Specialty Pharmacy Crossword

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Across
  1. 1. Competitors to a branded product that has an expired patent and are considered identical to the brand product
  2. 4. The first purchaser of a drug product – direct from the manufacturer
  3. 5. Competitors to the first-in-class biologic product that has an expired patent. These drugs are not currently considered to be identical to the original product (because of the nature of manufacturing with live products), but are considered to be therapeutic alternatives
  4. 9. A cost-savings feature of your prescription benefit plan that helps make sure the right medication is being prescribed under your plan
  5. 10. The part of the medical bill you must pay after the insurance company pays their part
  6. 14. A fixed amount that you must pay each policy year. This amount must be met before any benefits will be paid by your insurance company
  7. 15. A type of drug that is costly, requires special supply chain features (such as freezing or cold storage), typically indicated for a small group of patients, and where the patients may need special case management services
  8. 16. The price the wholesaler pays the manufacturer. Generally considered the ‘list’ price. This price is under the control of a manufacturer
Down
  1. 2. These are given to consumers for use at the point of service (the pharmacy counter). They mitigate the impact of insurance coverage cost sharing for a manufacturer’s product and might cover the full deductible cost, copays or coinsurance
  2. 3. A type of payment, usually by a third party, for health care costs
  3. 6. Any kind of drug typically available at any pharmacy counter
  4. 7. A therapeutic drug or a vaccine, made from living organisms — human, animal, yeast, or microorganisms
  5. 8. A list of drugs approved by a health plan or pharmacy benefits manager
  6. 9. Health plans that handle some or all of the pharmacy benefit for health plans (formulary design, cost sharing and tiers, pharmacist networks and contracts, price concession negotiation with manufacturers)
  7. 11. The entity responsible for processing insurance claims that can handle eligibility, enrollment, and premium payment oversight
  8. 12. Taking your medication exactly as your doctor prescribed
  9. 13. This term is used to describe submitting a claim to your insurance company. Sometimes the words “process” or “run” are used instead