Stakeholders across state and federal drug discount programs agree that reforms are desperately needed to resolve systemic challenges and make the programs work better for everyone — most importantly, the patients who rely on them.
Among the more pressing challenges plaguing both the 340B program and the Medicaid Drug Rebate Program (MDRP) are how to resolve and prevent duplicate discounts. The issue was top of mind at the recent 2022 Medicaid Drug Rebate Program conference in Chicago, where we hosted a virtual panel discussion on how technology could be a solution to this complex problem.
Kalderos believes communication and transparency across all stakeholders participating in drug discount programs are essential. That’s why we facilitated a conversation among representatives from covered entities, manufacturers and state payers to discuss how we can all work together to improve these programs, prevent duplicate discounts and make the experience more seamless for everyone.
Communication is key
When discussing the challenges surrounding 340B and other drug discount programs, panelists agreed that better communication is needed. Panelist Fern Paul-Aviles, director of 340B and regulatory program compliance at at Atrium Health (formerly Carolinas HealthCare System), highlighted how collaboration could increase efficiency and eliminate data inaccuracies, such as missing modifiers that determine 340B eligibility.
Most people don’t understand that hospitals and pharmacies have two different kinds of billing systems and methodologies. In a lot of cases, covered entities don’t even know that many states contract with a rebate processing company. I would suggest covered entities, states and rebate processors get to know each other so we can talk about issues and know who to reach when we have a question.
<span class="quote-author">Fern Paul-Aviles</span>
<span class="quote-title">Director of 340B and regulatory program compliance at at Atrium Health (formerly Carolinas HealthCare System)</span>
Panelist Jodi Hettinga, a drug rebate manager with Gainwell Technologies, echoed that sentiment, pointing out that building relationships and an open line of communication could help ensure the programs work better.
“I found that in my conversations with manufacturers, we weren’t speaking the same language,” said Hettinga. “So, I’ve made it my personal mission to build relationships with my manufacturing friends to eliminate difficult conversations.”
All three panelists agreed that when stakeholders have open lines of communication they can more easily identify where discount drug programs are faltering and forge holistic solutions that benefit everyone.
“We have to step back every once in a while and realize we’re all facing some of the same challenges,” said Ryan Bruce, a senior Medicaid analyst at AstraZeneca. “When we can have that face-to-face collaboration, we can alleviate a lot of our pain points.”
Harnessing technology to foster collaboration
Kalderos is committed to accelerating collaboration and facilitating transparency among all program participants. We offer technology-enabled solutions designed exclusively for both covered entities and drug manufacturers that support drug rebate compliance, preempt duplicate discounts and create balance among stakeholders. Our user-friendly platform, streamlined interfaces and machine learning provide a simplified sign-on experience and easy access to investigate all good faith inquiry claims.
As government-administered drug discount programs continue to expand, the need for greater collaboration and transparency is more pressing than ever. Our multi-sided technology can help all parties navigate these evolving programs and make them work better for everyone.
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