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Company pitches a mfr-payer-provider-patient collaboration for drug pricing
Kalderos, a Chicago analytics company, attracted new attention a year ago as it garnered a round of funding and won business from 7 of the top 15 pharma companies to help them manage their interactions with providers over the 340b program. That program, which represented $30 billion in 2019 drug revenue according to DrugChannels.net, enables hospital pharmacies to take significant discounts on drug purchases, ostensibly to provide lower-cost drugs to indigent patients—but the allocation of those funds is at the discretion of the hospital. The sales were up 23% from the year before and have tripled since 2014.
Kalderos’ position in this isn’t to restrict or control 340b sales on behalf of its pharma clients, but rather to enable them to efficiently allocate 340b discounts against other government discount programs—Medicaid, Medicare Part D and some commercial plans. Properly allocating discounts has saved pharma clients $100 million to date (the company launched in 2016), says Jeremy Docken, CEO and co-founder. (Most of these savings come from drugs that received duplicate discounts from state Medicaid programs; also, it’s worth noting that some discounts generate additional price reductions under Average Manufacturers Price [AMP] rules.)
Recently, Kalderos garnered an additional $28 million in Series B funding from Bain Capital Ventures and Mercato Partners. With the additional funding, says Docken, Kalderos is already building out data services for payers and providers, in addition to manufacturers. Transparency and “preventive drug discount management” among all the parties is the goal, he says and ultimately “to further streamline the interactions between participants in the healthcare ecosystem.”
For sure, revenue management and resolving multiple conflicting discount programs will be helpful to all parties involved. The larger question, of course, is whether those parties want to continue the current regulatory setup; the dissatisfaction of manufacturers with the open-endedness of the current 340b setup is growing.
On the horizon, Docken says Kalderos will get involved in patient copay and voucher programs, and perhaps manage them on behalf of pharma. Managing value-based contracting is another potential application. “The ultimate goal is to get discounts to the patients where they are most needed,” he says.