How is Nadac calculated?

The NADAC rate, defined by drug grouping, drug category, and pharmacy type is calculated as the average of the per unit cost observations. The NADAC is a simple average of the drug acquisition costs submitted by retail community pharmacies.

What is the basic reimbursement formula for pharmacies?

One of the most common structures offered to pharmacies contracted will reimburse the lowest of three prices. The contracted rate: The contracted rate is a formula that can look something like this- Average Wholesale Price (AWP) – 22% + $1.25 dispensing fee. It varies from one contract to the next.

How do you find the AWP for drugs?

The drug manufacturer may report the AWP to the individual publisher of drug pricing data, such as MediSpan or First Data Bank. The AWP may also be calculated by the publisher based upon a mark-up specified by the manufacturer that is applied to the wholesale acquisition cost (WAC) or direct price (DIRP).

How is WAC price calculated?

The wholesale acquisition cost (WAC) is an estimate of the manufacturer’s list price for a drug to wholesalers or direct purchasers, but does not include discounts or rebates. Without including rebates and other incentives provided by manufacturers, it is hard to estimate the actual cost of the drug.

What is Nadac in pharmacy?

The National Average Drug Acquisition Cost (NADAC) is based on the retail price survey and focuses on the retail community pharmacy acquisition costs. CMS has mandated that Medicaid pharmacy programs reimburse the actual acquisition cost (AAC) of drugs plus a professional dispensing fee.

What is Nadac per unit?

NADAC Per Unit: The National Average Drug Acquisition Cost per unit.

What method of reimbursement do most pharmacies use?

Pharmacists are generally paid for prescriptions in one of three ways:

• Direct payment by the patient.
• Reimbursement from a government program, usually either Medicaid (for indigent patients) or Medicare (for the elderly and the disabled).

What is AWP pricing in pharmacy?

The AWP, or average wholesale price, of prescription drugs was intended to represent the average price at which wholesalers sell drugs to physicians, pharmacies, and other customers. In practice, it is a figure reported by commercial publishers of drug pricing data, such as First DataBank and Thomson Medical Economics.

What is the difference between AWP and ASP?

For 704 single source brand codes, ASP is 26 percent below AWP at the median, and for 216 multisource brand codes, ASP is 30 percent below AWP at the median. The difference between ASP and AWP was greatest for generic drugs. For 1,152 generic national drug codes, ASP is 68 percent less than AWP at the median.

What is WAC vs AWP?

WAC = this is the public list price the drug companies set. Most wholesalers get at least 1-2% off this price (prompt pay discounts, etc), but many drugs are discounted much more (up to 90% off). AWP was the standard for reimbursement (payments to a pharmacy when they fill an Rx).

What is WAC drug price?

Wholesale Acquisition Cost (WAC) is defined in the U.S. Code as “…the manufacturer’s list price for [a] drug or biological to wholesalers or direct purchasers in the United States, not including prompt pay or other discounts, rebates or reductions in price…”

What is WAC price for pharmaceuticals?