The 46brooklyn Podcast

So now that drug pricing one on one is well and truly behind us, what did we say we're going to do next? Well, we said in our last episode that we wanted to talk more about what drug reference prices might tell us about the price of drugs today. What a crazy sentence that is. So to start back up, that's what we'll do. We'll talk about the drug pricing, news and notes at the start of 2023.

It has been a minute since we last had an episode of our Podcast, so it is probably appropriate to start with some reminders. Last year, we launched the Podcast and dove into some, but not all, of the drug reference prices available in the U.S.. We talked about the use of those reference prices within our work at 46brooklyn and ultimately got around to briefly discussing how drug benefits get financed in the commercial space. We called our first series, Drug Pricing 101 with the idea that we needed to introduce the core concepts of the U.S. drug supply chain to hopefully foster a better understanding of the data available at 46brooklyn.com and our drug pricing system as a whole.

Based upon what we have learned thus far about U.S. drug pricing, it makes sense at this point to take a step back and look at how most of us actually obtain medications. In this episode we explore how employer sponsored healthcare (i.e., prescription drug insurance from the company we work for) is obtained in the first place.

The search for truth in drug pricing is complicated by a lack of transparency. Fortunately for us, at least one drug company was committed to tell us what a drug actually costs to produce. Using the public information provided by the Mark Cuban Cost Plus Drug Company, we can follow albendazole's price from the factory all the way to the health plan in the retail pharmacy channel.

Now that we have a better understanding of drug pricing benchmarks thanks to our Drug Pricing 101 series, we review how 46brooklyn got its start using public Medicaid data to understand how what was charged for a drug doesn't always tell you what the provider was paid for the drug. 

You asked, we answered! On this episode, Ben is joined by some of the other 46brooklyn volunteers who help make the podcast possible and we collectively answer questions we've received regarding drug prices and the U.S. drug supply chain.

Many who have followed U.S. drug pricing efforts over the years are certainly familiar with a PBM's MAC, or maximum allowable cost, list. This episode explores MAC pricing with a focus on how a failure to agree on what a drug's price is – as evident by the numerous drug prices that potentially exist – has created a market for MAC prices to exist.

This episode of the podcast explores a pharmacy's cash, or usual and customary price. We rely upon an understanding of the prior discussed pricing benchmarks to contextualize why cash prices are so high at nearly all U.S. pharmacies.

On this episode of the Podcast, we explore National Average Drug Acquisition Cost (NADAC). An understanding of NADAC was critical into early efforts to explore drug channel pricing distortions, such as spread pricing in Ohio Medicaid in 2017-18.

This episode of the podcast explores the most distorted of all U.S. drug prices – Average Wholesale Price (AWP). As the pricing benchmark principally relied upon in contracts between drug supply chain participants, this pricing benchmark is arguably the most important to the U.S. healthcare system.

On this episode, we explore most of the drug prices set by drug manufacturers based upon sales they make to wholesalers.

The first episode of the 46brooklyn podcast sets the table on why we care about U.S. drug prices by summarizing data related to U.S. drug expenditures and making comparisons to known international prices of medications.