Date of Award
Master of Science in Pharmacy Administration
A questionnaire was mailed to the third party providers (n=313) registered with the National Council for Prescription Drug Programs (NCPDP), State Medicaid Programs and Blue Cross plans not listed with the NCPDP. The response rate was 41.5%. The respondents were evaluated for their demographics (number of prescriptions processed, number of subscribers, number of drug benefit models and type of third party) and pre approval process (if they required the provider to obtain pre approval, process of pre approval, time required for giving pre approval and person responsible for obtaining the pre approval). Information was also gathered on drug utilization review conducted on compounded prescriptions and the reimbursement scheme for compounded prescriptions. The results of the study revealed that the majority of third party providers do not perform any kind of drug utilization review on their compounded prescriptions. Also most of the third party providers in the study group did not require their provider to obtain pre approval nor did they have a preapproved list of compounded prescriptions. Moreover most of the respondents reimburse for drugs compounded for FDA unapproved uses. It appears that there is a need for the third party to reevaluate their current reimbursement, review and coverage of compounded prescriptions.
Nair, Renuka, "THIRD PARTY REIMBURSEMENT OF COMPOUNDED PRESCRIPTIONS" (1995). Open Access Master's Theses. Paper 271.