Patent ID: 7917372

Claim:
A pharmacy benefits management system comprising: pharmacy benefits means for receiving claim information relating to pharmacy benefits claims processed by a claims processing facility, said claim information including identification of drugs dispensed to individual patients; management means for receiving pharmacy benefits formulary information and price information relating to drugs in various classes; provider means for receiving pharmacy benefits plan structure information including deductible information and co-payment information stored therein to determine a recipient's prescription benefit plan and identify the subscriber of the prescription benefit plan; said management means further; calculates out-of-pocket costs, sponsor costs, and total costs of the drugs dispensed to patients based upon the determined prescription benefit plan, the identified subscriber, the received claim information, the received formulary information, the received pharmacy benefits plan structure, and the received price information; aggregates the out-of-pocket costs, sponsor costs, and total costs of the drugs dispensed to patients based upon at least one of identity of drug dispensed, type of drug dispensed, formulary information, identity of pharmacy dispensing drug, and identity of doctor prescribing drug; and transmits the aggregated out-of-pocket costs and sponsor costs to the recipient of prescription benefits.