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Pharmacy benefit management

Index Pharmacy benefit management

In the United States, a pharmacy benefit manager (PBM) is a third-party administrator (TPA) of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans. [1]

42 relations: AbbVie Inc., AdvancePCS, Alzheimer's disease, American Pharmacists Association, Assistant United States Attorney, Baxter International, Biosimilar, Catamaran Corporation, Centers for Medicare and Medicaid Services, CVS Caremark, CVS Health, CVS Pharmacy, Diversified Pharmaceutical Services, Employee Retirement Income Security Act of 1974, Express Scripts, Federal Employees Health Benefits Program, Federal Trade Commission, Food and Drug Administration, Formulary (pharmacy), GlaxoSmithKline, Health maintenance organization, Health policy, Managed care, Market power, Medco Health Solutions, Medicare Part D, Multiple sclerosis, Online pharmacy, Pharmaceutical Care Management Association, Philidor Rx Services, Preferred pharmacy network, Prescription drug, Rheumatoid arthritis, Rite Aid, Specialty drugs in the United States, Specialty pharmacy, Teva Pharmaceutical Industries, Third-party administrator, Trade secret, UnitedHealth Group, Valeant Pharmaceuticals, Vertical integration.

AbbVie Inc.

AbbVie is a publicly traded biopharmaceutical company founded in 2013.

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AdvancePCS

AdvancePCS Inc.

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Alzheimer's disease

Alzheimer's disease (AD), also referred to simply as Alzheimer's, is a chronic neurodegenerative disease that usually starts slowly and worsens over time.

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American Pharmacists Association

The American Pharmacists Association (APhA, previously known as the American Pharmaceutical Association), founded in 1852, is the first-established professional society of pharmacists within the United States.

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Assistant United States Attorney

An Assistant United States Attorney is an attorney employed by the United States Government and working under the supervision of a United States Attorney.

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Baxter International

Baxter International Inc. is a Fortune 500 American health care company with headquarters in Deerfield, Illinois.

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Biosimilar

A biosimilar (also known as follow-on biologic or subsequent entry biologic) is a biologic medical product which is almost an identical copy of an original product that is manufactured by a different company.

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Catamaran Corporation

Catamaran Corporation (formerly SXC Health Solutions) is a Schaumburg, Illinois based pharmacy benefit management company that sells services related to pharmacy benefit management and medical record keeping to businesses in the United States.

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Centers for Medicare and Medicaid Services

The Centers for Medicare & Medicaid Services (CMS), previously known as the Health Care Financing Administration (HCFA), is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.

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CVS Caremark

CVS Caremark (formerly Caremark Rx) (stylized as CVScaremark, previously CVS/caremark) is the prescription benefit management subsidiary of CVS Health, headquartered in Woonsocket, Rhode Island.

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CVS Health

CVS Health Corporation (previously CVS Corporation and CVS Caremark Corporation) (stylized as CVSHealth) is an American retail pharmacy and health care company headquartered in Woonsocket, Rhode Island.

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CVS Pharmacy

CVS Pharmacy is a subsidiary of the American retail and health care company CVS Health, headquartered in Woonsocket, Rhode Island.

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Diversified Pharmaceutical Services

Diversified Pharmaceutical Services entered the market in 1976 as the pharmacy benefit manager for United HealthCare (now United HealthGroup), a leading national managed care organization.

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Employee Retirement Income Security Act of 1974

The Employee Retirement Income Security Act of 1974 (ERISA) (codified in part at) is a federal United States tax and labor law that establishes minimum standards for pension plans in private industry.

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Express Scripts

Express Scripts Holding Company is an American Fortune 100 company.

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Federal Employees Health Benefits Program

The Federal Employees Health Benefits (FEHB) Program is a system of "managed competition" through which employee health benefits are provided to civilian government employees and annuitants of the United States government.

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Federal Trade Commission

The Federal Trade Commission (FTC) is an independent agency of the United States government, established in 1914 by the Federal Trade Commission Act.

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Food and Drug Administration

The Food and Drug Administration (FDA or USFDA) is a federal agency of the United States Department of Health and Human Services, one of the United States federal executive departments.

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Formulary (pharmacy)

At its most basic level, a formulary is a list of medicines.

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GlaxoSmithKline

GlaxoSmithKline plc (GSK) is a British pharmaceutical company headquartered in Brentford, London.

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Health maintenance organization

In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee.

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Health policy

Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific healthcare goals within a society".

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Managed care

The term "managed care" or "managed healthcare" is used in the United States to describe a group of activities ostensibly intended to reduce the cost of providing for profit health care while improving the quality of that care ("managed care techniques").

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Market power

In economics and particularly in industrial organization, market power is the ability of a firm to profitably raise the market price of a good or service over marginal cost.

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Medco Health Solutions

Medco Health Solutions, Inc. was an American Pharmacy Benefits Management (PBM) company which served more than 65 million people, before it was ultimately acquired by Express Scripts in April 2012.

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Medicare Part D

Medicare Part D, also called the Medicare prescription drug benefit, is an optional United States federal-government program to help Medicare beneficiaries pay for self-administered prescription drugs through prescription drug insurance premiums (the cost of almost all professionally administered prescriptions is covered under optional Part B of United States Medicare).

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Multiple sclerosis

Multiple sclerosis (MS) is a demyelinating disease in which the insulating covers of nerve cells in the brain and spinal cord are damaged.

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Online pharmacy

An online pharmacy, Internet pharmacy, or mail-order pharmacy is a pharmacy that operates over the Internet and sends the orders to customers through the mail or shipping companies.

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Pharmaceutical Care Management Association

The Pharmaceutical Care Management Association (PCMA) is an American national trade association representing pharmacy benefit managers.

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Philidor Rx Services

Philidor Rx Services is a Pennsylvania-licensed specialty online pharmacy, which mainly sold Valeant Pharmaceuticals International Inc drugs directly to patients and handled insurance claims on the customers' behalf.

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Preferred pharmacy network

Preferred pharmacy network is a group of pharmacies which involves a prescription drug plan that selects a group of preferred pharmacies, which likely include pharmacies willing to give the plans a larger discount than other pharmacies.

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Prescription drug

A prescription drug (also prescription medication or prescription medicine) is a pharmaceutical drug that legally requires a medical prescription to be dispensed.

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Rheumatoid arthritis

Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints.

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Rite Aid

Rite Aid Corporation is a drugstore chain in the United States and a Fortune 500 company.

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Specialty drugs in the United States

Specialty drugs or specialty pharmaceuticals are a recent designation of pharmaceuticals that are classified as high-cost, high complexity and/or high touch.

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Specialty pharmacy

Specialty pharmacy refers to distribution channels designed to handle specialty drugs — pharmaceutical therapies that are either high cost, high complexity and/or high touch.

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Teva Pharmaceutical Industries

Teva Pharmaceutical Industries Ltd. (טבע תעשיות פרמצבטיות בע"מ) is an Israeli multinational pharmaceutical company headquartered in Petah Tikva, Israel.

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Third-party administrator

A third-party administrator (TPA) is an organization that processes insurance claims or certain aspects of employee benefit plans for a separate entity.

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Trade secret

A trade secret is a formula, practice, process, design, instrument, pattern, commercial method, or compilation of information not generally known or reasonably ascertainable by others by which a business can obtain an economic advantage over competitors or customers.

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UnitedHealth Group

UnitedHealth Group Inc. is an American for-profit managed health care company based in Minnetonka, Minnesota.

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Valeant Pharmaceuticals

Valeant Pharmaceuticals International, Inc. is a multinational specialty pharmaceutical company based in Laval, Canada.

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Vertical integration

In microeconomics and management, vertical integration is an arrangement in which the supply chain of a company is owned by that company.

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References

[1] https://en.wikipedia.org/wiki/Pharmacy_benefit_management

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