DrugDashboards

Putting it all together

You've met the pieces — benchmarks, programs, players. Here they are on one page: who's who, how a drug actually travels from factory to patient, and why its price never sits still along the way.

The players, in one glance

Manufacturer
Makes the drug and sets its list price (WAC).
Wholesaler
Buys in bulk and distributes to pharmacies.
Pharmacy
Buys near NADAC, dispenses, gets reimbursed.
PBM
Runs the drug benefit: formulary, rebates, reimbursement.
Health plan / payer
Employer, Medicare, or Medicaid footing most of the bill.
Patient
Pays a copay or coinsurance at the counter.

A drug's journey, and its moving price

1
Manufacturer
sets the list price
WAC — list price
2
Wholesaler
distributes
small markup
3
Pharmacy
buys and dispenses
NADAC ≈ real cost
4
Patient
pays a share
copay / coinsurance
The drug flows left → right. The money and rebates flow the other way — the manufacturer pays a hidden rebate back to the PBM, which decides what the pharmacy is reimbursed and what the patient pays.

Why the price never sits still

A single drug doesn't have “a price” — it has a different one at every hop, and each is set by someone with different incentives:

  • It starts high. The manufacturer sets the WAC — the list price — and it climbs over time, because a higher list price funds bigger rebates.
  • Rebates pull it down, invisibly. The manufacturer hands a chunk back to the PBM as a rebate in exchange for a good formulary spot. That gap between list and net is money the patient at the counter usually never sees.
  • What pharmacies actually pay is lower still. NADAC— surveyed from real pharmacy invoices — is the closest thing to a true acquisition cost, and it's the number this whole site is built around.
  • Reimbursement is a separate number. The PBM decides what to pay the pharmacy — sometimes less than the pharmacy paid, which is how a store can lose money on a fill.
  • The patient pays yet another number. A copay or coinsurance, often calculated off the list price rather than the rebated net — so the patient can pay more than the plan does.

Follow a single $100 list price all the way through, and watch where the money actually lands:

Manufacturersets the list price (WAC)$100list priceWholesalerbuys, adds a markup$104+ markupPharmacydispenses to the patient$115sticker price+$4 wholesaler markup+$11 pharmacy markupThen money flows back$30 rebate$20 backManufacturerPBMkeeps $10Health planWho keeps the $95$70 manufacturer$11 pharmacy$10 PBM$4 wholesalerPatient paid $25 + plan paid $70 net = $95 in, $95 kept. Illustrative.

The through-line

Almost every fight in drug pricing — biosimilar uptake, PBM reform, Medicare negotiation, 340B — is really a fight over which of these numbers wins and who keeps the gap between them. Once you can see the gaps, the headlines make sense.

Now go see it live

Every benchmark in this guide is on the site as real, daily-updated data. Search any drug to see its NADAC, WAC, and ASP side by side; watch the shortages and fragility scores that these economics create; or trace where Medicaid's billions actually go.

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