Survey of Retail Prices (CMS-10241)

ICR 202109-0938-001

OMB: 0938-1041

Federal Form Document

Forms and Documents
Supporting Statement B
Supporting Statement A
IC Document Collections
ICR Details
0938-1041 202109-0938-001
Received in OIRA 201805-0938-013
Survey of Retail Prices (CMS-10241)
Revision of a currently approved collection   No
Regular 09/02/2021
  Requested Previously Approved
36 Months From Approved 09/30/2021
72,000 30,000
36,000 15,000
0 0

CMS is performing a "Survey of Retail Prices: Payment and Utilization Rates, and Performance Rankings." This study is divided into two parts. Part I focuses on the retail community pharmacy consumer prices. It also includes reporting by the States of payment and utilization rates for the 50 most widely prescribed drugs, and comparing State drug payment rates with the national retail survey prices. The template for States to use to complete (Effective July 1, 2013, CMS has suspended Part I of the nationwide retail survey for collecting information about consumer purchase prices, pending funding decisions.) Part II of this contract focuses on the retail community pharmacy ingredient costs. This segment provides for a survey of the average acquisition costs of all covered outpatient drugs purchased by retail community pharmacies. The prices will be updated on at least a monthly basis.

PL: Pub.L. 109 - 171 6001 Name of Law: Deficit Reduction Act
PL: Pub.L. 109 - 171 6001(f) Name of Law: Deficit Reduction Act

Not associated with rulemaking

  86 FR 27623 05/21/2021
86 FR 49332 09/02/2021

IC Title Form No. Form Name
National Average Drug Acquisition Cost (NADAC) Survey CMS-10241 National Average Drug Acquisition Cost (NADAC) Survey Request for Information

  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 72,000 30,000 0 42,000 0 0
Annual Time Burden (Hours) 36,000 15,000 0 21,000 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Miscellaneous Actions
We propose to expand the number of retail community pharmacies that are sent the survey request each month. Currently, 2,500 pharmacies are randomly drawn each month and have the option of voluntarily completing the survey request. To further expand the survey population to derive more responses each month and ensure statistical validity to the NADAC pricing file, We propose to expand the survey population to up to 6,000 retail community pharmacies surveyed each month. Overall, the change would add 21,000 hr (total) per year. We also propose to add a Survey Cover Sheet that explains protections for drug acquisition cost data submitted by pharmacies. The document has no burden.

Yes Part B of Supporting Statement
Mitch Bryman 410 786-5258 [email protected]


On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

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