Aberrant List and Profitable Prescriptions Rx

Aberrant List and Profitable Prescriptions Rx

Rx Products – Caremark’s Aberrant List

Orphenadrine
Clemastine Fumarate
Ziphex Tablets
Imubolic Capsules
Crotan Lotion

Below are downloadable marketing material links that you can use in your pharmacy.

Summary:

Lisa Faast discussed new prescription products and billing best practices for pharmacies. She highlighted Caremark’s updated aberrant list, which now tracks monthly metrics, affecting 25% of prescriptions or revenue. Products covered include Orphenadrine, Clemastine Fumarate, Ziphex Tablets, Imubolic Capsules, and Crotan Lotion. Orphenadrine offers a single-strength combination for pain relief. Clemastine Fumarate is an allergy medication also used for multiple sclerosis. Ziphex and Imubolic are prenatal supplements with higher copay abatements. Crotan Lotion is a 10% USP lotion for various itch conditions, available directly from Marnell Pharmaceuticals. Lisa emphasized compliance with PBM contracts and the importance of tracking aberrant list usage.

Action Items

[ ] No specific action items were assigned during this educational presentation. The speaker offered ongoing support through email (info@diversifyrx.com) and membership area for follow-up questions.

Outline

Introduction and Overview of the Meeting

Lisa Faast apologizes for her voice due to a cold and introduces the topic of new prescription products that benefit both patients and pharmacies.
She mentions the agenda, which includes billing best practices, a review of five products, and a Q&A session.
Lisa shares her screen to present the RX products for July 2022, emphasizing the importance of focusing on business growth.
She highlights the need to stay compliant with PBM contracts and mentions the importance of tracking metrics for Caremark’s aberrant list.

Caremark’s Aberrant List and Billing Best Practices

Lisa explains the changes in Caremark’s aberrant list, which now tracks percentage by calendar month instead of a rolling 30-day period.
She details the limits on dispensing products from the aberrant list, including not exceeding 25% of prescriptions or $2,500 in revenue.
Lisa emphasizes the importance of tracking aberrant list usage and mentions services that help pharmacies stay compliant.
She advises against using test claims and suggests using pharmacy management systems for benefit claims checks instead.

Coupon Rules and Test Claims

Lisa reviews Caremark’s coupon rules, stating that online coupons are only allowed for FDA-approved drugs and not for supplements or devices.
She explains the difference between online billing coupons and rebate programs, which can be used for supplements and devices.
Lisa advises against using test claims regularly, as they are monitored closely by Caremark.
She recommends using pharmacy management systems for benefit claims checks to avoid test claims.

Final Thoughts and Product Introductions

Lisa advises against going hog wild with supplements and devices, suggesting a modest goal for billing.
She emphasizes the importance of collecting co-pays and maintaining good systems for compliance.
Lisa introduces the first product, Orphenadrine, Aspirin, and Caffeine, highlighting its benefits as a muscle relaxer and pain medication.
She provides details on dosing, coverage, and purchasing information, including a discount code for the first order from Galt.

Clemastine Fumarate and Its Benefits

Lisa introduces Clemastine Fumarate, an allergy medication that is also used off-label for multiple sclerosis.
She explains the dosing and coverage details, noting that it is available from wholesalers and has a nice spread between AWP and cost.
Lisa highlights the product’s benefits for allergy relief and itching, and mentions its passion fruit flavor.
She provides information on where to purchase Clemastine Fumarate and its availability in glass bottles.

Ziphex Tablets and Its Unique Formula

Lisa introduces Ziphex, a new product from Solu Biomix, which is the exact formula of Ozesco but with a higher AWP to cost spread.
She explains the product’s benefits for prenatal and postpartum support, noting its wider coverage than Ozesco.
Lisa provides details on the copay card and mail-in rebate program for Ziphex, emphasizing its compliance with Caremark contracts.
She mentions that Ziphex will be added to the aberrant list in August and provides information on where to purchase it.

Imubolic Capsules and Its Immune Support

Lisa introduces Imubolic, a new product from Solu Biomix, which is the exact formula of Zymun but with a higher copay abatement.
She explains the product’s benefits for immune wellness and its wider coverage than Zymun.
Lisa provides details on the copay card and mail-in rebate program for Imubolic, emphasizing its compliance with Caremark contracts.
She mentions that Imubolic will be added to the aberrant list in August and provides information on where to purchase it.

Crotan Lotion and Its Broad Usage

Lisa introduces Crotan Lotion, a USP 10% lotion that is easy to apply and suitable for various itch conditions.
She explains the product’s benefits for dermatology, neurology, nephrology, and other conditions, noting its broad coverage.
Lisa provides details on purchasing Crotan Lotion directly from Marnell Pharmaceuticals and its availability in email bottles.
She emphasizes the product’s compliance with Caremark contracts and its copay program, which provides a typical copay of $30.

Conclusion and Q&A

Lisa concludes the presentation, encouraging participants to ask questions and providing contact information for further assistance.
She reiterates the benefits of the products discussed and their potential to boost pharmacies’ bottom lines.
Lisa thanks the participants and ends the meeting, inviting them to join the next open office hours session.