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Average Manufacturer Price

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The implementation of an AMP based reimbursement formula for Medicaid prescriptions is currently delayed by court action against CMS and language included in the Medicare Improvements for Patients and Providers Act of 2008. The Act delays implementation until September 30, 2009. Congressional action is needed for a meaningful, long-term AMP fix that will: clearly and accurately define AMP to reflect the retail class of trade; eliminate the requirement that CMS post AMP data reported by manufacturers; base reimbursement on the weighted average AMP, rather than the lowest AMP, to better reflect the true prices paid by pharmacies for generic drugs; and delay the creation of a new maximum reimbursement amount for a generic drug (also known as the “Federal Upper Limit” or FUL) until there are three, rather than two equivalent versions of that drug on the market.
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Average Manufacturer Price
Background
The Federal Deficit Reduction Act of 2005 (P.L. 109-171) included a number of provisions that
impact the Medicaid program and community pharmacy’s reimbursement for dispensing medication
to Medicaid beneficiaries. In particular, the Act seeks to replace the current standard for
reimbursing pharmacies for the ingredient cost of multiple source generic drugs with “average
manufacturer price” (AMP).
Status
The implementation of an AMP based reimbursement formula for Medicaid prescriptions is
currently delayed by court action against CMS and language included in the Medicare
Improvements for Patients and Providers Act of 2008. The Act delays implementation until
September 30, 2009. Congressional action is needed for a meaningful, long-term AMP fix that will:
clearly and accurately define AMP to reflect the retail class of trade; eliminate the requirement that
CMS post AMP data reported by manufacturers; base reimbursement on the weighted average
AMP, rather than the lowest AMP, to better reflect the true prices paid by pharmacies for generic
drugs; and delay the creation of a new maximum reimbursement amount for a generic drug (also
known as the “Federal Upper Limit” or FUL) until there are three, rather than two equivalent
versions of that drug on the market.
Grocery Industry Impact
If implemented as currently defined, the move to an AMP-based reimbursement formula is
estimated to reduce federal pharmacy reimbursements by nearly $8.4 billion over five years once
implemented.
Key Committees
Senate: Finance
House: Energy & Commerce
Position
FMI urges Congress to enact legislation to ensure that Medicaid recipients continue to have access
to their neighborhood, community pharmacy and cost-effective medications. In addition, Congress
needs to urge CMS to address the ongoing problem of inadequate dispensing fees under the
Medicaid program. Finally, Congress should discourage CMS from releasing AMP data until a final
definition has been established and the industry and the regulators have had an opportunity to ensure
that it is being calculated consistently.
FMI Contact
Cathy Polley, RPh; cpolley@fmi.org; 202-220-0631
Date Filed: August 2009



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