Читать книгу The Advanced Practice Registered Nurse as a Prescriber - Группа авторов - Страница 30

An employer or health system may restrict APRN prescribing more than the law does. The VA and health maintenance organizations such as Kaiser Permanente use preferred drug lists, or formularies, to promote evidence‐based prescribing and control costs. Similarly, Medicaid and Medicare set guidelines for drug benefits, while private health plans usually have different tiers of drug coverage to promote prescribing of effective lowest cost drugs.

Pharmacy benefit managers are another aspect of the medication distribution chain, negotiating with drug companies and pharmacies on behalf of health plans. They develop formularies on behalf of the health plans, negotiate discounts and rebates with the manufacturers, and contract with pharmacies to reimburse for drugs dispensed to health plan beneficiaries (Commonwealth Fund, 2019). Some retailers have drugs dispensed for reduced costs, such as a $4 or $10 prescription, or offer reduced rates based on membership (Torrey, 2019). Discount coupons are often available from the manufacturer for some high‐cost medications or discount programs.