U&C Pricing Strategy Critical for Chain Expansion

IndustryRetail Pharmacy
ProblemAlthough well over 90% of customers have prescription drug coverage, those who do not have coverage pay the usual and customary (U&C) cash price for their prescriptions. The U&C price impacts third party reimbursement through the lower of provision in pharmacy network contracts. A client was planning an accelerated expansion and needed to maintain a consistent U&C pricing strategy across their chain.
PHSI SolutionPHSI developed a U&C pricing strategy that required minimal day to day maintenance based on the client’s pricing philosophy. Specific pricing strategies were set for top-selling brand and generic drugs, and a default strategy was determined based on current third-party reimbursement rates. PHSI understood and took into account the constraints of the client’s pharmacy practice software in order to make pricing maintenance manageable.
ResultsPHSI provided a consistent strategy for U&C pricing at every pharmacy in the chain. Top-selling drugs were priced so that the client remained competitive in the cash market but increased third party profitability.