CONSAD Research Corporation

Health Care

ECONOMIC IMPACTS ON MANAGED CARE PLANS ATTRIBUTABLE TO ANY-WILLING-PROVIDER LEGISLATION FOR PHARMACIES

American Drug Stores

In this project, CONSAD provided economic evaluation and analytic support to a civil lawsuit that was initiated by American Drug Stores to allow their outlets in Massachusetts to provide prescription drugs and other pharmaceutical services within the pharmacy networks of certain managed care plans, in accord with the provisions of the state's any-willing-provider law. The law provides that any pharmacy chain or pharmacy that is not included in an established pharmacy network may enter the network if it accepts the network's contractual reimbursement arrangements.

The support provided by CONSAD consisted of analysis of the prospective impacts that allowing pharmacies operated by American Drug Stores to participate in the managed care plans' pharmacy networks would likely have on the costs of prescription drugs and other pharmaceutical services for those plans and for their clients, including especially health benefit plans provided by employers under the federal Employment Retirement Income Security Act (ERISA). The analysis also considered the probable effects on the accessibility of pharmacy services to subscribers to the health benefit plans, and on the economic viability and access to customers of independent community pharmacies in the state.