A recent Congressional Budget Office report, “Private Sector Price Prescription,” January 2007, used available private sector economic data to construct a hypothetical example of a one-handed prescription payment. In this example, the plan sponsor paid a total of US$88 for a prescription, including US$74 to the manufacturer (manufacturing cost), US$3 to the wholesaler (sales fee), US$5 to the retail pharmacy (prescription fee) and US$6 to pharmacy benefit managers (administrative fees). The profitability reflected in the relative amounts in this example supports the view that best business practices are to treat FCPs as applicable to production costs and hence producer prices. In addition, pharmaceutical industry representatives have never stated that they earn no profit at the federal maximum price or that the economy could support the CPF`s assessment of the burden on other participants. Third, the preamble to the final rule and the additional dod guidelines provide an overview of the application of the repayment obligation at periods between the NDAA`s entry into force and the effective date of the final rule. While DoD informally stated on its websites that refunds for these periods were due on May 26, 2009, it also pointed out that these obligations are governed by the Federal Incassing Act and, therefore, DoD has the power to waive or compromise, at the manufacturer`s request, its claims on these amounts “for all reasons that the manufacturer deems appropriate.” 13 In the preamble, it appears that these are “book cleaning” proposals for the periods preceding the rule, while ensuring that a manufacturer can agree to reimburse all products prospectively, while refunds for certain periods or products are compromised within the additional time.14 , or, in the case of covered drugs that are generic drugs, Level 1) of the uniform formula and availability of this drug through pharmacies without pre-authorization from the retail network. As under the proposed 2008 rule and the 2009 final rule, an agreement to honour the FCPs does not guarantee a preferred classification, given that FCPs are a maximum price and the cost-benefit standard for tier 2 classification (and, in some cases, Level 1) can lead to a lack of effectiveness of the CPF in some drug classes. Even under the proposed 2008 rule and the 2009 final rule, the use of FCPs does not depend on preferred form status. Paragraph 2 also defines drugs classified for the applicability of CCCPs. Paragraph 2 is unchanged from the 2009 final rule. This paragraph (2) answers, with paragraph 3, the questions “Who bears the burden of the CPF?” and “How do THE FCPs apply?” Producers bear the burden of the FCPs and apply through producer refunds.
The first option is not to require pharmaceutical manufacturers to reimburse DoD for amounts that go beyond federal prices, a rule that may require manufacturers to prospectively reduce the price of pharmaceuticals in the retail trade until the excess product is repaid. If a practical means could be developed to prospectively identify the subset of drugs that are considered the TRICARE DETAIL PHARMACY PROGRAM of prescriptions for all drugs that start the distribution chain through a sale by a manufacturer to a wholesaler, this alternative could also be consistent with status. In addition, VA guidelines are needed to help manufacturers process non-FAMP and FCP calculations. For example, rules must be established for the correct treatment of the negative, zero and falsely positive value of FAMPs and FCPs or FCPs of $0.01, in order to avoid inappropriate or absurd discount calculations. Ultimately, the use of VA and the sector is essential to address these types of issues.