Managed Markets & Payer Contracting

Managed markets and payer contracting vendors help manufacturers manage the complex financial relationships with payers, PBMs, and government programs. They address rebate administration, government pricing compliance, and gross-to-net optimization.

Core Services

• Rebate Administration: Processing and reconciling manufacturer rebates across commercial and government channels
• Government Pricing Compliance: Medicaid Best Price, 340B, FSS/VA pricing calculations and reporting
• Gross-to-Net Optimization: Modeling and managing the gap between list and net price
• Contract Management: Payer and PBM contract negotiation support, performance tracking
• Channel Strategy: Specialty distribution, buy-and-bill vs. pharmacy benefit, biosimilar contracting