Specialty drug definition

Specialty drug means a prescription drug that:

Specialty drug means a drug that:

Specialty drug means a prescription drug covered under Medicare Part D that exceeds

Examples of Specialty drug in a sentence

• Preferred brand drugs $40 copay/prescription (retail) $80 copay/prescription (mail order); deductible does not apply $40 copay/prescription (retail); deductible does not apply Non-preferred brand drugs $60 copay/prescription (retail) $120 copay/prescription (mail order); deductible does not apply $60 copay/prescription (retail); deductible does not apply Specialty drugs $60 copay/prescription (retail); deductible does not apply Not Covered Specialty drug coverage based on group policy.

• Preferred brand drugs $40 copay/prescription (retail) $80 copay/prescription (mail order); deductible does not apply $40 copay/prescription (retail); deductible does not apply Non-preferred brand drugs $60 copay/prescription (retail) $120 copay/prescription (mail order) deductible does not apply $60 copay/prescription (retail); deductible does not apply Specialty drugs $60 copay/prescription (retail); deductible does not apply Not Covered Specialty drug coverage based on group policy.

• The areas for review can include: • Pricing and discount guarantees • Benefit and plan design • Rebates • Fraud, waste and abuse • Retiree drug subsidy (RDS) year-end reconciliation • Employer group waiver plan (EGWP) prescription drug event • Formulary guidance and recommendations • Specialty drug diagnostic Audit Components InsRis will utilize proprietary software application tools to monitor 100% of claims.

More Definitions of Specialty drug

Specialty drug means a drug that provides treatment for serious, chronic, or life-threatening diseases that is covered under a patient's health plan or by a patient's carrier to which any of the following apply:

Specialty drug means a prescription drug outpatient specialty drug covered under Medicare Part D program established pursuant to Public Law 108-73, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, as amended from time to time, that exceeds the specialty tier cost threshold established by the Centers for Medicare and Medicaid Services.

Specialty drug means a prescription drug covered under Medicare Part D that exceeds the specialty tier cost threshold established by the Centers for Medicare and Medicaid Services.

Specialty drug means pharmaceutical products that are typically expensive and require special handling and monitoring such as patient training, care coordination, adherence monitoring. They can be administered orally or through injection, infusion, inhalation, or other non-oral methods. Many are biologically developed (biologics) and can be used to treat chronic, life threatening, and rare conditions.

Specialty drug means a prescription drug covered

Specialty drug means and includes any substance that is biologic, subsequent-entry biologic, biosimilar, or any medication that requires special handling, administration or monitoring as defined by the carrier.

Specialty drug or “Specialty” means a covered drug considered by Company to be a Specialty Drug based on consideration of the following factors: (i) whether the pharmaceutical product is prescribed and used for the treatment of a complex, chronic or rare condition; (ii) whether the pharmaceutical product has a high acquisition cost; and, (iii) whether the pharmaceutical product is subject to limited or restricted distribution, requires special handling and/or requires enhanced patient education, provider coordination or clinical oversight. A Specialty Drug may not possess all or most of the foregoing characteristics, and the presence of any one such characteristic does not guarantee that a pharmaceutical product will be considered a Specialty Drug. The term “Specialty,” when immediately preceding the terms “Generic Drug” or “Brand Drug”, means that the resulting term (e.g. “Specialty Generic Drug”) refers to a Generic Drug or Brand Drug that is considered a Specialty Drug, respectively.