In most health plan pharmacy networks, the cost component of the reimbursement formula is based on the average wholesale price (AWP). One true statement about the AWP for prescription drugs is that
A) AWPs tend to vary widely from region to region of the United States
B) The AWP is often substantially higher than the actual price the pharmacy pays for prescription drugs
C) A health plan's contracted reimbursement to a pharmacy for prescription drugs is typically the 39 AWP plus a percentage, such as 5%
D) The AWP usually is lower than the estimated acquisition cost (EAC) for most prescription drugs

Question

In most health plan pharmacy networks, the cost component of the reimbursement formula is based on the average wholesale price (AWP). One true statement about the AWP for prescription drugs is that
A) AWPs tend to vary widely from region to region of the United States
B) The AWP is often substantially higher than the actual price the pharmacy pays for prescription drugs
C) A health plan's contracted reimbursement to a pharmacy for prescription drugs is typically the  39 AWP plus a percentage, such as 5%
D) The AWP usually is lower than the estimated acquisition cost (EAC) for most prescription drugs

Quizplus · Accepted Answer

The AWP is often substantially higher than the actual price the pharmacy pays for prescription drugs. This is because the AWP is the manufacturer's suggested price for a drug and does not necessarily reflect the actual cost to acquire the drug. Therefore, using the AWP as the basis for reimbursement can lead to inflated costs for health plans and consumers.

In Most Health Plan Pharmacy Networks, the Cost Component of the Reimbursement