What Is NADAC? The Public Data Behind Drug Acquisition Costs
By BetterBuyRx Editorial Team
Written for cost and savings education only — not medical advice, and not medically reviewed. Always confirm details with your doctor or pharmacist. See our methodology.
Last updated
NADAC (National Average Drug Acquisition Cost) is a public dataset published by the Centers for Medicare & Medicaid Services (CMS) showing the average price a national sample of retail pharmacies pays to acquire specific drugs. It's updated weekly and used mainly by state Medicaid programs to help set pharmacy reimbursement rates. NADAC is not a retail or cash price, and it isn't the number you'll see on a pharmacy receipt.
If you've come across the term NADAC while researching drug pricing, it can sound like a tool for consumers, but it's actually a technical benchmark built for a different purpose. Here's what it measures, how it's used, and why it matters even though you won't pay the NADAC price yourself.
What NADAC actually measures
NADAC estimates what pharmacies pay wholesalers and manufacturers to acquire a given drug, based on a voluntary survey CMS runs with a national sample of retail community pharmacies. According to CMS's NADAC methodology documentation, the survey collects actual invoice pricing data, and CMS calculates a weighted average acquisition cost for each drug based on the responses. This is fundamentally a cost benchmark for the pharmacy's supply side, not a price benchmark for what a patient pays.
Search your medication on BetterBuyRx if you want to see what pharmacies are actually charging for a specific prescription, since NADAC reflects pharmacy acquisition cost rather than retail pricing.
How NADAC is calculated and updated
CMS publishes updated NADAC files weekly, drawing from ongoing survey responses. For generic drugs, NADAC values are generally based on a rolling multi-month average of survey data to smooth out short-term price swings, since generic pricing can fluctuate based on market competition and supply availability. Brand-name drug values tend to track more closely to recent data. Because it's survey-based rather than calculated from a fixed formula, NADAC can have gaps for drugs that didn't receive enough survey responses in a given period.
Why states use NADAC for Medicaid reimbursement
State Medicaid agencies need a defensible, data-driven way to decide how much to reimburse pharmacies for dispensing a drug to a Medicaid beneficiary, on top of a professional dispensing fee. According to KFF's overview of Medicaid drug facts, states commonly use NADAC or a similar acquisition-cost benchmark as the basis for this reimbursement calculation. This approach is meant to reflect what pharmacies are actually paying, rather than relying on older list-price benchmarks that had drifted far from real-world acquisition costs.
NADAC compared to other pricing benchmarks
| Benchmark | What it measures | Typical user |
|---|---|---|
| NADAC | Average price pharmacies pay to acquire the drug | State Medicaid programs, researchers |
| Usual and customary (U&C) | Retail cash price at a specific pharmacy | Cash-paying patients, pharmacies |
| Average Wholesale Price (AWP) | Older wholesale list-price benchmark | Historically used in contracts, less common now |
| Insurance contracted rate | Negotiated reimbursement for a specific plan | Insured patients, PBMs |
Why NADAC isn't useful for comparison shopping
Because NADAC is an average acquisition cost across a national sample of pharmacies, it doesn't tell you what a specific pharmacy near you will actually charge, and it excludes dispensing fees, insurance adjustments, and local market pricing decisions. Compare prescription prices on BetterBuyRx if your goal is to find the lowest actual price at a pharmacy you can visit, since that requires real-time retail pricing rather than a national acquisition-cost average.
Where to find NADAC data yourself
CMS publishes the NADAC files directly on Medicaid.gov's NADAC page, along with related retail price survey information. The data is provided in downloadable file formats intended for researchers, state agencies, and policy analysts, so it takes some technical comfort to work with directly. If you're simply trying to figure out what you'd pay for a prescription, a pharmacy price comparison tool will generally be more useful than working with the raw NADAC dataset.
Ask your pharmacist about your specific cost
NADAC and similar benchmarks explain part of the pricing picture, but your actual out-of-pocket cost depends on your specific insurance plan, pharmacy, and any discount programs available to you. Ask your pharmacist directly what your cost will be for a given prescription, and whether a generic or alternate pharmacy might cost less, since acquisition-cost data alone won't answer that question for your situation.
The bottom line on NADAC
NADAC is a legitimate, publicly available government dataset, but it's built for state Medicaid reimbursement policy, not for shoppers trying to find the best price nearby. Compare prescription prices on BetterBuyRx to see actual retail pricing across pharmacies, since prices vary by pharmacy, location, quantity, and eligibility regardless of what any national acquisition-cost average shows.
Frequently asked questions
Is NADAC the price I would pay at the pharmacy counter?
No. NADAC reflects the average price pharmacies pay to acquire a drug from wholesalers and manufacturers, not the retail price charged to a patient. Your actual price depends on insurance, the pharmacy's markup, dispensing fees, and other factors, so it will typically differ from the NADAC figure.
Who publishes NADAC data and how often is it updated?
The Centers for Medicare & Medicaid Services (CMS) publishes NADAC data, and it is updated on a weekly basis using survey data voluntarily submitted by a national sample of retail community pharmacies.
Why do states use NADAC?
Many state Medicaid programs use NADAC, or a similar acquisition-cost benchmark, to help set how much they reimburse pharmacies for dispensing drugs to Medicaid beneficiaries. It gives states a more current, survey-based estimate of actual pharmacy costs than older benchmarks.
Is NADAC data available to the public?
Yes. CMS publishes NADAC files on Medicaid.gov, and anyone can download the data, though it is presented as a technical dataset rather than a consumer-friendly price lookup tool.
Does NADAC apply to brand-name and generic drugs the same way?
NADAC covers both brand and generic drugs, but the way it is calculated differs. Generic drug NADAC values typically use a rolling multi-month average of survey responses, while brand drug values are generally based on more recent data, reflecting differences in how pricing for each category tends to move.
Sources
Compare prices & find savings
This guide is for cost and savings education only. It is not medical advice. Talk to your doctor or pharmacist before making any changes to your medications. Prices vary by pharmacy, location, quantity, and eligibility, and they change over time.
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