Definitions. For purposes of this Schedule C, the following terms have the following meanings:
Average Wholesale Price or AWP shall mean the price of a prescription drug dispensed as established and reported
by MediSpan, First DataBank, or other nationally recognized pricing source selected by PBM in its sole discretion
from time to time. AWP does not represent a true wholesale price, but rather is a fluctuating benchmark provided by
third party pricing sources.
In the event that there are court or government imposed or industry wide or pricing source initiated changes in the
AWP reporting source or source changes in the methodology used for calculating AWP, including, without limitation,
changes in the mark-up factor used in calculating AWP (collectively, the "AVP Changes"), the terms of any financial
relationship between the parties that relate to AWP shall be modified by Anthem such that the value of AWP for the
purpose of such relationship(s) shall have the same economic equivalence in the aggregate to the value used by the
parties prior to the AWP Change. The intent of this provision is to preserve the relative economics of both parties for
such financial relationships based upon AWP to that which existed immediately prior to the AWP Change.
Further, in the event that the AWP pricing benchmark used by PBM hereunder is replaced with another benchmark
calculation, PBM may switch to such new pricing benchmark upon 30 day prior written notice to Employer, and such
notice will identify any new pricing terms, if any, required to maintain economic equivalence in the aggregate under
the new benchmark.
Net Effective Reimbursement Rate shall mean the overall reimbursement rate paid to pharmacy Network Providers.
Single Source Generics shall mean those generic drugs which are provided by two or less Pharmaceutical
Manufacturers or such Generic Drugs that are in the market with supply limitations or competitive restrictions.
Specialty Drugs are high-cost, injected, infused, oral or inhaled medications (including therapeutic biological
products) that are used to treat chronic or complex illnesses or conditions. Specialty drugs may have special
handling, storage and shipping requirements, such as temperature control. Specialty drugs may require nursing
services or special programs to encourage patient compliance.
Brand Name Prescription Drug or Brand Drug shall mean a prescription drug that is not a Generic Drug.
Dispensing Fee shall mean the amount, other than the AWP minus a discount and any applicable incentives
determined by Anthem as compensation to Participating Pharmacies for providing prescription drugs.
Generic Prescription Drug or Generic Drug shall mean a prescription drug, whether identified by its chemical,
proprietary, or non-proprietary name, that is therapeutically equivalent and interchangeable with drugs having an
identical amount of the same active ingredient.
Enterprise Administrative Services Agreement — October 2012 Master Template 35
City of Nashua 06/17/2013
