Special Prescription Plans facilitate the community pharmacy supply, of medicines that have special ordering requirements and are, typically, very high cost.
The ABBVIE Hepatitis C medicine MAVIRET is the first medicine that will be processed as part of a ‘Special Prescription Plan’. This plan is named AbbVieCare.
Maviret processing requires AbbVie Registration
The AbbVie registration/training process supplies Toniq with pharmacy details including their Healthcare Logistics (HCL) ordering customer (header) code and supplies HCL with the pharmacy bank account, for professional fee payments.
Normally the pharmacy is ready to dispense the day after registration completion.
1) A Maviret patient needs to visit the pharmacy twice, once to submit the Rx and once to come in and pick up their medicine. A treatment is usually of 8 weeks duration and 2 lots of medicine of 84 tabs (or 1 OP) each are dispensed
2) Hold (or dispense) the Rx. This triggers two processes
- A professional fee is dispensed (automatically like a brand switch fee)
- An order is created automatically for the patient’s treatment quantity, to Healthcare Logistics
3) Edit order, check the quantity covers whole treatment. Send order F10.
4) Receive the order, when stock arrives (from Healthcare Logistics)
5) Contact the patient “Your medicine is here”
6) Unhold the Rx (if necessary) and pack the medicine ready for the patient
Claims, payments and Invoicing
All Maviret dispensing is cost neutral and the patient price is $0.00. Despite being coded NS, each Rx item generates a $0.00 claim item (for Pharmac’s information).
All Maviret dispensing data is sent to a Toniq webservice as it is processed. The pharmacy must be online to process a Maviret Rx. The data collected enables Toniq to prepare invoices on behalf of all pharmacies to Healthcare Logistics. Healthcare Logistics in turn pay pharmacy the professional fee on behalf of AbbVie, one per patient per treatment, on the 20th of the following month. Data is also sent to AbbVie for reconciliation purposes.
Pharmacy can link the Healthcare Logistics debtor account to the AbbVieCare medicine plan, for reconciliation purposes, but this is not needed for payment.
For example, a Maviret treatment started on the 2nd of Feb, is invoiced by Toniq in February and paid by Healthcare Logistics on the 20th March. Use the Prescription Details or the Dispensary Summary report to reconcile payments. (If actual debtor tracking is required see separate green paper: Tracking Maviret through debtors.)
The Prescription Details Report
The Prescription Details report, run for the Maviret dispensing/counselling fee (pharmacode 99999132), showing charges, will give information for reconciliation.
For example, to reconcile payments made on the 20th March:
Go to Reports, Prescription Reports, Prescription details, set the date range 01/02/19 to 28/02/19, select Maviret service fee (99999132) and tick Include Prices.
The Dispensary Summary Report
The Dispensary Summary report cannot be run for a specified fee, but the fee can be put into a medicine group (e.g. AbbVieCare) and the report can be run for that.
Go to: Stock control, Maintain medicine groups and create a group, e.g. AbbVieCare, then use Edit Medicine to set the Medicine group to AbbVieCare on the 3rd page of the fee medicine (99999132).
Claims show the $0.00 Maviret items, these are for Pharmac’s information and should not be excluded. The printed Rx forms should be sent in with the batch.
Using Retail debtors to track Maviret financially
Pharmacies may already have a debtor setup for AbbVie/Healthcare Logistics. Consider how this is used. If the account is or will be actively used (ever) for either ethical (not Maviret) or O.T.C sales do not use this account, setup a new one.
The debtor account used to track Maviret must be setup in Toniq Retail and then linked to the special prescription plan in Dispensary.
Debtor category setup
Since the debtor account to be used for Maviret is ‘special’, setting it up in a debtor category gives more general flexibility to include/exclude it from routine processing.
From the Main Menu of Toniq Retail
- 3. Debtors
- 2. Debtor Setup
- 3. Maintain account categories
- F3 add, give the category a name e.g. AbbVie Maviret, set options as below
- F12 Accept to save, escape back to main menu
From the main menu of Retail:
- 3. Debtors
- 1. Maintain debtor accounts
- Search for and check whether an unused debtor already exists for AbbVie/Healthcare Logistics.
If it is definitely unused, select it,
otherwise F3 Add a new debtor and name it e.g. AbbVie/HCL Maviret.
- Set the account category to AbbVie Maviret
- Next Page F11
- Set options as shown below
- Next Page F11 and set the balance options
- Next Page F11, Next Page F11 and Accept Details F12
Link the AbbVieCare special prescription plan to the debtor
From the Main Menu of Toniq Dispensary:
- Go to 7. Administration
- 1. Setup
- 9. Special prescription plan setup
- Press spacebar to select AbbVieCare and again to select the debtor account
Debtor payment and reconciliation
The Maviret treatment/counselling fees (pcode 99999132), automatically dispensed as part of the AbbVieCare plan, will show as transactions on the debtor account.
Payments received on the 20th of the month from Healthcare Logistics should reconcile to the total balance on the debtor account for the previous month.
To reflect the payment on the account use F6 Month to go to the previous month and then F8 Jrnl Entry to make the payment.