America's drug discount system is at a make-or-break moment. Patients in the U.S. are paying too much for prescription drugs compared to peer countries,1 even as spending for government discount programs has reached new heights.2
At the core of this dissonance is a collaboration breakdown. Mistrust among key stakeholders in the drug discount ecosystem have spilled over into courtrooms, legislatures and the front pages of major newspapers. And years of status quo complacency have stacked the deck against meaningful change.
But the very pressures that have pushed the system to the brink have also created an opening for a paradigm shift that can promote collaboration and ensure that programs work as intended. We call it "the Big Win" — a drug discount system that creates seamless collaboration, builds mutual understanding and puts the patient at the center of a system that delivers for them.
Alarm bells are going off across the drug pricing ecosystem. Out-of-pocket drug costs remain a heavy burden for many Americans. As discount programs expand, the cost of duplicate discounts and other inaccurate payments rises, creating operational burdens for all stakeholders. When drug discount programs become mired in dysfunction, patients are affected. The stakes have never been higher.
If we fail to get drug discount programs working as intended once more, adverse conditions will continue to harm every stakeholder — patients most of all. Here are the major pitfalls that threaten to derail the mission.
We all have to step back every once in a while and realize we’re all facing some of the same challenges."
The Game Plan for Success
It’s audacious to imagine a solution to these obstacles — and Kalderos has embraced that kind of audacious vision from the very beginning. Here, we lay out our game plan for taking on these obstacles one by one.
Through ongoing conversations with state Medicaid agencies and their vendors, Kalderos is continually learning what will make their lives easier. With that focus in mind, we are regularly evolving the claim-level data reports to suit their needs."
When we give stakeholders access to the same data, compiled and curated from multiple independent sources, we drastically reduce the disputes that have plagued the system for so long. It is essentially like getting everyone to finally speak the same language."
The Big Win
The Big Win is a drug discount system built on transparency and trust. It’s realized through a collaborative platform that gives all stakeholders access to the same data, allowing them to focus on a central mission: to better serve patients.
The endpoint of this mission is to achieve drug discount collaboration that will benefit covered entities, manufacturers and states alike. But perhaps most important, patients will finally receive the full advantages of a drug discount system that delivers for them.