PHSI Designs MAC Pricing Benefiting HMO and Retail Pharmacy
| Industry | Managed Care/ PBM |
| Problem | A Medicaid HMO wanted to ensure that their Maximum Allowable Cost (MAC) list was controlling generic expenditures while providing a reasonable profit to their retail pharmacy networks. |
| PHSI Solution | PHSI created a unique model to analyze the costs associated with generic drugs in order to create competitive MAC lists incorporating the needs of all market segments. The MAC list aligned incentives for all stakeholders to promote generic substitution. |
| Results | The Medicaid HMO aligned financial incentives while increasing their generic substitution rate and lowering network complaints on generic pricing. |
Poll Results
September Question of the Month
Should community pharmacies offer pharmacogenetic testing?
Yes: 85.7%
No: 14.3%
August Question of the Month
What percentage of the time do pharmacists and techs react to saving offers when seen with e-prescriptions in the notes field?
0%- 16.7%
1-33%- 75%
34-66%- 8.3%
67-99%- 0%
100%- 0%
July Question of the Month
Have you seen an uptake in utilization of the 22 newly FDA approved drugs from 2016?
Yes: 0%
No: 100%
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