“An 80% Discount Off of AWP is Still 24X the Cost of the Medication……”
Posted on Linkedin by Eric Bricker, M.D.
#Prescriptions: AWP Can be 125X the Drug Cost… But, Who are the Companies Behind #AWP?
Two Companies–FDB (First Databank, Inc.) and #MediSpan (a subsidiary of Wolters Kluwer)–Set the Prescription Drug Average Wholesale Price (#AWP) Used in PBM Pricing for All of America.
An Employee #HealthPlan Pays AWP – the PBM Discount.
The PBM then Turns Around and Pays the #Pharmacy the Maximum Allowable Cost (#MAC).
The ‘#SpreadPrice‘ Between [AWP – Discount] and [MAC] is what the PBM Keeps as Payment.
The National Average Drug Acquisition Cost (#NADAC) is What the Pharmacy Pays to Buy the Drug.
Here is an Example from a Previous AHealthcareZ Video:
Amlodipine (common generic blood pressure medication)
AWP = $2.38 Per Pill
AWP – 80% = $0.48
MAC = Proprietary (Unknown)
NADAC = $0.019
So the Plan Pays 48 Cents a Pill for a Drug that Costs 2 Cents a Pill!!
An 80% Discount Off of AWP is Still 24X the Cost of the Medication.
Interestingly, First Databank is Owned by Hearst Health… the Same Company that also Owns MCG Care Guidelines, which Sets the Rules for Prior Authorization for Most of the Health Plans in America.
Hearst Health is the Division of the Massive Private Media Company Hearst that Owns TV Channels and Newspapers.
Sources at AHealthcareZ YouTube Channel HERE: https://lnkd.in/gSJPSbw