| We’ve
compiled for you here a glossary of many of the terms you will find
in this report. Access a term by its first letter:
A – F
G
– O
P
– Z
G
– O
Generic Drug
Chemically equivalent copy designed from a brand-name drug where
the patent has expired. Generics are typically less expensive and
sold under the chemical name of the drug, not the brand name.
Generic
Sampling
Providing samples of generic drugs to medical offices and clinics
to encourage the prescribing of generic drugs when medically appropriate.
Gross
Cost of Script
Total cost of a prescription = AWP – AWP Discount + Dispensing
Fee + Member Cost Share Payment.
Growth
Hormones
Prescription hormone supplements used to treat patients with growth
deficiencies.
Guarantee
Rebate Per Mail Script
Pharmacy benefit manager guarantees a flat-dollar amount of rebate
for each mail-service prescription.
Guarantee
Rebate Per Retail Script
Pharmacy benefit manager guarantees a flat-dollar amount of rebate
for each retail prescription.
Injectables
Prescription drugs that are injected by patient or provider. Often
used as a synonym for high cost specialty or biotech drugs because
most are administered via injection.
Lifestyle
Drugs
Drugs that are not medically necessary but used to improve the quality
of life.
Mail
Cost Share (90-day Supply)
Cost share amount for 90 days of a prescription therapy typically
dispensed at a mail-order pharmacy. Some plan designs may allow
for this at a retail pharmacy.
Maintenance
Prescriptions
Drugs used to treat chronic diseases or conditions.
Managed
Care Organization (MCO)
An organization that finances and delivers a wide variety of health
care services through a network of preferred providers.
Maximum
Allowable Cost (MAC)
The unit price that has been established for a generic drug. The
same MAC price applies to all versions of identical generic drugs.
MAC prices were created because the cost of identical generic drugs
may differ from distributor to distributor.
MAC
Pricing Applied
MAC list used to price generic prescriptions
Maximum
Annual Benefit (MAB)
Total amount of expenses a plan will pay in a 12-month period.
Multi-source
Brand
A drug product manufactured by more than one company or source.
Multi-source is commonly used to describe a brand drug where generic
equivalents are available
Net
Cost (after copayments) of Script
Total amount paid for prescription less the cost sharing amounts.
Nexium®
Prescription proton pump inhibitor to treat gastro esophageal reflux
disease (GERD) and related stomach disorders.
Nonformulary
Drugs
Drugs not included on plan’s drug list or formulary.
Nonpreferred
Brands
Brand-name drugs not included on plan’s preferred drug list.
Oral
Contraceptives
Prescription drugs used to avoid pregnancy.
Other
Coverage Limitation(s)
Plan design limits on prescription coverage such as number of days
supply allowed.
Other
Nonsedating Antihistamines
Prescription allergy drugs that typically do not cause drowsiness.
Outbound
Telephone Calls
Calls made to plan members as part of disease or care management
programs to encourage compliance with treatment.
Over-the-counter
(OTC) Drug
U.S. Food and Drug Administration-approved drugs that do not require
a prescription to be purchased.
A – F
P – Z
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