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Ineffective formulary validations restrict patient access to medications and cost manufacturers millions of dollars.
- Formularies change frequently, which means rebates may be paid based on outdated information.
- Formulary data is frequently incomplete, outdated, or inaccurate and requires standardizing prior to processing.
- Relying on manual processes to handle and reconcile massive Rx volumes with thousands of complex payer and pharmacy benefit manager (PBM) contracts creates delays and mistakes that lead to overpayments.
How Model N Formulary Compliance helps you
This integrated data validation and formulary auditing solution enables you to overcome the challenges of ensuring formulary compliance.
Maximize market access
Formulary validations ensure your drugs receive the prioritized positioning outlined in payer and PBM contracts.
Reduce revenue leakage
Thorough audits of all products across plans within payment cycles reduces overpayments.
Streamline operations
Real-time formulary data is accessible throughout the year for more accurate, efficient, and comprehensive validations.
Improve customer satisfaction
Automated validations ensure precise, timely rebates and reduce the need for post-payment recovery.
$75M
Annual audits in individual companies have uncovered $25 to $75 million in overpayments due to non-compliant formularies
Ensure formulary compliance with a full-service automated data and formulary auditing solution
Model N Formulary Compliance eliminates the need for internal manual validations or third-party audits.
Integrated efficient data
Access collected and consistently stewarded formulary data that covers most commercial and government plan formularies across all therapeutic areas.
Rx-level formulary compliance
Compare contractual terms and conditions that drive rebates with published formulary data to determine formulary compliance at the plan or prescription level.
Reporting and visibility
Gain insight into formulary compliance outcomes and trends to support account management and future contract negotiations.
Evaluate formulary compliance during rebate processing
Model N Formulary Compliance integrates with Model N Validata and Model N Payer Management to provide an end-to-end solution for managing payer contracts. Along with streamlining processes, this robust solution improves calculation accuracy and prevents overpayments from occurring.
- End revenue leakage in payer contracting and rebating processes.
- Ensure contract and formulary compliance.
- Increase patient access to your life-changing products.
- Strengthen relationships with payers and PBMs.
Related Resources
Transform Your Approach to Formulary Compliance
Learn how Model N’s new integrated data validation and formulary evaluation solution can help you ensure formulary compliance. Watch Now
Formulary Frustrations: Overpayments Plague Pharma Manufacturers
Drug formularies support better patient outcomes by encouraging the use of safe, effective, and affordable medications. These lists specify preferred drugs covered by a plan or institution and serve as a gu ... VIEW POST
Efficiently Navigate the Complexities of Formulary Contracts
Learn how to efficiently navigate the complexities of formulary compliance and discover a new approach to validating your formulary position. VIEW Ebook
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