Summary and Investment Conclusions First DataBank and Medi-Span are the dominant providers of point-of-sale pricing information to US pharmacies. In December First DataBank announced it would provide National Average Drug…
Summary and Conclusions The prescription drug formularies of health plans sold on the Affordable Care Act’s (ACA’s) public health insurance exchanges (HIEs) are significantly more restrictive than the drug formularies…
Summary To get a sense of what drug coverage will look like across plans offered on the health insurance exchanges (HIEs), we analyzed the drug benefits of all Silver[1] plans…
Background State Medicaid programs use a variety of drug pricing benchmarks to determine how much a retail pharmacy is paid when a multi-source (generic, essentially) prescription is dispensed to a…
We’ve long argued that PBM gross margins should decline[1] as a byproduct of several pressures, the most prominent being a shift away from the Average Wholesale Price (AWP) drug pricing…
This note compares the two drug acquisition cost benchmarks (Average Manufacturer Price or AMP, and National Average Drug Acquisition Cost or NADAC) that CMS intends to make public. NADAC values…
Our bearish thesis on the drug trades generally and PBMs specifically has several moving parts; of these, the effect of the AWP[1]benchmark on generic dispensing margins is key The heart…