Pro Pharma Announces JCode Calculator™ Comparative Pricing Update 2013 to 2014

Major price changes in Specialty Injectables for 2013 vs. 2014
The JCode Calculator™
The JCode Calculator™
CANOGA PARK, Calif. - Feb. 3, 2015 - PRLog -- Pro Pharma Pharmaceutical Consultants, Inc., a pharmaceutical consulting organization which focuses on data analytical expertise, announced today that it has updated and enhanced the JCode Calculator™ 4th Quarter 2014 Update via their secured web access.  This is primarily for claims and billing professionals and provides improved efficiencies in resources, time and money. For the last several years Pro Pharma has analyzed the Annual Trend of price changes in the Prescription Drug Industry. The current year’s prices continue to increase for Average Wholesale Price (AWP) and Average Sales Price (ASP).

“Pro Pharma has analyzed the entire spectrum of Specialty Injectables for calendar years 2013 through 2014.  The average overall change in AWP in 2013 was 3.6% while the average change in ASP was 5.6%.  In 2014 the average overall change in AWP decreased slightly to 4.6% while the average change in ASP was 8.8%. ”, states Dr. Craig S. Stern, President of Pro Pharma Pharmaceutical Consultants, Inc. “These averages cover all specialty agents including Part B.  A small subset of outliers was removed from these averages to ensure that extremely large changes did not skew the results,” concludes Dr. Stern.

To summarize Dr. Craig Stern’s comments above:

         AWP Changes

·         2012 – 2013 = 3.6 %

·         2013 – 2014 = 4.6 %

ASP Changes

·         2012 – 2013 =  5.6 %

·         2013 – 2014 =  8.8 %

Pro Pharma’s JCode Calculator™ provides an invaluable resource to ensure standardization of reimbursement procedures to providers which results in overall savings to the organization due to consistent billing and reimbursement practices.  Specifically, there are a few categories which are highly sensitive to the potential of overcharges.

“The JCode Calculator™ is available on a daily, weekly, monthly and quarterly basis and can be purchased on the Pro Pharma Website. Pro Pharma continues to improve our product line by adding new features and client input is invaluable to our mutual success. Unique State Pricing can be added for ongoing clients as requested,” said Carol Stern, CEO of Pro Pharma.   “Call or email to schedule your online Demo and free evaluation.”

Please visit Pro Pharma Consultants website for complete information.

About Pro Pharma Pharmaceutical Consultants, Inc.

is a multi-service, woman owned, privately held consulting firm offering a vast portfolio of services to public and private entities including self-insured employers, Taft Hartley Trusts and unions, public employers, for-profit hospitals and integrated health networks, health care insurance companies, worker's compensation insurers, small-to-medium sized HMO's, and physician groups.

As a primary service to plan sponsors for achieving below trend results, PRO PHARMA provides an integrated program of administrative process improvements, clinical quality oversight, and provider/member education.

Pro Pharma’s Consulting services are grounded in the use of data and the communication of that information to define benefit trends, drivers and other analytical indicators.   PRO PHARMA markets Comprehensive Specialty Analyses™, JCode Calculator™, Invoice Screening ™, Pro Pharma Suite of Tools™, Rx MAC List™, Quality Management Program™, Treatment Calendar™, and Biotech Modeling™.  The Pro Pharma directly markets its products in the U.S. and collaborates with partners to reach international markets.

About Comprehensive Specialty Analyses™

Comprehensive Specialty Analyses™
utilizes a multi-pronged approach to analyze pharmacy and medical encounter claims through problem flagging, feedback on performance, peer to peer comparison, and others parameters. Comprehensive Specialty Analyses™ specifically identify pricing differences, usage, trends, and actionable opportunities in the medical data that were not apparent in the past.  In order to achieve these goals it is necessary to view the Medical Data from multiple perspectives, i.e., a 360 degree view that allows for seeing beyond the obvious of top drugs spend and top providers as well as compare and contrast it with the Pharmacy Claims Data.

About Invoice Screening™

About 10% of drugs spend is being paid from PBM Invoices, and should have been rejected by clients prior to payment.   Pro Pharma’s Invoice Screening™ analyzes invoices against:  formulary compliance, compliance with MAC pricing, eligibility, claims pricing, invalid claims, and excluded benefits, pre-payment as an Accounts Payable function.  This ensures that clients only pay for valid claims, which saves time and dollars in the long run.

About Pro Pharma Suite of Tools™

Pro Pharma’s Suite of Tools identifies the cost and clinical issues for both Pharmacy and Medical, and formulates management plans and objectives to develop action plans to address “prescriptions for change”.

About Rx MAC List™ (Pharmacy Maximum Allowable Cost™)

The Cost of Drugs is Skyrocketing.  Pro Pharma develops and maintains customized MAC Lists for clients to help manage the effects of rapid and high increase of drug prices.

About Quality Management Program™ (QMP)

Pro Pharma’s Quality Management Program™ (
QMP) is a multi-faceted approach that targets the pharmacy benefit cost and quality from multiple directions; namely, physician prescribing decisions, member demands, pharmacy oversight and patient education, HR rep education, and messaging to actives/retirees.  The program is focused on providing patients and physicians specific tools designed to make more informed purchasing decisions that expand member co-pay dollars.  The bottom line is:  payers (self-insured, employers, Trusts, etc.) lower their pharmacy trend.

About Treatment Calendar™

Pro Pharma’s Treatment Calendar™ is a proprietary program comprised of Artificial Intelligence rule sets, which allow for quality and cost comparisons by peer-to peer, peer-to-best in class, peer to national norms, and peer to local norms.

Pro Pharma
uses Clinical Protocols to analyze patient encounter data and diagnoses for required exams, tests, and medications.  In this way, physician practices can schedule the applicable services for each patient and then review them for exceptions.

Please visit the Pro Pharma Pharmaceutical Consultants, Inc. Website for more complete information at

Carol Stern, CEO
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