If you have used the RxTariff drug search tool, you have seen a price labeled "NADAC" next to your medication. Most patients have never heard of NADAC — it is not the price you pay at the pharmacy counter, and it is not your insurance copay. But understanding what NADAC is and why it matters is essential for understanding how the 2026 pharmaceutical tariff will actually move through drug prices.
What NADAC Stands For
NADAC stands for National Average Drug Acquisition Cost. It is a weekly survey conducted by the Centers for Medicare & Medicaid Services (CMS) that measures the average price retail community pharmacies pay to purchase drugs from manufacturers or wholesalers.
In plain English: NADAC tells you what your pharmacist paid for the drug before they sold it to you.
Who Publishes NADAC and Why
CMS publishes NADAC as a publicly available dataset at data.medicaid.gov. The primary purpose is to inform Medicaid reimbursement rates — the federal government uses NADAC as a benchmark to ensure state Medicaid programs are paying pharmacies appropriately for drugs.
The survey covers most drugs dispensed in retail pharmacies. Pharmacies report their actual invoice prices, and CMS aggregates them into a weekly national average. The data is freely available to anyone.
What NADAC Is NOT
NADAC is not:
- Your retail cash price — Pharmacies mark up drug costs significantly. Cash prices at the counter are typically 20–80% higher than NADAC.
- Your insurance copay — Copays are set by your insurance plan, not by acquisition cost.
- The manufacturer's list price (WAC) — Wholesale Acquisition Cost is the manufacturer's sticker price. NADAC is what pharmacies actually pay after wholesale discounts.
NADAC is the baseline cost before the supply chain and insurance system layers on their economics.
Why NADAC Matters for the 2026 Tariff
The Section 232 pharmaceutical tariff hits at the import level — the cost of bringing the drug or its active ingredients into the United States. This cost directly flows into the acquisition price that pharmacies pay, which is exactly what NADAC measures.
When this site shows you a drug's NADAC price, it is showing you the current baseline cost that sits at the front of the tariff exposure chain. A 100% tariff theoretically doubles the import cost — which flows up through the supply chain toward NADAC, toward retail, and eventually toward your copay.
For example:
- A drug with a NADAC of $500/month today could see acquisition costs rise toward $1,000/month if a 100% tariff fully passes through the supply chain.
- The same drug at $50/month NADAC (like many common generics) is exempt — NADAC stays flat.
How to Use NADAC Data
NADAC is the most reliable publicly available measure of drug acquisition cost. It is updated weekly and covers most retail drugs. On this site, we pull real-time NADAC data from the CMS API for any drug you search — so you see the actual, current government benchmark for what that drug costs at the pharmacy acquisition level.
Combine the NADAC price with the drug's tariff tier shown in the search results, and you have a data-driven basis for estimating your risk exposure.
Search your drug using the RxTariff tool to see its current NADAC price alongside its tariff classification.