Case Study: Leading Pharmaceutical Manufacturer identifies more than $45M in commercial exclusions with Kalderos

Kalderos identifies more than $45M in commercial exclusions for Company W with Commercial Discount Monitoring

A leading pharmaceutical manufacturer faced the challenge of identifying and excluding ineligible rebates claimed by Pharmacy Benefit Managers (PBMs), particularly for drugs already subject to 340B discounts. This unregulated area of commercial rebates created significant waste in drug costs. To address this, the manufacturer engaged Kalderos and its Commercial Discount Monitoring solution for its expertise and sophisticated 340B validations.

Kalderos implemented its Drug Discount Management platform to ingest and analyze the manufacturer's commercial claims data. The platform efficiently flagged potential 340B claims and data inconsistencies, which were then validated and submitted for exclusion. This solution provided the manufacturer with critical data analytics to strengthen its processes. As a result, Kalderos successfully identified over $45 million in commercial exclusions for the manufacturer between 2019 and 2023.