What Is NADAC?

How it affects what you pay

NADAC is primarily a reference and reimbursement benchmark used by state Medicaid programs and researchers, not a retail price you'll be quoted directly. The dollar amount you actually pay, whether through insurance, cash, or a discount card, includes the pharmacy's dispensing fee and markup on top of its acquisition cost, so your price will typically be higher than the underlying NADAC figure for that drug. Medicaid.gov describes NADAC data as updated weekly, with a monthly file that incorporates the previous month's pharmacy survey data and captures weekly price changes before the next update (Medicaid.gov, National Average Drug Acquisition Cost). Because it reflects underlying wholesale-level costs, NADAC data is more useful for understanding pricing trends than for predicting an exact retail price.

Example

Consider a hypothetical generic drug with a published NADAC figure representing its average per-unit acquisition cost across surveyed pharmacies. A specific pharmacy's actual price to a patient, whether cash or insurance-based, would typically be higher than that NADAC figure, since it adds a dispensing fee and the pharmacy's own margin on top. This is a general illustration, not a real drug's NADAC value or retail price.

Who uses NADAC data

State Medicaid programs commonly use NADAC as one input for setting pharmacy reimbursement rates, and researchers and policymakers use it to study drug pricing trends over time, since it's based on actual invoice costs reported through a regular pharmacy survey rather than list prices. Because NADAC updates on a regular schedule, it can also help illustrate how quickly acquisition costs for a given generic can shift, which sometimes flows through to changes in retail pricing.

Why NADAC isn't your retail price

If you're comparing prescription prices, NADAC is not the number to check for your own out-of-pocket cost, since it doesn't include dispensing fees or any markup. Instead, compare prescription prices on BetterBuyRx to see the actual retail cash and discount pricing available at pharmacies near you for a specific medication. Our guide on same drug, different price: how pharmacies set cash prices explains how pharmacies build a retail price on top of their acquisition cost.

If you're researching drug pricing trends

For consumers focused on lowering their own bill rather than researching wholesale pricing trends, search your medication on BetterBuyRx directly rather than relying on NADAC figures, since retail pricing depends on many factors NADAC doesn't capture.