Pharmacy Statistics
Reimbursement Formula:
Average Wholesale Price minus a percent plus a dispensing fee
(AWP – X % + dispensing fee)
OR
Maximum Allowable Cost plus a dispensing fee
(MAC + dispensing fee)
|
MEDICAID |
Lesser of: AWP-15% + dispensing fee OR Federal upper limit + dispensing fee OR Provider’s usual and customary charge (Dispensing fee = $3.50 to $4.70) |
|
CAREMARK |
Brand: AWP-16% + $1.50 Generic: MAC + $2.00 |
|
EXPRESS SCRIPTS |
Brand: AWP-15% + $2.10 Generic: MAC + $2.00 (Typical of school system) |
|
EBMS (ECKERD) |
Brand: AWP-13% + $2.50 Generic: MAC or AWP – 30-50% + $2.50 |
|
FEDERAL EMPLOYEE PROGRAM (FEP) |
Brand: AWP-15% + $1.50 Generic: MAC or AWP – 15% + $1.50 |
|
TRICARE (U.S. MILITARY PERSONNEL) |
Brand: AWP-15% + $2.00 Generic: MAC + $2.00 |
|
UNITED HEALTHCARE (BY MEDCO) |
Brand: AWP-15% + $1.50 Generic: MAC or AWP – 15% + $1.50 |
|
PCS (Varies with plan) |
Brand: AWP-15% + $1.25 Generic: MAC + $2.00 |
|
TELEPAID (Varies with plan) |
Brand: AWP-13% + $2.00 Generic: AWP – 35-50% + $2.00 |
|
MISCELLANEOUS PLANS IN GENERAL |
Brand: AWP – 13-15% + $2.00 to $2.50 Generic: Usually MAC + $2.00 to $2.50 OR: AWP – 30-80% + Dispensing Fee |
(Local MT Pharmacies)
|
|
2003 |
2004 |
2005 |
|
MONTANA |
$7.16 |
$7.35 |
NOT AVAILABLE |
(The Chain Pharmacy Industry Profile. National Association of Chain Drug Stores Foundation)
|
Pharmacy Type |
Number of Pharmacies |
Estimated Dollar Sales |
Estimated Sales Per Pharmacy |
Number Employed During Year |
Estimated Payroll |
Estimated Payroll Per Pharmacy |
Estimated Taxes Paid |
Estimated Taxes Per Pharmacy |
|
Traditional Chain Drug Stores |
(2005) 23 (2004) 23 (2003) 24 |
$116,914,000 $138,423,000 $101,160,000 |
$5,083,000 $6,018,000 $4,215,000 |
497 476 465 |
$13,275,000 $14,642,000 $10,309,000 |
$577,000 $637,000 $430,000 |
$1,947,000 $2,293,000 $1,691,000 |
$85,000 $100,000 $70,000 |
|
|
|
|
|
|
|
|
|
|
|
Independent Drug Stores |
(2005) 98 (2004) 104 (2003) 118 |
$196,958,000 $246,531,000 $174,484,000 |
$2,010,000 $2,370,000 $1,479,000 |
706 718 762 |
$18,855,000 $22,069,000 $16,894,000 |
$192,000 $212,000 $143,000 |
$3,330,000 $4,138,000 $2,991,000 |
$34,000 $40,000 $25,000 |
|
|
|
|
|
|
|
|
|
|
|
Supermarkets |
(2005) 40 (2004) 41 (2003) 42 |
$725,997,000 $769,497,000 $654,032,000 |
$18,150,000 $18,768,000 $15,572,000 |
4,073 4,678 3,940 |
$75,786,000 $80,725,000 $63,777,000 |
$1,895,000 $1,969,000 $1,519,000 |
$12,145,000 $12,933,000 $10,960,000 |
$304,000 $315,000 $261,000 |
|
|
|
|
|
|
|
|
|
|
|
Mass Merchants |
(2005) 36 (2004) 35 (2003) 32 |
$910,695,000 $1,332,775,000 $1,190,773,000 |
$25,297,000 $38,079,000 $37,212,000 |
4,171 7,137 5,374 |
$74,622,000 $142,280,000 $107,204,000 |
$2,073,000 $4,065,000 $3,350,000 |
$15,089,000 $22,151,000 $19,751,000 |
$419,000 $633,000 $617,000 |
|
|
|
|
|
|
|
|
|
|
|
TOTAL
|
(2005) 197 (2004) 203 (2003) 216 |
$1,950,564,000 $2,487,226,000 $2,120,449,000 |
$50,540,000 $65,235,000 $58,478,000 |
9,447 13,009 10,541 |
$182,538,000 $259,716,000 $198,184,000 |
$4,737,000 $6,883,000 $5,442,000 |
$32,511,000 $41,515,000 $35,393,000 |
$842,000 $1,088,000 $973,000 |
(The Chain Pharmacy Industry Profile 2006. National Association of Chain Drug Stores Foundation© 2006)
|
Number of Licensed Pharmacists |
Chain Community Pharmacist Jobs |
Independent Drug Store Pharmacist Jobs |
Community Pharmacist Jobs |
|
1,601 |
362 |
156 |
518 |
|
Payment Source |
Cost in Dollars |
Number of Prescriptions |
Average Price Per Prescription |
|
CASH |
$92,947,721 |
2,205,101 |
$42.15 |
|
THIRD PARTY |
$491,689,578 |
6,806,271 |
$72.24 |
|
MEDICAID |
$79,175,282 |
1,115,170 |
$71.00 |
|
OVERALL |
$663,812,589 |
10,126,542 |
$62.55 |
|
Average Pharmacy Reimbursement Across All Payers
|
Manufacturer or Wholesaler Costs |
Pharmacy Operating Costs |
Pharmacy Net Profit |
|
$64.86 Per prescription |
$51.72 (80%) |
$13.14 (20%) |
$1.83 (<3%) |
(The Chain Pharmacy Industry Profile 2006. National Association of Chain Drug Stores)
|
|
% VERY HIGH/HIGH |
% AVERAGE |
% LOW/VERY LOW |
|
Nurses |
82 |
15 |
3 |
|
Druggists/Pharmacists |
67 |
28 |
4 |
|
Medical Doctors |
65 |
31 |
4 |
|
High School Teachers |
64 |
27 |
7 |
|
Policemen |
61 |
31 |
8 |
|
Clergy |
54 |
35 |
8 |
|
Funeral Directors |
44 |
42 |
8 |
|
Bankers |
41 |
48 |
10 |
|
Accountants |
39 |
51 |
7 |
|
Journalists |
28 |
44 |
27 |
|
Real Estate Agents |
20 |
58 |
20 |
|
Building Contractors |
20 |
58 |
19 |
|
Lawyers |
18 |
46 |
35 |
|
Labor Union Leaders |
16 |
43 |
35 |
|
Senators |
16 |
48 |
35 |
|
Business Executives |
16 |
52 |
30 |
|
Stockbrokers |
16 |
56 |
23 |
|
Congressmen |
14 |
44 |
41 |
|
Advertising Practitioners |
11 |
50 |
35 |
|
Car Salesmen |
8 |
41 |
49 |
|
Telemarketers |
7 |
31 |
60 |
(The Chain Pharmacy Industry Profile 2006. National Association of Chain Drug Stores Foundation)
|
Pharmacy Benefits Manager (PBM) |
2005 Prescription (Rx) Volume |
Market Share of All Prescriptions |
|
Medoc Health Solutions |
397,223,877 |
12.5% |
|
Caremark Prescription Services |
387,514,842 |
12.2% |
|
Express Scripts, Inc. |
300,873,625 |
9.5% |
|
Wellpoint Pharmacy Management |
93,573,273 |
2.9% |
|
Aetna Pharmacy Management |
73,256,278 |
2.3% |
|
Anthem Rx |
62,647,821 |
2.0% |
|
MedImpact |
55,665,853 |
1.8% |
|
Prime Therapeutics |
34,411,968 |
1.7% |
|
Prescription Solutions |
44,851,819 |
1.4% |
|
Pharmacare |
44,350,812 |
1.4% |
|
Other |
252,465,608 |
8.0% |
|
Total PBM Volume |
1,766,835,776 |
55.7% |
|
3rd Party, No Processor/PBM |
543,566,108 |
17.1% |
|
2005 Community Pharmacy Rx Volume |
3,174,525,316 |
|
|
|
|
|
|
Top Three as % of PMB Rx’s |
61.4% |
|
|
Top Three as % of All Rx’s |
34.2% |
|
|
|
|
|
|
Top Ten as % of PBM Rx’s |
83.2% |
|
|
Top Ten as % of All Rx’s |
46.3% |
|
(The Chain Pharmacy Industry Profile 2006. National Association of Chain Drug Stores Foundation)
|
Year |
Medicaid |
Other Third Party (PBM) |
Cash |
|
1990 |
10.7% |
26.1% |
63.1% |
|
1991 |
12.8% |
28.0% |
59.2% |
|
1992 |
14.3% |
30.1% |
55.6% |
|
1993 |
14.9% |
34.7% |
50.5% |
|
1994 |
13.3% |
42.0% |
44.7% |
|
1995 |
12.7% |
49.1% |
38.2% |
|
1996 |
11.6% |
55.0% |
33.4% |
|
1997 |
11.1% |
59.8% |
29.1% |
|
1998 |
10.5% |
64.8% |
24.7% |
|
1999 |
10.8% |
68.2% |
21.0% |
|
2000 |
11.1% |
70.4% |
18.5% |
|
2001 |
11.0% |
73.0% |
16.0% |
|
2002 |
11.1% |
74.5% |
14.4% |
|
2003 |
11.7% |
74.7% |
13.7% |
|
2004 |
12.4% |
74.9% |
12.7% |
|
2005 |
12.7% |
75.9% |
11.4% |
(IMS HEALTH through 2001, Kluwer Pharmaceutical Audit for 2002-2005)