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Program Information
Ohio's "Best Rx" is a prescription drug discount card program designed to lower the cost of prescriptions for Ohio residents without drug insurance coverage who are either aged 60 and over or any age with incomes less than 300% of the federal poverty level. Click here for the new income guidelines. With the cost of prescription drugs continuing to rise, and the numbers without insurance coverage growing, the goal of Best Rx is to improve access to needed medications at a substantial discount and through a wide network of participating pharmacies.
The program is the result of legislation passed by the Ohio General Assembly and signed by the Governor in December 2003. With a framework initially conceived by a coalition of groups representing drug manufacturers (the Pharmaceutical Research and Manufacturers of America), the Ohio AFL-CIO, the American Association of Retired Persons, and others, Best Rx is designed to pass on to program participants most of the savings associated with negotiated drug prices and manufacturer rebates. Rather than paying a participating pharmacy's usual charge to an individual with no drug insurance coverage, a Best Rx participant pays the "Best Rx price." This price is the weighted average of what the state employee and state retiree health plans pay for that prescription, minus any rebate offered to the program by the drug’s manufacturer. There are small additional fees to cover the pharmacist's professional services and the administration of the program.
The Best Rx program has three key objectives:
- To maximize individual, pharmacy, and manufacturer participation;
- To maximize savings for Ohio consumers; and
- To provide services with efficiency and accountability
Program activities to meet those objectives include: coordinated and extensive outreach to eligible individuals; a streamlined application process requiring little documentation; prompt determination of eligibility and issuance of the "Best Rx" card; participant services to assure ready access to a participating pharmacy; administrative simplicity and efficient claims processing to recruit and retain pharmacies in the Best Rx network; offering the lowest possible Best Rx price through accurate calculations, frequent updates, and manufacturer agreements to provide voluntary rebates; and focused program reporting and evaluation. The state Controlling Board approved the program's selection of Envision Pharmaceutical Services, Inc. as Ohio's Best Rx program administrator. Envision, located in Twinsburg, Ohio, performs eligibility determination, automated pharmacy claims processing, and other administrative services as specified by the Department.
Several program enhancements Am. Sub. House Bill 468 effective April 4, 2007. To see a summary of the statute amendments click here .
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