Published online by Cambridge University Press: 27 April 2021
Rare is the pharmacist today who does not participate as a service provider in one or several third party prescription insurance programs. Latest figures indicate that 372.7 million prescriptions or 25.4 percent of all prescriptions dispensed in this country were paid for at least in part by some form of prescription drug insurance.’ The economic impact which these third party programs are having on the retail pharmacist has caused their prominence as one of the most serious and important issues in pharmacy today.
Most third party prescription programs (TPPPs) are similar in structure and include a program administrator or insurance company, a sponsor (often an employer or labor union), subscribers or beneficiaries. and the participating pharmacies. Typically, the insurer or program administrator (hereinafter. the administrator) offers a contract or a “pharmacy agreement” to each pharmacy in a particular area. Each pharmacy must then decide whether or not to accept the agreement and become a participating pharmacy.