Walgreens to Purchase Rite Aid Stores

PBIRx®
Intelligent Solutions in Pharmacy Benefits
12 Wheelers Farms Road, Milford, CT 06461
(888) 797-2479

Walgreens has finally received approval to acquire 1,932 Rite Aid stores, three distribution centers and inventory for $4.375 Billion in cash.  This acquisition will leave Rite Aid with 2,600 stores and thus, be one of the three remaining nationwide chain pharmacies together with CVS and Walgreens.  Walgreens will now be able to negotiate with drug manufacturers for lower drug costs, providing competition for CVS

The Rite Aid store purchases will begin in October and should be completed in the Spring of 2018 followed by rebranding those stores to Walgreens.  Most of the stores to be purchased are located in the Northeast and Southern United States.  As a result, Walgreens will have close to 10,000 locations (CVS has more than 9,600 stores) and expects to save about $300 Million annually through cost cuts over the next four years.   Walgreens also owns Duane Reade pharmacies .

It will be interesting to watch what happens to Rite Aid in the future as their stock plummets.    The deal does include the option for Rite Aid to join the Walgreens group purchasing  agreement for discounts on generics, which should help them to compete with the other chain pharmacies.

For additional reading, please access the following links:

https://www.reuters.com/article/us-rite-aid-m-a-walgreens-boots/walgreens-gets-regulators-nod-to-buy-rite-aid-stores-idUSKCN1BU1KP

http://money.cnn.com/2017/09/19/news/walgreens-rite-aid-deal/index.html

PBIRx has been exclusively providing intelligent solutions to clients in the management of pharmacy benefit costs since 1993. With a staff that includes IT personnel, actuaries, financial analysts, clinical pharmacists, attorneys, HIPAA Compliance Officers and many more experts, PBIRx’s mission is to create optimal health care outcomes while minimizing overall health care costs. For more information, please visit www.pbirx.com or call (888) 797-2479.

The Benefits Of Working With PBIRx

PBIRx®

Intelligent Solutions in Pharmacy Benefits

612 Wheelers Farms Road, Milford, CT 06461

(888) 797-2479

As health care costs continue to rise, the need for a team who can help ensure that you are paying the right price for various services is extremely important now more than ever. Though you likely contract with a Pharmacy Benefit Manager that adjudicates pharmacy claims at a significant profit margin and a "Medical" broker/consultant, there is a significant cost savings opportunity in working with PBIRx, an independent Pharmacy Benefit Auditing and Consulting firm, that can assist in returning some of that profit back to your benefits budget. After 25 years, PBIRx is proud of our growth of successful clients, who use our intelligence in the form of proprietary clinical algorithms and technology along with a dedicated team of experienced professionals with longevity in the pharmacy benefit industry.  

But why is PBIRx the right partner to move your PBMs profits to your budget? 

To start, PBIRx's proprietary AuditRx program and experience in hours of negotiating pharmacy benefit recoveries with various PBMs at a senior level gives clients a unique edge in understanding how discounts, guarantees and other fees in a PBM Agreement change with language in fine print. This experience translates to starting with an optimal PBM Agreement giving clients an immediate 10%- 15% savings adjunct to implementation of proprietary clinical algorithms, which identify client specific clinical programs resulting in an additional 10% -15% savings.

Next, pharmacy claims data is reviewed monthly so that plan design and clinical savings opportunities can be identified on a continuum. A recent example is when the manufacturer of the drug Glumetza for diabetes increased the AWP by 500% in late June of 2015. For one client with one member, the cost for one prescription increased to $9,300 from $1,700. PBIRx immediately reached out so that the prescribing physician was made aware of the significant cost increase with alternative lower cost therapeutic alternatives saving the client what could have been a $100,000 cost increase for one member with one prescription. 

All plan design recommendations are provided with member disruption (if any) and estimated savings, which is measured and provided back to the client comparing PBIRx projected savings to actual savings. This is a huge benefit to our clients because it provides them with the opportunity to truly see how much money they have saved as a result of our ongoing analyses. PBIRx has several proven proprietary plan design savings that go well beyond optimal PBM contract discounts and clinical programs with an increase in member cost share as a very last option.

Furthermore, facilitation of implementation of all recommendations are provided by PBIRx experts that pay attention to the detail required including physician and member communication materials. PBIRx becomes a team member for all our clients specializing in all aspects of the pharmacy benefit from their in house pharmacy, if any, to 340B audit and compliance, PBM contract negotiation and management of all financial terms and reconciliation of guarantees, invoices and rebates. PBIRx experts are also face to face with members to present all aspects of the pharmacy benefit and to be available to answer any questions at all open enrollment meetings.

Last, but certainly not least, the PBIRx team of experts provides several ad hoc reports including allocation rates, disease/drug compliance metrics, cost increase or decrease based on various copay options, patient assistance program facilitation, and challenges when PBMs recommend programs that actually increase client costs under the guise of pharmacy benefit management "cost savings" recommendations. For our Accountable Care Organization clients projected metrics have always been within 1% of accuracy.

To learn more about our services, ask questions, or request a courtesy PBM contract review, please visit us on our website or dial (888) 797-2479 today.

Pharmaceutical Terms Defined

PBIRx®

Intelligent Solutions in Pharmacy Benefits

612 Wheelers Farms Road, Milford, CT 06461

(888) 797-2479

 

In order to understand topics covered in the pharmaceutical industry, it is first important to understand the terms and acronyms that are used to detail them. Since the terms used by industry experts can be quite complex and highly specific, it is often difficult to decipher their meaning at first glance. However, not understanding such terms makes it much more difficult to fully grasp industry news as well as information pertaining to your healthcare and pharmacy benefit plans.

To help you better understand our industry, we've put together a list of five terms commonly used by our team along with their definitions; check them out below!

Average Wholesale Price (AWP): Average wholesale price for a drug that is determined by the manufacturer and applied to each NDC code. The AWP does not necessarily reflect what pharmacies pay for a drug, but it is generally accepted as a pricing measure.

Generic Effective Rate (GER): The rate calculated by looking at the AWP of a generic drug as well as all generic drug claims submitted for a specific plan.

Maximum Allowable Cost Price (MAC): When brand drugs have more than one generic equivalent, prices will differ among each depending on manufacturer and package size. The MAC for such drugs is determined and implemented by your Pharmacy Benefit Manager. Some brands also have a MAC applied i.e brand with two distributors.

National Drug Code (NDC): The code every FDA approved drug is assigned, which could be 10 to 11 digits. The first 4-5 digits represent the Labeler Code (manufacturer, repacker or distributor), the next 3-4 digits represent the Product Code (strength, dosage form and formulation), and the last 1-2 indicate the Package Code (package forms and sizes).

Patient Protection and Affordable Care Act (PPACA): Also known as Obamacare and the Affordable Care Act, PPACA is a federal regulation that was signed into law by President Obama on March 23, 2010, with several amendments to date.

Though these are just a few of the most popular pharmaceutical terms, they are a great place to start to increase your knowledge and understanding of this industry. Stay tuned for our next blog which will contain an additional five!

At PBIRx, it is our goal to make sure our clients are fully educated on their pharmacy benefit plans, which is why we take the time to explain what it all means, every step of the way. With us, there is no confusion or uncertainty when it comes to your healthcare costs. To learn more about how we can help, please visit us on our website or contact us at (888) 797-2479.