RSM Revenue Contract Management & Gross to Net

Billions of dollars in fines are handed down by the DoJ to manufacturers for inaccurate pricing to the US Government.   Manufacturers, by law, are to sell product at the manufacturer’s best price to the government (e.g. Medicare recipients, Military, VA, etc).   Today, manufacturers buy and integrate to contract management systems that help them manage sales and distribution contracts.   These systems are often expensive, and the integration can be complex considering the amount of ERP transaction and master data that flows to and from these systems in near real time.  RSM has developed a solution to keep all the data and calculations within Dynamics 365 which can save our clients hundreds of thousands of dollars. 

In conjunction with Industry experts, RSM has developed a Revenue Contract Management (RCM) solution - a comprehensive contract maintenance, chargeback processing, rebate management, and Gross to Net solution that also manages government pricing, 340B reporting, analytics and reporting.  

The RCM solution leverages Dynamics 365 Finance and Supply Chain Management for items, pricing, orders, shipments, customers, returns, and extends Dynamics to manage Wholesaler and GPO (group purchasing organization) or retailer contracts, wholesaler chargebacks, rebates and fees.  RCM performs a variety of validations for contract price, date, and membership at time of the sale, and then checks the validity of all inbound chargebacks and fees.   Often wholesalers send erroneous or duplicate chargebacks that can significantly erode product profit margins.  RCM will match all contract parameters with automatically adjudicating and optionally reversing the accrual or disputing the chargeback with the wholesaler.    

Government pricing (GP) and reporting, being the driver for much of this process, is also supported by RCM.   In addition to the above mentioned functionality, Class of Trade (COT) is considered in LCM for pricing data that is reported to the federal government. COT is used to determine which transactions will be included and/or excluded in the GP calculations to support government reporting requirements.

After transactions have settled, the process of measuring contract performance, calculating the average manufacturer’s price and gross to net, the challenge of government pricing and reporting begins.   RSM has worked with pharma industry experts to build on proven reporting and contract & product performance management methods within Power BI to meet government requirements.   

RSM has leveraged the extensive power of the Microsoft platform to eliminate pricey 3rd party systems and complex integrations for the Life Sciences Industry.