I'm all too familiar with the challenges and concerns that hold the attention of manufacturers, having spent most of my career in the pharmaceutical manufacturer space before joining Kalderos as Vice President of Strategy, Manufacturer Solutions.
I was drawn to Kalderos, not just for the bold mission of solving drug discount program challenges with trust, transparency and collaboration, but because I saw a company developing innovative solutions that address the specific challenges faced by all stakeholders, including manufacturers, states, covered entities and—most critically—patients.
When I speak to friends and colleagues in the pharmaceutical space they know that the current complex and opaque discount system is not sustainable in the long term, which is when I am happy to explain exactly how and why Kalderos is redefining how the business of healthcare performs so drug discount programs work better for all.
The challenges manufacturers face
Today's manufacturers are focused on immediate concerns of revenue and compliance.
Revenue recognition is an essential part of measuring an organization’s performance. It is critical that companies include drug discounts from contractual obligations in their financial planning process. However, when noncompliance occurs, it may have a negative impact on an organization's financial performance and reporting. This can lead to uncomfortable discussions with leadership and, in the worst case scenario, a need to restate earnings.
Manufacturers must avoid paying duplicate discounts in order to maintain a sense of revenue clarity and compliance in their operational processes. The issue of duplicate discounts continues to cause undue risk for manufacturers, and the matter is only becoming more pressing.
A number of long smoldering trends and recent developments have only increased apprehension surrounding these issues of revenue and compliance. The rapid growth in the number of contracted pharmacies for 340B, which has thankfully expanded coverage for many patients, has also increased the volume and intricacy of discounts to manage. What might have been a minor issue ten years ago can now be a major source of revenue leakage for manufacturers.
At the same time, there has been renewed government focus on compliance. High drug prices have caused 1 in 4 Americans to struggle to pay for their prescription medications, causing a valid spotlight to shine on the prescription drug distribution system. Manufacturers, providers and state payers are all well-advised to take steps to ensure that their drug discounts are being efficiently managed.
In short, the market has increased the urgency for companies to adopt a Drug Discount Management plan. Failure to do so could cause manufacturers to incur revenue losses, be forced to restate earnings or even face government penalties.
What Kalderos offers
From the beginning, what stood out to me about Kalderos was an approach that was innovative, based in technology, and—most importantly—sought input and consideration from all stakeholders to ensure that the solutions we provided would be a "win-win-win."
This is the vision that our company founder Jeremy Docken has carried since 2016, when he began Kalderos to provide a solution for Drug Discount Management that works in partnership with covered entities, states and manufacturers. Jeremy has vast knowledge and experience within the 340B space, and he has built a strong relationship with HRSA to confirm that every innovative solution Kalderos develops is going to make compliance easier, not harder, to maintain.
The foundation of collaboration is at the very center of our Discount Monitoring solution, built on Kalderos' first-of-its-kind digital platform.
Providing drug discount clarity with a unified view
Kalderos Discount Monitoring is the only modern, cloud-based solution that applies intelligent algorithms to claims level data, identifying the compliance issues that other approaches miss. Our technology has already empowered many manufacturers to review claims retrospectively with the newly designed and released Verify tool.
Verify uses machine learning and an easy-to-use interface to enable drug manufacturers to understand exactly what is owed. The manufacturers who utilize Verify have been able to reap multiple benefits, including a simplified workflow, support for every aspect of the dispute resolution process and an additional level of security for potential audits.
The truth is that Verify offers a tech-based solution for those concerns about revenue and compliance that can weigh heavy on the minds of manufacturers—within a framework that also delivers value to states and covered entities. It's precisely the type of collaborative and innovative solution that brought me to Kalderos in the first place.
Verify is unifying in the best way. And after seeing how Verify can help manufacturers and other stakeholders, it makes me excited for what else our team can do to redefine how the business of healthcare performs.