AMP is WAC (and other thoughts)
Latest posts and updates
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.
When I first got into this pharmaceutical health policy and reimbursement world in 2005, I mostly ignored 340B. It was a big discount that was required, and you couldn’t do anything about it, so it just was. Then maybe 2012 or so I remember Andy Swire from Amgen was super amped up about 340B…
Back to back. Arnold Ventures put out the latest anti-pharma talking points (h/t Brian Reid) and here were two back to back – Here’s the problem, it really isn’t about the cost of drugs. I mean you could take that drug price and reduce it 98% and the 25% cost share would still be too…
The Inflation Reduction Act (IRA) is a little fuzzy on the details of how Medicare negotiated prices get into the system. It says that pharmacies need to be able to purchase at this price but is silent about the mechanics. This stuff is hard. But gosh sometimes I feel like the implementation could be so…
LDT. Not a sandwich, not a drink but laboratory developed tests. On Monday, the Food and Drug Administration (FDA) put out the long anticipated final rule on LDTs. If you’re more of a prescription drug policy person, get used to following LDT policy. We’ve moved from tests that are nice but, even if you have…
What the math. Yesterday afternoon CMS released a technical memo on the changes to True Out-of-Pocket (TrOOP) Costs and the maximum monthly cap for the Medicare prescription payment plan (MP3.) Simply put, they put out a memo that shows the math for the smoothing program. I need to work through some of the examples because,…
Updated 8/8/24. I live in a headspace that assumes everyone is up to date on the nuances of things and that I don’t need to write about it because it’s old news. And then I read this article in the Pink Sheet on how Medicare-negotiated prices may not get favorable coverage and realized that nope,…
Just… wow. Healthcare has a lot of rabbit holes but as the head of the Department of Health and Human Services, copay accumulators should be understood at a basic level. I’m not asking about alternative funding and to draw up a case study. Just that accumulators can’t be used in Medicare. Basics. Heck a simple…
Last week MedPAC, the Medicare advisory committee to Congress, had a really interesting session on generic drug pricing in the Medicare prescription drug program (Part D.) There is always so much focus on branded drugs that an opportunity to flip the script and learn about the 90% of prescription drug utilization in Part D (and…
PDAB-adieu. This week Governor Youngkin vetoed a bill that would have established a prescription drug affordability board (PDAB) in the state. The PDAB would have had authority over state-sponsored and state-regulated health plans. Younkin said that the PDAB would have determined drug availability solely on cost rather than unique patient needs and the opinions of…
Confession. I think Mark Cuban’s Cost Plus Drugs is underwhelming at best and, at worst, the death of independent pharmacies. I’ve been following it since inception, and I just can’t get excited about it – at least not yet. Cost Plus Drugs dispenses about 3,000 generic drugs. There is the transparent price, a 15% markup,…