Methods and system for providing drug pricing information from multiple pharmacy benefit managers (pbms)

Abstract

A system according to certain aspects of the disclosure provides drug pricing information from multiple PBMs to users. For example, the system may obtain, calculate, and/or estimate drug prices that are available under contracts or agreements between PBMs and various pharmacies. These prices may be prices of drugs for purchase at the various pharmacies. In response to requests for prices of particular drugs, the system can display relevant prices. For example, the system displays a price for each pharmacy chain and/or displays prices for a particular geographical area. The users can compare the prices for a particular drug and determine which pharmacy they would like to purchase the drug from. The system can provide a discount coupon that allows the users to purchase the drug at the price listed by the system at the selected pharmacy.

What is claimed is: 
     
         1 . A method of displaying prices for drugs from a plurality of pharmacy benefit managers, the method comprising:
 providing a user interface using a computer processor;   receiving information identifying a first drug from the user interface;   obtaining a first set of prices for the first drug that is associated with a first pharmacy benefit manager (PBM), wherein a pharmacy benefit manager processes a claim relating to a drug and has an agreement with one or more pharmacies relating to a price of one or more drugs, the first set of prices comprising at least one price for the first drug and each price in the first set of prices being determined by an agreement between the first PBM and a pharmacy;   obtaining a second set of prices for the first drug that is associated with a second pharmacy benefit manager, the second set of prices comprising at least one price for the first drug and each price in the second set of prices being determined by an agreement between the second PBM and a pharmacy;   ranking the at least one price for the first drug in the first set of prices for the first drug and the at least one price for the first drug in the second set of prices for the first drug in an order that is different from lowest to highest; and   displaying a price from said ranking in the user interface.   
     
     
         2 . The method of  claim 1 , wherein said ranking comprises, in response to determining that the at least one price for the first drug in the first set of prices is higher than or equal to the at least one price for the first drug in the second set of prices, ranking the at least one price in the first set of prices higher than the at least one price in the second set of prices. 
     
     
         3 . The method of  claim 2 , wherein said ranking the at least one price in the first set of prices higher than the at least one price in the second set of prices is performed in response to determining that a difference between the at least one price for the first drug in the first set of prices and the at least one price for the first drug in the second set of prices does not exceed a threshold value. 
     
     
         4 . The method of  claim 2 , wherein said ranking the at least one price in the first set of prices higher than the at least one price in the second set of prices is based on a first acceptance rate associated with the at least one price in the first set of prices and a second acceptance rate associated with the at least one price in the second set of prices. 
     
     
         5 . The method of  claim 3 , wherein a higher ranked price from said ranking is displayed in the user interface. 
     
     
         6 . The method of  claim 3 , further comprising determining a preferred order for ranking prices from the first PBM and prices from the second PBM, the preferred order indicating that prices from the first PBM are to be ranked higher than prices from the second PBM. 
     
     
         7 . The method of  claim 1 , wherein:
 a first percentage indicates a portion of prices from the first PBM to be displayed in the user interface;   a second percentage indicates a portion of prices from the second PBM to be displayed in the user interface; and   said ranking comprises ranking the at least one price for the first drug in the first set of prices and the at least one price for the first drug in the second set of prices based at least in part on the first percentage and the second percentage.   
     
     
         8 . The method of  claim 7 , wherein the second percentage is linked to a threshold value for ranking prices from the first PBM over the second PBM such that adjusting the second percentage adjusts the threshold value and adjusting the threshold value adjusts the second percentage. 
     
     
         9 . The method of  claim 1 , wherein:
 the first PBM administers claims relating to a first health insurance plan, and an agreement between the first PBM and a first pharmacy specifies a price of the first drug for a member of the first health insurance plan and a first price of the first drug for a customer that is not a member of the first health insurance plan, the at least one price for the first drug in the first set of prices being the first price of the first drug for a customer that is not a member of the first health insurance plan; and   the second PBM administers claims relating to a second health insurance plan, and an agreement between the second PBM and a second pharmacy specifies a price of the first drug for a member of the second health insurance plan and a second price of the first drug for a customer that is not a member of the second health insurance plan, the at least one price for the first drug in the second set of prices being the second price of the first drug for a customer that is not a member of the second health insurance plan.   
     
     
         10 . The method of  claim 9 , further comprising:
 displaying in the user interface the first price of the first drug for a customer that is not a member of the first health insurance plan; and   in response to selection of the first price received from the user interface, generating a discount coupon for a purchase of the first drug at the first price at the first pharmacy.   
     
     
         11 . A system of displaying prices for drugs from a plurality of pharmacy benefit managers, the system comprising:
 computer hardware comprising one or more computer processors; and   a module executing on the one or more computer processors and configured to:
 provide a user interface using a computer processor; 
 receive information identifying a first drug from the user interface; 
 obtain a first set of prices for the first drug that is associated with a first pharmacy benefit manager (PBM), wherein a pharmacy benefit manager processes a claim relating to a drug and has an agreement with one or more pharmacies relating to a price of one or more drugs, the first set of prices comprising at least one price for the first drug and each price in the first set of prices being determined by an agreement between the first PBM and a pharmacy; 
 obtain a second set of prices for the first drug that is associated with a second pharmacy benefit manager, the second set of prices comprising at least one price for the first drug and each price in the second set of prices being determined by an agreement between the second PBM and a pharmacy; 
 rank the at least one price for the first drug in the first set of prices for the first drug and the at least one price for the first drug in the second set of prices for the first drug in an order that is different from lowest to highest; and 
 display a price from said ranking in the user interface. 
   
     
     
         12 . The system of  claim 11 , wherein the module performs said ranking at least in part by, in response to determining that the at least one price for the first drug in the first set of prices is higher than or equal to the at least one price for the first drug in the second set of prices, ranking the at least one price in the first set of prices higher than the at least one price in the second set of prices. 
     
     
         13 . The system of  claim 12 , wherein the module performs said ranking the at least one price in the first set of prices for the first drug higher than the at least one price in the second set of prices for the first drug at least in part in response to determining that a difference between the at least one price for the first drug in the first set of prices and the at least one price for the first drug in the second set of prices does not exceed a threshold value. 
     
     
         14 . The system of  claim 12 , wherein the module performs said ranking the at least one price in the first set of prices higher than the at least one price in the second set of prices based at least in part on a first acceptance rate associated with the at least one price in the first set of prices and a second acceptance rate associated with the at least one price in the second set of prices. 
     
     
         15 . The system of  claim 13 , wherein a higher ranked price from said ranking is displayed in the user interface. 
     
     
         16 . The system of  claim 13 , wherein the module is further configured to determine a preferred order for ranking prices from the first PBM and prices from the second PBM, the preferred order indicating that prices from the first PBM are to be ranked higher than prices from the second PBM. 
     
     
         17 . The system of  claim 11 , wherein:
 a first percentage indicates a portion of prices from the first PBM to be displayed in the user interface;   a second percentage indicates a portion of prices from the second PBM to be displayed in the user interface; and   the module performs said ranking at least in part by ranking the at least one price for the first drug in the first set of prices and the at least one price for the first drug in the second set of prices based at least in part on the first percentage and the second percentage.   
     
     
         18 . The system of  claim 17 , wherein the second percentage is linked to a threshold value for ranking prices from the first PBM over the second PBM such that adjusting the second percentage adjusts the threshold value and adjusting the threshold value adjusts the second percentage. 
     
     
         19 . The system of  claim 11 , wherein:
 the first PBM administers claims relating to a first health insurance plan, and an agreement between the first PBM and a first pharmacy specifies a price of the first drug for a member of the first health insurance plan and a first price of the first drug for a customer that is not a member of the first health insurance plan, the at least one price for the first drug in the first set of prices being the first price of the first drug for a customer that is not a member of the first health insurance plan; and   the second PBM administers claims relating to a second health insurance plan, and an agreement between the second PBM and a second pharmacy specifies a price of the first drug for a member of the second health insurance plan and a second price of the first drug for a customer that is not a member of the second health insurance plan, the at least one price for the first drug in the second set of prices being the second price of the first drug for a customer that is not a member of the second health insurance plan.   
     
     
         20 . The system of  claim 19 , wherein the module is further configured to:
 display in the user interface the first price of the first drug for a customer that is not a member of the first health insurance plan; and   in response to selection of the first price received from the user interface, generate a discount coupon for a purchase of the first drug at the first price at the first pharmacy.