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Hard-earned Insights That Help Drug Manufacturers Achieve Their Growth, Compliance, & Profitability Objectives
CMS Enforcement for ASP in Medicare Part B
CMS Enforcement of Average Sales Price (ASP) Submissions for all Medicare Part B Eligible Pharmaceuticals and BiopharmaceuticalsRecently, CMS has been sending letters to pharma and biopharma manufacturers (with and without MDRP agreements) indicating that they believe...
Top 3 Reasons Your AMP Changed
Top 3 Reasons Your AMP ChangedLarge variances in Average Manufacturer Price (AMP) values are a common source of inquiry for pharmaceutical manufacturers. Questions often arise when internal stakeholders are trying to understand an undesired rebate liability or a...
Emerging Drug Price Disclosure Legislation – April 2020
Continued Emergence of Drug Price Disclosure LegislationTips for staying compliant with an accelerating trendStates Have Gotten Aggressive with Fines Against Pharma Companies for Price Reporting Noncompliance This paper, our third in a series that looks at the rising...
2023 Update: Best Price Accumulator Adjustment Ruling
Update – 2023 Best Price & Accumulator Adjustment Program Ruling2023 was shaping up to be a year of challenging decisions for manufacturers and restricted access to critical pharmaceuticals for patients. The 2023 implementation of the proposed CMS Medicaid Best...
Medicaid: From Simple Concept to an Operational Labyrinth
Medicaid – From a Simple Concept to an Operational LabyrinthThe federal government created Medicaid in 1965 as a public insurance program to expand existing federal support for healthcare services. It has since ballooned from its basic insurance program roots. Today,...
Inflation Reduction Act Impacts for Drug Manufacturers
Inflation Reduction Act Likely to Have a Negative Financial Impact On Many Drug ManufacturersOn August 16, 2022, the Inflation Reduction Act of 2022 was signed into law with provisions aimed at lowering drug, health care and energy costs for consumers in the United...
Branded Prescription Drug Fee Payment Deadline Approaching
Branded Prescription Drug Fee – Payment Deadline ApproachingFriendly reminder to all of our industry colleagues! The final Branded Prescription Drug Fee invoices should be mailed soon. No later than August 31st of each year, the IRS mails the final fee calculation to...
Key Terms in Pharmaceutical Government Pricing
Key Terms in Pharmaceutical Government PricingPharmaceutical pricing can be a challenge to understand and a difficult landscape to navigate. There are multiple prices set for each individual National Drug Code (NDC) – some publicly available and some not. WAC, ASP,...
Understanding Class of Trade (COT) in Pharma Industry
For pharmaceutical manufacturers, assigning Class of Trade designations to government pricing data can be a tedious exercise. However, it can have large implications on Medicaid rebate liabilities and present compliance risks if not managed correctly. Let’s take a...