The hospital pharmacy establishes patient charges for drugs, supplies, pharmaceuticals and services in consultation with Clinical Finance who defines the current markup.

AWP - Average Wholesale Price - The AWP per unit is the basis upon which all patient charges are developed

Cost - Information from First Data Bank/Multum via computer upload is the primary source of drug cost information with additional information obtained from the Blue Book or the Red Book.

Per Diem- A per diem charge is a charge that is made daily.

Unit - The unit is usually the smallest dose form available, such as the tablet, capsule, ampule, vial, unit of use package, single dose, or CMS billing unit.

1. Oral and Topical Preparations

a. AWP x current mark-up = patient charge per unit

b. The minimum charge is $0.60

c. Patient charge is rounded to the nearest $0.05

2. Injectables

a. AWP x current mark-up = patient charge per unit

b. The minimum charge is $10.20

c. Patient charge is rounded to the nearest $0.05.

3. I.V. Admixtures

An I.V. Admixture is an intravenous parenteral that has been compounded by the pharmacy or reconstituted by the pharmacy.

a. Pricing for a compounded admixture prepared by pharmacy AWP x current mark-up + $5.00 - minimum of $30.00 Ingredient added - each - AWP x current mark-up rounded to the nearest $0.05

b. Pricing for a compounded admixture prepared by nursing IV fluid - AWP x current mark-up + $5.00 - minimum of $30.00

c. Non-compounded large volume IV fluids

Distributed and charged by Central Sterile Supply

d. Total Parenteral Nutrition

These solutions are custom made and contain varying types and amounts of ingredients. The drugs are charged by the standard formula - AWP x current mark-up - by the pharmacy computer system.

4. Controlled Substances

Oral - AWP x current mark-up + $1.00 - minimum of $1.80

Injection - AWP x current mark-up + $1.00 - minimum of $11.35

5. Investigational Drugs

The Research Pharmacy reviews all new study protocols prior to study approval by the Institutional Review Board (IRB).  At that time, pharmacy charges are determined prior to initiation of study.  Research Pharmacy uses a standard pricing template to determine pharmacy charges for each study.  Charges are calculated as follows for each type of research study.

a.             Industry-sponsored clinical trials –  Initiation and Maintenance fees will be calculated, based on requirements for the study.  Initiation fees start at $1000.00 and range up to $2700.00.  See template.  Pharmacy dispensing fees (range from $10.00 to $50.00 per treatment) will be calculated per study and billed to primary investigator throughout the study.  Industry-sponsored trials cover all drug preparation expenses related to the drugs being studied.

b.            Oncology Cooperative trials – The Pharmacy will charge the patient for the usual charges for the material owned by the hospital that are used in the preparation and administration of the study medication.  If the study medication is provided for the study, there will be no charge for the drug.  Initiation fees and dispensing fees will be waived for this type of study.

c.             Investigator-initiated studies – Most of these studies are supported by a federal grant solely, and in some cases have industry financial support.  Initiation and maintenance fees, along with dispensing fees will be calculated and charged, just like Industry-sponsored trials.  In addition, a majority of these studies will not have study drug provided from a drug manufacturer.  When needed, pharmacy will purchase drug and the investigator will reimburse pharmacy for all drug and supply expenses prior to study closing.

d.            Individual treatment IND (Compassionate use or Emergency treatment type) – The study agent will be supplied by the drug company, CDC or other recognized supplier.  Materials used to prepare and administer the dose will not be covered by the study agent supplier. In most cases, the pharmacy will not charge the patient for the supplied study agent, unless the drug company has an IND-waiver to charge from the FDA (eg. Glucarpidase).  In cases of IND-waiver to charge, the drug company will pharmacy will charge only the cost to the patient (no dispensing fee added).

e.             Pharmacy stores will supply researchers with drugs or reagents needed for lab or clinical research, and cost of the drugs will be charged to the investigator’s account.  An IDT form with researcher’s account number will be supplied at the time the drug is picked up.

7. Other Product Sales

Pharmacy inventory items are sold to authorized individuals, departments, state agencies or medical facilities, and other governmental or quasi-governmental services or agencies. Authority for sale of goods are contained in the State of Arkansas Purchasing Regulations. Pricing guidance is established and approved by the Clinical Programs Administration.

a. Items in the original commercial package are sold at the acquisition cost. If the purchasing group is not on the UAMS campus, a 10% fee is added for processing.

b. Repackaged items are sold at cost of the item plus an add costs for the packaging and labor. - This may only be sold to groups on the UAMS Campus.

c. Manufactured products will only be sold to departments on the UAMS campus and will be priced to include.

Cost of material

Packaging material

Labor cost

Cost for quality control procedures and record keeping

Special storage cost

4. Out-Patient Pricing

1. Brand Name Products - AWP x 0.9 plus current markup
2. Generic Products – AWP x 0.5 plus current markup
3. Nominally Priced Products – Acquisition cost is £ 25% of AWP – AWP x 0.3 plus current markup.
4. Employees will be given a 15% discount on the usual price on medications

1. AWP + current mark-up
2. The minimum charge is $10.20

Prescriptions paid for by charitable organizations, including the UAMS Department of Social Services, will be priced at $0.50 above the actual acquisition price.

1. Sample medication, investigational drugs and any other medications that have been obtained by the pharmacy at no cost will be dispensed free of charge. Any drugs that have been purchased by the pharmacy that are dispensed in conjunction with an investigational drug will be priced according to the Outpatient Pharmacy pricing formula that would have been used if the investigational drug had not been part of the order.
2. Drugs or Supplies will be sold to other UAMS departments via interdepartmental transfer at actual acquisition cost.
3. According to Arkansas State Law and federal Office of Drug Pricing, drugs or supplies will not be sold to any person or agency outside of UAMS. If it is necessary to dispense to an outside agency in emergency situations, the drugs or supplies will be loaned with the expectation of the identical product being returned.