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Starting in 2025, out-of-pocket drug spending will be capped at $2,000 per year.
Prescription drug list prices in the United States continually are among the highest in the world. [1] [2] The high cost of prescription drugs became a major topic of discussion in the 21st century, leading up to the American health care reform debate of 2009, and received renewed attention in 2015.
For each medicine surveyed, the local price is compared with an international reference price. This is usually drawn from MSH's International Medical Products Price Guide. This guide contains, for each drug, a set of prices from suppliers to developing countries and also a set of prices agreed by buyers such as government departments of health.
Drugs which do not appear on the formulary at all mean consumers must pay the full list price. To get drugs listed on the formulary, manufacturers are usually required to pay the PBM a manufacturer's rebate, which lowers the net price of the drug, while keeping the list price the same. [20]
Pharmacy and Therapeutics (P&T) is a committee at a hospital or a health insurance plan that decides which drugs will appear on that entity's drug formulary.The committee usually consists of healthcare providers involved in prescribing, dispensing, and administering medications, as well as administrators who evaluate medication use. [1]
The guide has been published annually since 1986 with the World Health Organization becoming involved in 2000, [2] [3] though has not been updated since 2015. [4] The prices in the guide are specifically for low and middle income countries (LMIC). [2] There are two sources of price data in the guide: Buyers and Suppliers.
Medication costs can be the selling price from the manufacturer, that price together with shipping, the wholesale price, the retail price, and the dispensed price. [3]The dispensed price or prescription cost is defined as a cost which the patient has to pay to get medicines or treatments which are written as directions on prescription by a prescribers. [4]
In the United States, the average wholesale price (AWP) is a prescription drug term referring to the average price for medications offered at the wholesale level. [1] The metric was originally intended to convey real pricing information to third-party payers, including government prescription drug programs.