Nominal Price Contracting in the PostDRA Era GPO Perspective Ron Hartmann, Pharm'D' VP, Pharmacy Med

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Nominal Price Contracting in the Post-DRA
EraGPO Perspective Ron Hartmann, Pharm.D.VP,
PharmacyMedAssets Supply Chain Systems
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Deficit Reduction Act 2005

• Three major changes that are affecting pharmacy
  contracting and hospitals/clinics
• Requires States to provide for the collection of
  information (NDCs) for each Medicaid single
  source and 20 multiple source drugs with highest
  volume that are physician administered
• Changes to the calculation of AMP, ASP, BP
• Nominal prices are now included in Medicaid best
  price calculation unless specifically excluded
  (such as for 340B Covered Entities)

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Nominal Price Exclusions

• The following sales at nominal price will be
  excluded from Best Price calculations
• Sales to covered entities in section 340B(a)(4)
  of PHS Act
• Intermediate care facilities for mentally
  retarded
• Government owned/operated nursing homes
• Any other facility that the Secretary determines
  is a safety net provider

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Loss of Nominal Pricing

• The following products have lost nominal pricing
  to the majority of providers over the past
  several years
• Proton Pump Inhibitors (Protonix, Nexium,
  Prevacid)
• Coumadin
• Toprol XL
• Zocor
• Climera
• Birth Control Pills

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Loss of Nominal Pricing

• Manufacturers have continued to offer Nominal
  Pricing for Inpatient purchases of several of
  these items by 340B-DSH Hospitals (PPIs, Coumadin
  in U/D packaging only)
• Safety net providers (DSH hospitals) cannot
  purchase under their GPO contracts for their
  outpatient products thus experiencing increased
  cost of goods on products that used to be
  available at a nominal price.

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Questions?