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Hard-earned Insights That Help Drug Manufacturers Achieve Their Growth, Compliance, & Profitability Objectives
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...
Unit Rebate Amount Calculation For Medicaid
How to Calculate A Unit Rebate AmountFor people who regularly work in the pharmaceutical industry within the government pricing space, the question of how a URA is calculated may be one easily answered. For even the most seasoned pharma executives not exposed to...
Pharma Impacts of Unwinding Medicaid Continuous Enrollment
Part I – Unwinding Medicaid Continuous Enrollment May 2022After a slight decline from 2017 to 2019, Medicaid enrollment rose sharply throughout the pandemic. Historically, Medicaid enrollment tracks with unemployment rates. When rates rise, enrollment increases....
Why Prepare Now for 2024 Medicaid Rebate Cap Removal
Reasons to prepare now for the 2024 Medicaid rebate cap removalDoes it feel like proposed Medicaid rule changes are too far in the future to think about? Or the proposed changes appear so dramatic that it seems unlikely to pass into law, so there’s little need to...
Is Wholesale Distribution Right for Drug Makers?
Is wholesale distribution the best option for drug manufacturers?In today’s market, customer mergers and consolidations leave drug manufacturers few options in establishing a distribution strategy to make their products available and remain profitable. The popular...