OIG Reports Fourth Quarter 2025 Drug Pricing Comparison Shows ASP-AMP Spreads
The HHS Office of Inspector General released its quarterly comparison of Average Sales Prices (ASP) and Average Manufacturer Prices (AMP) for drugs in the fourth quarter of 2025. This routine report identifies drugs where ASP exceeds AMP by specified thresholds, which triggers potential Medicaid reimbursement adjustments under federal law. The data covers Medicare Part B drugs and provides transparency into pharmaceutical pricing differentials that affect both Medicare and Medicaid programs. CMS uses these comparisons to determine when Medicaid best price penalties may apply.
Significant ASP-AMP spreads can trigger Medicaid rebate adjustments and affect managed care pharmacy costs, particularly for specialty drugs and physician-administered medications covered under both Medicare Part B and Medicaid managed care carve-ins.