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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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…
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Caught my eye — 09/06/24
Read more: Caught my eye — 09/06/24The slight panic of 4 months left in the year is starting to hit but the amazing weather in the D.C. area made it seem just a bit less urgent. If you need any help with policy work these next few months or filling a speaking gig, I’m here for it. MedPAC was back this…
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MP3 Take 2
Read more: MP3 Take 2For 2024, the Medicare prescription benefit (Part D) has implemented an out-of-pocket cap (OOP) for beneficiaries. Once they spend $8,000, they have $0 cost sharing. For patients on branded medicines, this can bring the total annual OOP to about $3,300. But in 2025, the Part D redesign (courtesy of the Inflation Reduction Act) gets much…
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Caught my eye — 8/30/24
Read more: Caught my eye — 8/30/24In many places, this is the last weekend to hit the pool so let’s keep this short so you can get out there and get the most out of this long weekend. Just two quick stories and you’re off. DTC You Know Me. Both Lilly and Pfizer made news this week with their latest direct…
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340B, Caught my eye, Drug Prices, Generics, Inflation Reduction Act, Medicare Negotiation, Medicare Part D, Medicare Transaction FacilitatorCaught my eye — 8/23/24
Read more: Caught my eye — 8/23/24It’s an Inflation Reduction Act (IRA) hangover kind of week. Last week the first Medicare negotiated prices for 2026 were announced and this week is the “what does this mean?” week with everyone catching up and chiming in. What I wrote last week stands but if you want another review, Health Affairs/KFF has you covered.…
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Biosimilars, Caught my eye, Drug Prices, Employers, Inflation Reduction Act, Medicare Negotiation, Medicare Part D, Pharmacy Benefit ManagersCaught my eye — 8/16/24
Read more: Caught my eye — 8/16/24Just a quiet health policy week. Well actually, depending on your level of wonkiness, it kind of was? But let’s get into what you need to know. They’re Here! On Thursday, the Centers for Medicare & Medicaid Services released the “negotiated” prices for the initial ten Medicare prescription drug benefit drugs (Part D); these prices…
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The Day has Arrived
Read more: The Day has ArrivedIn my 20s, today would have been like the Super Bowl for nerdiness. I would have been really excited about the first look at the negotiated rates for the first 10 drugs, effective January 2026. But I’m not. Why is my wonkiness holding back? So my hunch is that plans will put the competitor drugs…
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