MedImpact_ADOA_Pricing_Proposal_2023-2025__12-16-2022.xlsx
XLSX spreadsheet 69 KB Posted
- Attached to
- Master Agreement AZ|CTR051357
- Contract number
- CTR051357
- Issued by
- Arizona
About this file
This document is a pricing proposal from MedImpact to the Arizona Department of Administration (ADOA) for a pharmacy benefits management contract, covering both commercial and Employer Group Waiver Plan (EGWP) segments. The proposal outlines pricing and rebate structures for various prescription drug channels including retail 30-day, retail 90-day, mail order, specialty retail, and specialty mail services.
The proposal presents detailed pricing terms for 2023-2025, featuring consistent discounting across drug categories. Brand and generic medication discounts range from 18.25% to 86.60%, with dispensing fees between $0.00 and $0.55. Rebate projections show incremental increases year-over-year, with potential for higher rebates if formulary changes are implemented for basal insulin and autoimmune drug classes. Rebate amounts vary by channel, with specialty channels showing the highest rebate potential, ranging from $1,853.85 to $3,126.00 depending on the year and formulary approach. The proposal offers two rebate scenarios: one with the current formulary setup and another contingent on specific formulary modifications.
View the file
Other files
Show all 21
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
MedImpact Pricing Proposal
| ADOA Commercial | ADOA EGWP (MVS01) | ||||||||
| Current 2023 | Proposed 2023 | Proposed 2024 | Proposed 2025 | Current 2023 | Proposed 2023 | Proposed 2024 | Proposed 2025 | ||
| Retail 30 | Brand Discount | 19.25% | 19.25% | 19.25% | 19.25% | 19.25% | 19.25% | 19.25% | 19.25% |
| Generic Discount | 86.50% | 86.50% | 86.55% | 86.60% | 85.50% | 85.50% | 85.55% | 85.60% | |
| Dispensing Fee | $0.40 | $0.40 | $0.40 | $0.40 | $0.55 | $0.55 | $0.55 | $0.55 | |
| Rebates (with current formulary set up) | $245.01 | $252.00 | $270.00 | $289.00 | $195.14 | $201.00 | $215.00 | $230.00 | |
| Rebates (requires formulary changes to basal insulin and autoimmune classes) | N/A | $257.00 | $275.00 | $294.00 | N/A | N/A | N/A | N/A |
| Retail 90 | Brand Discount | 23.00% | 23.00% | 23.00% | 23.00% | 23.00% | 23.00% | 23.00% | 23.00% |
| Generic Discount | 89.50% | 89.50% | 89.55% | 89.60% | 92.00% | 92.00% | 92.05% | 92.10% | |
| Dispensing Fee | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |
| Rebates (with current formulary set up) | $735.03 | $757.00 | $810.00 | $867.00 | $585.43 | $603.00 | $645.00 | $690.00 | |
| Rebates (requires formulary changes to basal insulin and autoimmune classes) | N/A | $772.00 | $826.00 | $884.00 | N/A | N/A | N/A | N/A |
| Mail Order | Brand Discount | 25.50% | 25.50% | 25.50% | 25.50% | 25.50% | 25.50% | 25.50% | 25.50% |
| Generic Discount | 89.50% | 89.50% | 89.55% | 89.60% | 90.75% | 90.75% | 90.80% | 90.85% | |
| Dispensing Fee | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |
| Rebates (with current formulary set up) | $735.03 | $757.00 | $810.00 | $867.00 | $585.43 | $603.00 | $645.00 | $690.00 | |
| Rebates (requires formulary changes to basal insulin and autoimmune classes) | N/A | $772.00 | $826.00 | $884.00 | N/A | N/A | N/A | N/A |
| Specialty Retail | Brand Discount | 19.25% | 19.25% | 19.25% | 19.25% | 19.25% | 19.25% | 19.25% | 19.25% |
| Generic Discount | 86.50% | 86.50% | 86.55% | 86.60% | 85.50% | 85.50% | 85.55% | 85.60% | |
| Dispensing Fee | $0.40 | $0.40 | $0.40 | $0.40 | $0.55 | $0.55 | $0.55 | $0.55 | |
| Rebates, generic claims included (with current formulary set up) | $2,205.08 | $2,492.00 | $2,791.00 | $3,126.00 | $1,853.85 | $2,095.00 | $2,346.00 | $2,628.00 | |
| Rebates, generic claims exclulded (with current formulary set up) | N/A | $2,723.00 | $3,050.00 | $3,416.00 | N/A | $2,363.00 | $2,647.00 | $2,965.00 | |
| Rebates, generic claims included (requires formulary changes to basal insulin and autoimmune classes) | N/A | $2,536.00 | $2,840.00 | $3,181.00 | N/A | N/A | N/A | N/A |
| Specialty Mail | Brand Discount | 18.25% | 18.25% | 18.25% | 18.25% | 19.50% | 19.50% | 19.50% | 19.50% |
| Generic Discount | 72.00% | 72.00% | 72.00% | 72.00% | 75.00% | 75.00% | 75.00% | 75.00% | |
| Dispensing Fee | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |
| Rebates, generic claims included (with current formulary set up) | $2,205.08 | $2,492.00 | $2,791.00 | $3,126.00 | $1,853.85 | $2,095.00 | $2,346.00 | $2,628.00 | |
| Rebates, generic claims exclulded (with current formulary set up) | N/A | $2,723.00 | $3,050.00 | $3,416.00 | N/A | $2,363.00 | $2,647.00 | $2,965.00 | |
| Rebates, generic claims included (requires formulary changes to basal insulin and autoimmune classes) | N/A | $2,536.00 | $2,840.00 | $3,181.00 | N/A | N/A | N/A | N/A |
File details come from the government source that posted it. Updated .