These are some of the common pricing models used in the pharmaceutical industry. The specific pricing model that is used for a drug may vary depending on a number of factors, including the type of drug, its intended use, and the target patient population.
Wholesale acquisition cost (WAC) pricing: This is the list price set by the manufacturer and is the highest price at which the drug can be sold to wholesalers or distributors.
Average wholesale price (AWP): This is a pricing benchmark that is often used by pharmacies to set the price of drugs. AWP is typically higher than the WAC price, as it includes a markup for wholesalers and distributors.
Average manufacturer price (AMP): This is the average price paid by wholesalers to manufacturers for a drug. The AMP is used by government programs such as Medicaid to set reimbursement rates for drugs.
Gross-to-net adjustment: This adjustment is made to the wholesale acquisition cost (WAC) price to account for discounts and rebates that are given to wholesalers, pharmacy benefit managers (PBMs), and other intermediaries. The gross-to-net adjustment can significantly reduce the net price of a drug.
Value-based pricing: This pricing model is based on the value that the drug provides to patients and the healthcare system. Value-based pricing takes into account factors such as the effectiveness of the drug, its impact on patient outcomes, and its cost savings to the healthcare system.
Tiered pricing: This is a pricing model that is based on the patient's ability to pay for the drug. Tiered pricing can include discounts for patients who are uninsured, have low income, or are enrolled in government programs.
Negotiated pricing: This pricing model is based on negotiations between the manufacturer, wholesaler, and/or pharmacy benefit manager (PBM). Negotiated pricing can result in significant discounts on drugs for patients, but can also reduce the amount of revenue that manufacturers receive for their drugs.