Resource Center
Hard-earned insights that help drug manufacturers achieve their growth, compliance, and profitability objectives
Medicaid – From a 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 Likely To Have A Negative Financial Impact On Many 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...
Understanding Class of Trade (COT) in the Pharmaceutical 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...
Beware of the Many Operational Challenges of Medicaid Rebate Processing
Beware of the Many Operational Challenges of Medicaid Rebate ProcessingFor most pharmaceutical manufacturers, participation in the U.S. Federal Medicaid Drug Rebate Program (MDRP) is an important and necessary component of their commercialization...
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,...
Part I 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....
Update 2023 Best Price Accumulator Adjustment Program 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...