tag:blogger.com,1999:blog-28450497.post3536081623722974179..comments2007-11-08T22:29:12.544-05:00Adam J. Feinhttp://www.blogger.com/profile/15774296048321605590afein@pembrokeconsulting.comBlogger4125tag:blogger.com,1999:blog-28450497.post-14309751354187615732007-11-08T22:29:00.000-05:002007-11-08T22:29:00.000-05:00Marc,<BR/><BR/>Let me give you another idea to consider.<BR/><BR/>Cost-plus models break pharmacy reimbursement into two parts:<BR/><BR/>1. Cost of the drug (AMP)<BR/><BR/>2. Cost of distribution and dispensing (Markup & Dispensing fee)<BR/><BR/>In contrast, traditional "list minus" reimbursement, such as AWP-%, combine both of these elements into a single payment. <BR/><BR/>Thus, cost-plus programs create much more transparency about the true drug costs while also making it possible for payers to define a specific value to distribution & dispensing. So perhaps it will now be easier to do exactly what you propose?<BR/><BR/>A big unknown will be the role of side payments (a.k.a. rebates) that flow between manufacturers and payors/PBMs. These are not computed within AMP/ASP.<BR/><BR/>AdamAdam J. Feinhttp://www.blogger.com/profile/15774296048321605590noreply@blogger.comtag:blogger.com,1999:blog-28450497.post-38789685805286915422007-11-08T13:56:00.000-05:002007-11-08T13:56:00.000-05:00Who needs Hollywood writers when we have Adam Fein??!!<BR/><BR/>Mr. Fein, the supply chain is fouled. You are correct in basing your opinions on that fact. However, I believe you need to backtrack your research further upstream (ie drug manufacturers). They could simply lower their prices rather than offering $15-50 off "coupons" to be administered at the retail level. Doesn't that make much more sense than trying to "blame" retail pharmacy by implementing the AMP plan. After all it's simple Wal Mart economics...Lower prices sell more product.Marcnoreply@blogger.comtag:blogger.com,1999:blog-28450497.post-87210442130717307302007-11-08T12:42:00.000-05:002007-11-08T12:42:00.000-05:00I hesitated before approving the above comment since the (anonymous) author just takes a swipe at me without contributing anything meaningful to our conversation. I ultimately decided to approve the comment because I want everyone to see an example of the emotional, data-free reactions that I receive in my inbox every day.<BR/><BR/>And to answer the question: I have not worked in a retail pharmacy. That’s why I can be objective and fact-based in my analyses. The Illinois Pharmacists Association highlighted Drug Channels recently, saying: “It is not always a comforting examination (from the Pharmacist’s viewpoint, anyway), but it is thoughtful and in a lot of ways hard to argue with.” (See <A HREF="http://www.drugchannels.net/2007/09/tidbits-from-september.html" REL="nofollow">Tidbits from September</A>.)<BR/><BR/>As always, I look forward your constructive comments.<BR/><BR/>AdamAdam J. Feinhttp://www.blogger.com/profile/15774296048321605590noreply@blogger.comtag:blogger.com,1999:blog-28450497.post-70631189536210420792007-11-08T12:41:00.000-05:002007-11-08T12:41:00.000-05:00Dr. Fein ,<BR/><BR/>You certainally are entitled to your veiwpoints, however, you should remove the word "expert" from the description of Drug Channels. Have you ever spent any time in a retail pharmacy or examined the financials of a typical "retail pharmacy"?Anonymousnoreply@blogger.com