Company reports that since 2016, its tech-enabled platform for Drug Discount Management has identified nearly $1 billion in inaccurate drug discount claims
Company reports that since 2016, its tech-enabled platform for Drug Discount Management has identified nearly $1 billion in inaccurate drug discount claims
CHICAGO, June 13, 2023 — Data infrastructure and analytics company Kalderos, creator of the world’s first Drug Discount Management platform, released its 2023 annual report today. The report, titled “Mission Critical: Bringing drug discount stakeholders together so patients win,” outlines Kalderos’ vision for a new paradigm of cooperation among drug discount program stakeholders in which everyone benefits — particularly patients.
As the Medicaid Drug Rebate Program (MDRP), 340B Drug Pricing Program and other similar programs expand, so do the volume and cost of duplicate discounts and other inaccurate drug discount claims. Across the healthcare industry, outdated technology, inadequate infrastructure and intractable data silos make it difficult to prevent these misapplied discounts, resulting in drug manufacturer overpayment.
In response to this systemwide challenge, Kalderos’ MDRP Discount Monitoring solution analyzes and validates claims data while flagging potential duplicate discounts and other inaccurate claims. Between 2016 and Q1 2023, Kalderos’ MDRP Discount Monitoring solution identified nearly $1 billion in inaccurate discount requests. As Kalderos partners with an increasing number of drug manufacturers to process even bigger data sets, that number continues to grow.
“The findings in our third annual report are significant,” said Kalderos CEO Brent Dover. “We urge all stakeholders in drug discount programs to work together on building cooperation and trust. Full transparency and information are mission critical to attaining these goals and enabling our healthcare system to better serve patients.”
Costs of inaccurate discount payments
Across dozens of assessments produced for prospective customers of Kalderos’ MDRP Discount Monitoring solution, Kalderos identified an average of 5% potentially inaccurate discounts, mainly duplicate discounts between Medicaid and 340B. Manufacturers contend with widely varying rates of inaccurate drug discount claims and resulting overpayment; some assessments identify more than 10% potentially inaccurate claims and some as low as 2%.
Outside of their financial impact, inaccurate discount payments also lead to mounting administrative responsibilities for manufacturers and 340B covered entities that can redirect valuable resources away from patients. But the free-flowing system of data enabled by Kalderos relieves all stakeholders of the arduous process of tracking down misapplied discounts.
Engaging Covered Entities
Drug discount programs are critical for the support they provide safety-net healthcare providers and their patients, many of whom live in vulnerable communities.
To date, thousands of 340B covered entities have used Kalderos’ Discount Hub solution to participate in the good faith inquiry process and resolve concerns related to duplicate discounts. In recent years, covered entities have been increasingly engaged in reviewing MDRP claims on the platform, which has nearly halved the average response time from 135 days in 2022 to 69 days in 2023. This reduced response time accelerates duplicate discount verification and resolution of inaccurate claims.
From 2016 through the first quarter of this year, CEs using the Kalderos platform responded to 842,637 discount verification requests. By the end of Q1 2023, the total dollar value of CE-verified duplicate discounts on the Kalderos platform was about $110 million.
Back-to-back years of strong growth
For Kalderos, 2022 was a year of impressive progress across several metrics:
- Annual revenue more than doubled for the second consecutive year.
- Total customers also doubled for the second straight year.
- The number of employees at Kalderos grew by more than 50%.
Kalderos’ third annual report, “Mission Critical: Bringing drug discount stakeholders together so patients win,” is available now.
About Kalderos
Kalderos is a data infrastructure and analytics company that created the world’s first Drug Discount Management platform, simplifying drug discount program compliance for all stakeholders. The platform applies sophisticated data models and machine learning to identify and resolve noncompliance, with collaboration-oriented solutions built for both drug manufacturers and covered entities. Based in Chicago, Kalderos was founded in 2016 by a team dedicated to reducing inefficiencies in the U.S. healthcare system, empowering everyone to focus on the health of people. More information can be found at www.kalderos.com.
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Media contact:
Philip Anast
Amendola (for Kalderos)
312-576-6990