The AlignRx Blog

Providing information to support the viability of independent pharmacies

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MAC pricing

3 Pricing Benchmarks That Influence Your Pharmacy's Reimbursement

Independent pharmacy owners and operators are able to bill insurance companies for filled prescriptions drugs and other pharmaceutical products through a contractual relationship established directly with a pharmacy benefit management organization and/or through membership in a pharmacy services administration organization (PSAO). In both circumstances, it will serve a pharmacy owner or operator well to understand key benchmarks that impact pricing and reimbursement. Standard reimbursement terminology that appears in managed care agreements and addenda include Average Wholesale Price, Wholesale Acquisition Cost, National Average Drug Acquisition Cost, and Maximum Allowable Cost. Navigating a pharmacy provider agreement is undoubtedly a complex process and you can take the step as an independent pharmacy owner or operator to become more informed.