Enhanced Network Services
With Rite Aid Health Solutions, our network services provide a variety of options and benefits, including:
- 50,000 participating pharmacies nationwide
- Immediate access through the National Network
- Lower drug cost through the Preferred Network
- Your own network through Rite Aid Health Solution's Network Contract/ Consultative Services
- Use of your existing network supplemented by the National Network
- Use of your own network exclusively
- Maintenance Drug Programs
- Cost-effective pharmacy tiering
- Pricing Control
- Generic Solutions
Maintenance Drug Programs
Our maintenance drug programs are offered in two forms in mail order and retail. Through Rite Aid's mail-order pharmacy, we provide maintenance medications from state-of-the-art mail-service pharmacy facilities for those members desiring home delivery.
With our innovative retail program, Rite Fill 90, we have contracted with some of our retail network pharmacies to provide 90-day supplies of maintenance medications at deeply discounted rates. We have found that members consistently prefer to obtain their drugs from their local pharmacist whenever possible, which allows for a much higher penetration of prescriptions being filled at a deeper discount for you.
Cost-Effective Pharmacy Tiering
Pharmacy tiering allows for variable benefit designs by individual pharmacy or pharmacy networks. This supports any drug coverage variations or copay differences by pharmacy/pharmacy network at the member, group or plan level. Pharmacies must agree to accept a more aggressive reimbursement rate and provide counseling services to members. Participation is optional and not all pharmacies agree to participate. To help you control costs, our pharmacy network system allows you to charge higher copays to members that use non-preferred and out-of-network pharmacies.
Pricing Control
In order to control expenditures at retail pharmacies, Rite Aid Health Solutions sets a maximum allowable cost (MAC) for most multi-source medication (brands that have generic alternatives and the generic products themselves). Our participating pharmacies are obligated to observe established MAC prices when dispensing generic drugs.
Rite Aid Health Solution's MAC Manager is a software application that allows you to generate new maximum allowable cost (MAC) prices whenever and however you need it - to fit your operational goals. It enables you to generate MAC reports based on pricing changes, additions and terminations, and automatically updates in real-time. The biggest benefit is that you can control MAC pricing with incredible flexibility for your entire prescription benefit in just a few hours per month.
Generic Solutions
By showing members how to get the most from their prescriptions, maximizing generic utilization and educating them on the effectiveness of over-the-counter drugs, we can reduce your members' annual drug utilization number while improving outcomes. Our formulary options focus on generic medications.
We offer a four tier MAC pricing structure that provides the ultimate control in pricing multi-source products. The following MAC pricing options are offered in any combination:
- Your own MAC pricing
- Rite Aid Health Solution's MAC pricing
- HCFA's MAC pricing
- Baseline MAC pricing
Rite Aid Health Solutions has a competitive MAC table option that ensures all generic drugs have a MAC price whether or not a listed HCFA or Baseline is available. If a generic drug category is listed on the MAC list, the pharmacy will be reimbursed no more than the assigned MAC list price. If a brand product is substituted for the generic product, a Dispense as Written (DAW) matrix assigned to each plan benefit design will determine any cost differences or penalties that should be assigned to either the pharmacy or the member.
Generic products can provide as much as 50-80% cost savings in comparison to the equivalent brand and can significantly lower your overall prescription drug costs. MAC pricing stabilizes the generic drug cost across the range of all generic prices.
