The PACCT solution will be priced on a PMPM/PEPM basis and rated on each client’s population and geographic location. For example, a commercial health plan may have a different rating than a state Medicaid plan. Once the rating is calculated, there will be a predictable cost that ensures the plan and its members will be covered for these high-cost but life-changing drugs. Please note the rating charge includes the cost of the therapies only and excludes administration and professional fees.
Coverage is actively designed for the three therapies listed above. OutcomeRx is currently evaluating additional existing high-cost therapies as well as new products coming to the market and will expand its PACCT coverage in the near future.