Pharmaceutical Revenue Management Services

We assisted a biopharmaceutical manufacturer that was in the midst of a product launch enter contracts with the Department of Veterans Affairs (VA) and Centers for Medicaid and Medicare Services (CMS) for participation in the Federal Supply Schedule and Medicaid Drug Rebate programs. We supported the client in drafting methodology and policy documents, gathering data needed for calculations (using EY technology) and considering pricing implications associated with participation in government pricing programs. This supported a smooth and efficient product launch.

We guided a major pharmaceutical manufacturer through a large Medicaid Drug Rebate program pricing restatement. This project spanned multiple years, involving updates to product master attributes, customer classes of trade and transaction type classifications to comply with CMS rules and regulations. Following the successful restatement, the client determined that the EY solution was more efficient and customized to their needs and transitioned to our solution for ongoing government pricing operations, calculations and Medicaid processing.

Using the EY Medicaid Rebate processing technology, our clients have been able to recuperate significant and material amounts. When a manufacturer does a government pricing restatement or best price (BP) true-up that results in a decreased unit rebate amount (URA), many states do not automatically submit adjustments for overpayments. Our technology automates the identification of those situations so the manufacturer can apply those balances toward rebates owed to states, preventing revenue leakage.