How Medicaid URA cap removal impacts manufacturer operations & the drug discount landscape
William Born, Vice President, Product Strategy, Kalderos
Cathy Burton-Meza, Associate Director, Government Rebate Operations at Gilead
The dynamic political landscape surrounding drug pricing is sure to present changes and challenges for drug manufacturers in 2021, especially in the area of drug discounts. One impactful change is the removal of the Medicaid Unit Rebate Amount cap, which aims to create a painful financial disincentive for manufacturers who have increased a drug’s price faster than the rate of inflation. The Congressional Budget Office has scored this provision as a way to reduce direct spending in Medicaid by $15.9B in the next decade.
However, removing this cap has other implications, especially for drug manufacturers. Learn how this change may impact your 340B strategy and how you operationalize the processing of Medicaid rebate claims. Evolving from paying discounts on time to paying the right amount has never been more important. Explore how to navigate this developing situation to effectively manage your drug discount programs.
Key points of discussion:
- Discuss policy updates around Medicaid URA caps
- The impact of the removal of the Medicaid URA cap
- Re-evaluating the importance of paying the right discount versus paying on time
- Updating your Medicaid Drug Rebate claim process to meet this changing landscape
- Using the most advanced technologies to ensure best chances of paying the right discount
- Where can machine learning fit into your process to enable you to pay on time
- Implications and interplay with other discount programs
About the Sponsors
Kalderos created the world’s first Drug Discount Management platform, which uses sophisticated models and machine learning to resolve noncompliance in drug discount programs through its 340B Pay and Discount Monitoring solutions. Based in Chicago, Kalderos was founded in 2016 by a team dedicated to reducing inefficiencies in the U.S. healthcare system, empowering everyone to focus on the health of people.For more information please visit www.kalderos.com.