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On Drug Prices
Published in Mickey C. Smith, E.M. (Mick) Kolassa, Walter Steven Pray, Government, Big Pharma, and the People, 2020
Average Wholesale Price (AWP). Neither an average Price nor a Price charged by wholesalers, this figure is a vestige of earlier times. Few, if any, wholesalers even consider AWP today when pricing their prescription products. It is, however, commonly used by retailers and others who dispense medications as the basis for many pricing decisions. Due to its availability from many sources, the AWP is often used as a surrogate for actual Prices when studying prescription Price trends.
Medicare Set-Asides
Published in Julie Dickinson, Anne Meyer, Karen J. Huff, Deborah A. Wipf, Elizabeth K. Zorn, Kathy G. Ferrell, Lisa Mancuso, Marjorie Berg Pugatch, Joanne Walker, Karen Wilkinson, Legal Nurse Consulting Principles and Practices, 2019
Jennifer C. Jordan, Leslie Schumacher
Average wholesale price (AWP) was originally a term referring to the average price for drugs purchased at the wholesale level. Today, reimbursement amounts are typically based on AWP minus some negotiated percentage, making the published AWP grossly in excess of real prescription drug prices.
The Drug Use Process
Published in William N. Kelly, Pharmacy, 2018
All drug pricing is based primarily on a figure called average wholesale price (AWP). This is the cost assigned to the product by the manufacturer and listed in a regularly published source such as the Drug Topics Red Book or American Druggist Blue Book.24 AWP is typically not the average price at which wholesalers sell the drug. A common joke among pharmacists is that AWP stands for “ain't what's paid.” Despite its inaccuracy, the AWP is what third-party payers—insurance companies and PBMs—historically have used to calculate their reimbursement for the ingredient cost of a prescription, but AWP may no longer be useful and will probably disappear from use.
Review of cyclin-dependent kinase 4/6 inhibitors in the treatment of advanced or metastatic breast cancer
Published in Journal of Drug Assessment, 2021
Lakyn Husinka, Pamela H. Koerner, Rick T. Miller, William Trombatt
Financially, when evaluating the same patients from the PDC analysis, the patient out of pocket copay was highest for ribociclib patients with commercial insurance accompanied with commercial secondary or a prescription assistance program (PAP). However, in patients lacking a secondary payer, ribociclib had the lowest final copay. Patients on abemaciclib with a secondary payer had the lowest levels of final copay (Table 2). Additionally, 9% of patients had a zero dollar final copay. When reviewing the average copay of each patient’s first CDK 4/6 inhibitor dispense, palbociclib and abemaciclib had a lower out-of-pocket cost compared to the AWP of the medications at $68 and $83. The first fill average cost of ribociclib was more than 4x abemaciclib at $376. Although these products are expensive with an average 30 day average wholesale price (AWP) of $14,089 the final patient out-of-pocket cost is much lower.
Real-world treatment patterns, cost of care and effectiveness of therapies for patients with squamous cell carcinoma of head and neck pre and post approval of immuno-oncology agents
Published in Journal of Medical Economics, 2020
Pranav Abraham, Jonathan Karl Kish, Beata Korytowsky, Janna Radtchenko, Prianka Singh, James Shaw, Bruce Feinberg
Acute care interventions were identified using admission codes for hospitalizations and emergency department (ED) visits. Paid costs were not available for medical claims. Standardized costs were created for both medical and pharmacy claims for drug costs (cost per administration of any antineoplastic agent or other pharmaceutical) by using the average wholesale price (AWP) for drugs coded with NDC codes and the Centers for Medicare & Medicaid Services (CMS) Average Sales Price (ASP) for drugs coded with J, Q, or C codes. The CMS Clinical Laboratory Fee Schedule (CLFS), the Medicare Physician Fee Schedule (MPFS), and Hospital Outpatient Prospective Payment System (OPPS) were used to standardize procedure costs. Inpatient costs were derived using the cost-to-charge ratio from HCUP (Healthcare Costs and Utilization Project). All costs were adjusted to 2017 US dollars (USD).
Cost-effectiveness model of abiraterone plus prednisone, cabazitaxel plus prednisone and enzalutamide for visceral metastatic castration resistant prostate cancer therapy after docetaxel therapy resistance
Published in Journal of Medical Economics, 2019
Yazan K. Barqawi, Matthew E. Borrego, Melissa H. Roberts, Ivo Abraham
Our economic evaluation was from the US healthcare payer perspective and included direct medical costs expressed in 2019 $US (Table 1). mCRPC drug treatment costs were obtained from RED BOOK Online (Greenwood Village, Colorado, USA) which lists drug product pricing of medications in the US35. Drug treatment costs were calculated as the Average Wholesale Price less 15% (AWP-15%) to estimate a discounted payer price36. In addition, the model included costs of grade III/IV adverse events that occurred in ≥5% of patients obtained from clinical trials, package insert information and published resource17,24,27,37–40.