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Chargeback Overview

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Salud y medicina
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Contract Contract Price: $70 Purchase Price: $70 WAC Price: $100 Chargeback: $30 Chargeback Model Wholesaler Contract Pharmacy Eligible Entity Manufacturer
Chargeback Programs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Contract: Products & Pricing
Contract: Membership
Sales and Discounts U.S. Sales and Discounts from 3Q’09 to 4Q’10 ,[object Object],[object Object],Total = $1,479 $200 $400 $600 $800 $1,000 $1,200 $1,400 $1,600 3Q 2009 4Q 2009 1Q 2010 2Q 2010 3Q 2010 4Q 2010 Dollar (in thousands) Sales - Discounts Chargebacks Rebates $102 $87 $872 $109 $119 $941 $112 $128 $1,060 $141 $130 $1,073 $156 $154 $1,085 $180** $172 $1,128
Top 5 Wholesalers by CB Amount Paid in 4Q’10 ,[object Object],[object Object],Top 5 Wholesalers $10 $20 $30 $40 $50 $60 $70 AVITAN McAllister AmeriDrug Borris & Dawson Whole Drug CB Amount (in thousands) $63.2 $43.3 $34.6 $24.3 $3.1
CB Claims Processed from 3Q’09 to 4Q’10 ,[object Object],[object Object],[object Object],Chargeback Claims Volume 20,000 40,000 60,000 80,000 100,000 120,000 140,000 AVITAN McAllister AmeriDrug Borris & Dawson Number of Chargeback Claims 3Q 2009 4Q 2009 1Q 2010 2Q 2010 3Q 2010 4Q 2010
Top 5 Programs by CB Amount Paid from 3Q’09 to 4Q’10 ,[object Object],[object Object],Top 5 Programs $10 $20 $30 $40 $50 $60 $70 $80 ADAP AHF FSS PHS SPHS CB Amount (in thousands) 3Q 2009 4Q 2009 1Q 2010 2Q 2010 3Q 2010 4Q 2010
[object Object],[object Object],Sample Invoice Ship-to info on wholesaler submission Bill-to info not on wholesaler submission
Sample Claim Line Chargeback amount requested WAC HIN # (Health Identification Number) or DEA # NDC (National Drug Code) Contract # Contract Price Eligible Entity Wholesaler Contract
Validating Eligibility ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Validation Example
Warning, 4.49% Fatal, 1.11% Error, 0.18% Valid, 93.86% Percent of Claims Validated in 4Q’10 ,[object Object],[object Object],Claim Statuses Overridden-Accept, 0.33% Overridden-Reject, 0.04% Status Percent # of Lines Valid 93.86% 347,540 Warning 4.49% 16,620 Fatal 1.11% 4110 Overridden-Accept 0.33% 1220 Error 0.18% 650 Overridden-Reject 0.04% 130
Wholesaler Contract Pharmacy Patient of Eligible Entity (PHS) CP Serves Multiple 340Bs Eligible Entity (PHS)
Who is Purchasing?
Questions?

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