definiens: means with respect to a Product, t he gross amount invoiced by PFIZER, its Affiliates and its sublicensees of such Product to Third Parties, less, without duplication, the following to the ext ent actually invoiced, paid, granted or accrued : sales returns a nd allowances, trade, quantity and cash discounts a nd adjustments granted on account of billing errors, r ejected goods, damaged or defective goods, recalls, returns, rebates, chargeback rebates, reimbursements or simi lar payments granted or given to wholesalers or oth er distributors, buying groups, health care insurance carriers or other institutions ; adjustments arising from consumer discount programs or other similar program s ; customs or excise duties, sales tax, consumption tax, value added tax, and other taxes ( except income tax es ) or duties relating to sales ; any reductions of payment in respect of sales to the United States government, a ny state government or any foreign government, or t o any other Governmental Authority, or with respect to an y government - subsidized program or managed care organization ( provided that any reductions, discoun ts or adjustments that apply collectively to multip le products including the Product shall be allocated pro rata t o the amounts invoiced for Products ) ; and freight a nd insurance ( to the extent that PFIZER bears the cost of freigh t and insurance for a Product ) . Net Sales shall be determined from books and records maintained in accordance wit h generally acceptable accounting principles in the United States, as consistently applied by PFIZER with resp ect to sales of all its pharmaceutical or biologic products