Pharmacy Network

Network background and design

We have contracted with most chain pharmacies as well as independent pharmacies to provide a network that reaches across the country. The PDMI retail pharmacy network has contractual agreements with over 69,000 pharmacies nationwide. These agreements cover all aspects of the business we support, including commercial and Medicare plans, Hospice and many other specialty programs.

Network Pricing

We guarantee to the penny that every dollar billed by the pharmacy is passed to the plan to ensure there is the maximum amount of savings possible. We do not collect any revenue from a differential between what the pharmacy bills and what the client pays – guaranteed. We aggressively manage a proprietary MAC (maximum allowable cost) list to ensure our clients are paying the most appropriate price for their generic drugs. We offer a wide array of options for designing a pharmacy network that meets your needs.

Network Options

  1. Lease network - This option provides you with access to our national pharmacy network which includes chain pharmacies as well as independent ones at very competitive brand and generic prices. You have the option to lease a network for a per-paid-claim administrative fee.
  2. Wrap-around network - You can utilize the lease network for out-of-area access and PDMI will develop your proprietary network for local pharmacy access. This is an attractive option for the client who has a large concentration of membership within a local market area; it puts the client in a position to negotiate more favorable terms and provides members with national pharmacy access in and out of the local area.
  3. Owned network -If you have a large enough membership base, you may consider building an owned national pharmacy network. If you qualify for this option, and it fits into your plan design, PDMI can develop a national network on your behalf.