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 — 11/1/24
Read more: Caught my eye — 11/1/24As I write this, the elementary school across the street has Thriller playing at the 5th grade Halloween party happening in the parking lot. Things change and they stay the same. Not the worst reminder this week. Waiting. Payment rules expected from the Centers for Medicare & Medicaid Services plus maybe eventually the Medicare Transaction…
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Caught my eye — 10/25/24
Read more: Caught my eye — 10/25/24Caught my eye .. This week I am struck by connections between 340B and pharmacy benefit managers (PBMs) in terms of being issue areas that need complete makeovers. A glow up won’t do; we’re beyond that. But the trajectory toward change is very different. PBMs and payers (maybe) benefit from the way PBMs currently work.…
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340B, Caught my eye, Drug Prices, Inflation Reduction Act, Medicare Negotiation, Medicare Part D, Medicare Transaction Facilitator, Medicare Transaction FacilitatorCaught my eye — 10/18/24
Read more: Caught my eye — 10/18/24Order (Not) Ready. The National Community Pharmacists Association surveyed just under 500 independent pharmacy owners and the results are really interesting. Almost ¾ had not signed 2025 Part D pharmacy contracts as of about a month ago. Of those that dispense GLP-1 agonists, 96% lose money on them; it makes sense why 59% are thinking…
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On the Horizon — Orphan Drugs and IRA
Read more: On the Horizon — Orphan Drugs and IRANot everything can be important, or nothing is. It’s the time of year when white boards and Post-It easels come out and prioritization for 2025 gets reviewed. From a consultant perspective, I love these exercises. It allows for a look at what needs direct action, coalition or monitoring. And the $ has to go to…
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Caught my eye — 10/11/24
Read more: Caught my eye — 10/11/24It’s time to set 2025 priorities and action plans – an exercise I love to do — and this week’s caught my eye is a hodgepodge of things to consider. Planning Woes. I’ve been wanting to write about the presidential candidates and what they might do in terms of health policy and pharmaceuticals if elected.…
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Caught my eye — 10/3/24
Read more: Caught my eye — 10/3/24For most drugs, it is not IF but WHEN they will be negotiated by Medicare so if you thought you could ignore guidance coming out this week, you were wrong. Everyone on the pharma side needs to be thinking of how the Inflation Reduction Act impacts them, even if you’re early on in the pipeline…
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Biosimilars, Caught my eye, CMMI, Drug Prices, Employers, Healthcare Costs, Obesity, Pharmacy Benefit ManagersCaught my eye — 9/27/24
Read more: Caught my eye — 9/27/24If you haven’t trained your teams on Medicare Part D changes for 2025, hop to it. Or reach out to me. These are January 1 issues and we’re about to hit October…. Let me clear my throat. The STAT news breaking news headline read “Sanders says pharmacy benefit managers (PBMs) won’t penalize Novo for cutting…
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340B, Caught my eye, Drug Prices, Healthcare Costs, Inflation Reduction Act, Medicare Advantage, Medicare Negotiation, Medicare Part DCaught my eye — 9/20/24
Read more: Caught my eye — 9/20/24Adding On. So glad to see this research from Avalere conducted on behalf of the Community Oncology Alliance (COA) on the impact of the Inflation Reduction Act (IRA) negotiation on Medicare Part B provider reimbursement. While in Medicare Part D, negotiated prices do not factor into Average Manufacturer Price, the legislation is silent on whether…
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Caught my eye — 9/13/24
Read more: Caught my eye — 9/13/24On the pile. 46Brooklyn put out a piece demonstrating the difficulty of understanding drug prices. It is a doozy of a read. A set-aside-time-to-concentrate read. But if you are skeptical about drug pricing and want to lump it all on manufacturers, you should take the time to read it. Big picture, there is no single…
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More MP3 Math (3M of M3P)
Read more: More MP3 Math (3M of M3P)As I wrote about previously, in 2025, the Medicare prescription drug benefit (Part D) gets a $2,000 out-of-pocket (OOP) cap for beneficiaries and the ability to “smooth” the cost sharing over the course of the year. This program is called the Medicare Prescription Payment Plan (M3P). Last week I created slides showing the month expenditures…
Latest news
- Caught my eye — 1/24/25
- Caught my eye — 1/16/25
- Caught my eye — 1/10/25
- Caught my eye — 12/20/24
- Nurturing the Potential of Biosimilars
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