AMP is WAC (and other thoughts)
Latest posts and updates
ABOUT AMP is WAC
Average Manufacturer Price (AMP) is not equal to Wholesale Acquisition Cost (WAC), but it is close. And since the whole world of health policy and reimbursement is a bit WAC-y, that’s what we’re calling this update/blog part of the site. All of the opinions and thoughts presented here are our own and not the views of clients or affiliates.
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Caught my eye — 11/10/23
Read more: Caught my eye — 11/10/23Guess which one costs more. This Wall Street Journal article has been making the rounds this week. It highlights how if there are two prices for a drug, plans tend to prefer the higher cost one with higher rebates. I hesitate to call it news because it seems so obvious to those of us who…
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Same Same Was Different : Proposed Biosimilar Interchangeability Flip
Read more: Same Same Was Different : Proposed Biosimilar Interchangeability FlipLast year CMS proposed regulations allowing for Part D sponsors to remove a reference product from a formulary and immediately substitute it with an interchangeable biologic or an unbranded biologic product approved under the same biological license application. In the final rule, they pulled back and said they would not finalize the proposal until at…
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Caught my eye — 11/3/23
Read more: Caught my eye — 11/3/23InNOvation. Seagen said they aren’t looking at a drug that would treat early-stage bladder cancer because it would be subject to negotiation too soon after approval and wouldn’t have a financial return on the investment. Today the National Pharmaceutical Council published a great piece in Health Affairs that goes deeper into the subject of innovation…
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Part D: Hope on the horizon (Part IV)
Read more: Part D: Hope on the horizon (Part IV)The Medicare negotiation patient listening sessions are being held this week; many of the patients are talking about affordability challenges and the need to switch medicines/treatments because of cost. Some of the patients said they are looking forward to the negotiation so they can have lower cost sharing. To me, this demonstrates the need to…
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Caught my eye — 10/27/23
Read more: Caught my eye — 10/27/23Caught my ear? This story on NPR about drug shortages and how one woman is trying to plug the holes was fantastic. Two takeaways – (1) never underestimate a mother whose kid needs help and (2) figuring out drug shortages should be more systematic and not a game of “whack a mole.” Nothing but net.…
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Prediction: MA is the new PBM (Part D, III)
Read more: Prediction: MA is the new PBM (Part D, III)I’d like to make a prediction. The next big political focus (after PBMs, if we give up on PBMs?) is going to Medicare Advantage. There is a lot of money flowing through managed care and scrutiny feels inevitable. It is just that if you’re following the dollar, a lot is going that way. A few…
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Caught my eye — 10/20/23
Read more: Caught my eye — 10/20/23Want a friend, get a cat. A doctor prescribes a cat for a patient. I question the out-of-pocket costs of the Rx, but point taken. Speaking of PETS. A few Alzheimer’s updates – Déjà vu. The Part B premiums increased in 2024 due to newly approved Alzheimer’s treatments. It wasn’t noted in the fact sheet…
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They don’t build them like they used to. For Part D, it’s better (Part 2)
Read more: They don’t build them like they used to. For Part D, it’s better (Part 2)Recently my treadmill became a paperweight. The technician came out and said that it would be better to buy the parts and fix it because the new ones were just not made as well as my old one. A refrain I’ve heard over the years as it relates to heating units, refrigerators, etc. But Part…
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Caught my eye — 10/13/23
Read more: Caught my eye — 10/13/23Medicare Math. Medicare Part B premiums will go up about 6% next year, Social Security cost of living adjustment will be 3.2%. Really Stupid Vaccine Policies. Sometimes a story hits just right like this Washington Post opinion piece on RSV vaccines for adults and how the access is harmed by coverage policies. This year two…
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Part D Evolution, Part 1: Enrollment
Read more: Part D Evolution, Part 1: EnrollmentThis time of year brings on a sense of nostalgia for me related to the Medicare prescription drug benefit (Part D). Back in 2005, I had just started working at Avalere and we got our first data on what plans were offering for the inaugural year of the benefit. I remember launching into the file…
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