Patent Publication Number: US-2011054935-A1

Title: System and method for cached replenishment of pharmaceuticals

Description:
TECHNICAL FIELD  
     This disclosure relates generally to techniques for managing the dispersal and replenishment of pharmaceutical inventories. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS  
       Non-limiting and non-exhaustive embodiments of the disclosure are described, including various embodiments of the disclosure with reference to the figures, in which: 
         FIG. 1  is a block diagram of a system for disbursing and restocking medications, according to one embodiment. 
         FIG. 2  is a block diagram of a one embodiment of a system for dispersal of medications through a pharmacy and for restocking and replenishment of disbursed inventory, the diagram depicting a restocking scenario. 
         FIG. 3  is a block diagram of the system of  FIG. 2  depicting traditional replenishment. 
         FIG. 4A  is a block diagram of one embodiment of a Qualified Program Management Module (QPMM) that can enable a pharmacy to implement a traditional replenishment model. 
         FIG. 4B  is a block diagram of one embodiment of a replenishment module configured to implement a traditional replenishment model. 
         FIG. 5  is a flow chart of a method for replenishment of pharmaceuticals. 
         FIG. 6  is a block diagram of a system for dispersal of medications through a pharmacy and for restocking and cached replenishment of disbursed inventory, the diagram depicting cached replenishment. 
         FIG. 7A  is a block diagram of an embodiment of a QPMM that can enable a pharmacy to implement a cached replenishment model. 
         FIG. 7B  is a block diagram of one embodiment of a cached replenishment module configured to implement a cached replenishment model. 
         FIG. 8  is a flow chart of a method for cached replenishment of pharmaceuticals. 
         FIG. 9  is a block diagram of a system for dispersal of medications through a pharmacy and for restocking and prepurchased replenishment of disbursed inventory, the diagram depicting prepurchased replenishment. 
         FIG. 10A  is a block diagram of an embodiment of a QPMM that can enable a pharmacy to implement a prepurchased replenishment model. 
         FIG. 10B  is a block diagram of one embodiment of a prepurchased replenishment module configured to implement a prepurchased replenishment model. 
         FIG. 11  is a flow chart of a method for prepurchased replenishment of pharmaceuticals. 
         FIG. 12  is a flow chart of a method for replenishment of pharmaceuticals beyond a quantity replenished by prepurchased replenishment. 
     
    
    
     DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS  
     A number of drug discount programs are available to certain qualified entities. These drug discount programs include the federal  340 B program (hereafter “ 340 B program” or “ 340 B”), also known as section  602  or “PHS” pricing, purchasing cooperatives commonly referred to as Group Purchasing Organizations (GPOs), and Patient Assistance Programs (PAPs). 
     The  340 B program is a federally administered program that allows certain eligible health care providers  102  (“Covered Entities”) within the health care safety-net to purchase outpatient medications from manufacturers at or below a defined discount price. The  340 B program is not a governmental purchasing program, but is a discount programmed administered by the federal government. Pharmaceutical manufacturers are required to sell covered medications to qualified entities at or below a statutorily defined “ceiling price” as a condition for Medicaid participation. The  340 B program is discussed in greater detail below with reference to  FIG. 1 . 
     Group Purchasing Organizations (GPOs) are purchasing cooperatives in which organizations with non-profit status can participate. The Nonprofit Institutions Act (15 U.S.C.A. 13c) exception to the Robinson-Patman Act permits some organizations to take advantage of their status as non-profit institutions to purchase products, including pharmaceutical drugs, for their employees, retirees, dependents and other eligible individuals by participating in a GPO. A GPO eligible entity realize significant drug discounts on pharmaceutical drugs purchased for its “own use.” 
     Patient Assistance Programs (PAPs) may also provide significant drug discounts to consumers. PAPs are run by pharmaceutical companies to provide free medications to people who cannot afford to buy their medicine. There are over 1000 PAPs offered with varying criteria for eligibility. 
     Discount drug programs may be referred to generally as a “qualified programs” and a health care provider covered by such a program may be referred to as a “qualified entity.” A Covered Entity under the  340 B program is a type of qualified entity, as the term qualified entity is used herein. The common thread of the aforementioned qualified programs is that each can provide significant drug discounts to eligible patients when properly utilized. Although the  340 B, GPO, and PAP discount programs are specifically mentioned, these programs are merely examples of qualified programs. The teachings of this disclosure may extend to any discount program and related regulatory scheme. As such, this disclosure should not be read as limited to any particular set of qualified programs and/or any particular set of qualified entities. 
     Qualified programs generally are heavily regulated and the complexity of regulations renders many qualified entities and, retail pharmacies unable to support these programs. The regulations often mandate complex inventory management and payment schemes to prevent such unethical practices as diversion of discounted products and double-dipping of discounts and government rebates. Moreover, the regulations are strict, imposing heavy penalties for violation. In some cases, failure to follow the regulations of a particular qualified program may constitute a criminal offense and result in disbarment from participation in qualified programs, including Medicare and/or Medicaid. Consequently, complying with these regulations can demand large overhead and for the unsophisticated qualified entities and retail pharmacies the regulatory structure of such programs presents an untenable risk. As a result, such qualified entities are in the unique position of having access to significant discount pricing of pharmaceutical drugs, but are largely unable to manage the burden of complying with such programs. 
     The level of savings available through the discounts offered by qualified programs, however, makes supporting these programs highly desirable. Unique systems and methods can be implemented to enable retail pharmacies to participate in qualified programs and to report, manage inventory, and replenish inventory in compliance with the mandated regulations. 
     A computer program, for example, can be designed and implemented to provide the required functions in accordance with the regulations to enable retail pharmacies to participate in these discount programs. As another example, a “plug-in” module to extend the functionality of the Coordination of Benefits (COB) systems that are already in wide use among retail pharmacies can be similarly designed and implemented to fulfill the regulatory requirements of qualified programs. Still another example is a system running on another computer that interfaces with the COB system and/or computer system running the COB system. 
     The present disclosure provides an improved system and method to enable a pharmacy to appropriately replace dispensed inventory, either by replenishment or by restocking. According to one aspect of the present disclosure, the systems and methods disclosed facilitate cached replenishment to improve inventory management of a pharmacy that sells medications to both qualified patients of qualified entities and to non-qualified patients. The systems and methods disclosed can enable the pharmacy to properly replace pharmaceuticals sold to qualified patients of qualified entities participating in one or more qualified programs while tracking and maintaining the integrity of the inventory for each such program. Replacement of pharmaceuticals sold to qualified patients of qualified entities can be accomplished through a process that can be referred to as replenishment. As previously mentioned, the systems and methods can be implemented as part of a stand-alone system, as an adaptation or plug-in for an existing system such as a COB system, or as a separate system interfacing with an existing system such as a COB system. 
     According to another aspect of the present disclosure, the systems and methods can also enable the pharmacy to appropriately replace pharmaceuticals sold to non-qualified patients, without overstocking due to inventory replaced through replenishment. Replacement of pharmaceuticals sold to non-qualified patients can be accomplished through traditional restocking. The systems and methods coordinate a cached replenishment with a drug manufacturer and/or wholesaler to replace pharmaceuticals sold to qualified patients of qualified entities participating in a qualified program. The coordination of the cached replenishment prevents the pharmacy from inadvertently ‘over ordering’ inventory when an order is placed to replace inventory dispensed under a qualified program. As previously mentioned, the systems and methods can be implemented as part of a stand-alone system, as an adaptation or plug-in for an existing system such as a COB system, or as a separate system interfacing with an existing system such as a COB system. 
     According to another aspect of the present disclosure, the systems and methods can enable a pharmacy to virtually replenish inventory that will be sold in the future under a qualified discount plan. Prepurchased replenishment allows a pharmacy to leverage limited-duration advantageous pricing periods, by pre-ordering anticipated inventory replenishment at deeper discount pricing available during such advantageous pricing periods. The systems and methods monitor for limited duration advantageous pricing and then pre-order prepurchased replenishment containers according to anticipated inventory replenishment requirements, purchasing prepurchased replenishment containers at the advantageous pricing. The systems and methods coordinate prepurchased replenishment credit with a drug manufacturer and/or wholesaler, on behalf of the pharmacy, for pre-ordered replenishment inventory. Accordingly, when the replenishment threshold for that medication is met, the pharmacy receives a replacement container through replenishment at the advantageous pricing. As previously mentioned, the systems and methods can be implemented as part of a stand-alone system, as an adaptation or plug-in for an existing system such as a COB system, or as a separate system interfacing with an existing system such as a COB system. 
     The described features, structures, or characteristics may be combined in any suitable manner in one or more embodiments. Those skilled in the art will recognize that the invention can be practiced without one or more of the specific details, or with other methods, components, materials, etc. In other instances, well-known structures, materials, or operations are not shown in detail to avoid obscuring aspects of the invention. 
     Furthermore, the described features, operations, or characteristics may be combined in any suitable manner in one or more embodiments. It will also be readily understood that the order of the steps or actions of the methods described in connection with the embodiments disclosed may be changed as would be apparent to those skilled in the art. Thus, any order in the drawing or Detailed Description is for illustrative purposes only and is not meant to imply a required order, unless specified to require an order. 
     Embodiments may include various steps, which may be embodied in machine-executable instructions to be executed by a general-purpose or special-purpose computer (or other electronic device). Alternatively, the steps may be performed by hardware components that include specific logic for performing the steps or by a combination of hardware, software, and/or firmware. 
     Embodiments may also be provided as a computer program product including a machine-readable storage medium having stored thereon instructions that may be used to program a computer (or other electronic device) to perform processes described herein. The machine-readable storage medium may include, but is not limited to, hard drives, floppy diskettes, optical disks, CD-ROMs, DVD-ROMs, ROMs, RAMs, EPROMs, EEPROMs, magnetic or optical cards, solid-state memory devices, or other types of media/machine-readable medium suitable for storing electronic instructions. Suitable networks for configuration and/or use as described herein include one or more local area networks, wide area networks, metropolitan area networks, and/or “Internet” or IP networks, such as the World Wide Web, a private Internet, a secure Internet, a value-added network, a virtual private network, an extranet, an intranet, or even standalone machines which communicate with other machines by physical transport of media (a so-called “sneakernet”). In particular, a suitable network may be formed from parts or entireties of two or more other networks, including networks using disparate hardware and network communication technologies. 
     One suitable network includes a server and several clients; other suitable networks may contain other combinations of servers, clients, and/or peer-to-peer nodes, and a given computer may function both as a client and as a server. Each network includes at least two computers, such as the server and/or clients. A computer may be a workstation, laptop computer, disconnectable mobile computer, server, mainframe, cluster, so-called “network computer” or “thin client”, personal digital assistant or other hand-held computing device, “smart” consumer electronics device or appliance, or a combination thereof. 
     The network may include communications or networking software, such as the software available from Novell, Microsoft, Artisoft, and other vendors, and may operate using TCP/IP, SPX, IPX, and other protocols over twisted pair, coaxial, or optical fiber cables, telephone lines, satellites, microwave relays, modulated AC power lines, physical media transfer, and/or other data transmission “wires” known to those of skill in the art. The network may encompass smaller networks and/or be connectable to other networks through a gateway or similar mechanism. 
     Each computer includes at least a processor and a memory; computers may also include various input devices and/or output devices. The processor may include a general purpose device, such as an Intel®, AMD®, or other “off-the-shelf” microprocessor. The processor may include a special purpose processing device, such as an ASIC, PAL, PLA, PLD, Field Programmable Gate Array, or other customized or programmable device. The memory may include static RAM, dynamic RAM, flash memory, ROM, CD-ROM, disk, tape, magnetic, optical, or other computer storage medium. The input device(s) may include a keyboard, mouse, touch screen, light pen, tablet, microphone, sensor, or other hardware with accompanying firmware and/or software. The output device(s) may include a monitor or other display, printer, speech or text synthesizer, switch, signal line, or other hardware with accompanying firmware and/or software. 
     The computers may be capable of using a floppy drive, tape drive, optical drive, magneto-optical drive, or other means to read a storage medium. A suitable storage medium includes a magnetic, optical, or other computer-readable storage device having a specific physical configuration. Suitable storage devices include floppy disks, hard disks, tape, CD-ROMs, DVDs, PROMs, random access memory, flash memory, and other computer system storage devices. The physical configuration represents data and instructions which cause the computer system to operate in a specific and predefined manner as described herein. 
     Suitable software to assist in implementing the invention is readily provided by those of skill in the pertinent art(s) using the teachings presented here and programming languages and tools, such as Java, Pascal, C++, C, database languages, APIs, SDKs, assembly, firmware, microcode, and/or other languages and tools. Suitable signal formats may be embodied in analog or digital form, with or without error detection and/or correction bits, packet headers, network addresses in a specific format, and/or other supporting data readily provided by those of skill in the pertinent art(s). 
     Several aspects of the embodiments described will be illustrated as software modules or components. As used herein, a software module or component may include any type of computer instruction or computer executable code located within a memory device. A software module may, for instance, comprise one or more physical or logical blocks of computer instructions, which may be organized as a routine, program, object, component, data structure, etc., that performs one or more tasks or implements particular abstract data types. 
     In certain embodiments, a particular software module may comprise disparate instructions stored in different locations of a memory device, which together implement the described functionality of the module. Indeed, a module may comprise a single instruction or many instructions, and may be distributed over several different code segments, among different programs, and across several memory devices. Some embodiments may be practiced in a distributed computing environment where tasks are performed by a remote processing device linked through a communications network. In a distributed computing environment, software modules may be located in local and/or remote memory storage devices. In addition, data being tied or rendered together in a database record may be resident in the same memory device, or across several memory devices, and may be linked together in fields of a record in a database across a network. 
     Much of the infrastructure that can be used according to the present invention is already available, such as: general purpose computers; computer programming tools and techniques; computer networks and networking technologies; digital storage media; authentication; access control; and other security tools and techniques provided by public keys, encryption, firewalls, and/or other means. 
       FIG. 1  is a block diagram of a system  100  for disbursing and restocking medications. The participants include health care providers  102 , patients  104 , pharmacies  106 , and pharmaceutical suppliers  107  (e.g., manufacturers  108  and wholesalers). The health care providers  102  provide health care services to patients  104 . Medications are dispensed to a patient  104  through the use of one or more pharmacies  106  under the supervision of a health care provider  102 . Depending on the arrangement, the pharmacy  106  may provide medications to a health care provider  102  or may provide medications directly to a patient  104 . The pharmacy medication inventory  110  that is disbursed is replaced by placing orders with pharmaceutical suppliers  107 . The suppliers  107  can include manufacturers  108  and/or wholesalers  109 . The inventory  110  disbursed under a qualified program can be replaced through a replenishment model and inventory  110  disbursed to nonqualified customers can be replaced through traditional restocking procedures, as discussed in greater detail below with reference to  FIGS. 3 ,  5 , and  7 . 
     The pharmacy  106  has an inventory  110  of medications. In an inventory  110 , containers  112  include a quantity of medication units  114 . The medication units  114  are discrete units and may be dispensed to a patient  104  and/or a health care provider  102 . A container  112  has a corresponding national drug code (NDC)  116 , or other identifying code. Typically an NDC  116  comprises eleven digits, with the first nine digits identifying the type of medication and the last two digits identifying the number of medication units  114  in the container  112 . For example, a medication “Feel Good” may be identified by an NDC  116  having the first nine digits 123234345. If Feel Good is sold in a container  112  that is a bottle of one hundred medication units, the corresponding NDC  116  may be 123234345-11. If Feel Good is sold in a container  112  of ten medication units, the corresponding NDC may be 123234345-10. 
     A pharmacy  106  will try to maintain enough inventories  110  to meet all the demands of its patients, clients, and customers, while attempting to minimize shelf space. Shelf space at a pharmacy  106  is very limited and to the extent it draws from other retail floor space, can be costly. Moreover, some medications have a shelf life and, if not dispensed, expire and must be discarded. To minimize shelf space and expiration of medications, a pharmacy may establish inventory thresholds to dictate minimum and maximum inventory levels. A maximum threshold may dictate the maximum number of medication units  114  on hand at any given time. A maximum threshold may be determined based on shelf space and/or projected dispensing of the medication. A replacement threshold may be established to dictate the number of medication units  114  to be dispensed before an order is placed with a manufacturer  108  or wholesaler  110  to replace the inventory. Once the replacement threshold number of medication units has been dispensed, an order is placed. A replacement threshold is generally a multiple of a fill level. A fill level is the minimum number of containers  112  that can be ordered for a given NDC  116 , as established by a supplier  107 , whether a manufacturer  108  or a wholesaler  109 . A fill level may enable a supplier  107  to achieve economies of scale. A fill level may be determined based on the characteristics of the medication and/or constraints of practical shipping of the medication. 
     As an example of inventory thresholds, if a first supplier  107  distributes a medication “Feel Good” with an NDC  116  corresponding to a container  112  that is a bottle of one hundred medication units  114 , the supplier  107  may establish a fill level of one bottle for the medication Feel Good. The minimum order for that particular NDC  116  from that first supplier  107  is one bottle. The pharmacy  106  may decide that it should replace its inventory of the Feel Good medication every time a full bottle is distributed, and accordingly the pharmacy can establish a replacement threshold of one bottle. When one hundred medication units  114  of Feel Good are dispensed, an order of one bottle is placed with the first supplier  107  to replace the dispensed medication units  114  of Feel Good. As will be appreciated, in this example, the replacement threshold of the pharmacy  106  could be two bottles, or any number of bottles. 
     A second supplier  107  may choose to sell the same medication Feel Good with an NDC  116  corresponding to a container  112  that contains ten medication units  114 . To achieve economies of scale, the supplier  107  may establish a fill level of five containers. Thus, the minimum order for “Feel Good” with that particular NDC  116  is five containers  112 . The pharmacy  106  may determine that it needs to replace its inventory for the medication “Feel Good” when  100  medication units  114  are dispensed. Accordingly, the pharmacy  106  may establish a replacement threshold of ten containers for Feel Good with that particular NDC  116 . 
     As another example, consider a medication “EZinhale” sold in a container  112  that is a single inhaler. Accordingly, there is also only one medication unit  114  (i.e. inhaler) per container  112 . To achieve economies of scale, a supplier  107  may establish a fill level of five. EZinhale may be an extremely popular medication with an extremely long shelf life. A pharmacy may sell ten EZinhale inhalers in any given week. A replacement order may take a full week to receive. Accordingly, the pharmacy  106  may establish a maximum threshold of thirty inhalers, due to the demand, and a replacement threshold of ten, so as to always have at least ten inhalers on hand in the event a replacement order is delayed a week. 
     As can be appreciated from these examples, the scenarios for disbursing and replacing medication inventory are numerous and varied. A person of ordinary skill in the art will appreciate that the scenarios provided are merely illustrative, and the present disclosure is not to be limited in any way by any particular dispensing or replacement scenario, or any particular thresholds that may be established to manage inventory. In one embodiment, a minimum threshold may be established, rather than a replacement threshold and/or a maximum threshold. Still other thresholds may be established as well. 
     Some of the health care providers  102  may be qualified entities  102   b  that are eligible to participate in one or more discount programs (i.e. qualified programs). As mentioned above, these qualified programs include, but are not limited to Group Purchasing Organizations (GPOs), Patient Assistance Programs (PAPs), and the  340 B program. Participation in these programs can significantly impact pricing of the health care provided by qualified entities to qualified patients  104   a,  including any medications dispensed to such qualified patients  104   a.  Health care providers  102  that are not eligible to participate in a discount program are referred to herein as non-qualified entities  102   a.    
     The  340 B program, for example, can significantly impact the pricing of medications. The  340 B program is a federally administered program that allows certain eligible health care providers, or qualified entities  102   b,  within the health care safety-net to purchase outpatient medications from manufacturers at or below a defined discount price. These eligible health care providers are also referred to as “Covered Entities.” A Covered Entity is also one type of “qualified entity  102   b,  ” as the term is defined above and used herein. For sake of simplicity in referring to the Figures, Covered Entities will be referred to in the more general sense as qualified entities  102   b,  although it will be appreciated that the term “qualified entities” encompasses more than simply Covered Entities under the  340 B program. 
     Eligibility for participation in a  340 B program is determined by entity status, specifically by receiving one of several grants or by being a certain type of Disproportionate Share Hospital or Federally Qualified Health Center (FQHC) or look-alike. Eligible entities can participate in the  340 B program as qualified entities  102   b.  Eligible entities include core health care safety-net providers and a number of health facilities. Health care safety-net providers deliver care to low-income and other vulnerable populations, including the uninsured and those covered by Medicaid. Many of these safety-net providers have either a legal mandate or an explicit policy to provide services regardless of a patient&#39;s ability to pay. Major safety-net providers include public hospitals and community health centers and clinics, as well as teaching and community hospitals, private physicians, and other providers who deliver a substantial amount of care to these populations. 
     Various Federally Qualified Health Centers (FQHCs) can also be eligible entities under  340 B. FQHCs include Consolidated Health Centers, Migrant Health Centers, Health Care for the Homeless Programs, school-based health centers, Public Housing Primary Care Programs, PL 93-638 tribal health centers, urban Indian health centers, and qualified community health clinics. FQHC look-alikes can also be eligible entities under  340 B. FQHC look-alikes are organizations that meet all of the eligibility requirements of an organization that receives a PHS Section  330  grant, but does not receive grant funding. 
     Other entities that may be eligible under  340 B may include, native Hawaiian health centers, Ryan White Care Act Grantees, Title X Family Planning, black lung clinics, comprehensive hemophilia diagnostic treatment centers, state or locally funded centers treating sexually transmitted diseases or tuberculosis, certain disproportionate share hospitals, and other safety-net organizations. 
     In administering the program, the federal government requires that pharmaceutical suppliers  107 , both manufacturers  108  and wholesalers  109 , sell covered medications to qualified entities  102   b  at or below a statutorily defined “ceiling price” as a condition for Medicaid participation. Covered medications may include any medication reimbursed by Medicaid, including prescription or over-the-counter medications. The  340 B price is the ceiling price, meaning it is the most that qualified entities  102   b  can be charged for medications purchased directly from manufacturers  108 . In compliance with statutes, the ceiling price may be derived from Medicaid pricing. The qualified entities  102   b  are allowed, and even encouraged, to negotiate sub-ceiling prices with drug suppliers  107 . Accordingly, the qualified entities  102   b  can realize substantial cost reductions on medications used for qualified patients  104   a  in an outpatient setting. 
     The qualified entities  102   b  may provide  340 B pharmacy access for their patients  104  through one of three methods. A first method is a clinic dispensary, or an on-site pharmacy  106  in the form of a dispensing cabinet, that utilizes a small inventory  110  of basic medications. A second method is a full-service, in-house pharmacy  106  created and operated by the qualified entity  102   b  on its premises. A third method is a contracted pharmacy  106  which is an external pharmacy under contract with the qualified entity  102   b  to provide pharmacy services and medications to the provider  102  and/or provider&#39;s patients  104 . 
     A qualified entity  102   b  may prefer to provide pharmacy services to patients by contracting with an external pharmacy. This approach allows a qualified entity  102   b  to offer to qualified patients  104   b  all of the benefits and services of a full-service pharmacy without the costs of operating a full-service in-house pharmacy. Contracting with a pharmacy can also greatly reduce the administrative burden of the qualified entity  102   b  to be able to make the  340 B discount available to patients. In exchange for participating in the covered program as its dispensing agent, a contracted pharmacy receives a dispensing fee. 
     The profits that can be realized under the  340 B program can be substantial. As noted above, the qualified entities  102   b  can freely negotiate sub-ceiling prices with drug manufacturers  108 . Often the drug manufacturers  108  and the wholesalers  109  offer the qualified entities  102   b  deeply discounted prices (or limited duration advantageous pricing). These periods of limited duration advantageous pricing may be offered to ‘blow-out’ excess inventory, among other reasons. The discounts are significant, often pennies on the dollar of regular price. These discounts are offered periodically for a relatively short duration such as one or two weeks at a time. Rather than offering the deep discounts to all consumers, the drug manufacturers  108  and wholesalers  120  may prefer to further discount prices to  340 B qualified entities  102   b.  The tight regulatory control and relative scarcity of  340 B qualified entities  102   b  offer a relatively isolated, and thus ideal, market to which the drug manufacturers  108  and wholesalers  109  can offer the deepest discounts. 
     Although the potential savings and fees to be shared are substantial, the burdens shared between the qualified entity  102   b  and the pharmacy  106  are also substantial. Moreover, additional challenges are introduced by the contract pharmacy arrangement. For example, because the  340 B program is a provider-specific medication discount program, the qualified entity  102   b  is the only organization that can legally purchase  340 B medications, and the qualified patients  104   b  of the qualified entity  102   b  are the only people who can receive those medications. Therefore, a contract pharmacy  106  must operate under a “bill-to/ship-to” arrangement, where medications are shipped by the supplier  107  directly to the pharmacy  106 , and the bill for the medications is sent to the qualified entity  102   b.  Coordinating payments from the qualified entity  102   b  to the supplier  107  to replenish inventory depleted through qualified disbursements can require significant overhead for a contracted pharmacy  106 . The contract pharmacy  106  must then ensure that only qualified patients  104   b  receive those discounted medications 
     The  340 B program further prohibits “double-dipping.” The qualified entities  102   b  cannot request  340 B prices for the same medication for which Medicaid will request a rebate in order to prevent double-dipping. A qualified entity  102   b  can receive a discount through the  340 B program, or Medicaid can receive a discount via rebate. However, both may not occur for the same dispensed medication units  114 . The administrative burden required for a contract pharmacy  106  to prevent double-dipping can be substantial. 
     The  340 B program also prohibits all forms of  340 B medication resale or diversion. A patient  104  who receives medication through a  340 B program must be a qualified patient  104   b  of a qualified entity  102   b  to help prevent diversion of  340 B program products to non-qualified patients  104   a.  Diversion under the  340 B program is the distribution of  340 B medications to non- 340 B qualified patients  104   a,  either intentionally or unintentionally. The qualified entity  102   b  may not resell or transfer a  340 B discounted drug (either directly or through a contract pharmacy  106 ) to a person who is not a qualified patient  104   b  of the qualified entity  102   b.  Preventing diversion in a pharmacy  106  that disburses medications to both non-qualified patients  104   a  and qualified patients  104   b  can create a significant administrative burden. 
     One method of inventory control a pharmacy  106  may employ to comply with  340 B regulations involves maintaining a separate physical inventory. Essentially the pharmacy  106  maintains a  340 B inventory and a regular inventory. This method can require significant shelf space and substantially doubles the administrative overhead to maintain the inventory. Maintaining a separate inventory also presents challenges in tracking which inventory is  340 B inventory and which inventory is not. Moreover, having separate  340 B inventory creates a high risk of diversion, or distributing  340 B medication to non-qualified patients  104   a.  When the regular inventory is depleted, the  340 B medication could easily be sold to a non-qualified patient  104   a,  whether intentionally or unintentionally. 
     The replenishment model, another method of inventory control, is very effective in preventing diversion and double-dipping while also providing an option for reduced costs. In one implementation, the replenishment model enables a pharmacy  106  to manage their  340 B inventory virtually while receiving  340 B replacement medication on a replenishment basis. The replenishment model provides a form of inventory control that allows a pharmacy  106  to dispense medication to  340 B covered patients  104  from its own inventory  110 , and then have that inventory  110  replenished by the qualified entity  102   b.  In effect, the pharmacy  106  “loans” the qualified entity  102   b  the medication, and the qualified entity  102   b  then orders replacement inventory for the pharmacy  106 . The present disclosure is directed to methods and systems for implementing a replenishment model of inventory control. Accordingly, more detailed explanation of replenishment generally, and two variations of replenishment, is provided in connection with  FIGS. 3-11  below. 
     In addition to the challenges of coordinating bill-to/ship-to arrangements and avoiding double-dipping and diversion, other regulatory oversight and the sheer complexity of the regulations creates significant challenges to many general-service pharmacies that may seek to support the  340 B program. The complexities of the programs and the regulations of the discount programs make computer programs and/or computer systems that facilitate participation in such discount programs desirable. 
     Computer programs and/or systems can be designed and implemented to provide the required functions in accordance with the regulations of one or more discount programs to enable pharmacies to participate in these discount programs. Typically a pharmacy  106  will have a computer or computer system  122  at the pharmacy  106 . The pharmacy  106  may further have Coordination of Benefits (COB) software. The COB software may comprise a COB module running on the pharmacy computer system  122  or a separate COB system on a separate computer and or computer system. As used herein, a COB system  124  can be either a COB module and/or a COB system. A pharmacy  106  typically utilizes the COB system  124  when a patient is covered by two different insurance carriers. The COB system  124  can determine which insurance carrier pays which portion of an amount owed. The COB system  124  can coordinate a first adjudication of a prescription to a first payer (e.g., a first insurer) and a second adjudication of the prescription to a second payer (e.g., a second insurer). The COB system  124  may also be used to manage clinical programs, such as adherence and persistence programs. 
     In one embodiment, a computer program or system to facilitate participation in one or more discount programs can be designed to interface with the existing COB system. An interface with an existing COB system can be accomplished through a software API, a hardware API, an adaptation of the existing COB system, or a plug-in for the COB system. In another embodiment, a computer system may also be configured to implement a COB system as part of providing functions to enable participation in discount programs. 
     Many COB systems use an industry standard data format, such as the National Council for Prescription Drug Programs (NCPDP) standard. The COB data structures (e.g., the NCPDP compliant data structures) may be utilized to provide pharmacy replenishment functions to support one or more qualified programs. In this way, a pharmacy may leverage its existing COB systems and/or infrastructure to support highly-complex qualified programs and avoided the diversion and “double-dipping” regulatory pitfalls associated with such programs. Although the NCPDP standard is specifically mentioned herein, there are many variations of the COB system and data structures in the art, any of which may be modified and/or adapted for use in a replenishment pharmacy system. As such, this disclosure should not be read as limited to any particular COB data structure. 
     Restocking 
       FIG. 2  is a block diagram of one embodiment of a system  200  for dispersal of medications through a pharmacy  206 . The system  200  allows for restocking and replenishment of disbursed inventory. The diagram depicted shows the interactions between participants in a restocking scenario. The pharmacy  206  disburses to patients  204  of health care providers  202 . The health care providers  202  can include both non-qualified entities  202   a  and qualified entities  202   b  and the patients  204  can include both non-qualified patients  204   a  and qualified patients  204   b.  The qualified entities  202   b  can be qualified under, and participate in, one or more qualified programs  220 . 
     In the simple restocking scenario of  FIG. 2 , the pharmacy  206  disburses medication  214  to only non-qualified patients  204   a  of health care providers  202 . When the pharmacy inventory  210  for a medication  214  drops below a minimum threshold, or when a replacement threshold has been met, the pharmacy replaces the disbursed inventory  210  by placing a restocking order. The pharmacy  206  restocks inventory  210  for the medication  214  from suppliers  207 , which can be pharmaceutical manufacturers  208  and wholesalers  209 . 
     The pharmacy  206  can have a computer system  222  to facilitate various administrative functions of the pharmacy such as inventory management, transaction processing, and adjudication. Adjudication is the term for the procedure in which a pharmacy  206  determines the co-pay or other cost to be born by a patient  204 , the process in which insurance coverage is requested on behalf of a patient  204  for purchased medication, and the determination of which insurance provider pays which portion of the amount due in cases where an insured has multiple insurers. As is well known in the art, the computer system  222  can comprise a processor (not shown), an output device (not shown) in electrical communication with the processor, and a memory (not shown) electrically coupled to the processor and output device. The memory may comprise an operating system and a plurality of applications and/or software modules. The computer system  222  may further include a COB system  224 . 
     The computer system  222  can track medication disbursements. In one embodiment, barcode or like technology can be used to track disbursements. Each medication container  212  can include a barcode or other identifier, which is disposed on the container. The barcode or other identifier may include information as to the type of medication, the corresponding NDC  216 , the amount of medication, the cost, etc. An optical scanner or other device used for scanning may be in electrical communication with the computer system  222  through any one of a number of conventional connections and/or networks, including but not limited to USB, PS2, and the Internet. 
     The computer system  222  can facilitate placement of a restocking order to replace disbursed inventory  210 . The computer system  222  can track disbursements and manage minimum thresholds and/or replacement thresholds. When inventory  210  needs to be replaced, the computer system  222  can place an order with a supplier  207 . 
     In the embodiment of  FIG. 2 , a qualified program management module (QPMM)  230  can extend the COB system  224  to facilitate participation of the pharmacy in one or more discount programs. The QPMM  230  can be configured to extend the functionality of the COB system  224  to administer the highly-regulated qualified programs. The QPMM  230  operates in parallel with the COB system  224  of the pharmacy  206 . The QPMM  230  can track medication disbursements via the pharmacy computer system  222 , including any barcode scanning equipment or other tracking system or technology. The QPMM  230  can perform inventory tracking and management functions and replenishment functions that may provide the additional benefit of reducing costs for the qualified entity  202   b,  pharmacy  206 , and/or qualified patient  204   b.  Replenishment is discussed in greater detail below with reference to  FIG. 3 . If the pharmacy  206  is a contracted pharmacy operating under a replenishment model, after the qualified entity  202   b  provides the pharmacy  206  with replacement medication, the qualified entity  202   b  recoups from the pharmacy  206  any revenues generated for the medication minus dispensing and other service fees payable to the pharmacy  206 . The larger the differential between the disbursement price of the medication and the replacement cost, the greater the savings for the qualified entity  202   b.  The QPMM  230  can coordinate recoupment of revenues, and may aid in increasing the differential to increase the savings for the qualified entity. The QPMM  230  can also be used to delay replenishment and/or restocking orders as needed. For example, a particular patient may require a very expensive medication. The pharmacy may only sell that medication to the one patient, and may not want to stock such an expensive medication until a few days before that patient is expected to re-fill the prescription. The QPMM  230  can facilitate coordinating the delayed replenishment and/or delayed restocking. 
     In another embodiment, a QPMM  230  can simply provide the functionality to administer the qualified programs, rather than extending the functionality of the COB system  224 . The QPMM  230  can interface with the computer system  222  and/or the COB system  224 . The QPMM  230  operates in parallel with the computer system  222  and/or the COB system  224  of the pharmacy  206 . The QPMM  230  can track medication dispersals by gathering tracking information from the pharmacy computer system  206 . The QPMM  230  is discussed in greater detail below with reference to  FIGS. 3-11 , with particular reference to  FIGS. 4A ,  4 B,  7 A,  7 B,  10 A and  10 B. 
     In a restocking scenario, as depicted in  FIG. 2 , the pharmacy  206  may disburse two containers  212   a  of medication  214  to non-qualified patients  204   a.  The disbursement may meet or exceed a replacement threshold, such that the computer system  222  sends a replacement order to a supplier  207  requesting two replacement containers to restock the inventory  210 . The pharmacy  206  pays the supplier for the order of replacement containers. Accordingly, the supplier sends two replacement containers  212   b  to the pharmacy  206 . The replacement containers  212   b  are received, replacing the disbursed inventory  210  and restoring the inventory levels. The system  200  achieves the desired outcome in this scenario; the pharmacy inventory levels are restored to the same number of containers  212  as were on hand prior to disbursement of the two disbursed containers  212   a.  However, in a mixed disbursement scenario, involving disbursements to both non-qualified patients  204   a  and qualified patients  204   b,  a different outcome may result. The restocking procedures of the pharmacy and the replenishment procedures under a qualified plan may interfere and/or overlap. The overlap may cause inaccurate or improper replacement of disbursed medication in a manner that leads to an excess inventory situation as described below with reference to  FIG. 3 . 
     Replenishment 
       FIG. 3  is a block diagram of the system  200  of  FIG. 2 , the diagram showing the interactions between participants in a restocking and replenishment scenario. In the replenishment and restocking scenario of  FIG. 3 , one or more qualified entities  202   b  contract with a pharmacy  206  to disburse medications to their qualified patients  204   b.  The contracted pharmacy  206  may be a retail pharmacy. Although under contract with the one or more qualified entities  202   b,  the contract pharmacy  206  may disburse medication  214  to both non-qualified patients  204   a  and qualified patients  204   b  of a variety of health care providers  202  (both non-qualified entities  202   a  and qualified entities  202   b ). As before, when the pharmacy inventory  310  for a medication  314  drops below a minimum threshold, or when a replacement threshold has been met, the pharmacy  206  replaces the disbursed inventory  210  by placing a restocking order. The computer system  222  of the pharmacy  206  can facilitate placing the restocking order, as described above with reference to  FIG. 2 . In addition, when a replenishment threshold has been met, the QPMM  230  coordinates a replenishment order. 
     In one embodiment the QPMM  230  can comprise a software module running on a separate computer, as depicted in  FIG. 3 . The separate computer can be a separate computer at the pharmacy or managing service computer in network communication with one or more pharmacy computer systems. The QPMM  230  can be in electrical communication through a network with the pharmacy computer system  222  and/or computers of the health care providers (not shown). In another embodiment, the QPMM  230  can be a software module resident on the pharmacy computer system  222 . 
     The QPMM  230  tracks the amount of dispensed medication and determines when the number of qualified disbursements reaches a replenishment threshold. In one embodiment, upon the number of qualified disbursements reaching the replenishment threshold, the QPMM  230  can coordinate replenishment by sending a replenishment order to a supplier  207  on behalf of a qualified entity  202   b.  The QPMM  230  can facilitate a “bill-to/ship-to” arrangement that enables a qualified entity  202   b  to make payment directly to the supplier  207 , in compliance with the  340 B program requirements or requirements of another qualified program  220 , while replenishment containers are shipped directly to the contracted pharmacy  206 . The supplier  207  can wait to send replenishment containers until payment is received, or immediately send the replenishment containers and await payment. On some occasions, the replenishment order and payment will be received by the supplier  207  nearly simultaneously. 
     As will be appreciated by a person of ordinary skill, the replenishment model may be complicated by the fact that various qualified programs  220  may have different regulations regarding how medications are replenished to the contracted pharmacy  206 . For example, under  340 B, replenishment medications  214  may be purchased by the qualified entity  202   b  and shipped directly from the manufacturer to the contracted pharmacy  206 . Accordingly, the QPMM  230  may be configured to support a “bill-to/ship-to” arrangement, wherein replenishment medications  214  may be ordered directly from the supplier for shipment to the contracted pharmacy  206  with payment by the qualified entity  202   b.  However, other qualified programs may not allow for this type of transaction. As such, the QPMM  230  may be configured to perform the appropriate replenishment processes according to the appropriate qualified program  220 . For example, in another embodiment, the QPMM  230  can also send to the qualified entity  202   b  payment instructions, or even a bill on behalf of the supplier  207 . In still another embodiment, the QPMM  230  can coordinate an arrangement whereby the supplier  207  sends the requested replenishment containers to the contract pharmacy  206  and then the supplier  207  bills the paying qualified entity  202   b.    
     In still another embodiment, the QPMM  230  can coordinate a replenishment order by notifying an operator through an output device (not shown). The output device may include a monitor or display running a suitable graphical user interface to thereby notify a user. Notifications can also be performed through a variety of other techniques including but not limited to email, updating a record in a database, a hardcopy print-out updating a spreadsheet, facsimile, telephone call, SMS text message, and the like. 
     The restocking and replenishment scenario, as depicted in  FIG. 3 , illustrates a challenge often encountered when a pharmacy  206  is replacing inventory disbursed to both non-qualified patients  204   a  and qualified patients  204   b.  In the scenario of  FIG. 3 , the pharmacy may disburse two containers  212   a  of medication  214  to non-qualified patients  204   a  and one container  212   c  of medication  214  to qualified patients  204   b  of qualified entities  202   b.  The total number of containers disbursed (in this case three) may exceed a replacement threshold. Accordingly, a typical computer system  222  at a pharmacy  206  sends a replacement order to a supplier  207  requesting three replacement containers to restock the inventory  210 . The pharmacy  206  pays the supplier for the order of replacement containers. Accordingly, the supplier sends three replacement containers  212   b  to the pharmacy  206 . The replacement containers  212   b  are received, the disbursed inventory  210  is replaced, restoring the inventory levels restored. 
     Meanwhile, the QPMM  230  is also monitoring disbursements of medication  214  by the pharmacy  206  and tracking qualified disbursements. As previously described, the QPMM  230  tracks the number of qualified disbursements until a replenishment threshold is met, at which point the QPMM  230  coordinates a replenishment order on behalf of one or more qualified entities  202   b  to request replenishment containers be sent to the pharmacy  206 . If the replenishment threshold in the scenario of  FIG. 3  is one container, the QPMM  230  will coordinate a replenishment order requesting that one replenishment container be sent to the pharmacy  206 . Accordingly, the supplier sends an additional container  212   d  to the pharmacy  206 . 
     The resulting outcome is different than desired because the pharmacy receives more replacement containers than are needed and an “excess inventory” situation results. A total of four replacement containers are sent to the pharmacy  206 , three restocking containers and one replenishment container. The pharmacy  206  receives the four replacement containers, which is one container more than the inventory requirements of the pharmacy  206  and one more container than actually desired. The pharmacy  206  receives an extra container that was not needed and for which it has paid a wholesale price that is likely higher than a discount price under a qualified discount program. As is evident, this outcome is undesirable. 
     The pharmacy having excess inventory (a.k.a. inventory swell) is problematic for various reasons. The excess inventory consumes space. The pharmacy  206  may not have sufficient shelf space to properly store the additional replacement container  212   d  and/or the pharmacy may not timely sell the medication units  214  in the additional replacement container  212   d  before the end of the shelf life. The excess inventory can also go “stale” (i.e. expire). If the medication units  214  remain in inventory longer than the shelf life, then under various statutes and regulations the medication units expire and must be discarded. An excess inventory situation, in which the excess inventory exceeds the available shelf space and/or the shelf life of the medication  214 , causes unnecessary and costly waste. These problems are exacerbated when a particular medication is ordered solely for a particular patient, and an excess inventory of that medication results. 
     The discrepancy between desired inventory level and actual inventory level after an excess inventory situation arises does not resolve itself without manual intervention. The computer system  222  of the pharmacy  206  will continue to restock inventory as the replacement threshold is met and the QPMM  230  will continue to coordinate replenish inventory to comply with the qualified discount programs  220 . Manual intervention is necessary to stop the pharmacy computer system  222  from placing future restocking orders. Manual intervention can be a costly administrative burden. 
     The excess inventory situation results due to the desirability of interfacing with and/or extending functionality of an existing pharmacy computer system  222  and/or COB system  224 , combined with the impracticability (or inability) of altering restocking functionality of the existing pharmacy computer system  222  and/or COB system  224 . Accordingly, a system and method that simply and efficiently facilitates interfacing with and/or extending an existing pharmacy computer system  222  and/or COB system  224  is desirable. A system utilizing a system and/or method of cached replenishment, as described below with reference to  FIG. 6  can alleviate the challenges just described. 
       FIG. 4A  is a block diagram of one embodiment of a QPMM  230  that can enable a pharmacy to implement a traditional replenishment model. The QPMM  230  can comprise a communications module  431 , a COB system integration module  432 , an adjudication module  433 , a reporting module  434 , an inventory tracking module  435 , a replacement drug selection module  436 , and a replenishment module  437 . The communications module  431  can enable the QPMM  230  to communicate with systems (e.g., computing devices and the like) of a pharmacy, a qualified entity, a supplier, and/or the like. The communications module  431  can also be configured to interact with a COB system of the pharmacy. 
     The COB system integration module  432  may be configured to extend the functionality of an existing COB system in the pharmacy. As discussed above, the COB system integration module  432  may extend and/or override one or more fields in one or more COB data structures to include information relating to a qualified entity and/or qualified program. The modified COB data structure may be used by the other components of the QPMM  230 . 
     The adjudication module  433  can inject qualified program and/or qualified entity information into a COB data structure during the pharmacy&#39;s adjudication process (e.g., as medication is dispensed to a patient). In addition, the adjudication module  433  may interact with the inventory tracking module  435  and/or replenishment module  437  to determine whether an alternative NDC medication could be used to replenish the medication dispensed to the patient. 
     The reporting module  434  can process data in the COB data structure and generate reporting information per the requirements of the qualified programs and/or qualified entities served by the QPMM  230 . As discussed above, qualified programs, such as  340 B, GPO, and/or PAP programs may impose significant reporting requirements. These reporting requirements may be used to prevent abuse of the qualified programs (e.g., via diversion and/or double-dipping). The reporting module  434  may be configurable so that its operation may be modified responsive to changes in the requirements of the regulatory schemes governing qualified programs and/or qualified entities and/or the creation of new qualified programs and/or qualified entities. 
     The inventory tracking module  435  and/or the replenishment module  437  may track the inventory that the pharmacy “loans” to various qualified entities as the pharmacy dispenses medication to the patients of the qualified entities. The inventory tracking module  435  and/or the replenishment module  437  can track the number of medication units disbursed to qualified patients of qualified entities. The inventory tracking module  435  and/or the replenishment module  437  can determine when the number of qualified disbursements reaches a replenishment threshold. The inventory tracking module  435  may be configured to schedule replenishments of medications according to the dictates of the particular qualified program and/or qualified entity being serviced. 
     The replacement drug selection module  436  can monitor the discount pricing offered by suppliers under one or more qualified discount programs. The replacement drug selection module  436  can further determine a cost effective combination of containers by which to replenish inventory of the pharmacy. For example, a particular pharmacy may have corresponding replenishment threshold of one hundred medication units. A supplier may be offering a replenishment container of one hundred medication units for a discount program price of $25. A different supplier may be offering a replenishment container of fifty medication units for a discount program price of $10. The replacement drug selection module can determine that a more cost effective replenishment order would be to purchase two replenishment containers at $20 ($10 each), as compared to purchasing one replenishment container for $25. The replacement drug selection module  436  accordingly can configure the replenishment module  437  to coordinate replenishment orders through the supplier selling the containers of fifty for $10 and configure the replenishment module  437  to order the $10 containers. 
     The replenishment module  437  coordinates a replenishment transaction with a qualified entity, a pharmacy, and a supplier. As explained previously, the replenishment module  437  may track the inventory that the pharmacy “loans” to various qualified entities as the pharmacy dispenses medication to the patients of the qualified entities. The replenishment module  437  can track the number of medication units disbursed to qualified patients of qualified entities. The replenishment module  437  can determine when the number of qualified disbursements reaches a replenishment threshold. Once the replenishment threshold is reached, the replenishment module  437  can coordinate payments by one or more qualified entities and shipment to the pharmacy by a supplier. The replenishment module  437  can comprise a qualified entity interface module  438  and a supplier interface module  439 , as discussed in greater detail below with reference to  FIG. 4B . 
     A person having ordinary skill in the art will appreciate that a QPMM  230  can be configured a variety of ways, including combining and/or integrating one or more of the modules and/or functions described above. A QPMM  230  can also comprise additional modules to perform additional functions as necessary to enable compliance with requirements of one or more qualified discount programs. Furthermore, a QPMM  230  can also comprise fewer modules and functions than described above. 
     As can also be appreciated, the QPMM  230  runs on a computer comprising a processor and a memory, including any of the memory embodiments discussed above. The memory may include an operating system and a memory comprising the modules of the QPMM  230  as previously discussed. 
     The QPMM  230  may be in electrical communication with health care provider computers and a pharmacy computer  222  (depicted in  FIG. 3 ) through a network. In one embodiment, upon reaching the replenishment threshold, the QPMM  230  may notify a user through an output device. The output device may include a monitor or display running a suitable graphical user interface to thereby notify a user. Notification may also be performed through a variety of other techniques including email, updating a record in a database, hardcopy print-out, updating a spreadsheet, and the like. 
     The QPMM  230  may be in electrical communication through a network, or another network, with a computer at a supplier. When a replenishment threshold corresponding to an NDC is reached, the QPMM  230  may notify the supplier computer and place an order for a replacement container. The replacement container typically comprises the same number of medication units. In this manner, disbursed medication units are replaced expeditiously. 
     The QPMM  230  may notify a health care provider computer of when a prescription is received at the participating pharmacy, when the prescription is filled, and the medication unit that is dispensed. A health care provider  202  is thereby informed of the status of prescriptions provided to its patients  204 . If desired, the health care provider  202  may also be informed as to the replenishment of inventory  210  disbursed through qualified disbursements. As disclosed herein, the system  200  is able to ensure compliance with the  340 B program. 
     The QPMM  230  may further maintain an account corresponding to the NDC and the individual health care providers. The account may include information regarding the dispersal of the medication units, a charge associated with the dispersal of each medication unit, orders for replacement containers corresponding to the NDC, and the charge associated with the dispersal of each replacement container. The QPMM  230  may determine each health care provider&#39;s share of cost for the replacement container. As can be appreciated, calculating share of cost may be determined in a variety of ways but typically is proportional to the number of medication units prescribed by each health care provider. The QPMM  230  may further generate an invoice for each health care provider  302  to convey the share of cost. The invoice may be communicated to each health care provider over the network. 
       FIG. 4B  is a block diagram of one embodiment of a replenishment module  437  configured to implement a traditional replenishment model. The replenishment module  437  can include a qualified entity interface module  438  and a supplier interface module  439 . The qualified entity interface module  438  can coordinate payments from qualified entities to suppliers for replenishment orders. The qualified entity interface module  438  can be configured to coordinate such payments in a variety of prescribed methods as may be necessary to comply with the requirements of one or more qualified discount programs. Moreover, the qualified entity interface module  438  can be configured to coordinate payments from qualified entities in a variety of prescribed methods as may be necessary to interface with the protocols and methods of a variety of qualified entities, since these protocols and methods may vary from among qualified entities. For example, some qualified entities may receive electronic communications providing replenishment order information and payment instructions, whereas other qualified entities may require receipt of a hard copy document before payments will be processed. 
     The supplier interface module  439  can coordinate replenishment orders from suppliers. The supplier interface module  439  can be configured to place replenishment orders in a variety of prescribed methods as may be necessary to comply with the requirements of one or more qualified discount programs. Moreover, the supplier interface module  439  can be configured to place replenishment orders in a variety of methods as may be necessary to interface with the protocols and methods of a variety of suppliers, since these protocols and methods may vary among suppliers. For example, some suppliers may receive electronic communications that include a replenishment order, whereas other qualified entities may require receipt of a hard copy document before a replenishment order will be processed. 
       FIG. 5  is a flow diagram of one embodiment of a method  500  for replenishment of pharmaceuticals. A patient served and/or covered by a qualified entity may present a prescription to the pharmacy. The pharmacy receives  510  the prescription and begins processing the prescription. The pharmacy may adjudicate  512  the prescription. The adjudication may be accomplished by a computer system at the pharmacy. The computer system at the pharmacy may further comprise a COB system. The adjudication  512  may comprise providing the medication to the patient, determining the patient&#39;s portion of the cost of the medication (e.g., the co-pay), determining an insurer&#39;s portion of the cost, or the like. 
     During the adjudication  512 , information relating to the adjudication may be gathered and stored in a COB data structure and/or COB system of the pharmacy. Such information may relate to the qualified entity that provides coverage and/or care to the patient, and/or the qualified program used by the qualified entity to obtain discounted medications. Information identifying the patient&#39;s qualified entity and/or qualified program may also be obtained and stored in a COB data structure. The qualified program-related information can be used to adjudicate the prescription transaction (e.g., determine the co-pay or other cost to be borne by the patient and/or the qualified entity covering the patient), to generate reporting information required by the qualified program, to perform inventory management, and manage payment in accordance with policies and procedures of the qualified program. 
     Disbursements of medication are monitored  514 . A QPMM can monitor the disbursements of medication to qualified and/or non-qualified patients. Monitoring can occur by interfacing with the computer system at the pharmacy and/or the COB system on the computer system. Interfacing with the COB system can be accomplished directly and/or by accessing one or more COB data structures. When monitoring the disbursements, the number of qualified disbursements can be tracked  516 . When a qualified disbursement occurs, the method  500  can determine  518  whether replenishment is needed. Replenishment under a given qualified plan may be dictated by the regulations of the qualified program and/or qualified entity; replenishment may be required after a certain amount of medication has been “loaned” to the qualified entity by the pharmacy and/or the inventory of the medication loaned by the pharmacy has been depleted to a threshold level. The method can determine whether the number of qualified disbursements has reached or exceeded a replenishment threshold. If replenishment is not needed, then the method can end. 
     If the method  500  determines that replenishment is needed, the method may determine  520  whether a lower cost alternative medication is available in place of the medication dispensed to the patient at step  512 . As discussed above, in some cases, an equivalent medication may be available from an alternative supplier (e.g., manufacturer or wholesaler) for a lower price. Available equivalent medications may be identified using the NDC of the medication dispensed at step  512 . The medication may be equivalent, or even identical, and simply the quantity in the container may be different. The nature of the qualified entity and/or the qualified program may determine whether a particular discounted medication is available. If an acceptable lower-cost alternative is found, the new replenishment information, including the alternative NDC and supplier information, may be recorded  522 . The recorded information can also be stored  524  in a COB data structure. The stored information can include information relating to the qualified entity, qualified program, and/or alternative replenishment NDC may be stored in the pharmacy&#39;s COB system. As discussed above, the COB system of a pharmacy may be extended to allow for the storage of data relating to qualified programs, entities, and the like. In this way, the existing infrastructure of the pharmacy may be leveraged to provide for replenishment support and/or management of qualified entities and their patients. 
     Method  500  may use the replenishment information that is accessed, whether original information or new information, to coordinate the payment and shipping functions of replenishment and to replenish the medication according to the regulations of the particular qualified program and/or qualified entity identified in the COB data structure. If a “bill-to/ship-to” arrangement is allowed by the qualified program and/or qualified entity, the method  500  may dispatch an order for replenishment medication to a supplier to be shipped to the pharmacy. The billing for the order may be sent to the qualified entity. As discussed above, in some cases the medication may be replenished from a different supplier to take advantage of periodic discounts available to the qualified entity and/or qualified program. 
     The replenishment information that is accessed  526  by the method  500  can include, but is not limited to, information about the qualified entity, the qualified plan, the NDC, and the supplier. The replenishment information is used to coordinate replenishment. The replenishment information can be accessed  526  from the COB data structure. In an alternative embodiment, the replenishment information can be accessed from data in the memory of the pharmacy computer system and/or COB system. 
     The replenishment information that is accessed  526  can be used by the method  500  to coordinate  528  payment for the replenishment order by the qualified entity. The replenishment information can include, but is not limited to, contact information for the qualified entity, preferred and/or accepted forms of communication with the qualified entity, and protocols and procedures followed by (or for interfacing with) the qualified entity. The replenishment information can further include pricing and quantity information, as well as qualified plan information. Coordination of payment may include electronic communication and/or hard copy communication to the qualified entity. The communication can outline instructions and terms for payment to the supplier. In another embodiment, the communication to the qualified entity can be an invoice sent on behalf of the supplier containing information regarding the shipment of the replenishment order. In another embodiment, coordination of payment may comprise providing the supplier with information as to how to directly bill the qualified entity for a replenishment shipment to a pharmacy. 
     The replenishment information can also be used by the method  500  to coordinate  530  shipment of the replenishment medication to the pharmacy. The replenishment information can include, but is not limited to contact information for the supplier, protocols and forms of communication accepted by the supplier, the pharmacy shipping address, preferred and/or accepted forms of shipment, preferred and/or accepted forms of communication with the pharmacy, protocols and procedures for interfacing with the pharmacy, and quantity and packaging information. Coordination of shipment of replenishment medication may include electronic communication and/or hard copy communication to a supplier providing shipping instructions. In another embodiment, the communication to the supplier can include instructions and information for the supplier to directly bill the qualified entity for a replenishment shipment. 
     After payment and shipment are coordinated, the method  500  can determine  532  whether reporting is necessary and/or appropriate under the qualified discount plan under which the medications were disbursed. The nature and timing of the reporting may vary depending on the particular qualified program and/or qualified entity serviced by method  500 . If reporting is required, the method  500  can perform reporting  534  according to the requirements of the applicable qualified discount plan. If no reporting is necessary, the flow of the method  500  can continue. Performing reporting may further comprise accessing the pharmacy COB data, and filtering the data to extract any data relating to a particular qualified program and/or qualified entity. The filtered data may be used to generate one or more reports for the pharmacy, qualified entity, and/or qualified program. The reporting data may indicate the amount and nature of medication distributed to qualified entity patients, any replenishment actions taken, and the like. In alternative embodiments, access and filtering may be performed on a continual basis (e.g., as prescriptions are adjudicated), regardless of reporting. 
     The method  500  can also determine  536  whether the qualified provider should be reimbursed by the pharmacy for the difference between the disbursement price of the medication and the replenishment cost paid (minus any overhead and service fees charged by the pharmacy). Of course, the reimbursement  536  may be omitted if the replenishment coordination at steps  528  and  530  does not require reimbursement and/or reimbursement is prohibited by the qualified program and/or qualified entity. 
     A QPMM interfacing with a computer system and/or a COB system at the pharmacy can perform much, or all, of the method. The QPMM can monitor  514  disbursements of medication, track  516  qualified disbursements, determine  518  whether replenishment is needed, and/or access  526  replenishment information to coordinate completion of replenishment. The QPMM can coordinate completion of replenishment by coordinating payment  528 , coordinating shipment  530 , performing reporting  534 , and/or reimbursing a qualified entity  538 . The QPMM can also, where possible, identify  520  any alternative replenishment medication, and modify  522  and store  524  new replenishment information for the identified alternative medication. 
     Cached Replenishment 
     As explained previously, traditional replenishment can result in an excess inventory situation when a pharmacy is disbursing medication to both qualified patients and non-qualified patients. As previously explained, an excess inventory situation can arise when an existing computer system of a pharmacy places restocking orders for all disbursed inventory, while at the same time a QPMM coordinates replenishment orders for the medications disbursed under a qualified discount plan. The creation of an excess inventory situation is undesirable because of the administrative burden and/or potential for wasted time and resources. Moreover, creating software to modify functioning of an existing pharmacy computer system and/or COB system is challenging due to variations among existing systems and/or CPB modules. Accordingly, a system and method that simply and efficiently facilitates interfacing with and/or extending an existing pharmacy computer system and/or COB system is desirable. A system utilizing a system and/or method of cached replenishment can reduce or even eliminate excess inventory situations and can enable simple and efficient interfacing with and/or extension of the functionality of an existing pharmacy computer system. 
       FIG. 6  is a block diagram of another embodiment of a system  600  for dispersal of medications through a pharmacy  206 . The system  600  enables restocking and cached replenishment of disbursed inventory. The diagram depicts the interactions between participants in a restocking and a cached replenishment scenario. The system  600  comprises a QPMM  630  that includes a system and/or method of cached replenishment. As before, the pharmacy  206  disburses to patients  204  of health care providers  202 . The health care providers  202  can include both non-qualified entities  202   a  and qualified entities  202   b  and the patients  204  can include both non-qualified patients  204   a  and qualified patients  204   b.  The qualified entities  202   b  can be qualified under, and participate in, one or more qualified programs  220 . 
     In a cached replenishment and restocking scenario, as depicted in  FIG. 6 , the pharmacy  206  disburses medication  214  to both non-qualified patients  204   a  and qualified patients  204   b  of health care providers  202 , similar to the scenario of  FIG. 3 . As before, when the pharmacy inventory  210  for a medication  214  drops below a minimum threshold, or when a replacement threshold has been met, the pharmacy  206  replaces the disbursed inventory  210  by placing a restocking order. The computer system  222  of the pharmacy  206  can facilitate placing the restocking order. In addition, when a replenishment threshold has been met, the QPMM  630  can coordinate a cached replenishment order. 
     The QPMM  630  can be in electrical communication through a network with the pharmacy computer system  222  and/or computers of the health care providers (not shown). The QPMM  630  tracks the amount of dispensed medication and determines when the number qualified disbursements reach a replenishment threshold. Upon the number of qualified dispersals reaching the replenishment threshold, the QPMM  630  coordinates a cached replenishment order by sending a cached replenishment order to a supplier  20 . 
     The cached replenishment order generates a replenishment purchase, but delays shipment of the ordered replenishment medication until the pharmacy places a restocking order with the supplier. The qualified entity  202   b  pays the supplier  207  the price of the replenishment container under the qualified discount program. However, rather than the supplier  207  immediately shipping the replenishment container to the pharmacy  206 , the supplier  207  holds shipment of the replenishment container until a restocking order for the pharmacy  206  is received from the pharmacy  206  or from the QPMM  630 . The replenishment purchase is a purchase of a cached replenishment container. Accordingly the supplier  207  may reserve, or set aside, for the pharmacy  206  a container  212  of medication  214 . The manufacturer may virtually set aside the cached replenishment container  212 . In another embodiment, the manufacturer may physically set aside the cached replenishment container  212 . When a restocking order is received by the supplier  207  from the pharmacy  206 , the total number of restocking containers ordered is reduced by the number of cached replenishment containers reserved to the pharmacy  206 . Then the remaining number of restocking containers and the cached replenishment containers are all shipped to the pharmacy  206 . 
     As portrayed in  FIG. 6 , the pharmacy  206  may disburse one container  212   c  of medication units  214  to a qualified patient  204   b.  The QPMM  630  monitors the disbursements of medication units  214  by the pharmacy  206  and tracks the number of qualified disbursements. When the number of qualified disbursements reaches a replenishment threshold the QPMM  630  coordinates a cached replenishment order on behalf of one or more qualified entities  202   b  to purchase a cached replenishment container for the pharmacy  206 . 
     If the replenishment threshold in the scenario of  FIG. 6  is one container, the QPMM  630  will coordinate a cached replenishment order requesting a cached replenishment container and delayed shipment to the pharmacy  206 . The one or more qualified entities  202   b  pay the discount price under the appropriate qualified discount program  220  for the cached replenishment container. The supplier  207  receives the cached replenishment order and receives payment from the qualified entities  202   b.  A cached replenishment container is reserved for the pharmacy. The supplier  207  does not ship any replenishment containers until a restocking order is received from the pharmacy  206 . 
     Subsequently, in the scenario of  FIG. 6 , the pharmacy  206  may disburse two containers  212   a  of medication  214  to non-qualified patients  204   a.  The total number of containers  212  disbursed, three in this case, may also exceed a replacement threshold, or reduce the pharmacy inventory  210  for the medication  214  below a minimum threshold. When this happens, typically a computer system  222  at a pharmacy  206  sends a replacement order to a supplier  207  requesting three replacement containers to restock the inventory  210 . A pharmacy computer system  222  typically does not track qualified disbursements separately from regular disbursements, as described above. Accordingly, the computer system  222  seeks to replace all disbursed inventory, and thus orders three containers, the total number of containers disbursed by the pharmacy  206 . 
     The supplier  207  receives the restocking order from the pharmacy  206  and recognizes the cached replenishment container reserved for the pharmacy  206 . Accordingly, one replacement container is subtracted from the total number of containers ordered in the restocking order, reducing the restocking order to two containers. The supplier  207  sends the pharmacy  206  a bill for two replacement containers and the pharmacy  206  pays the supplier  207  for only the two containers. The supplier  207  then sends the pharmacy  206  two restocking containers  212   b  for the restocking order and one cached replenishment container  212   d.  A total of three replacement containers are sent from the supplier. The replacement containers  212   b  d are received, the disbursed inventory  210  is replaced and the inventory levels are restored. 
     The desired outcome is achieved under the cached replenishment scenario. The pharmacy  206  disbursed three total containers (two to non-qualified patients  212   a  and one to qualified patients  212   b ), and received three replacement containers. The pharmacy  206  pays the wholesale price for replacement containers for medication disbursed to non-qualified patients and the qualified program discount price for replacement containers for medication disbursed to qualified patients. Moreover, an excess inventory situation is avoided. Finally, the result is accomplished without modification to the normal functioning of a computer system  222 , or a COB system  224  running thereon, that is already in use at a pharmacy  206 . 
     As can be appreciated, coordinating delayed shipment of a cached replenishment container can be accomplished a variety of ways. For example, a physical container  212  may be purchased on behalf of the pharmacy. Shipment of this container (“cached replenishment container”) however, is delayed until a restocking order is received from the pharmacy or QPMM. The supplier  207  reserves, or sets aside, a cached replenishment container  212  until a restocking order is received for that medication  214 . When the restocking order is received, the supplier subtracts the total number of containers  212  ordered by the total number of replenishment containers  212  reserved, or set aside, for the pharmacy  206 . The cached replenishment containers are then sent to the pharmacy along with any additional replacement containers. 
     In another embodiment, a computer system at the supplier may track a cached replenishment container as a special type of credit. The computer system creates (or indicates to the supplier to create) a cached replenishment credit to the pharmacy  206 . The cached replenishment credit is for a replenishment container of medication credited to the pharmacy  206 . Rather than crediting a dollar amount, the cached replenishment credit is for a replenishment container. 
     The QPMM  630  can coordinate a cached replenishment with a supplier  207  in a variety of ways. The QPMM  630  can generate a hardcopy (e.g. paper) cached replenishment request that is sent to the supplier  207 . In another embodiment, the QPMM  630  generates an electronic request that is communicated to a computer system (not shown) of a supplier  207 . The computer system of the supplier  207  can process the electronic request automatically. In still another embodiment, the QPMM  630  has permission to access a database of the supplier  207 , and the QPMM  630  can generate a delayed shipment of a cached replenishment container to a pharmacy by directly manipulating data in the supplier database. In still another embodiment, the QPMM  630  can coordinate a cached replenishment order by notifying an operator through an output device (not shown). The output device may include a monitor or display running a suitable graphical user interface to thereby notify a user. Notifications can also be performed through a variety of other techniques including but not limited to email, updating a record in a database, a hardcopy print-out updating a spreadsheet, facsimile, telephone call, SMS text message, and the like. 
     The QPMM  630  can coordinate a cached replenishment with a qualified entity  204   b  in much the same way as coordinating a typical replenishment. The QPMM  630  can send to the qualified entity  202   b  payment instructions. In still another embodiment, the QPMM  630  can coordinate a cached replenishment entirely through a qualified entity  202   b  by providing the qualified entity  202   b  with payment instructions, as well as information to send with payment to the supplier  207  to request delayed shipment of a cached replenishment container to the appropriate pharmacy  206  in exchange for the payment. 
       FIG. 7A  is a block diagram of one embodiment of a QPMM  630  that can enable a pharmacy to implement a cached replenishment model. The QPMM  630  can comprise a communications module  731 , a COB system integration module  732 , an adjudication module  733 , a reporting module  734 , an inventory tracking module  735 , a replacement drug selection module  736 , and a cached replenishment module  737 . The communications module  731 , the COB system integration module  732 , the adjudication module  733 , the reporting module  734 , the inventory tracking module  735 , and the replacement drug selection module  736  can each operate similar to the corresponding modules of the QPMM  230  as described above with reference to  FIG. 4A . The cached replenishment module  737  enables implementation of a cached replenishment model. 
     The cached replenishment module  737  coordinates a cached replenishment transaction with a qualified entity, a pharmacy, and a supplier. The cached replenishment module  737  may track the inventory that the pharmacy “loans” to various qualified entities as the pharmacy dispenses medication to the patients of the qualified entities. Described differently, the cached replenishment module  737  can track the number of medication units disbursed to qualified patients of qualified entities. The cached replenishment module  737  can also determine when the number of qualified disbursements reaches a replenishment threshold. In another embodiment, the cached replenishment module gathers and/or receives disbursement monitoring and tracking information from the communications module  731  and/or the inventory tracking module  735 . 
     Once the replenishment threshold is reached, the cached replenishment module  737  can coordinate a cached replenishment by coordinating payments by one or more qualified entities to a supplier to purchase a delayed shipment of a cached replenishment to the pharmacy. The supplier recognizes and reserves a cached replenishment container for the pharmacy and delays shipment of the container to the pharmacy until a restocking order is received. When a restocking order for the medication is received from the pharmacy, the replenishment container is shipped to the pharmacy. The supplier can deduct the number of cached replenishment containers from the total number of containers of medication ordered by the pharmacy and ship the remaining number of containers as restocking containers. The supplier can then bill the pharmacy for only the number of restocking containers shipped. Accordingly, the total number of containers shipped is equal to the total number of containers disbursed and the pharmacy is billed for only the restocking containers, and not for the replenishment containers. In this manner, an excess inventory situation is avoided and a desired result is achieved. 
     In another embodiment, the cached replenishment module coordinates a cached replenishment by coordinating generation of a cached replenishment credit. The cached replenishment credit can be a special type of credit for a replenishment container rather than for a paid amount. Accordingly, the supplier will offset a future restocking order by a container rather than by a paid dollar amount. In still another embodiment an actual physical container is purchased on behalf of the pharmacy and set aside. 
       FIG. 7B  is a block diagram of one embodiment of a replenishment module  737  configured to implement a cached replenishment model. The cached replenishment module  737  can include a qualified entity interface module  738  and a supplier interface module  739 . The qualified entity interface module  738  can coordinate payments from qualified entities to suppliers for replenishment orders. The qualified entity interface module  738  can be configured to coordinate such payments in a variety of prescribed methods as may be necessary to comply with the requirements of one or more qualified discount programs. Moreover, the qualified entity interface module  738  can be configured to coordinate payments in a variety of methods as may be necessary to interface with the protocols and methods of a variety of qualified entities, since these protocols and methods may vary from among qualified entities. For example, some qualified entities may receive electronic communications providing cached replenishment order information and payment instructions, whereas other qualified entities may require receipt of a hard copy document before payments will be processed. 
     The supplier interface module  739  can coordinate cached replenishment orders with suppliers. The supplier interface module  739  can be configured to place cached replenishment orders in a variety of prescribed methods as may be necessary to comply with the requirements of one or more qualified discount programs. Moreover, the supplier interface module  739  can be configured to place cached replenishment orders in a variety of methods as may be necessary to interface with the protocols and methods of a variety of suppliers, since these protocols and methods may vary from among suppliers. For example, some suppliers may receive electronic communications that include a cached replenishment order, whereas other qualified entities may require receipt of a hard copy document before a cached replenishment order will be processed. Still other suppliers may allow a QPMM to directly access the a computer system and/or database at the supplier. The QPMM can manipulate the data in the computer system and/or database at the supplier to reflect a cached replenishment credit. 
       FIG. 8  is a flow diagram of one embodiment of a method  800  for cached replenishment of pharmaceuticals. A patient served and/or covered by a qualified entity may present a prescription to the pharmacy. The pharmacy receives  810  the prescription and begins processing the prescription. The pharmacy may adjudicate  812  the prescription. The adjudication may be accomplished by a computer system at the pharmacy. The computer system at the pharmacy may further comprise a COB system. The adjudication  812  may comprise providing the medication to the patient, determining the patient&#39;s portion of the cost of the medication (e.g., the co-pay), determining an insurer&#39;s portion of the cost, or the like. During the adjudication  812 , information relating to the adjudication may be gathered and stored in a COB data structure and/or COB system of the pharmacy. Such information may relate to the qualified entity that provides coverage and/or care to the patient, and/or the qualified program used by the qualified entity to obtain discounted medications. Information identifying the patient&#39;s qualified entity and/or qualified program may also be obtained and stored in a COB data structure. 
     Disbursements of medication are monitored  814 . A QPMM can monitor the disbursements of medication to qualified and/or non-qualified patients. Monitoring can occur by interfacing with the computer system at the pharmacy and/or the COB system. Interfacing with the COB system can be accomplished directly and/or by accessing one or more COB data structures. When monitoring the disbursements, the number of qualified disbursements can be tracked  816 . When a qualified disbursement occurs, the method  800  can determine  818  whether a replenishment is needed. Replenishment under a given qualified plan may be dictated by the regulations of the qualified program and/or qualified entity; replenishment may be required after a certain amount of medication has been “loaned” to the qualified entity by the pharmacy and/or the inventory of the medication loaned by the pharmacy has been depleted to a threshold level. The method can determine whether the number of qualified disbursements has reached or exceeded a replenishment threshold. If replenishment is not needed, then the method can end. 
     If the method  800  determines that replenishment is needed, the method may optionally determine  820  whether a lower cost alternative medication is available in place of the medication dispensed to the patient at step  812 . As discussed above, in some cases, an equivalent medication may be available from an alternative supplier (e.g., manufacturer or wholesaler) for a lower price. Available equivalent medications may be identified using the NDC of the medication dispensed at step  812 . The medication may be equivalent, or even identical, and simply the quantity in the container may be different. The nature of the qualified entity and/or the qualified program may determine whether a particular discounted medication is available. If an acceptable lower-cost alternative is found, the new replenishment information, including the alternative NDC and supplier information, may be recorded  822 . The recorded information can also be stored  824  in a COB data structure. The stored information may be stored in the pharmacy&#39;s COB system and can include information relating to the qualified entity, qualified program, and/or alternative replenishment NDC. 
     Method  800  may use the replenishment information that is accessed, whether original information or new information, to coordinate cached replenishment within the requirements and regulations of the particular qualified program and/or qualified entity identified in the COB data structure. The replenishment information can include, but is not limited to, information about the qualified entity, the qualified plan, the NDC, and the supplier. The replenishment information is used to coordinate cached replenishment, including purchase of a cached replenishment container and delayed shipment of such container to the pharmacy. The replenishment information can be accessed  826  from the COB data structure. In an alternative embodiment, the replenishment information can be accessed  826  from data in the memory of the pharmacy computer system and/or COB system. 
     The replenishment information can be used by the method  800  to coordinate  828  payment for the cached replenishment order by the qualified entity. The replenishment information can include, but is not limited to, contact information for the qualified entity, preferred and/or accepted forms of communication with the qualified entity, and protocols and procedures followed by (or for interfacing with) the qualified entity. The replenishment information can further include pricing and quantity information, as well as qualified plan information. Coordination of payment may include electronic communication and/or hard copy communication to the qualified entity. The communication can outline instructions and terms for payment to the supplier. In another embodiment, the communication to the qualified entity can be an invoice sent on behalf of the supplier containing information regarding the shipment of the replenishment order. In another embodiment, coordination of payment may comprise providing the supplier with information as to how to directly bill the qualified entity for a replenishment shipment to a pharmacy. 
     The replenishment information can also be used by the method  800  to coordinate  830  delayed shipment of the replenishment container to the pharmacy. The shipment from the supplier to the pharmacy is delayed until such time as the pharmacy places are restocking order with the supplier for the same medication. As can be appreciated, the delayed shipping can be accomplished a variety of ways, including but not limited to a request to hold shipment, instructions regarding delay of shipment, instructions to delay filling the cached replenishment order, generation of a special type of credit for a cached replenishment container, and reserving a physical container for later shipment. 
     The replenishment information can include, but is not limited to contact information for the supplier, protocols and forms of communication accepted by the supplier, the pharmacy shipping address, preferred and/or accepted forms of shipment, preferred and/or accepted forms of communication with the pharmacy, protocols and procedures for interfacing with the pharmacy, and quantity and packaging information. Coordination of shipment of replenishment medication may include electronic communication and/or hard copy communication to a supplier providing shipping instructions. In another embodiment, the communication to the supplier can include instructions and information for the supplier to directly bill the qualified entity for a replenishment shipment. 
     After payment and delayed shipment are coordinated, the method  800  can determine  832  whether reporting is necessary and/or appropriate under the qualified discount plan under which the medications were disbursed. The nature and timing of the reporting may vary depending on the particular qualified program and/or qualified entity serviced by the method  800 . If reporting is required, the method  800  can perform reporting  834  according to the requirements of the applicable qualified discount plan. If no reporting is necessary, the flow of the method  800  can continue. Performing reporting may further comprise accessing the pharmacy COB data, and filtering the data to extract any data relating to a particular qualified program and/or qualified entity. The filtered data may be used to generate one or more reports for the pharmacy, qualified entity, and/or qualified program. The reporting data may indicate the amount and nature of medication distributed to qualified entity patients, any replenishment actions taken, and the like. In alternative embodiments, access and filtering may be performed on a continual basis (e.g., as prescriptions are adjudicated), regardless of reporting. 
     The method  800  can also optionally determine  836  whether the qualified provider should be reimbursed by the pharmacy for the difference between the disbursement price of the medication, and the replenishment cost paid (minus any overhead and service fees charged by the pharmacy). Of course, the reimbursement  836  may be omitted if the cached replenishment coordination at steps  828  and  830  does not require reimbursement and/or reimbursement is prohibited by the qualified program and/or qualified entity. 
     A QPMM interfacing with a computer system and/or a COB system at the pharmacy can perform much, or all, of the method  500 . The QPMM can monitor  814  disbursements of medication, track  816  qualified disbursements, determine  818  whether replenishment is needed, and/or access  826  replenishment information to coordinate completion of a cached replenishment. The QPMM can coordinate completion of a cached replenishment by coordinating payment  828  for a cached replenishment container and coordinating delayed shipment  830  of the cached replenishment container. The QPMM can also perform reporting  834 , and/or reimbursing a qualified entity  838 . The QPMM can also, where possible, identify  820  any alternative replenishment medication, and modify  822  and store  824  new replenishment information for the identified alternative medication. 
     Prepurchased Replenishment 
     Some suppliers may offer advantageous discount pricing, which can be even lower than qualified discount plan pricing. A prepurchased replenishment model can enable a health care provider, a pharmacy, and/or a patient to enjoy greater cost savings by more fully taking advantage of advantageous discount pricing. 
     Advantageous discount pricing is typically offered only at certain times (e.g. at the end of the quarter, end of the month, etc.) and typically for a relatively short duration, such as one or two weeks at a time. These periods of limited duration advantageous pricing may be offered to ‘blow-out’ excess inventory, among other reasons. The discounts can be significant; often a fraction of the regular price, and often lower than even qualified discount plan prices. The replenishment functionality of a QPMM may be configured to identify such discounts and take advantage of them when they are available and when permitted by the regulations of a qualified program. 
     When an advantageous pricing situation is identified, replenishment containers are purchased by qualified entities based on predicted and/or forecasted future needs of a corresponding contracted pharmacy. The replenishment containers are ‘prepurchased’ in that shipment of the replenishment containers does not take place at the time of purchase, but rather shipment of the replenishment containers is delayed until a replenishment threshold for the medication is reached at the pharmacy and actual replenishment is necessary to restore inventory levels. 
       FIG. 9  is a block diagram of another embodiment a system  900  for dispersal of medications through a pharmacy  206 . The system  900  enables restocking and prepurchased replenishment of disbursed inventory. The diagram portrays the interactions between participants in a prepurchased replenishment scenario. The system  900  comprises a QPMM  930  that includes a system and/or method of prepurchased replenishment. As before, the pharmacy  206  disburses to patients  204  of health care providers  202 . The health care providers  202  can include both non-qualified entities  202   a  and qualified entities  202   b  and the patients  204  can include both non-qualified patients  204   a  and qualified patients  204   b.  The qualified entities  202   b  can be qualified under, and participate in, one or more qualified programs  220 . 
     In a prepurchased replenishment scenario, as portrayed in  FIG. 9 , the pharmacy  206  stocks a medication  214  for disbursement to non-qualified patients  204   a  and qualified patients  204   b.  The QPMM  930  monitors disbursements and tracks qualified disbursements. As part of tracking qualified disbursements, the QPMM  930  may determine anticipated replenishment needs. For example, the pharmacy in the scenario of  FIG. 9  may expect to disburse two hundred units of the medication  214  to qualified patients  204   b  during a given time period (e.g. a month, six weeks, a quarter). The QPMM  930  can forecast or calculate an estimated replenishment need for the period that roughly approximates the expected disbursements of the medication  214 . Accordingly, in the scenario of  FIG. 9  the QPMM  930  may forecast a replenishment need of two hundred units of the medication  214 . 
     The QPMM  930  also identifies advantageous pricing situations for medications the pharmacy distributes and/or equivalents of those medications. When the QPMM  930  identifies an advantageous pricing situation for a medication  214 , the QPMM  930  coordinates a prepurchased replenishment transaction. The QPMM  930  coordinates a prepurchased replenishment by coordinating a purchase of replenishment containers  212  and ensuring that shipment of the replenishment containers  212  is delayed until replenishment is needed to replace inventory of the pharmacy that is disbursed as qualified disbursements. The number of replenishment containers  212  purchased is based on the forecasted need for a period. The prepurchased replenishment purchase is coordinated by arranging for payment from one or more qualified entities  202   b  and delayed shipment of the purchased replenishment containers from the supplier  207  to the pharmacy  206 . 
     For the scenario of  FIG. 9 , the QPMM  930  may identify an advantageous pricing scenario in which containers of one hundred units of medication  214  are advantageously priced. Accordingly, the QPMM  930  can coordinate a prepurchased replenishment transaction in which two containers of one hundred are pre-purchased. The two containers of one hundred are purchased to cover the forecasted need of two hundred units to disburse as qualified disbursements during a given period of time. The two containers are not shipped at the time of the purchase. Rather, shipment is delayed until replenishment is needed to restore inventory levels due to qualified disbursements. 
     At some time after the prepurchased replenishment transaction, the pharmacy  206  may make qualified disbursements. For sake of illustration, consider if the actual need exceeds the forecasted need in the scenario of  FIG. 9 . Rather than only two hundred medication units  214  being disbursed as qualified disbursements, three hundred medication units  214  are disbursed as qualified disbursements to qualified patients  204   b.  Three containers  212   c  of one hundred medication units  214  can be disbursed. 
     In the scenario of  FIG. 9 , a replenishment threshold of two hundred medication units  214  may be established. Accordingly, when three hundred medication units  214  are disbursed as qualified disbursements, the replenishment threshold is reached and replenishment is needed to restore pharmacy inventory levels. The QPMM  930  can coordinate a replenishment order. 
     When the supplier  207  receives the replenishment order, the number of prepurchased replenishment containers that were pre-purchased, up to but not exceeding the total number of replenishment containers ordered, are then shipped to the pharmacy  206 . Consider when two replenishment containers are pre-purchased consistent with prepurchased replenishment, as in the scenario of  FIG. 9 . If a replenishment order were to request only one container, one of the prepurchased replenishment containers is shipped as a replenishment container  212   d.  The qualified entity has pre-purchased the container at the advantageous pricing, and thus no payments are necessary for the replenishment order. In this manner, the qualified entity and/or pharmacy are able to more fully take advantage of discount pricing. For a subsequent order of one container, the second prepurchased replenishment container is shipped as replenishment container  212   d,  and again the qualified entity need pay nothing because the prepurchased replenishment container was pre-purchased. 
     For a replenishment order that exceeds the number of prepurchased replenishment containers that have been pre-purchased, the number of pre-purchased containers is subtracted from the total number of replenishment containers ordered. The qualified entity pays for additional replenishment containers to make up the difference. These additional replenishment containers are purchased at regular qualified discount pricing rather than advantageous pricing. All of the prepurchased replenishment containers are shipped as well as the additional replenishment containers purchased. 
     Turning again to the scenario of  FIG. 9 , the three hundred medication units  214  disbursed as qualified disbursements can be replenished by three replenishment containers of one hundred medication units. A replenishment order of three containers exceeds the two prepurchased replenishment containers that were pre-purchased. Accordingly, both of the prepurchased replenishment containers are shipped to the pharmacy as replenishment containers  212   d.  One additional replenishment container is shipped  212   e  to cover the total replenishment order. The QPMM coordinates the replenishment transaction for the additional replenishment container  212   e.  The qualified entity  202   b  pays the current qualified discount price for the additional replenishment container  212   e,  but has achieved greater cost savings by paying only the advantageous price for the two prepurchased replenishment containers shipped as replenishment containers  212   d.  The desired outcome is achieved. The pharmacy disbursed three total containers to qualified patients, and received three total replenishment containers. The pharmacy paid a lower price for at least some of the containers. Again, the result is accomplished without modification to the normal functioning of a computer system  222 , or a COB system  224 , that is already in use at a pharmacy. 
     As described previously, a prepurchased replenishment transaction can be coordinated by the QPMM  930 . The QPMM  930  can also coordinate a subsequent replenishment order by coordinating payments from the qualified entities  202   b  and shipment to the pharmacy  206  by the supplier  207 . To facilitate prepurchased replenishment, while accommodating traditional replenishment for additional replenishment containers, the QPMM  930  can track prepurchased replenishments and appropriately reduce traditional replenishment orders according to prepurchased replenishments. In this manner, the QPMM  930  can coordinate appropriate payments from the qualified entity and avert overpayments by the qualified entity. 
     A person having ordinary skill will appreciate that the QPMM can coordinate the actual replenishment order consistent with a traditional replenishment model or consistent with a cached replenishment model. In the case of traditional replenishment, shipment of the replenishment containers would occur when the replenishment order is received, as just described. In the case of cached replenishment, the prepurchased replenishment containers may be converted to cached replenishment containers upon receipt of a replenishment order. 
     As can be appreciated, coordinating delayed shipment of a prepurchased replenishment container can be accomplished a variety of ways. For example, the prepurchased replenishment container may be an actual container  212  which is purchased on behalf of the pharmacy. Shipment of the container however, is delayed until a replenishment order is received from the pharmacy. The supplier  207  reserves, or sets aside, the container  212  until a replenishment order is received for that medication  214 . When the replenishment order is received, the supplier subtracts the total number of containers  212  ordered by the total number of prepurchased replenishment containers  212  reserved, or set aside, for the pharmacy  206 . 
     In another embodiment, the prepurchased replenishment container may be “virtual” in that it is stored and tracked electronically by a computer system at the supplier  207 . The prepurchased replenishment container then corresponds to an actual replenishment container that is reserved or set aside for the pharmacy. In still another embodiment, a computer system at the supplier  207  may track a prepurchased replenishment container as a special type of credit. The computer system creates (or indicates to the supplier to create) a prepurchased replenishment credit to the pharmacy  206 . The prepurchased replenishment credit is for a replenishment container of medication credited to the pharmacy  206 . Rather than crediting a dollar amount, the prepurchased replenishment credit is for a replenishment container. In this manner the desired advantageous pricing can be obtained for purchasing the prepurchased replenishment container. 
     The QPMM  930  can coordinate a prepurchased replenishment with a supplier  207  in a variety of ways. The QPMM  930  can generate a hardcopy (e.g. paper) prepurchased replenishment request that is sent to the supplier  207 . In another embodiment, the QPMM  630  generates an electronic prepurchased replenishment request that is communicated to a computer system (not shown) of a supplier  207 . The computer system of the supplier  207  can process the electronic request automatically. In still another embodiment, the QPMM  930  has permission to access a database of the supplier  207 , and the QPMM  930  can generate a delayed shipment of a prepurchased replenishment container to a pharmacy by directly manipulating data in the supplier database. In still another embodiment, the QPMM  930  can coordinate a prepurchased replenishment order by notifying an operator through an output device (not shown). The output device may include a monitor or display running a suitable graphical user interface to thereby notify a user. Notifications can also be performed through a variety of other techniques including but not limited to email, updating a record in a database, a hardcopy print-out updating a spreadsheet, facsimile, telephone call, SMS text message, and the like. 
     The QPMM  930  can coordinate a prepurchased replenishment with a qualified entity  204   b  in much the same way as coordinating a typical replenishment or a cached replenishment. The QPMM  930  can send payment instructions to the qualified entity  202   b.  In still another embodiment, the QPMM  930  can coordinate a prepurchased replenishment entirely through a qualified entity  202   b  by providing the qualified entity  202   b  with payment instructions, as well as information to send with payment to the supplier  207  to request delayed shipment of a prepurchased replenishment container to the appropriate pharmacy  206  in exchange for the payment. 
       FIG. 10A  is a block diagram of an embodiment of a QPMM  930  that can enable a pharmacy to implement a prepurchased replenishment model. The QPMM  930  can comprise a communications module  1031 , a COB system integration module  1032 , an adjudication module  1033 , a reporting module  1034 , an inventory tracking module  1035 , a replacement drug selection module  1036 , a replenishment module  1037 , and a prepurchased replenishment module. The communications module  1031 , the COB system integration module  1032 , the adjudication module  1033 , the reporting module  1034 , the inventory tracking module  1035 , and the replenishment module  1037  can each operate similar to the corresponding modules of the QPMM  230  as described above with reference to  FIG. 4A . The prepurchased replenishment module  1037 , in combination with inventory tracking module  1035 , the replacement drug selection module  1036 , and/or the replenishment module  1037 , enables implementation of a prepurchased replenishment model of replenishment. 
     The replacement drug selection module  1036  can identify advantageous pricing situations by various monitoring activities, including but not limited to monitoring supplier price lists, supplier databases, electronic communications, industry publications, and electronic communications such as email and SMS text messages. The QPMM  930  can also be notified of advantageous pricing by a pharmacy or a health care provider. Using the NDC, the replacement drug selection module  1036  may determine one or more equivalent medications to the dispensed medication. An equivalent medication may have a different NDC number than the medication dispensed to the patent  104 , but may be chemically and biologically equivalent (e.g., the same medication produced by a different manufacturer). The replacement drug selection module  1036  may determine whether there would be pricing advantages to replenishing the pharmacy with the alternative medications and/or whether the qualified program is able to purchase the alternative medication. If so, the replacement drug selection module  1036  may present the option to the prepurchased replenishment module  1040  as an advantageous pricing situation. 
     The prepurchased replenishment module  1040  coordinates a prepurchased replenishment transaction with a qualified entity and a supplier. The prepurchased replenishment module  1040  can track the inventory that the pharmacy “loans” to various qualified entities as the pharmacy disburses medication to qualified patients of the qualified entities. Since the QPMM  930  is communicatively coupled to the systems of the pharmacy (e.g., coupled to the COB systems of the pharmacy), the prepurchased replenishment module  1040  may monitor the national drug code (NDC) of the medication disbursed to the patients of the qualified entities. Using the tracking information, the prepurchased replenishment module  1040  can forecast an estimated future need. The prepurchased replenishment module  1040  may forecast needs based on an average number of units of medication sold during a given period. The prepurchased replenishment module  1040  may track seasonal variations (e.g., cold and flu medications during winter months, allergy medications during spring and summer months). In another embodiment, the prepurchased replenishment module  1040  may forecast needs by using the tracking information to access a table or database. 
     Once a forecasted need and an advantageous pricing situation are identified, the virtual replenishment module  1040  can coordinate pre-purchase of the estimated needs of the pharmacy by the qualified entities. The prepurchased replenishment module  1040  can coordinate payments by one or more qualified entities to a supplier to purchase a delayed shipment of a prepurchased replenishment container to the pharmacy. The supplier recognizes and reserves a prepurchased replenishment container for the pharmacy and delays shipment of the container to the pharmacy until an actual replenishment order is received. When an actual replenishment order for the medication is received from the pharmacy, the replenishment container is shipped to the pharmacy. The supplier can deduct the number of prepurchased replenishment containers from the total number of containers of medication ordered by the pharmacy and coordinate a replenishment transaction for the remaining number of containers. In this manner, the qualified entities can achieve greater cost savings by taking advantage of advantageous pricing. 
     In another embodiment, the prepurchased replenishment module coordinates a prepurchased replenishment by coordinating the generation of a prepurchased replenishment credit. The prepurchased replenishment credit can be a special type of credit for a replenishment container rather than for a paid amount. Accordingly, the supplier will offset a future replenishment order by a container rather than by a paid dollar amount. In still another embodiment an actual physical container is purchased on behalf of the pharmacy and set aside. 
       FIG. 10B  is a block diagram of one embodiment of a prepurchased replenishment module  1040  configured to coordinate prepurchased replenishment transactions. The prepurchased replenishment module  1040  can include a qualified entity interface module  1041  and a supplier interface module  1042 . The qualified entity interface module  1041  can coordinate payments from qualified entities to suppliers for prepurchased replenishment orders. The qualified entity interface module  1041  can be configured to coordinate such payments in a variety of prescribed methods as may be necessary to comply with the requirements of one or more qualified discount programs. Moreover, the qualified entity interface module  1041  can be configured to coordinate payments in a variety of methods as may be necessary to interface with the protocols and methods of a variety of qualified entities, since these protocols and methods may vary from among qualified entities. For example, some qualified entities may receive electronic communications providing cached replenishment order information and payment instructions, whereas other qualified entities may require receipt of a hard copy document before payments will be processed. 
     The supplier interface module  1042  can coordinate prepurchased replenishment orders with suppliers. The supplier interface module  1042  can be configured to place prepurchased replenishment orders in a variety of prescribed methods as may be necessary to comply with the requirements of one or more qualified discount programs. Moreover, the supplier interface module  1040  can be configured to place prepurchased replenishment orders in a variety of methods as may be necessary to interface with the protocols and methods of a variety of suppliers, since these protocols and methods may vary among suppliers. For example, some suppliers may receive electronic communications that include a prepurchased replenishment order, whereas other qualified entities may require receipt of a hard copy document before a prepurchased replenishment order will be processed. Still other suppliers may allow a the QPMM  930  to directly access the a computer system and/or database at the supplier. The QPMM  930  can manipulate the data in the computer system and/or database at the supplier to reflect a cached replenishment credit. 
       FIG. 11  is a flow chart of a method  1100  for prepurchased replenishment of pharmaceuticals. The method  1100  forecasts  1110  the replenishment needs of the pharmacy for a given period of time. A forecast of the estimated replenishment needs of the pharmacy can be derived by monitoring disbursements of medication to qualified and/or non-qualified patients and tracking the number of qualified disbursements. Monitoring can occur by interfacing with the computer system and/or the COB system at the pharmacy. Interfacing with the COB system can be accomplished directly and/or by accessing one or more COB data structures. Information gathered by tracking the qualified disbursements can be used to derive disbursement patterns and to predict, or project, future disbursements. The projected future disbursements can be used to forecast or identify estimated needs. 
     The method  1100  can also identify  1112  advantageous pricing situations. The advantageous pricing situations can be identified  1112  by various monitoring activities, including but not limited to monitoring supplier price lists, supplier databases, electronic communications, industry publications, and electronic communications such as email and SMS text messages. Using the NDC for medication stocked at a pharmacy, the method can also determine one or more equivalent medications to the stocked medication. An equivalent medication may have a different NDC number than the medication dispensed to a patient, but may be chemically and biologically equivalent (e.g., the same medication produced by a different manufacturer, a different size container or other packaging). The nature of the qualified entity and/or the qualified program may determine whether a particular discounted medication is available. If an acceptable lower-cost alternative is found, the new replenishment information, including the alternative NDC and supplier information, may be recorded  822 . The method  1100 , when identifying  1112  advantageous pricing, may determine whether there would be pricing advantages to replenishing the pharmacy with the alternative medications and/or whether the qualified program allows purchase of the alternative medication. Information about the advantageous pricing situation can be stored in a COB data structure for use in coordinating a prepurchased replenishment transaction. The stored information may be stored in the pharmacy&#39;s COB system and can include information relating to the qualified entity, qualified program, and/or alternative replenishment NDC. 
     With a forecast of replenishment needs and an advantageous pricing situation identified, the method  1100  can determine  1114  whether to coordinate a prepurchased replenishment transaction. As part of the determination, the method  1100  may consider whether the advantageous pricing situation is still in effect. Moreover, the method  1100  may consider the actual inventory of the pharmacy in relation to the estimate of replenishment needs. The method  1114  may also consider whether prepurchased replenishment is possible under the requirements of one or more qualified plans under which the pharmacy makes qualified disbursements. If the method  1100  determines  1114  that prepurchased replenishment should not occur, the method can end. If the method  1100  determines that prepurchased replenishment should occur, flow continues to coordinate the cached replenishment transaction. 
     The method  1100  can coordinate a prepurchased replenishment transaction in two parts: by coordinating  1116  payments for the replenishment containers by qualified entities to the supplier, and coordinating  1118  delayed shipment of the replenishment containers by the supplier. To coordinate  1116  payments the method  1100  can use replenishment information that may be stored in a COB data structure. The replenishment information can include, but is not limited to, contact information for the qualified entity, preferred and/or accepted forms of communication with the qualified entity, and protocols and procedures followed by (or for interfacing with) the qualified entity. The replenishment information can further include pricing and quantity information, as well as qualified plan information. Coordination of payment may include electronic communication and/or hard copy communication to the qualified entity. The communication can outline instructions and terms for payment to the supplier. In another embodiment, the communication to the qualified entity can be an invoice sent on behalf of the supplier containing information regarding the shipment of the replenishment order. In another embodiment, coordination of payment may comprise providing the supplier with information as to how to directly bill the qualified entity for a replenishment shipment to a pharmacy. 
     The method  1100  can also use replenishment information stored in a COB data structure to coordinate  1118  delayed shipment of the replenishment container to the pharmacy. The replenishment information can include, but is not limited to contact information for the supplier, protocols and forms of communication accepted by the supplier, the pharmacy shipping address, preferred and/or accepted forms of shipment, preferred and/or accepted forms of communication with the pharmacy, protocols and procedures for interfacing with the pharmacy, and quantity and packaging information. The shipment from the supplier to the pharmacy is delayed until such time as the pharmacy necessitates an actual replenishment and places a replenishment order with the supplier for the same medication that was pre-purchased. As can be appreciated, the delayed shipping can be accomplished a variety of ways, including but not limited to a request to hold shipment, instructions regarding delay of shipment, instructions to delay filling the prepurchased replenishment order, generation of a special type of credit for a prepurchased replenishment container, and reserving a physical container for later shipment. 
     In another embodiment, coordination  1116  of qualified entity payments and coordination  1118  of delayed shipment of prepurchased replenishment containers can be accomplished in a single step. For example, the communication to the supplier can include instructions and information for the supplier to directly bill the qualified entity for a replenishment shipment. As another example, the communication to the qualified entity can include instructions to pass on to the supplier to instruct the supplier to delay shipment of the prepurchased replenishment containers. 
     A QPMM interfacing with a computer system and/or a COB system at the pharmacy can perform much, or all, of the method  1100 . The QPMM can monitor disbursements of medication and track qualified disbursements to forecast whether replenishment is needed. The QPMM can identify advantageous pricing situations by monitoring pricing via a computer network or electronic communication with computer systems at the supplier. The QPMM can coordinate completion of a prepurchased replenishment by coordinating payment  1116  for a prepurchased replenishment container and coordinating delayed shipment  1118  of the cached replenishment container. 
       FIG. 12  is a flow chart of a method  1200  for replenishment of pharmaceuticals beyond a quantity replenished by prepurchased replenishment. When a replenishment threshold is reached (i.e. the number of qualified disbursements to qualified patients meets or exceeds a replenishment threshold), actual replenishment is needed. The method  1200  identifies  1210  the number of containers the pharmacy needs replenished based on the number of qualified disbursements. This number may be referred to as the actual replenishment need of the pharmacy. The method  1200  can then ship  1212  the number of replenishment containers that correspond to the number of prepurchased replenishment containers purchased, up to but not exceeding the actual replenishment need. Once the prepurchased replenishment containers are shipped, the method can determine  1214  whether additional replenishment is needed, based on the actual replenishment need as compared to the number of prepurchased replenishment containers purchased. If no additional replenishment is needed, the method can end. If additional replenishment is needed, the method  1200  can coordinate the additional replenishment by coordinating  1216  payment by a qualified entity and coordinating  1218  shipment to the pharmacy. 
       FIG. 13  is a flow chart of a method  1300  for cached replenishment of pharmaceuticals in conjunction with prepurchased replenishment. When a replenishment threshold is reached (i.e. the number of qualified disbursements to qualified patients meets or exceeds a replenishment threshold), actual replenishment is needed. The method  1300  identifies  1310  the number of containers the pharmacy needs replenished based on the number of qualified disbursements. This number may be referred to as the actual replenishment need of the pharmacy. The method  1300  then converts prepurchased replenishment containers into cached replenishment containers, up to but not exceeding the actual replenishment need. Once the prepurchased replenishment containers are converted to cached replenishment containers, the method can determine  1314  whether additional replenishment is needed, based on the actual replenishment need as compared to the number of prepurchased replenishment containers purchased. If no additional replenishment is needed, the method can end. If additional replenishment is needed, the method  1300  can coordinate the additional cached replenishment by coordinating  1316  payment by a qualified entity and coordinating  1318  delayed shipment to the pharmacy. The method then ends. 
     Consistent with cached replenishment as described above, once the number of disbursed medication units reaches a replacement threshold, the pharmacy computer system may place a restocking order. The number of containers ordered in the restocking order can be reduced by the number of cached replenishment containers associated with the pharmacy. The cached replenishment containers are shipped and any additional replacement containers requested are also shipped. The pharmacy is only charged for the additional replacement containers, beyond the number of cached replenishment containers shipped. 
     It will be obvious to those having skill in the art that many changes may be made to the details of the above-described embodiments without departing from the underlying principles of the disclosure.