# List Price A drug's **list price** — formally the **wholesale acquisition cost (WAC)** — is the manufacturer's published price before any discounts or rebates. It is the headline figure cited in "drug costs $X" stories, yet almost no one pays it: the **net price** after [[Drug Rebate]]s is often dramatically lower. ## Why It Matters The gap between list and net price is the central mechanic of U.S. [[Drug Pricing]]. Because [[Pharmacy Benefit Managers]] negotiate rebates as a percentage off list, a *higher* list price can mean a *bigger* rebate — a structural incentive to inflate the sticker. Worse, patient cost-sharing is frequently calculated on the list price, so patients can pay more precisely because rebates are larger. List-vs-net opacity is why drug-pricing transparency is a perennial (and perennially stalled) reform demand. See [[Drug Pricing]] and [[Spread Pricing]].