Diplomat Pharmacy Inc. is the nation’s largest independent provider of specialty pharmacy services.
Diplomat Specialty Pharmacy (DSP) represents Diplomat’s traditional strength: specialty pharmacy solutions that go beyond basic care. DSP works tirelessly to help patients manage complex, chronic conditions in disease states such as oncology, immunology, and rare disease.
DSP provides innovative tools, including starter kits for side-effect management and our proprietary CarePak™ for easy dose tracking. Services include complete benefits investigations, dedicated efforts for prior authorizations and appeals, and start-to-finish funding assistance.
Diplomat Specialty Infusion Group (DSIG) complements Diplomat Specialty Pharmacy, providing specialized infusion therapies to patients nationwide.
DSIG’s customized programs keep all members of the care team informed and patients on track. Areas of excellence include bleeding disorders, alpha-1 antitrypsin deficiency, hereditary angioedema, immune globulin, and parenteral and enteral nutrition.
EnvoyHealth provides tailored solutions for healthcare innovators. Partners can strengthen their market presence through a unique blend of customization, scale, and agility. EnvoyHealth offers patient access and engagement; noncommercial pharmacy; technology services; remote patient monitoring; virtual office; and health economics and outcomes research.
Diplomat is not a PBM. However, we do offer specialty benefit management solutions as part of our payer services pillar. These include formulary and rebate management, delegated prior authorization, and more solutions aimed at improving outcomes and value.
Specialty drugs are typically administered on a recurring basis. These medications treat complex, chronic diseases and require specialized handling and administration. Diplomat has expertise across a broad range of high-growth specialty therapies, including in oncology, immunology, rare disease, and specialty infusion.
Diplomat was incorporated in Michigan on March 26, 1975.
Diplomat employed more than 2,000 people as of Dec. 31, 2017.
Diplomat’s corporate headquarters is at 4100 S. Saginaw St., Flint, MI 48507. This facility is also home to Diplomat Specialty Pharmacy (DSP)’s Great Lakes Distribution Center, our primary pharmacy distribution facility. We are licensed to dispense prescriptions and provide pharmacy services in all U.S. states and territories. To view all our locations, click here.
The store that would become Diplomat opened as Ideal Pharmacy in Flint, Michigan, in 1973. It was the fourth store in a small chain owned in part by Dale Hagerman, RPh. When Dale’s son, Phil, graduated from college in 1975, Dale traded in his stock to buy the store. The father-son team founded the company on a simple tenet: “Take good care of patients and the rest falls into place.” Today, that tradition continues—always focused on exceptional patient care.
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Our clinical care covers many conditions, including the following:
Alpha-1 antitrypsin deficiency
Growth hormone deficiency
Human immunodeficiency virus
Lysosomal storage disorder
Parenteral and enteral nutrition
Pulmonary arterial hypertension
Respiratory syncytial virus
Von Willebrand disease
Call 877.977.9118 or fax 800.550.6272.
Yes! Continue reading for more information about Medicare prescription drug coverage and your rights as a patient.
Your Medicare Rights
You have the right to request a coverage determination from your Medicare drug plan if you disagree with information provided by the pharmacy. You also have the right to request a special type of coverage determination called an “exception” if you believe any of these apply:
You need a drug that is not on their drug plan’s list of covered drugs, or formulary.
A coverage rule (such as prior authorization requirement or a quantity limit) should not apply to you for medical reasons.
You need to take a non-preferred drug and want the plan to cover said drug at a preferred-drug price.
What You Need to Do
You or your prescriber can contact your Medicare drug plan to ask for a coverage determination by calling the plan’s toll-free phone number on the back of your plan membership card or by going to your plan’s website. You or your prescriber can request an expedited (24-hour) decision if your health could be seriously harmed by waiting up to 72 hours for a decision. Be ready to tell your Medicare drug plan:
The name of the prescription drug that was not filled. Include the dose and strength, if known.
The name of the pharmacy that attempted to fill your prescription.
The date you attempted to fill your prescription.
If you ask for an exception, your prescriber will need to provide your drug plan with a statement explaining why you need the off-formulary or non-preferred drug or why a coverage rule should not apply to you.
Your Medicare drug plan will provide you with a written decision. If coverage is not approved, the plan’s notice will explain why coverage was denied and how to request an appeal if you disagree with the plan’s decision.
Refer to your plan materials or call 1.800.MEDICARE for more information.
PRA Disclosure Statement: According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this collection is 0938-0975. The time required to complete this information collection is estimated to average one minute per response, including the time to review instructions, search existing data resources, and gather the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Baltimore, Maryland 21244-1850.
CMS does not discriminate in its programs and activities. To request this form in an accessible format (e.g., Braille, Large Print, Audio CD), contact your Medicare Drug Plan. If you need help contacting your plan, call 1.800.MEDICARE.
Form No.: CMS-10147 OMB Approval No.: 0938-0975
Diplomat connects patients to funding assistance from third parties, including foundations and manufacturer programs. This money helped patients with copays for specialty medications, which can often be expensive due to research and development costs.
Diplomat’s fiscal year ends Dec. 31.
Diplomat’s independent auditor is BDO USA LLP.
Diplomat launched its initial public offering Oct. 10, 2014.
Diplomat common stock is traded on the New York Stock Exchange under the ticker “DPLO.”
Diplomat’s CUSIP number is 25456K 101.
No; Diplomat does not pay dividends.
The transfer agent and registrar of Diplomat common stock is Computershare Trust Company, N.A.
The extent to which patients take medication as prescribed.
The initial process of determining financial responsibility for an insurance claim.
A medication designed to relieve nausea and prevent vomiting.
A law stating that any provider may dispense to patients on Medicare.
A person who receives health insurance benefits.
The process of determining how a given service or prescription is covered by a health insurance plan.
A starter kit Diplomat ships with certain medications to help patients with potential side effects. Care Kits can include over-the-counter medications and educational materials.
Proprietary packaging with rows of clear blisters that hold oral medications, helping patients take complex medication regimens according to the prescribed schedule.
The amount patients must pay for services or prescriptions after meeting their health insurance plan deductible, usually expressed as a percentage.
The fee patients must pay each time they receive a medical service or prescription.
The date a prescription order is written. This might be different from the start date.
The amount patients must pay each year before their health insurance plan will begin paying.
To deliver prescribed medication.
Services that not covered by a health insurance plan.
A type of health insurance where patients are reimbursed after filing a claim. The health plan might pay the medical provider directly. In most cases, patients can choose any physician, hospital, or other provider. This is also known as an indemnity plan.
A list of drugs covered by a health insurance plan.
Third-party patient assistance toward copayments.
A type of health insurance where patients receive all care from in-network providers. In most cases, patients must obtain referrals from their primary care physician to see other providers. Generally, care received outside the network is not covered.
The study and treatment of blood, blood-forming organs, and blood diseases.
A drug administered via injection.
A list of pharmacies, healthcare providers, and hospitals through which patients of a given health insurance plan may receive care.
A letter written or certified by a physician that explains why a patient needs a given drug and why a substitute drug would be inappropriate or less than optimal.
The maximum amount a health insurance plan will pay for all non-essential benefits while an insured person is enrolled in that plan.
A medication that can only be dispensed by select pharmacies. These are typically specialty medications designed to treat chronic and complex conditions.
A specific pharmacy through which the health insurance plan requires patients to fill their prescriptions.
A federal health insurance program administered by states for low-income individuals and families.
A federal health insurance program for people 65 and older, as well as disabled people.
The Medicare plan that covers inpatient services such as those performed at hospitals, hospices, and skilled nursing facilities.
The Medicare plan that covers medically necessary services and supplies, such as physician services, home healthcare, durable medical equipment (DME), and clinical laboratory services. Limited outpatient prescription drugs are covered under Medicare Part B.
Medicare’s optional prescription drug coverage.
A supplemental insurance policy to Medicare. Medigap is private health insurance that helps fill gaps between coverage from Medicare parts A and B.
A device used to turn liquid into a fine spray.
The date the patient will be out of medication and more medication is needed.
The study and treatment of cancer.
A set time of year when people can enroll in a health insurance plan without a qualifying event (e.g., marriage, divorce, birth of a child). Open enrollment usually occurs near the end of each year, but the dates might differ between plans.
A medication taken by mouth.
A list of pharmacies, healthcare providers, and hospitals not contracted with a given health insurance plan. Services obtained out of network are typically more expensive or not covered.
The dollar limit on the portion of covered medical expenses that the insured must pay during a benefit period. When the out-of-pocket limit is met, the insured will not have to pay further deductibles or coinsurance for that year.
A request for payment successfully billed to the health insurance plan. Afterward, the patient may still have a copayment.
An entity other than the patient that finances or reimburses the cost of health services.
A type of health insurance where patients might be required to choose a primary care physician (PCP), who makes referrals to in-network providers. Patients can choose to receive care from out-of-network providers, but such care generally is more expensive and requires patients to file a claim for reimbursement.
A condition diagnosed or treated before a person begins a new health insurance policy.
Pharmacies through which the health insurance plan offers reduced copays. Patients may still fill at non-preferred pharmacies.
A type of health insurance plan in which patients can see both in-network and out-of-network providers. Typically, out-of-pocket expenses are lower when using in-network providers.
The amount people pay to belong to a health insurance plan. Premiums for employer-sponsored health insurance are usually deducted from paychecks automatically.
The doctor directing someone to take a certain medication.
A doctor’s order for medicine or another healthcare intervention.
A process through with certain claims must be approved before a health insurance plan covers medication.
Preventing the spread or occurrence of disease or infection.
A denial stating the health insurance plan will not pay for a given medication.
An unwanted result of therapy.
A pharmacy that manages specialty medications, which are generally expensive and designed to treat chronic and complex conditions.
The first day of treatment.
The process of trying other medications before “stepping up” to more expensive drugs.