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Drug pricing, finally explained.
Medicaid alone spends $104 billion a year on drugs — through a maze of secret prices most pharmacists were never taught. Short, plain-English guides, with the real data behind every claim.
Pricing terms, decoded
NADAC, WAC, ASP, AWP, MAC — what every benchmark means, and which are real prices versus made-up ones.
How to read an NDC
The 11 digits on every drug package — what they mean, and the 10-vs-11-digit mess that trips everyone up.
How a drug gets to market
Brand vs generic, NDA vs ANDA, patents and exclusivity, and why prices collapse when protection ends.
Biosimilars, explained
Why there's no such thing as a 'generic biologic', the four-letter suffixes, and what 'interchangeable' really means.
Specialty drugs
A sliver of prescriptions, half of all drug spend — what makes a drug 'specialty' and why they run the market.
Why drugs go into shortage
The paradox that the cheapest drugs break first — sole-source generics, sterile injectables, and thin margins.
Rebates and the gross-to-net gap
The hidden money flow: why list prices and what's really paid diverge, and how rebates quietly shape your formulary.
The PBM contracts
The most consequential secret documents in health care — and what subpoenas, audits, and lawsuits pried out of them.
The pharmacy carve-out
When a state takes the drug benefit back from PBMs and pays pharmacies directly — what changes, who's done it, and why pharmacies fight for it.
Medicare Part D
How the outpatient drug benefit is priced: plans, the $2,000 cap, and Medicare's new power to negotiate.
Medicaid
The rebate machine, NADAC reimbursement, and why the same generic costs different amounts state to state.
The 340B program
The federal discount that funds safety-net care — how it works, why it exploded past $100B, and why it's so fought over.
The community pharmacy
Where it all lands: PBMs, spread pricing, PSAOs, and why pharmacies close while filling record volume.
Putting it all together
The whole picture: the players, how a drug travels the system, and why its price moves up and down at every step.
More guides on the way
Coming next: how to read a pharmacy claim, and the patient's side — copay, coinsurance, deductibles, and why the same drug costs everyone a different amount.