902795_PBM-Bid_Form.xlsx

This is a Bid Form for Pharmacy Benefit Management (PBM) Services for the Alameda County Behavioral Health Department (ACBHD) in California, containing a comprehensive medication pricing schedule and adjudication fee structure. The bid form presents a sample of 28 commonly used medications across psychiatric and behavioral health treatments, including both generic and brand-name drugs such as Aripiprazole, Invega Sustenna, Quetiapine, Risperidone, and various antidepressants and anti-anxiety medications. Bidders are required to provide percentage discounts on Average Wholesale Price (AWP), proposed dispensing fees per prescription, and other service-related fees across a three-year contract period with an option for a two-year renewal. The form calculates estimated annual prescription quantities ranging from single doses for injectable medications to 90-count quantities for oral medications, with annual Rx volumes varying from 1 to 75 prescriptions per medication.

The bid evaluation is structured around two primary cost components: Table A establishes the medication costs based on the formula A×[(B-D+E)], where vendors propose percentage discounts (column D) and dispensing fees (column E) that reduce the AWP baseline cost, with the grand total for all medications across three years estimated at $1,023,399.03. Table B requires bidders to propose a prescription adjudication fee not to exceed $17.00 per paid claim, with an estimated 1,600 annual paid claims. The savings section allows bidders to propose additional discounts for brand-named medications, guaranteed generic average discounts, 340B program dispensing fees, prior authorization fees, and various administrative fees for eligibility loading, formulary changes, and programming services. All quoted prices are established as maximum fees for the contract term, with vendors agreeing not to exceed the proposed rates throughout the performance period.