Article

Best practices for WAC decreases

Wholesale Acquisition Cost (WAC) decreases have become more common in recent years as manufacturers look to broaden patient access. And while the intent of these decreases may be positive, the way manufacturers manage them can add unintended economic hardship to the very dispensing sites they — and their patients — rely on. 

These dispensing sites — such as health systems, long-term care facilities, government-supported sites, community pharmacies, and retail pharmacies — often purchase products in advance to ensure timely access for their patients. But when a WAC decrease takes effect, reimbursement rates from insurance providers will often drop too, which may result in the dispensing sites not recovering what they paid for a drug.

For organizations operating on razor-thin margins, that kind of loss can be a real financial shock.


Independent pharmacies are particularly vulnerable. They're already facing significant economic hardship from declining reimbursement rates1, rising costs2, increased competition3, and the resulting shrinking profit margins. A WAC decrease can turn their inventory into a liability, leaving them even worse off and, in some cases, at risk of closing down completely.

The good news is that this type of negative result is avoidable with a few proactive choices from manufacturers in how they manage their WAC decreases. These changes are easy to do. They just take some planning. 

As a pharma services and distribution partner, Cencora helped support WAC decreases of products across sixteen different therapeutic areas over the past two years4. Based on this experience, we've developed a set of “best practices” that we believe may result in a more effective management of WAC decreases with less disruption to dispensing sites.

 

1. Change the timing of your customer communications

Many manufacturers approach communications about WAC decreases the same way they handle increases. However, a WAC decrease requires a different mindset.  

Manufacturers will often delay announcements about WAC increases to prevent customers from buying excess inventory at the lower price. However, upcoming decreases should be communicated as early as possible. This is so customers have time to exhaust their inventory at the current price as well as, when possible, avoid unnecessary purchases at the current price. The less inventory your customers hold at the higher WAC price, the less they'll be impacted financially when it goes down.

In addition, early notice affords your customers more time to make returns if it’s possible or needed, while avoiding times of year that are challenging for returns, such as around holidays or at times when they have limited staffing.

Our recommendation

We recommend communicating a WAC decrease to customers between one to three months before it takes place.

2. Use a program that doesn't involve moving product

Manufacturers may offer programs to make whole any customers who are still carrying inventory at the higher WAC. However, the type of program makes a difference.

The structure of certain programs, create a hardship on the customer to have to move a product as a result of pricing changes, such as by returning it or swapping inventory. It can be difficult, time-consuming, and expensive — adding to the significant administrative burden dispensing sites are already managing.

Our recommendation

Focus on a rebate-based program where customers can avoid the financial loss of a WAC decrease without having to physically return the product.

A rebate-based program supports a positive customer experience for dispensing sites by keeping the product in the channel, while also supporting continuity of care for patients.

Tips for a successful rebate program 

  • Eligibility window: Base eligibility on purchases from the past 30 days, or at minimum 15 days.
  • Rebate calculations: Credit the per-unit difference between the old and new WAC.
  • Distributor support: Partner with an authorized distributor to track sales data and process rebate payments. 
  • Program scalability: Simplify the program as much as possible to make it easier to offer across all dispensing sites.
     

3. Be mindful of how you treat your customer segments

Some manufacturers will only target strategic customers with notifications about upcoming WAC decreases or applicable rebate programs.

However, pricing changes can have a significant impact on all dispensing sites, regardless of size. In fact, WAC decreases can have a disproportionately negative impact on smaller independent pharmacies that are operating on very thin margins. 

Our recommendation

Treat all your customers the same. Have one standard communication that goes to all customers at the same time and use the same rebate program across all customers.

The program could be either managed internally, or externally by your distribution partner, or a combination of both. For example, some manufacturers prefer to directly manage programs with large retail chains. Regardless of how it's managed, the program and associated communications should be the same. 

4. Engage your distribution partner early

It is important to engage with a distribution partner before you announce the WAC decrease to your customers. This allows your distribution partner to help you pursue the best plan for your shared customers.

Early engagement also provides sufficient time to address any changes needed to the distribution contract and your partner may be able to help you identify the best time to execute the WAC change in relation to your distribution contract. For example, it may be easier on all stakeholders to wait until the current contract expires.

Our recommendation

We recommend notifying your distribution partner at least nine months prior to executing a WAC decrease.

A smarter strategy for WAC decreases

Rethinking your approach to WAC decreases doesn't just benefit dispensing sites and patients; it also ultimately benefits your success as well. When dispensing partners remain financially stable, they're better equipped to keep products available, maintain patient access, and continue serving as a vital access point for your products. By minimizing disruption and showing a commitment to shared success, manufacturers can strengthen their long-term relationships with dispensing sites, help patients have better access to care, and create an even stronger reputation in their channels. 

Cencora is committed to supporting both its manufacturer partners and sites of care who dispense their products. If you have questions about how to manage your WAC pricing changes, contact your Cencora Sourcing Manager or click here today.

This article may contain marketing statements and shall not constitute legal advice. Cencora, Inc. strongly encourages readers to review all available information related to the topics mentioned herein and to rely on their own experience and expertise in making decisions related thereto.


REFERENCES 

1. Cheema, Muhammad. PBM Price Negotiations Have Unintended Consequences for Independent Pharmacies. Pharmacy Times. 27 November 2024. Accessed 28 August 2025. Available online at https://www.pharmacytimes.com/view/pbm-price-negotiations-have-unintended-consequences-for-independent-pharmacies 

2. Nowosielski, Brian. Independent Pharmacies Continue to Face Financial Hardships as the Clock Ticks on PBM Reform. Total Pharmacy Journal. 7 March 2024. Accessed 28 August 2025. Available online at: https://www.drugtopics.com/view/independent-pharmacies-continue-to-face-financial-hardships-as-clock-ticks-on-pbm-reform 

3. Hassanein, Nada. Independent pharmacies know their communities. But many are struggling to stay open. Stateline. 17 January 2025. Accessed 17 August 2025. Available online at: https://stateline.org/2025/01/17/independent-pharmacies-know-their-communities-but-many-are-struggling-to-stay-open/

4. Internal data as of June 24, 2025


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