2019 Ryan White HIV/AIDS Program CLINICAL CONFERENCE
U.S. Drug Pricing: It’s Complicated
AverageWholesale Price (AWP)
WholesaleAcquisition Cost (WAC)
NonfederalAverageManufacturer Price (Non-FAMP)
AverageManufacturer Price (AMP)
Private sectorprices
BestPrice
24%ofnon-FAMP plus additional discounts
Negotiationonmost-favored commercial customerprice
Unit rebate:23.1% /13%ofAMPor AMP–BestPriceplus CPI penalties
Rebates toPBMs Copay assistance Other price concessions
Federal Supply Schedule (FSS)Price
340BPrice
Medicaid Price
Federal CeilingPrice
Generics
FederalUpper Limit
Federal Ceiling; “Big4”Price
Supplemental rebatesand discounts negotiated (including ADAPs)
StateMaximum Allowable Cost
Supplemental discounts negotiated (VAandDoD)
Commercial PayerMAC
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340B and the Ryan White HIV/AIDS Program
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340B Background
The 340B Drug Pricing Program was developed to allow manufacturers to continue offering discounted drugs to safety net entities, following the introduction of the Medicaid Drug Rebate Program Medicaid required manufacturers to calculate average and best prices for the Medicaid program, and any discounts to safety net entities would reduce Medicaid reimbursement The 340B Program was established to allow manufacturers to exclude these discounts from their Medicaid calculations
Slide18of31FromTHorn,MS atNewOrleans,LA,December4-7,2019,RyanWhiteHIV/AIDS ProgramCLINICALCONFERENCE, IAS USA.
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