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In the US, where a system of quasi-private healthcare is in place, a formulary is a list of prescription drugs available to enrollees, and a tiered formulary provides financial incentives for patients to select lower-cost drugs. For example, under a 3-tier formulary, the first tier typically includes generic drugs with the lowest cost sharing ...
Medication costs can be the selling price from the manufacturer, that price together with shipping, the wholesale price, the retail price, and the dispensed price. [3]The dispensed price or prescription cost is defined as a cost which the patient has to pay to get medicines or treatments which are written as directions on prescription by a prescribers. [4]
Drugs can be defined as specialty because of their high price. [3] [4] [5] Medicare defines any drug with a negotiated price of $670 per month or more as a specialty drug. These drugs are placed in a specialty tier requiring a higher patient cost sharing.
The spokesperson said the methodology used to determine drug tiers is the same regardless of the condition. This practice is not unique to Blue Cross Blue Shield NC.
Branded drugs may have marketing budgets that meet or exceed the cost of research and development. [116] Generic drug manufacturers determine price based on what the name-brand equivalent is sold for. If multiple generic drug companies manufacture the same drug, price is often driven down towards production costs.
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The first list was published in 1977 and included 208 medications. [8] [2] [9] The WHO updates the list every two years. [10] There are 306 medications in the 14th list in 2005, [11] 410 in the 19th list in 2015, [10] 433 in the 20th list in 2017, [12] [13] 460 in the 21st list in 2019, [14] [15] [16] and 479 in the 22nd list in 2021.
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