A primer on prescription drug pricing benchmarks in the United States.
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2025-12
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Abstract
The price of a prescription drug can be difficult to determine in the United States. Pricing benchmarks are reference points used to determine acquisition costs as drugs are physically moved through the supply chain, to reimburse pharmacies, to calculate rebates, and to determine patient payments. Public health insurance programs, including Medicare and Medicaid, leverage different pricing benchmarks to pay for drugs for their beneficiaries, and the same drug can vary in price by program. The goal of this primer is to explain the most commonly used drug pricing benchmarks and their current contexts for use.
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Hung, Anna, and Sean Dickson (2025). A primer on prescription drug pricing benchmarks in the United States. Journal of managed care & specialty pharmacy, 31(12). pp. 1326–1335. 10.18553/jmcp.2025.31.12.1326 Retrieved from https://hdl.handle.net/10161/33870.
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Anna Hung
Anna Hung, PharmD, PhD, MS is a pharmacist and health services researcher interested in payer and patient decision making related to pharmacy benefits. Previously, she collaborated with the Defense Health Agency to evaluate the budgetary impact of their antidiabetic drug formulary changes. She has also worked with a variety of managed care organizations to assess their drug utilization and clinical management programs. Her methodological research interests include health care cost evaluations, quasi-experimental study designs, and stated preference research.
Dr. Hung received her Doctor of Pharmacy, Master of Science, and Doctor of Philosophy from the University of Maryland. Her PhD is in pharmaceutical health services research, with concentrations in pharmacoeconomics, comparative effectiveness research, and patient-centered outcomes research. Prior to joining the Department of Population Health Sciences, she completed a post-doctoral fellowship at the Duke Clinical Research Institute and served as Co-Chief Fellow.
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