173.75 Determination of drug prices charged to participants.

(A) Subject to division (B) of this section, the amount that an Ohio’s best Rx program participant is to be charged for a quantity of a drug purchased under the program shall be established in accordance with all of the following:

(1) If the drug is not included in a manufacturer agreement entered into under section 173.81 of the Revised Code, the participant shall be charged an amount that is computed according to the drug’s base price established under section 173.74 of the Revised Code.

(2) If the drug is included in a manufacturer agreement entered into under section 173.81 of the Revised Code, the participant shall be charged an amount that is computed by subtracting from the drug’s base price established under section 173.74 of the Revised Code the amount of the manufacturer payment that applies to the transaction, as established under section 173.812 of the Revised Code.

(3) If an administrative fee is specified in rules adopted under section 173.83 of the Revised Code, the participant shall be charged the amount of the administrative fee.

(4) If the drug is dispensed by a terminal distributor of dangerous drugs under an agreement entered into under section 173.79 of the Revised Code, and the terminal distributor charges a professional fee pursuant to the agreement, the participant shall be charged the amount of the professional fee.

(5) If the drug is dispensed through the drug mail order system included in the program pursuant to section 173.78 of the Revised Code, the participant shall not be charged a professional fee.

(B) When a quantity of a drug is purchased by an Ohio’s best Rx program participant, the participating terminal distributor or drug mail order system dispensing the drug shall charge the lesser of the amount that applies to the transaction, as established in accordance with division (A) of this section, or the usual and customary charge that otherwise would apply to the transaction. When a drug is purchased at the usual and customary charge pursuant to this division, the transaction is not subject to sections 173.71 to 173.91 of the Revised Code as the purchase or dispensing of a drug under the program.

Effective Date: 07-01-2007