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THE COMFY CHAIR As a reminder, gross profit equals the revenues received by a pharmacy minus the costs of products (net of discounts and returns) bought from a manufacturer or a wholesaler.

For a single prescription, these revenues include the amounts paid for drug ingredient costs, customer copayments or coinsurance, and dispensing fees.

I estimate these discounts to average about 4% for brand drugs and 10% for generic drugs. Note that these discounts are in addition to a pharmacy’s negotiated invoice discounts, which are generally small for single-source brand-name drugs.

Last week, Myers and Stauffer, the contractors collecting pharmacy acquisition costs and revenue data for the Center for Medicare and Medicaid Services (CMS), unexpectedly presented average per-prescription pharmacy profit margins, by payer and prescription type. (See pages 64-67.) Nobody expected this CMS inquisition. No, wait, their two weapons are fear, surprise, and ruthless efficiency. National Average Retail Prices (NARP) TIGHTEN THE RACK I view the NADAC data to be much less reliable than the NARP data.

They didn't wait very long to follow through on the implied visibility to pharmacies’ prescription economics, as I predicted in Transparency is Here! Below, I summarize the new gross profit and margin computations based on NADAC and NARP data, along with adjusted numbers that account for the acquisition cost survey’s flaws. The NADAC methodology calls for a random monthly sample of approximately 2,000-2,500 chain and independent pharmacies, or about 3-4% of total locations.

Taking into account the brand/generic mix, the overall average gross profit and margin figures are: The adjusted figure looks pretty reasonable.

For comparison, the latest NCPA Digest reports that an independent pharmacy’s average gross profit dollars per prescription were $12.40 in 2011. These averages vary dramatically by payer and prescription type.

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FURTHER STUDY This video shows Myers and Stauffer agents collecting pharmacy acquisition cost data.

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Gross margin expresses gross profit as a percentage of revenues.

Gross profit measures the portion of a pharmacy's revenues available for the operating expenses and operating profit of a pharmacy.

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