Kalderos has streamlined the drug discount reimbursement process - reducing friction for both covered entities and manufacturers.
In the traditional model, receiving drug discounts from manufacturers relied on multiple parties and systems to accurately track data about purchases that had happened in the past. The burden was on covered entities to ensure there were no duplicate discounts.
With the Kalderos model, discount requests can be verified and processed in real time via a discount request submission process using Kalderos Request. Request simplifies the multiple checks and balances in the system required to get the discounts to the right parties in an efficient and compliant manner. This increases the viability of the 340B Program as a whole.
Here is how it works:
- Leverage existing 340B eligibility: Ensure you are enrolled as an active 340B covered entity on the HRSA website. If you participate in any sub-ceiling contracts, the manufacturer has loaded them into the platform to properly calculate your discount amount.
- Purchase drug: When you need to purchase a qualified NDC, purchase the product from your wholesaler on a non-340B account (e.g. WAC).
- Dispense product to patient: As you would before, the pharmacy (either in-house or contract) will dispense the product to the patient.
- Qualify dispensation as 340B eligible: Determine whether the patient qualifies under 340B eligibility rules. This step is often completed by a TPA or 340B administrator.
- Submit dispensation information to the Kalderos Platform: After confirming the dispensation is 340B-eligible, use the Kalderos Platform to submit the claim as a discount request. This initiates a request for the manufacturer to pay the 340B discount.
- Manufacturer reviews discount request: The relevant manufacturer will review the discount request and the request will either be deemed “Approved” for payment or “Failed” to meet the necessary criteria. You will have the opportunity to correct or reverse prior discount requests as well.
- Receive payment: Once a discount request has been “Approved” and submitted for payment, the payment is sent via ACH to your bank account.