Package Adjusted Price Calculation

To ensure the ceiling price is operational in the marketplace, HRSA will publish the package adjusted price. The package adjusted price is equal to the raw ceiling price (prior to rounding it to two decimal places) multiplied by the package size and case package size.

Package Adjusted Price = (AMP - ClosedURA The CMS Medicaid Drug Rebate (MDR) system performs the URA calculation using the drug manufacturer's pricing. The specific methodology used is determined by law and depends upon the drug's classification. Drug manufacturers remain responsible for correctly calculating the URA for their covered outpatient drugs.) × ClosedPS Defines the size of a single package for an NDC (i.e., if a case of a dozen bottles of 100 pills, PS = 100). × ClosedCSP Defines the size of the cases for an NDC (i.e., if a case of a dozen bottles of 100 pills, CSP = 12).

The published package adjusted price will be rounded to two decimal places. The package adjusted price, along with the ceiling price, can be viewed by covered entities who have authorized access to the pricing component of Closed340B OPAIS The 340B Office of Pharmacy Affairs Information System (OPAIS) is a collection of information submitted by covered entities, contract pharmacies, and manufacturers maintained and verified by HRSA's Office of Pharmacy Affairs (OPA)..

 

Example of Package Size and Case Size:

  • A 100 mL vial of a drug is sold in cartons of 6 vials. The package size in this case is 100 because that is the number of billing units in the package. AMP is reported per mL. The case pack size is 6 because that is the smallest number of units an individual purchaser could procure.

    • AMP = 14.546842

    • URA = 3.345800

    • Raw ceiling price = 11.201042 340B ceiling price = 11.20

    • Package size is 100 mL (AMP is reported per mL) Case Package size is 6 vials per carton

    • Package adjusted price = (14.546842 - 3.345800) * 100 * 6 = 6720.625200 Displayed package adjusted price will be $6720.63