Monitoring and Analyzing Revenue Leakage

Discounted purchases under the 340B Drug Discount Program have rapidly increased, requiring manufacturers to closely monitor program abuse to minimize market cannibalization, diversion, and margin loss. Manufacturers lack a unified view of commercial and 340B transactions to monitor and analyze potential revenue leakage.

Industry Challenges

Despite the 340B certification and audit process, compliance and revenue leakage is a growing fiduciary risk. Manufacturers lack controls and transparency to all relevant sales, product movement, and discounts aligned by covered entity and contract pharmacy. Some hospital systems are voluntarily settling with manufacturers in advance of CMS Final Rule on 340B, but manufacturers lack data to negotiate settlements.

Traditional syndicated datasets contain gaps and can be difficult to align with chargeback data to identify revenue loss. The inability to identify contract pharmacy lines in 867 data, along with issues arising from blinded or blocked portions of that data, can limit broader use of these datasets for analysis.

IntegriChain Delivers Answers Your Revenue Stream Questions

IntegriChain Revenue Analytics leverages its best-in-class channel master data and analytics to deliver an unparalleled unified view of how patients access products. These datasets offer an unparalleled, unified view of commercial and 340B transactions across all covered entities, sites of care, owned pharmacies, and contract pharmacies to address today’s revenue analysis data challenges. Using your 867 data, enriched with IntegriChain un-blinding and master data, you can visualize 340B trends and forecasts, detect 340B abuse and audit targets, support the audit and settlement process, and identify incorrectly priced returns. With Revenue Analytics, you can access, visualize, and analyze data to answer:

Sales & Marketing Questions

  • How much cannibalization of commercial sales is there?
  • How much 340B business is switching to Retail or Specialty Pharmacy?
  • How will 340B trends impact margins and sales mix over the next few years?

Finance & Audit Questions

  • How can we establish controls over a program with material revenue risk?
  • How can we stop abusive margin erosion?
  • How can we negotiate fair settlement based on HRSA audit or covered entity self-disclosure?

Patient Journey Questions

  • Are Payers or IDNs moving patients to lower cost sites of care?
  • Is there limited distribution adversely impacting the patient journey? Services? Out-of-pocket expenses?

Learn more:

Contact us today to learn more about how IntegriChain can help you analyze your revenue streams and monitor discounted drug purchases and revenue leakage: 609.806.5005