Balancing Participation With Profitability


The Preferred Approach

Is participation in preferred cost-share networks always the best choice for independent pharmacies? This article explores the key differences in cost sharing networks and how independents can differentiate on quality and value for maximum profitability.

Broad, Restricted or Preferred?

Independent community pharmacies should participate in some preferred cost-share networks so that they can offer their patients low-cost options. But participating in every preferred cost-share network would cannibalize gross margins.

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Focus on patient connections

Did you know the biggest predictor of medication adherence, according to the NCPA, is the patient's connection to their pharmacist? Independents stand out for high-touch patient care, and it's that level of care that can make the difference when it comes to retaining patients in preferred cost-share Part D networks.

Why? Because standard cost-share pharmacies can still fill prescriptions for patients participating in a preferred cost-share plan. And although these patients may pay a higher copay, many are willing and able to pay more to have their prescriptions filled at the pharmacy of their choice.

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Adding value adds up

Preferred cost-share networks create a need for standard cost-share pharmacies to differentiate themselves on quality and value. That means focusing on the health and wellness of their patients and standing out from pharmacies that could potentially fill the same prescriptions at a lower copayment. Immunizations, delivery services, wellness programs, disease-specific education, health fairs and other patient care services can all be important ways independent pharmacies set themselves apart from the competition and add value for patients. And these differentiators become profitable retention opportunities that lead to patients choosing to stay with a pharmacy over switching to a pharmacy in the preferred cost-share network.

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Learn more about how the Elevate Provider Network is evaluating preferred cost-share network opportunities for their members to balance participation that will continue to drive prescription growth.


i NCPA Adherence Report Card. Available online at


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