WO2005109279A3 - Pharmacy benefits design - Google Patents

Pharmacy benefits design Download PDF

Info

Publication number
WO2005109279A3
WO2005109279A3 PCT/US2005/014723 US2005014723W WO2005109279A3 WO 2005109279 A3 WO2005109279 A3 WO 2005109279A3 US 2005014723 W US2005014723 W US 2005014723W WO 2005109279 A3 WO2005109279 A3 WO 2005109279A3
Authority
WO
WIPO (PCT)
Prior art keywords
scripts
drugs
group
allowances
insured
Prior art date
Application number
PCT/US2005/014723
Other languages
French (fr)
Other versions
WO2005109279A2 (en
Inventor
Elizabeth M Warren
Timothy B Sandman
Jacob M Hutti
Jonathan T Lord
Julie E Whitworth
Elizabeth M Shaw
William K Fleming
Heidari Teresa L Watson
Original Assignee
Humana Inc
Elizabeth M Warren
Timothy B Sandman
Jacob M Hutti
Jonathan T Lord
Julie E Whitworth
Elizabeth M Shaw
William K Fleming
Heidari Teresa L Watson
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Humana Inc, Elizabeth M Warren, Timothy B Sandman, Jacob M Hutti, Jonathan T Lord, Julie E Whitworth, Elizabeth M Shaw, William K Fleming, Heidari Teresa L Watson filed Critical Humana Inc
Priority to EP05741791A priority Critical patent/EP1749275A2/en
Publication of WO2005109279A2 publication Critical patent/WO2005109279A2/en
Publication of WO2005109279A3 publication Critical patent/WO2005109279A3/en

Links

Classifications

    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q10/00—Administration; Management
    • G06Q10/06—Resources, workflows, human or project management; Enterprise or organisation planning; Enterprise or organisation modelling
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q40/00—Finance; Insurance; Tax strategies; Processing of corporate or income taxes
    • G06Q40/02—Banking, e.g. interest calculation or account maintenance

Landscapes

  • Business, Economics & Management (AREA)
  • Engineering & Computer Science (AREA)
  • Economics (AREA)
  • Strategic Management (AREA)
  • General Business, Economics & Management (AREA)
  • Entrepreneurship & Innovation (AREA)
  • Marketing (AREA)
  • Finance (AREA)
  • Human Resources & Organizations (AREA)
  • Physics & Mathematics (AREA)
  • Accounting & Taxation (AREA)
  • General Physics & Mathematics (AREA)
  • Theoretical Computer Science (AREA)
  • Development Economics (AREA)
  • Educational Administration (AREA)
  • Game Theory and Decision Science (AREA)
  • Technology Law (AREA)
  • Operations Research (AREA)
  • Quality & Reliability (AREA)
  • Tourism & Hospitality (AREA)
  • Medical Treatment And Welfare Office Work (AREA)

Abstract

A pharmacy benefits plan is designed such that covered that covered scripts are placed into Groups and allowances are provided for the purchase of scripts within each Group. Each Group comprises scripts for pharmaceuticals that provided medical benefits within a given time frame. A first Major Group is assigned to scripts for drugs that are prescribed for conditions that would otherwise result in further medical treatment and expense if said drugs were not taken by an insured. A second Major Group is assigned to scripts for drugs that are prescribed for conditions that would not normally result in subsequent medical costs if the drugs were not taken. Relatively high allowances are provided for scripts in said first Major Group such that the out-of-pocket costs of a given scrip will not be a barrier to said insured obtaining and taking said scripts. Relatively low allowances are provided for scripts in said second Major Group such that an insured will be further motivated to ask their doctor about low cost alternative drugs for a given treatment.
PCT/US2005/014723 2004-05-06 2005-05-02 Pharmacy benefits design WO2005109279A2 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP05741791A EP1749275A2 (en) 2004-05-06 2005-05-02 Pharmacy benefits design

Applications Claiming Priority (6)

Application Number Priority Date Filing Date Title
US56851704P 2004-05-06 2004-05-06
US60/568,517 2004-05-06
US57258604P 2004-05-19 2004-05-19
US60/572,586 2004-05-19
US60191804P 2004-08-16 2004-08-16
US60/601,918 2004-08-16

Publications (2)

Publication Number Publication Date
WO2005109279A2 WO2005109279A2 (en) 2005-11-17
WO2005109279A3 true WO2005109279A3 (en) 2007-05-18

Family

ID=35320881

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2005/014723 WO2005109279A2 (en) 2004-05-06 2005-05-02 Pharmacy benefits design

Country Status (2)

Country Link
EP (1) EP1749275A2 (en)
WO (1) WO2005109279A2 (en)

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20020032582A1 (en) * 2000-09-14 2002-03-14 Feeney Robert J. System for medication dispensing and integrated data management
US20020091552A1 (en) * 2000-09-21 2002-07-11 Access Transport Services, Inc. System and associated methods for providing claimant services and access to claimant records and reports via a computer network
US20030125986A1 (en) * 2001-12-14 2003-07-03 Collosi Joseph J. Prescription dispensing device
US20030144884A1 (en) * 1994-10-28 2003-07-31 Christian Mayaud Computerized prescription system for gathering and presenting information relating to pharmaceuticals

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030144884A1 (en) * 1994-10-28 2003-07-31 Christian Mayaud Computerized prescription system for gathering and presenting information relating to pharmaceuticals
US20020032582A1 (en) * 2000-09-14 2002-03-14 Feeney Robert J. System for medication dispensing and integrated data management
US20020091552A1 (en) * 2000-09-21 2002-07-11 Access Transport Services, Inc. System and associated methods for providing claimant services and access to claimant records and reports via a computer network
US20030125986A1 (en) * 2001-12-14 2003-07-03 Collosi Joseph J. Prescription dispensing device

Also Published As

Publication number Publication date
WO2005109279A2 (en) 2005-11-17
EP1749275A2 (en) 2007-02-07

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