Malamulo otsatirawa a Pharmacy Benefit Management, Medicare, ndi Medicaid. Chonde dziwani kuti mndandandawu umatchulidwanso kuchokera pamabuku onse a inshuwalansi monga momwe zingakhalire.
Average Price Manufacturer (AMP)
AMP ndiyo maziko a ndalama zowonjezera mankhwala kwa madokotala pansi pa Medicaid.
Centers for Medicare & Medicaid Services imatanthawuza izi monga zomwe amalonda akulipira ogulitsa mankhwala, ndipo sizinali zenizeni zenizeni za malipiro a mankhwala ozunguza bongo. Dipatimentiyi imagwiritsa ntchito zilembo zapadera za ndalama za boma zomwe zimayimilidwa pazigawo zonse za boma. FUL ndi nambala yeniyeni ya malipiro a Medicaid.
Mtengo wamtengo wapatali (ASP)
CMS imagwiritsa ntchito ASP monga nambala yaikulu kuti awerengere ndalama zothandizira mankhwala omwe amalembedwa pansi pa Medicare Part B. Mwezi uliwonse, aliyense wogwiritsa ntchito mankhwala osokoneza bongo amavomerezedwa ndi US Food and Drug Administration ayenera kuitanitsa ku CMS mtengo wamtengo wapatali womwe umagulitsidwa pa katundu uliwonse umene umagulitsa kwa ogulitsa, zipatala, ndi mankhwala . ASP imasiyana ndi AMP makamaka pokhala apamwamba kwambiri. Kusiyana kumeneku kumachokera kuzinthu zomwe ASPs sizikusinthira mtundu wa mankhwala kapena wogula.
Avereji ya mtengo wamba (AWP)
Ma PBM ndi makampani a inshuwalansi a zaumoyo amadalira kwambiri AWP kuti awerengere ndalama za kubwezera mankhwala. Ndizofanana ndi AMP chifukwa opanga mankhwala amagwiritsira ntchito njira yomweyo yofotokozera zoyenera. Chiwerengero cha zomwe amalonda akulipira zogulitsa nthawi zambiri zimasiyana ndi AMP, komabe, monga tafotokozera pansipa.
Thompson Reuters amalumikiza ndi kufalitsa AWPs chaka chilichonse mu Red Book .
Malipiro ogawa
Misonkho yobwereka imaphatikizidwanso ku chiwongoladzanja cha mankhwala kubweza ndalama za pharmacy za kuchita bizinesi ndi kupereka chisamaliro cha odwala ndi uphungu. Bungwe la National Association of Chain Drugstores limatchula ndalamazo monga monga malipiro a antchito, ngongole yobwereka kapena kubwereka, mankhwala ogulitsa mankhwala, kupereka zofalitsa zosindikizidwa kwa odwala ndikukumana limodzi ndi odwala. Malipiro othandizira, omwe amasiyanasiyana ndi mtundu wa mankhwala ndipo amatha kukambirana ndi a inshuwalansi zapadera kapena kukhazikitsidwa ndi mapulogalamu a boma a boma, ayeneranso kulandira phindu laling'ono kwa mankhwala. Izi sizili choncho nthawi zonse ndipo zikungowonjezereka pansi pa Medicaid monga mayiko akuyang'ana kusunga ndalama mu pulogalamu yomwe nthawi zambiri imakhala chinthu chimodzi chofunika kwambiri pa bajeti.
Chigawo Chachikulu Chachigawo (FUL)
CMS imawerengetsa FUL kwa mankhwala ambiri omwe amaperekedwa ku Medicaid opindula mwa kuchulukitsa AMP ya mankhwala ndi 175%. Cholinga cha Chitetezo cha Odwala ndi Affordable Care Act, kapena Obamacare, miyeso yochepa yobwezera ndalama zolimbitsa thupi zolembera mankhwala ndi mankhwala osokoneza bongo omwe amapezeka kuchokera kwa opanga opanga imodzi. Chochititsa chidwi, sikuti malipiro akuyenera kubwezera ndalama zonse m'mabuku onse.
Fomu yotchedwa maximum maximum adalandizidwa mtengo, kapena MAC, ingagwiritsidwe ntchito kwa mankhwala ochiritsira mankhwala ochiritsira.