To understand repackaging, you must first understand what an NDC number is. Each drug is given a National Drug Code number, otherwise known as an NDC number. The first four digits represent the manufacturer/company code. The last two digits are the package size and everything in between is the code for the drug and the strength.

The chart below is a partial list showing different prices on the different NDCs for Nexium 20mg. Keep in mind that only one company, Astra Zeneca, makes Nexium. They have six different NDC numbers. The remaining NDCs are repackaged NDC numbers.

 AWP = Average Wholesale Price

Repackaging typically occurs when a company buys a large bottle of a prescription medication such as Nexium, and makes it into smaller bottle sizes. So, if a company buys a 1000 count bottle of Nexium and simply divides it into 10 bottles of 100, this is repackaging. The new bottle of 100 is given a new NDC and a new price. The price is at the discretion of the re-packager. As you can see above, the prices of these repackaged Nexium’s range from $4.49 to $14.61 per capsule.

An even bigger problem (as if the repackaging wasn’t enough) is that most drug pricing for consumer plans are based on AWP minus a certain percentage. When you purchase drugs through mail order, you will not know if the AWP they are using in the formula is the $4.49 or the $14.61 or something in between. Traditional PBMs will not share this information with you. Truly transparent PBMs such as Lakeview PBM Solutions, will.