What is NADAC?

NADAC (National Average Drug Acquisition Cost) is a federal pricing benchmark published weekly by the Centers for Medicare and Medicaid Services (CMS), reflecting the average price retail pharmacies pay wholesalers to acquire prescription drugs. NADAC is collected through a voluntary monthly survey of retail community pharmacies conducted by Myers and Stauffer LC, a CMS contractor. Participating pharmacies submit invoice data showing actual prices paid to wholesalers for each NDC (National Drug Code). CMS then calculates a volume-weighted average across all reporting pharmacies and publishes the result weekly on Wednesdays.

NADAC is NOT what your PBM charges your plan. Your PBM cost is set by your contract, typically AWP-X% with a MAC list overlay on generics, plus dispensing fees. The gap between NADAC and PBM-billed cost is called spread, and on generic drugs it commonly runs 100 to 400 percent on legacy contracts.

For plan sponsors, NADAC is the cleanest publicly available proxy for true acquisition cost and the foundation of pass-through PBM contracts, 340B ceiling-price math, and most independent drug-spend analysis.