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The Centers for Medicare & Medicaid Services' Medicaid Drug Rebate (MDR) system performs the URA calculation using the labeler's reported pricing. The specific methodology used is determined by law and depends upon whether a drug is classified as single source ("S" drug category), innovator multiple source ("I" drug category), or non-innovator multiple source ("N" drug category). Current URA Calculation for "N" Drug ProductsFor "N" drugs, the URA is equal to 11% of Average Manufacturer Price (AMP). See the links in the Downloads section below for an example of an "N" drug URA calculation. Current URA Calculation for "S" or "I" Drug ProductsFor "S" or "I" drugs, the URA is determined through three steps or calculations. The first calculation provides the basic URA, the second provides the additional URA, and the third adds the basic URA and the additional URA together to determine the total URA. Step One – Basic URA – The basic URA equals the greater of a) AMP times 15.1 percent
OR
b) AMP minus BP Step Two – Additional URA – The additional URA is calculated as follows: - Divide the Baseline AMP by the Baseline Consumer Price Index-Urban (CPI-U). See the links in the Downloads section below for a definition of Baseline AMP and Baseline CPI-U.
- Multiply the resulting number by the quarterly CPI-U. See the links in the Downloads section below for a definition of the quarterly CPI-U.
a) If this number is less than the quarterly AMP, subtract it from the quarterly AMP to determine the additional URA
b) If this number is equal to or greater than the quarter's AMP, the additional URA is equal to zero Step Three - Total URA - The Total URA is equal to Basic URA + Additional URA. See the links in the Downloads section below for an example of an "S" or "I" drug URA calculation.
Page Last Modified: 06/20/2006 2:30:00 PM
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