy: JMCP 01/2013; 19:S41-53.
- Journal of managed care pharmacy: JMCP 01/2013;
- Journal of managed care pharmacy: JMCP 01/2013; 19:S1-53.
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ABSTRACT: BACKGROUND: Current available contraceptive methods vary greatly in efficacy and overall costs. Although long-acting methods, such as intrauterine systems/devices (IUS/IUD) and implants, may have higher upfront medication costs than short-acting methods, such as oral contraceptives (OC), the latter may incur greater medical failure-related costs due to their dependence on user compliance. OBJECTIVE: To develop a framework to estimate the potential cost savings from the introduction of an IUS in a U.S. health plan’s formulary setting. METHODS: A budget impact model (BIM) was developed to assess the potential cost savings using a before-and-after comparison approach. Multiple contraceptive methods, up to a maximum of 8, can be selected across an adjustable time horizon between 1 and 5 years. The number of women using contraception was calculated from the U.S. Census and the National Survey of Family Growth. Contraceptive failure rates (i.e., pregnancies, induced abortions, live births, spontaneous abortions, and ectopic pregnancies) were derived from product labeling and published literature. Total costs included drugs, administration, physician visits, and contraceptive failures. Pharmacy costs were based on wholesale acquisition cost (WAC), whereas medical costs were based on Medicare Reimbursement Rate for physicians. Model outputs included annual health plan cost, per member per month (PMPM) costs, and per treated member per month costs. RESULTS: Assuming a 5% weighted increase in the number of women using IUS from branded OC, generic OC, injectable contraceptive, vaginal ring, transdermal patch, and implant in a hypothetical cohort of 1 million plan members for a 3-year time frame, the model estimates a reduction in total annual cost by $1.8 million and 1,066 contraceptive failures, translating into a cost savings of $0.05 PMPM. Potential cost savings could range from $0.02 PMPM to $0.10 PMPM, depending on different possible scenarios. CONCLUSIONS: Long-acting contraception methods, such as IUS, are highly effective in preventing large number of unintended pregnancies leading to cost savings of the health plan formulary budget.Journal of managed care pharmacy: JMCP 01/2011; 17(3):234.
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ABSTRACT: Multiple sclerosis (MS) is a costly and crippling neurologic disease. Approximately 250,000 to 400,000 persons in the United States are currently diagnosed with MS. Most individuals experience their first symptoms between the ages of 20 and 40 years; therefore, this disease may have substantial impact over many years of life on health, quality of life, productivity, and employment. Whereas a number of studies have utilized a cross-sectional design to evaluate the costs associated with MS, no study has used a large administrative claims database to analyze the direct costs associated with newly diagnosed MS. To estimate the additional health care utilization and costs in otherwise healthy patients with newly diagnosed MS. This was a retrospective cohort analysis of the Medstat MarketScan Commercial Claims and Encounters database, which is composed of medical and pharmacy claims for approximately 8 million beneficiaries from 45 U.S. commercial health plans. Cases extracted from the database included adults aged 18 to 64 years with either (a) at least 2 medical claims with a diagnosis of MS (ICD-9-CM code 340) in any diagnosis field on the claim or (b) 1 prescription (medical or pharmacy) claim for injectable MS drug therapy (interferon beta-1a, interferon beta- 1b, glatiramer acetate) for dates of service between January 1, 2004, and December 31, 2006. Natalizumab was not used to identify MS cases, but was used to exclude potential comparison group subjects. The index date for patients with MS was the first qualifying diagnosis or pharmacy claim. Each MS patient was matched to 5 "healthy comparison" cases without MS diagnoses or treatment using the following variables: region, insurance type, gender, relation to employee, age, and enrollment period. Cases with any condition listed in the Charlson Comorbidity Index were excluded from both the MS and "healthy comparison" cohorts. Each "healthy comparison" case was assigned the index date of the matching MS patient. Continuous enrollment 12 months pre- and post-index was required for both the MS and "healthy comparison" groups. Costs broken down by type of utilization were adjusted to 2010 dollars using the appropriate medical component of the Consumer Price Index. Use of services and costs were compared using chi-square, t-tests, parametric and nonparametric tests. 1,411 MS cases (65.6% female) were matched to 7,055 "healthy comparison" cases (65.6% female). In the analyses of all-cause health care services during the 12-month post-index period, MS patients were significantly more likely to use all categories of health services examined. Compared with the "healthy comparison" group, new MS patients were 3.5 times as likely to be hospitalized (15.2% vs. 4.3% for MS vs. comparison, respectively), twice as likely to have at least 1 emergency room (ER) visit (25.5% vs. 12.2%) and 2.4 times as likely to have at least 1 visit for physical, occupational, or speech therapy (23.7% vs. 9.9%; P < 0.001 for all comparisons). MS patients also had higher mean 12-month costs related to each category of service (inpatient services $4,110 vs. $836; radiology services $1,693 vs. $259; ER $432 vs. $189; office visits $849 vs. $310; therapies $295 vs. $81, respectively; all P values < 0.001). Total mean 12-month all-cause health care costs were significantly higher for MS patients than for the "healthy comparison" group ($18,829 vs. $4,038, respectively, P < 0.001). Claims attributed to MS by diagnosis code in any field on the claim or use of an MS injectable drug accounted for a mean cost of $8,839 (46.9%), and MS injectable drugs accounted for $4,573 (24.3%) of total all-cause health care costs. Newly diagnosed MS patients have significantly higher rates of hospitalizations, radiology services, and ER and outpatient visits compared with non-MS "healthy comparison" patients. MS presents a considerable burden to the U.S. health care system within the first year of diagnosis.Journal of managed care pharmacy: JMCP 11/2010; 16(9):703-12.
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ABSTRACT: Patients with bone metastasis secondary to prostate or breast cancer or multiple myeloma are predisposed to skeletal-related events (SREs), such as surgery or radiation to the bone, pathologic fracture, and spinal cord compression. Inpatient costs of these and other SREs represent an estimated 49%-59% of total costs related to SREs. However, information on payer costs for hospitalizations associated with SREs is limited, especially for costs associated with specific SREs by tumor type. To examine costs from a payer perspective for SRE-associated hospitalizations among patients with multiple myeloma or bone metastasis secondary to prostate or breast cancer. Patients with SRE hospitalizations were selected from the MarketScan commercial and Medicare databases (January 1, 2003, through June 30, 2009). Sampled patients had at least 2 medical claims with primary or secondary ICD-9-CM diagnosis codes for prostate cancer, breast cancer, or multiple myeloma and at least 1 subsequent hospitalization with principal diagnosis or procedure codes indicating bone surgery, pathologic fracture, or spinal cord compression. For patients with prostate cancer or breast cancer, a diagnosis code for bone metastasis was also required. If secondary diagnoses or procedure codes for SREs were present in the claim, they were used to more precisely identify the type of SRE for which the patient was treated, resulting in 3 mutually exclusive categories: spinal cord compression with or without pathologic fracture and/or surgery to the bone; pathologic fracture with or without surgery to the bone; and only surgery to the bone. Related readmissions within 30 days of a previous SRE-associated hospitalization date of discharge were excluded to minimize the risk of underestimating costs. Mean health plan payments per hospitalization, measured as net reimbursed amounts paid by the health plan to a hospital after subtracting patient copayments and deductibles, were analyzed by cancer type and type of SRE. A total of 555 patients contributed 572 hospitalizations that met the study criteria for prostate cancer, 1,413 patients contributed 1,542 hospitalizations for breast cancer, and 1,361 patients contributed 1,495 hospitalizations for multiple myeloma. The mean age range was 61 to 72 years, and the mean length of stay per admission was 5.9 to 11.6 days across the 3 tumor types. The ranges of mean health plan payment per hospital admission across tumor types were $43,691-$59,854 for spinal cord compression, with or without pathologic fracture and/or surgery to the bone; $22,390-$26,936 for pathologic fracture without spinal cord compression, with or without surgery to the bone; and $31,016-$42,094 for surgery to the bone without pathologic fracture or spinal cord compression. The inpatient costs associated with treating SREs are significant from a payer perspective. Our study used a systematic process for patient selection and mutually exclusive categorization by SRE type and provides a per episode estimate of the inpatient financial impact of cancer related SREs assessed in this study from a third-party payer perspective.Journal of managed care pharmacy: JMCP 11/2010; 16(9):693-702.
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ABSTRACT: Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are widely prescribed for the treatment of hypertension and heart failure, as well as for kidney disease prevention in patients with diabetes mellitus and the management of patients after myocardial infarction. To (a) describe ACE inhibitor and ARB utilization and spending in the Medicaid fee-for-service program from 1991 through 2008, and (b) estimate the potential cost savings for the collective Medicaid programs from a higher ratio of generic ACE inhibitor utilization. A retrospective, descriptive analysis was performed using the National Summary Files from the Medicaid State Drug Utilization Data, which are composed of pharmacy claims that are subject to federally mandated rebates from pharmaceutical manufacturers. For the years 1991-2008, quarterly claim counts and expenditures were calculated by summing data for individual ACE inhibitors and ARBs. Quarterly per-claim expenditure as a proxy for drug price was computed for all brand and generic drugs. Market shares were calculated based on the number of pharmacy claims and Medicaid expenditures. In the Medicaid fee-for-service program, ACE inhibitors accounted for 100% of the claims in the combined market for ACE inhibitors and ARBs in 1991, 80.6% in 2000, and 64.7% in 2008. The Medicaid expenditure per ACE inhibitor claim dropped from $37.24 in 1991 to $24.03 in 2008 when generics accounted for 92.5% of ACE inhibitor claims; after adjusting for inflation for the period from 1991 to 2008, the real price drop was 59.2%. Brand ACE inhibitors accounted for only 7.5% of the claims in 2008 for all ACE inhibitors but 32.1% of spending; excluding the effects of manufacturer rebates, Medicaid spending would have been reduced by $28.7 million (9%) in 2008 if all ACE inhibitor claims were generic. The average price per ACE inhibitor claim in 2008 was $24.03 ($17.64 per generic claim vs. $103.45 per brand claim) versus $81.98 per ARB claim. If the ACE inhibitor ratio had been 75% in 2008 rather than 64.7%, the Medicaid program would have saved approximately 13% or about $41.8 million, again excluding the effects of manufacturer rebates. If the ACE inhibitor ratio had been 90% in 2008, the cost savings for the combined Medicaid fee-forservice programs would have been about 33% or about $102.3 million. The total cost savings opportunity with 100% generic ACE inhibitor utilization in 2008 and an ACE inhibitor ratio of 75% was $75.1 million (24%) or $142.3M (46%) with a 90% ACE inhibitor ratio. Factors that affect Medicaid spending by contributing to increased utilization of ACE inhibitors and ARBs, such as the rising prevalence of hypertension, heart disease, and diabetes, can be offset by reduction in the average price attained through a higher proportion of ACE inhibitors and a higher percentage of generic versus brand ACE inhibitors.Journal of managed care pharmacy: JMCP 11/2010; 16(9):671-9.
- Journal of managed care pharmacy: JMCP 11/2010; 16(9):713-7.
- Journal of managed care pharmacy: JMCP 11/2010; 16(9):718-28.
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ABSTRACT: Like many payers, the Department of Defense (DoD) has limited ability to work directly with prescribers to ensure appropriate medication use. Many older beneficiaries are prescribed multiple maintenance medications, placing them at higher risk for adverse drug interactions, contraindicated medication use, and other polypharmacy-related problems. Medication reviews may mitigate these risks, but the optimal venue for medication therapy management is unclear. To (a) determine if beneficiaries will respond to a mailed request from the DoD to pursue a medication review; (b) identify medication review location and outcomes from the patient perspective; and (c) assess the statistical significance of changes in the number of prescription medications overall and for key categories, including maintenance medications and contraindicated medications, relative to a propensity-matched comparison group. A total of 4,000 TRICARE beneficiaries aged 55 years or older, residing in North Carolina, who obtained 10 or more maintenance medications (defined by a unique combination of drug, strength, and dosage form) during the 90-day baseline period from May 3, 2008, to July 31, 2008, were mailed letters requesting their participation in the study. Consenting subjects received a personalized medication list to review with their physicians or pharmacists and a survey form to complete after the review. Survey results were compared by location of medication review (i.e., physician's office, pharmacy, or both). Changes from the 90-day baseline to 90-day post-intervention period were calculated for prescription utilization measures (total drug count, maintenance drug count, count of Beers list medications, and count of contraindicated drug combinations) for the subsample of subjects who completed the survey (n = 373) and for subjects who received the initial consent letter (n = 3,856) versus a propensity-matched comparison sample drawn from neighboring states. Variables included in the propensity score were gender, age group, military rank, catchment status indicating proximity to military pharmacies, enrollment status, number of pharmacy settings used, and each of 30 binary disease indicators. A total of 1,469 subjects responded to the consent letter (response rate = 38.1%); 606 subjects consented to participate (consent rate = 15.7%); and 373 subjects returned a completed survey (completion rate = 9.7%). Among those who completed the survey, 190 (50.9%) received reviews in a physician's office; 103 (27.6%) received reviews in a pharmacy; 60 (16.1%) received reviews in both locations; and 20 (5.4%) reported a different location or no location. 61 survey respondents (16.4%) indicated that they were told to stop a medication, and 77 (20.6%) reported a dosage change. Medication changes occurred significantly more frequently for reviews performed at a physician's office compared with other review locations. Therapeutic classes most frequently stopped or adjusted for dosage were antidiabetics, diuretics, antilipidemics, renin-angiotensin aldosterone system inhibitors, anticoagulants, nonsteroidal anti-inflammatory drugs, and beta-adrenergic blocking agents. 85% of respondents reported that the medication review was worth doing. In the assessments of changes in prescription utilization from the baseline to post-intervention periods, no significant by-group differences were noted among those who completed the study relative to their matched comparison subjects. In the comparison of subjects who received the initial consent letter with their matched counterparts, small but statistically significant differences were observed for several prescription utilization measures, including changes in use of high-risk Beers list medications (P = 0.033); use of electrolytic, caloric, and water balance medications (P = 0.038); and use of hypertension medications (P = 0.028). The magnitude of the decrease observed among comparison subjects, however, exceeded that observed among the case subjects. Response was poor to a mailing that promoted a beneficiary- initiated medication review. The absence of significant changes following the medication review suggests several possibilities: a mailed intervention is ineffective in promoting medication review; medication regimens for study subjects are already optimized to the extent obtainable through a routine medication review; or the study sample size was too small to detect relevant changes. Most drug regimen changes were dosage adjustments for current medications or substitutions within the same therapeutic class. The extent to which comprehensive assessment of a patient's medication regimen, including nonprescription and herbal agents, was performed is unclear. More intensive interventions may be required to ensure that medication regimens are being actively managed among those who use a large number of prescription medications.Journal of managed care pharmacy: JMCP 10/2010; 16(8):578-92.
- Journal of managed care pharmacy: JMCP 10/2010; 16(8):640.
- Journal of managed care pharmacy: JMCP 10/2010; 16(8):629-39.
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ABSTRACT: Anemia in patients with chronic kidney disease (CKD) is associated with increased morbidity and mortality, decreased quality of life, and substantial health care costs. Iron therapy is recommended, usually in combination with an erythropoiesis-stimulating agent (ESA), in many CKD patients with anemia and low iron levels to raise hemoglobin levels to a range of 10 to 12 grams per deciliter; iron deficiency is defined by a ferritin score less than 100 micrograms (mcg) per liter and transferrin saturation (TSAT) less than 20%. To examine the use of intravenous (IV) iron and its associated economic and clinical outcomes in Medicare beneficiaries with stage 3 or stage 4 CKD and anemia. This was a retrospective cohort analysis using 2006 and 2007 Medicare 5% Standard Analytic Files (SAF). Use of therapy with IV iron and/or ESAs was identified among patients diagnosed with CKD and anemia. The study index quarter was the first quarter in 2006 during which the patient had primary or secondary diagnoses of both CKD and anemia. Based on the receipt of IV iron or ESA treatment in the index quarter, patients were classified into 1 of 4 treatment groups: IV iron and ESA; IV iron without ESA; ESA without IV iron; neither IV iron nor ESA. Therapy with oral iron was not measurable with this database. Clinical and economic outcomes, including the progression to advanced CKD stages, development of anemia, mortality, hospitalization, and net Medicare reimbursement (i.e., not including patient or supplemental plan contribution) for all-cause health care services, were examined for 1 year following the index quarter. Between-group differences were tested using Pearson chi-square for categorical variables and the Kruskal-Wallis nonparametric test for reimbursement. Multivariate logistic regression models were estimated to assess the associations of mortality, inpatient hospitalization, skilled nursing facility (SNF) admission, and hospice care with treatment regimen, controlling for patient demographic and clinical characteristics. Of the 4,310 study patients with both CKD and anemia, 2,913 (67.6%) received neither IV iron nor ESA; 984 (22.8%) received ESA without IV iron; 277 (6.4%) received IV iron and ESA; and 136 (3.2%) received IV iron without ESA in the index quarter. Logistic regression analyses showed that patients receiving neither IV iron nor ESA (reference group) were at increased risk of death compared with patients receiving both IV iron and ESA (OR = 0.62, 95% CI = 0.42-0.90). Additionally, patients receiving neither IV iron nor ESA were more likely to be hospitalized compared with patients receiving both IV iron and ESA (OR = 0.66, 95% CI = 0.50-0.87), IV iron without ESA (OR = 0.55, 95% CI = 0.38-0.79), and ESA without IV iron (OR = 0.73, 95% CI = 0.62-0.87). Further, patients not receiving IV iron or ESA were more likely to be admitted to an SNF than patients receiving both IV iron and ESA (OR = 0.44, 95% CI = 0.32-0.61), IV iron without ESA (OR = 0.57, 95% CI = 0.36-0.88), and ESA without IV iron (OR = 0.56, 95% CI = 0.47-0.67). Patients receiving neither IV iron nor ESA in the index quarter had the highest mean [SD] total Medicare reimbursement per patient in the subsequent year ($42,353 [$52,887]) compared with patients receiving IV iron without ESA ($28,654 [$32,068]), IV iron and ESA ($34,152 [$30,506]), or ESA without IV iron ($38,172 [$35,591], P = 0.001). Use rates of IV iron and ESA in a sample of Medicare enrollees with CKD and anemia in 2006 suggest that anemia management therapies may be underutilized; however, oral iron therapy use was not measurable with the study database, and therapies initiated after the index quarter were not measured. Patients not treated with IV iron or ESA had significantly higher rates of hospitalization and SNF admission than patients treated with either IV iron or ESA. Further, mortality was significantly higher in patients receiving neither IV iron nor ESA than in patients who received IV iron and ESA. Additionally, total all-cause health care costs were higher among patients receiving neither IV iron nor ESA treatment compared with patients treated with IV iron and/or ESA.Journal of managed care pharmacy: JMCP 10/2010; 16(8):605-15.
- Journal of managed care pharmacy: JMCP 09/2010; 16(7):507-8.
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ABSTRACT: An article on the front page of the Wall Street Journal on October 6, 2006, thrust into the public media the otherwise esoteric controversy concerning the use of average wholesale price (AWP) as the primary basis for reimbursements to pharmacies for pharmaceuticals in the United States. Although used widely for nearly 40 years, AWP had been criticized prior to this investigative report as unreliable, subject to manipulation, and not representative of the actual purchase price for pharmaceuticals. The Wall Street Journal article, based on a tentative settlement of litigation in which First DataBank (San Francisco, CA) and the McKesson Corporation (San Francisco, CA) were accused of unilaterally increasing AWPs, included the findings that (a) at least since 2003, AWP was not based on calculation of an "average" wholesale price but instead reflected the pricing of McKesson Corporation, a single drug wholesaler; and (b) AWP had undergone a systematic change beginning in 2001 when First DataBank had converted its markups of wholesale acquisition cost (WAC) to a common multiplier of 1.25,1 effectively increasing the AWP by 4% for AWPs that were previously calculated using a multiplier of 1.20. In March 2009, the future of AWP became uncertain as a result of circumstances surrounding the court settlement of the litigation that had begun in 2005 against First DataBank. On March 17, 2009, U.S. District Court Judge Patti B. Saris approved the proposed settlement of 2 civil action lawsuits filed by private health plan payers of pharmaceuticals against the 2 largest publishers of AWP, First DataBank (along with wholesaler McKesson) and Medi-Span (Indianapolis, IN, subsidiary of Wolters Kluwer Health). On March 30, 2009, Judge Saris signed a final order and judgment certifying the class (of "Private Payor" purchasers) which settled 2 national class action lawsuits against the 2 largest publishers of AWP. As part of the formal settlement, Medi-Span and First DataBank agreed to adjust the markup factor used to calculate AWP downward to 1.20 times WAC "for any prescription pharmaceutical" that had "a mark up factor basis from WAC to AWP in excess of 1.20" for the 1,442 specific national drug code (NDC) numbers that were listed in the court complaint. The "rollback" of AWP as a result of reducing the WAC/DP (direct price) multiplier to no more than 1.20 was implemented by First DataBank and Medi-Span on September 26, 2009, 180 days from the date of the judgment, as ordered. At the same time, these AWP publishers voluntarily implemented price modifications to all products that had a WAC markup greater than 1.20. This decision expanded the list of NDC numbers from the 1,442 specified in the lawsuit to well over 50,000 items. The expanded list included both prescription and nonprescription (over-the-counter [OTC]) items, both active and inactive NDC numbers on the drug database, as well as a variety of markup factors. The adjusted AWPs had markup factors that ranged from 1.20 to 1.33. About two-thirds to three-fourths of the NDC numbers with adjusted AWPs had a pre-settlement WAC markup of 1.25. This U.S. District Court decision on March 30, 2009, was also accompanied by separate announcements from the defendants Medi-Span and First DataBank that they would voluntarily discontinue publication of AWP.Journal of managed care pharmacy: JMCP 09/2010; 16(7):492-501.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.
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