Sources

Every modeled number on this site comes from a single maintained benchmarks module and carries one of the sources below. Live numbers are fetched from CMS NADAC at request time and show their effective date.

Pricing Data

• CMS NADAC (National Average Drug Acquisition Cost), refreshed weekly — the live benchmark behind the Spread Check tool
• Cost Plus Drugs published pricing formula (acquisition + 15% + $5 dispensing)
• LillyDirect and NovoCare published direct-program pricing
• State Medicaid professional dispensing fee surveys (cost-of-dispensing studies)

Market & Regulatory

• FTC interim staff report on Pharmacy Benefit Managers (2024) — spread pricing and channel steering
• Consolidated Appropriations Act (CAA) 2021 and subsequent amendments — PBM transparency and disclosure requirements
• ERISA fiduciary requirements for plan sponsors
• Industry utilization benchmarks (e.g. IQVIA use-of-medicines reporting)

Analysis

• Claims-file findings are generated from your uploaded data by our analysis service at request time — they are your numbers, not benchmarks
• Scenario-model figures are labeled assumptions; each scenario page lists them with sources