Limited Distribution Drugs definition
Examples of Limited Distribution Drugs in a sentence
PBM’s exclusive specialty guarantee requires Members fill specialty products at PBM's specialty pharmacy, other than Limited Distribution Drugs that are not available at the PBM Specialty Pharmacy.
This Specialty Assistance Program will only apply to Specialty Drugs where manufacturer assistance or alternative funding is available for such drugs at the Specialty Pharmacies or pharmacies that dispense Limited Distribution Drugs; and this Specialty Assistance Program does not apply to Specialty Drugs purchased from pharmacies other than the designated Specialty Pharmacies or pharmacies that dispense Limited Distribution Drugs.
MedTrak will submit all Claims for Limited Distribution Drugs by Non-Best-In-Class Specialty Pharmacies to Client for authorization.
Notwithstanding the foregoing, Limited Distribution Drugs not dispensed by Optum Specialty Pharmacy may be obtained from other Network Pharmacies.
The Non-Best-In-Class Specialty Pharmacy Paid Claim Charge does not apply to Limited Distribution Drugs.
The Charges for Limited Distribution Drugs are subject to the rates set by the Pharmacy and/or the pharmaceutical manufacturer.
Compound prescription drug Claims, 340B claims, Indian Health Services and/or Tribal claims, Direct Member Reimbursement Claims, Coordination of Benefit Claims, Long Term Care Claims, Home Infusion Claims, vaccines, claims with ancillary charges , third party billed claims, Limited Distribution Drugs, fraudulent claims and claims filled outside the PBM National Network shall be excluded from the guarantee.
CLIENT acknowledges drug price increases due to market conditions, new to market product, manufacturer changes or drug wholesaler’s Select Special Priced Products including, but not limited to Limited Distribution Drugs (LDD) are not subject to financial guarantees, unless otherwise specified.