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D-2.3. Cost Per Prescription

The HHSC pharmacist estimates the cost per prescription by doing the following:

  1. Querying First Data Bank to obtain the National Average Drug Acquisition Cost or the Wholesale Acquisition Cost price. If those price points are not available, staff use the Average Wholesaler Pricing and the Net Cost to Wholesaler price from the COI. The pharmacist does not include the dispensing fee in the cost estimate.
  2. Reviewing the drug package insert and determining any requirements with the potential to limit the quantity or duration of drug therapy
  3. Calculating the maximum quantity allowed and the estimated cost per prescription.