1. (1) the name of the manufacturer;
2. (2) the drug product's NDC;

3. (3) a description of the drug product that includes the;

   1. (a) name;
   2. (b) strength;
   3. (c) dosage form; and
   4. (d) package size;
4. (4) the FDA classification of the drug product as brand or generic;
5. (5) the effective date of the WAC increase for the drug product;
6. (6) the amount of the WAC increase for the drug product;
7. (7) the WAC resulting from the reported cost increase for the drug product;
8. (8) the WAC one calendar year prior to the effective date of the reported cost increase of the drug product;
9. (9) the WAC two calendar years prior to the effective date of the reported cost increase of the drug product;
10. (10) a written description, suitable for public release, of the factors that led to the increase in the WAC of the drug product and the significance of each factor; and
11. (11) the manufacturer's aggregate company-wide research and development costs for the most recent year for which final audit data is available.

The reported WAC history shall include the following information:

KEY: data, data reporting, insurance, pharmacy manufacturer

Date of Last Change: May 11, 2022

Authorizing, and Implemented or Interpreted Law: 31A-2-201; 31A-48-103