Insights into the Future of Healthcare

How Do WAC, AMP, ASP, 340B, and MFP Fit Together? A Branded Drug Pricing 101 with Inma Hernandez

Inma Hernandez, PharmD, PhD, Senior Advisor for Drug Prices at the Centers for Medicare and Medicaid Services, joins Perspectives to give an overview of drug pricing regulatory dynamics for branded drugs in the US. The episode is a step-by-step walkthrough of the different prices a branded drug can have in the U.S. and how those prices are established across commercial insurance, Medicaid, Medicare Part B, and Medicare Part D. Inma explains the alphabet soup of WAC, AMP, best price, ASP, and MFP; how rebates and statutory discounts translate list prices into the net prices realized by innovators; and how pricing decisions in one market can spill over into others. The episode then layers in 340B and the drug pricing provisions within the Inflation Reduction Act. Consider this a U.S. Branded Drug Pricing 101 taught by a nationally recognized expert in pharmaceutical pricing and policy with a graphical representation linked below that is worth printing for your desk. Topics discussed include, How net prices for branded drugs are established across commercial insurance, Medicaid, Medicare Part B, and Medicare Part D, The differences between WAC, AMP, best price, ASP, and MFP, How commercial rebates can spill over into Medicaid and 340B through best price, How 340B impacts the economics of a drug across different insurance markets, and How inflation rebates and Medicare drug price negotiation add another layer to this framework.