Accelerated Pharmaceutical Contracting for Market Access Excellence

While a strong pharma pricing and contracting strategy can play a major role in nearly every aspect of drug commercialization, manufacturers often lack efficient processes to interpret, create, and manage contracts; navigate new regulations; and comply with all local, county, state, and federal laws. Manufacturers who rely on piecemeal processes leave themselves vulnerable to increased risk, delays, compliance violations, and revenue leakage.

Successful pharmaceutical manufacturers can achieve contracting excellence by choosing a partner that can manage regulatory process and compliance standards across government price, rebate, and chargeback management that can easily be maintained and adhere to growing demand.

IntegriChain’s pricing and contracting strategic services provide pharmaceutical manufacturers with the following resources and outcomes:

• Experienced GP analysts with a network of attorneys, auditors and risk advisors.
• Scrub and unify transaction data to IntegriChain point of care outlet and Class of Trade master.
• Government pre-deal analysis and contract document creation.
• Best-practice methodology and configuration by price type and contract.
• Calculate & validate all monthly, quarterly and annual prices.
• Audit trail explaining final prices, interim results, and calculation methodologies.
• Expertise and proven methodology for over 200 manufacturers.
• Communicates 340B & FSS Prices to wholesalers, distributors and 3PL.
• More than 200 manufacturers rely on IntegriChain’s business processes for rebate adjudication and government pricing.

Pharmaceutical rebates, originally created to better align the incentives of payers and providers, have now become an essential element of complex commercial and government access challenges. This complex rebate process makes it extremely difficult for manufacturers to focus their time and resources on business processes and managed market strategies.

As a trusted partner for government pricing as well as rebate management, IntegriChain processes hundreds of thousands of claims for a wide range of common fees annually. With modules to support different rebate types, manufacturers can scale their payer analytics and contracting functions.

• Interpret contract language, rebate schedules, formulary compliance and amendments.
• Reconcile price protection against actual contract language.
• Calculate unit rebate amounts for Medicaid, SPAP, Tricare and Managed Career Commercial and Part D Contract.
• Validate claims for eligibility, 340B pharmacy, duplication & aberrant quantities.
• Manage adjustments, disputes and interest with Payers / States or TPA
• Generate payment packages including reports, ROSI, PQAS, etc.
• Coordinate payments, fund replenishment and bank reconciliation.
• Experienced SMEs provide consulting and advisory services.
• Integration expertise and proven methodology.

$9B+ industry rebates

Eliminate Chargeback Overpayments

Chargebacks are a constant source of material business risk and revenue leakage. Because chargeback errors persist for a multitude of reasons, all pharmaceutical manufacturers that pay fees need a tool to verify contract compliance, otherwise they could be paying triple what they should.

• Account and Class of Trade master data management
• GPO membership maintenance
• Government-program-eligible accounts (Big 4, OGA, and 340B)
• Pricing management
• Contract management
• Contract price notifications to authorized wholesalers and 3PLs844 EDI management (chargeback claims)
• Chargeback data reconciliation

• Managing debt memos and lines
• Validations and HDA error processing reconciliation
• Resubmission processing
• Chargeback reconciliation reporting and 849 integration
• Generate chargeback payment request to ERP
• Operational reporting
• Wholesaler scorecards

IntegriChain’s chargeback data management uncovers 10-15% gross margin erosion.

Expert management of the complexities and compliance requirements of government pricing, including comprehensive and auditable control reports covering all price calculation details.

An integrated technology and services solution to address challenges related to the complexity of reporting requirements, data collection and management, timing and deadlines, and legal and financial risks.