# What should this prescription cost? Research log

Research by Known Quantity LLC for /for-good/prescription-price/ (and the hub /for-good/health-costs/). Started 2026-11-13.
Rule: every factual sentence on the page traces to a row here (row ids P1, P2, ...). Quotes are kept under 15 words.

How sources were read: the data.medicaid.gov API calls and the Cost Plus Drugs FAQ were read in a web browser on 2026-11-13. The build computer could not reach medicaid.gov, data.medicaid.gov or costplusdrugs.com (its network proxy blocks them), so the rows below were then confirmed by reading the Medicaid.gov pages and the NADAC methodology document on 2026-11-13, and the exact wording is quoted.

This log is general information, not medical or legal advice.

## Sources

| id | Title | Date | Publisher | URL | Kind |
|---|---|---|---|---|---|
| S1 | Pharmacy Pricing (NADAC overview) | read 2026-11-13 | Medicaid.gov (CMS) | https://www.medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing/index.html | Primary (government) |
| S1b | Survey of Retail Prices | read 2026-11-13 | Medicaid.gov (CMS) | https://www.medicaid.gov/medicaid/prescription-drugs/retail-price-survey/index.html | Primary (government) |
| S1c | Methodology for Calculating the NADAC (December 2024) | read 2026-11-13 | Medicaid.gov (CMS) | https://www.medicaid.gov/sites/default/files/2024-12/nadacmethodology-december2024.pdf | Primary (government) |
| S2 | NADAC (National Average Drug Acquisition Cost) 2026, dataset fbb83258-11c7-47f5-8b18-5f8e79f7e704 | read 2026-11-13 (API response seen in a browser) | data.medicaid.gov (CMS) | https://data.medicaid.gov/dataset/fbb83258-11c7-47f5-8b18-5f8e79f7e704 | Primary (government data) |
| S3 | data.medicaid.gov search API (finds each year's NADAC dataset) | read 2026-11-13 (API response seen in a browser) | data.medicaid.gov (CMS) | https://data.medicaid.gov/api/1/search?fulltext=NADAC%20National%20Average%20Drug%20Acquisition%20Cost%202026&page-size=5 | Primary (government data) |
| S4 | Frequently asked questions | read 2026-11-13 | Mark Cuban Cost Plus Drug Company | https://www.costplusdrugs.com/faq/ | Company page |
| S5 | Cost Plus Drugs public pricing API | read 2026-11-11 and 2026-11-13 (API responses seen in a browser) | Mark Cuban Cost Plus Drug Company | https://us-central1-costplusdrugs-publicapi.cloudfunctions.net/main | Company data |

## A. What NADAC is

| id | Claim on the page | Source | Quote (under 15 words) / note |
|---|---|---|---|
| P1 | NADAC stands for National Average Drug Acquisition Cost and is published by CMS, the federal agency that runs Medicare and Medicaid. | S1, S2 | Dataset title on S2: "NADAC (National Average Drug Acquisition Cost)". Publisher shown on data.medicaid.gov: Centers for Medicare & Medicaid Services. |
| P2 | It is the average price retail pharmacies pay to buy a drug. | S1b, S1c | S1b: the survey gives "covered outpatient drug prices by averaging survey invoice prices from retail community pharmacies across the United States" and "focuses on the retail community pharmacy acquisition costs." S1c (Purpose): "The NADAC is designed to create a national benchmark that is reflective of the prices" paid by retail pharmacies. |
| P3 | It comes from a survey of retail pharmacies' purchase prices, and the prices are updated every week. | S1, S1b, S2 | S1b: "a monthly nationwide survey of retail community pharmacy covered outpatient drug prices"; "the NADAC file is updated on a weekly basis." S1: "We update the National Average Drug Acquisition Cost (NADAC) data and comparison data weekly." S1c: "Pharmacies are requested to voluntarily submit invoices." S2 carried as_of_date 2026-11-11 as its newest week on 2026-11-13. |
| P4 | It is a national average, not what any one pharmacy paid. | S1b | S1b: prices come from "averaging survey invoice prices from retail community pharmacies across the United States." |
| P5 | Some drugs are not in the survey. | S2 | A search of S2 returns no rows for drugs it does not cover. The page says so when a search comes back empty. |
| P6 | The survey measures what pharmacies pay on the invoice. Discounts and rebates that are not on the invoice line are not part of that price, which matters most for brand-name drugs. | S1c | S1c (Survey Request): discounts or rebates "not reflected on the invoice at the drug line item level" are left out of the NADAC calculation. S1c also classifies drugs for rate setting as B (brand), G (generic) and B-ANDA, the last "identified as brand drugs since they are generally marketed and priced as brand drugs." That rebates matter most for brands is our reading, not a quote. |

## B. The NADAC data the page reads (S2, S3)

| id | Fact | Value | Source / note |
|---|---|---|---|
| P10 | 2026 dataset id | fbb83258-11c7-47f5-8b18-5f8e79f7e704 | S2. The id changes each calendar year; the page looks it up with S3 and falls back to this id. |
| P11 | Fields used | ndc_description, ndc, nadac_per_unit, pricing_unit (EA, ML or GM), classification_for_rate_setting (G generic, B brand), effective_date, as_of_date | S2, row seen 2026-11-13: ATORVASTATIN 20 MG TABLET, nadac_per_unit 0.02858, pricing_unit EA, classification G, effective 2026-10-21, as of 2026-11-11 |
| P12 | Every package code (NDC) and every weekly as_of_date is its own row | 2,998 rows matched "ATORVASTATIN 20 MG%" across 2026 | S2. So the page keeps only the newest as_of_date and shows one line per drug description. When package codes of one description differ in price, it uses the middle (median) price and says so. |
| P13 | Cross-origin browser requests are allowed | HTTP 200 with CORS for https://knownquantityllc.com, about 3.8 seconds | S2, checked 2026-11-13 |

## C. Cost Plus Drugs (S4, S5)

| id | Claim on the page | Source | Quote / note |
|---|---|---|---|
| P20 | Cost Plus Drugs is one online (mail-order) pharmacy that lists cash prices. | S4 | Prices are listed on its site and shipped to the buyer. |
| P21 | Its prices include a 15% markup on its cost. | S4 | FAQ, read 2026-11-13: 15% markup. The FAQ does not state a pharmacy fee amount, so the page does not either. |
| P22 | Shipping is extra; standard shipping is about $5. | S4 | FAQ, read 2026-11-13. |
| P23 | Prices change. | S4, S5 | The API returns the current listed price; the page tells people to check the Cost Plus site. |
| P24 | The public API returns a quote for a drug code and a quantity (requested_quote), plus name, strength, form, brand or generic, and a product link. It carries a deprecation notice. | S5 | Response fields seen live on 2026-11-11: medication_name, strength, form, ndc, requested_quote, requested_quote_units, brand_generic, url, deprecation_notice. |
| P25 | How the page gets a quote without sending your quantity: it asks for the listed price of 30 and of 90 units (the same two numbers for everyone). For 30 or 90 it shows that price. For any other amount it draws a straight line between the two and labels the result an estimate. | S5 | Our method. Not a Cost Plus statement. |

## D. Our explanations (not sourced facts; labelled as advice on the page)

- A pharmacy also pays for staff and rent, so a fair price is higher than what it paid for the drug.
- What you can do: ask the cash price, ask about a 90-day fill, compare pharmacies, ask your doctor about a generic or another strength, call your plan. Do not stop or skip a medicine because of price; talk to your pharmacist or doctor first.
- Your insurance copay can be lower than any cash price. Compare both.
- The yearly figure assumes the same fill every month (12 fills).

## Not used (could not confirm on 2026-11-13)

- Any Cost Plus pharmacy or dispensing fee amount (not stated on S4).
- Any claim that NADAC is used to set a particular state's Medicaid payment.