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News



March 13, 2013
18 years later and the Coughlin PPN still means savings

In 1995, Coughlin & Associates Ltd. established a preferred provider network (PPN) of pharmacies in the National Capital Region.  Its primary objective at the time was to contain the rapidly rising costs of prescription drugs.

The issue of rising drug costs has not changed.  In fact, it is still one of the biggest challenges facing many plan sponsors as they attempt to manage the rising costs of their benefit plans.  

The Coughlin PPN has helped contain costs.  It does so by limiting pharmacy dispensing fees, ingredient mark-ups and encouraging generic substitution wherever possible.

Under the Coughlin PPN, participating Ontario-based pharmacies agree to limit their dispensing fee to the level allowed under the Ontario Drug Benefit (ODB) plan.  Today, that limit is $8.40 per prescription.  (On April 1, 2013, it will increase to $8.62 per prescription.)   That prescription limit contrasts to the average dispensing fee of $11.09, as reported by Express Scripts Canada (ESC), the largest drug card supplier in Ontario.  Many of the large pharmacy chains have dispensing fees of $11.99 or more per prescription.

In other words, based on ESC data, the Coughlin PPN offers plan sponsors potential dispensing fee savings of an average $2.69 per prescription.  

In addition to the dispensing fee savings, the Coughlin PPN has an automatic generic substitution feature.  Plus, ingredient mark-up costs are limited to eight per cent.  Both help contain the cost of prescription drugs for plan sponsors.  

In 2012, Coughlin’s Ottawa offices reimbursed just under 295,000 prescription drug claims, 64 per cent of which were dispensed by participating Coughlin PPN pharmacies.  The result:  The Coughlin PPN generated dispensing fee savings for our clients of more than $500,000 in that year.  

Since its founding, the Coughlin PPN network has grown to 567 pharmacies throughout Ontario. 

While many are concentrated in the National Capital Region, participating pharmacies can now be found in most major centres throughout the province.  We also have affiliations with some pharmacy chains that operate throughout Ontario and, in some cases, have special arrangements with providers located near our clients’ locations.

The Coughlin PPN allows your plan members to have their drug prescriptions filled and dispensed at a lower cost.  Those savings serve to lower the overall benefit costs of plan sponsors.  There is no additional cost to employees.  In many cases, Coughlin PPN pharmacies take extra steps to provide better service to plan members.

For more information about the Coughlin & Associates Ltd., Preferred Provider Network, contact Coughlin Managed Care Consultant Joe Zadzora at 613-231-2266, extension 256 or email jzadzora@coughlin.ca.

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