The NBP Rx Modeling Tool allows corporations to review their current Prescription Drug Pricing as compared to what is the best Marketplace pricing currently available. More often than not, PBM contracts are Evergreen contracts that continue to renew without regard to current market pricing, services and market trends.

By completing and providing all the information requested below, NBP will provide a confidential Current Marketplace Prescription Drug Cost and Savings Analysis within five business days of submission.

This is a no cost, no obligation Analysis that will provide the “Peace of Mind” in knowing your company has the deepest discounts, lowest dispensing fees and highest rebates available in the Marketplace.
Company Name
Contact Name
Title
Telephone - -
Fax - -
E-Mail


Current Plan Design
Two Tier
Three Tier
   
Number of Employees
Active
Pre 65 Retirees
Post 65 Retirees
(If no retirees are present, please enter "0".)
2006 Total Rx Company Net Cost
$

 
2007 Three Month Total Rx
Company Net Cost
$
 

Retail Copays
Deductible
Generic
(specify $ or %)
Preferred Brand
(specify $ or %)
Non Preferred Brand
(specify $ or %)
   
Mail Copays
Deductible
Generic
(specify $ or %)
Preferred Brand
(specify $ or %)
Non Preferred Brand
(specify $ or %)
   
Mandatory Generic
Yes
No
   
Mandatory Mail
Yes
No

     
Retail
Number of Prescriptions Dispensed in 2006
First 3 months of 2007
Generic
Brand

Retail Prescription Discounts/Fees

Generic AWP%
(Mac and/or)

Brand AWP%
(AWP)

Dispensing Fee
Administration Per Rx
Rebate Per Rx
   
MAC
Yes
No



Mail Order Number of Prescriptions Dispensed in 2006
First 3 months of 2007
Generic
Brand

Mail Order Prescription Discounts/Fees
Generic AWP%
(Mac and/or)
Brand AWP%
(AWP) 
Dispensing Fee
Administration Per Rx
Rebate Per Rx
   
MAC
Yes
No


Please provide answers to the following questions:

1) Select Current Retail Pharmacy Network Size:

2) Select Current PBM:

3) How many years have you been with your current PBM?

4) If savings opportunity existed would you rather consider an alternative PBM Vendor?
Yes
No

Thank you for taking the time to provide this information!
  



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