Systems and methods for facilitating the establishment of pharmaceutical rebate agreements

• US 8,635,083 B1
• Filed: 09/30/2008
• Issued: 01/21/2014
• Est. Priority Date: 04/02/2008
• Status: Active Grant

• Current Assignee: McKesson Corp.
• Original Assignee: Mckesson Financial Holdings Limited (McKesson Corp.)
• Inventors: Casu, Jennifer Michelle
• Primary Examiner(s): NGUYEN, HIEP VAN
• Application Number:
  US12/242,317
• Time in Patent Office: 1,939 Days
• Field of Search: 705/2
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/02 Marketing; Price estimation or determination; Fundraising
• CPC Class Codes: G06Q 30/06 Buying, selling or leasing transactions

Abstract

Systems and methods for facilitating the establishment of pharmaceutical rebate agreements or arrangements may be provided. One or more rebate offers associated with one or more pharmaceutical products manufactured by the drug manufacturer may be received from a drug manufacturer via a network. One or more respective conditions associated with the one or more rebate offers may be established by the drug manufacturer. At least a portion of the one or more rebate offers may be electronically presented to a payer of pharmaceutical benefits. A selection of at least one of the presented rebate offers may be received from the payer via the network. The selection may initiate an enrollment of the payer for the at least one selected rebate offer.

Claims

1. A computer-implemented method for facilitating the establishment of pharmaceutical rebate agreements, the method comprising:

receiving, from a plurality of drug manufacturers by a rebate marketplace aggregator system comprising one or more computers, information associated with a plurality of available rebate offers, each rebate offer associated with one or more pharmaceutical products manufactured by one of the plurality of drug manufacturers, the received information for each rebate offer comprising one or more respective conditions established by a relevant drug manufacturer for receiving rebates in association with the rebate offer;

electronically presenting, by the rebate marketplace aggregator system, at least a portion of the plurality of rebate offers to a payer of pharmaceutical benefits; and

receiving, by the rebate marketplace aggregator system from the payer, a selection of at least one presented rebate offer; and

facilitating, by the rebate marketplace aggregator system based at least in put upon the received selection, an enrollment of the payer for the at least one selected rebate offer.

2. The method of claim 1, further comprising:

receiving, by the rebate marketplace aggregator system from the payer, one or more search criteria associated with available rebate offers; and

identifying, by the rebate marketplace aggregator system, the at least a portion of the plurality of rebate offers for presentment based at least in part on the received one or more search criteria.

3. The method of claim 1, wherein the one or more respective conditions for one of the plurality of rebate offers comprise one or more of a condition associated with listing a pharmaceutical product as a preferred pharmaceutical product, a limitation on a number of pharmaceutical products that may be offered by the payer as preferred pharmaceutical products within a therapeutic class, or a condition associated with a co-payment differential between a preferred pharmaceutical product and one or more non-preferred pharmaceutical products.

4. The method of claim 1, further comprising:

collecting, by the rebate marketplace aggregator system subsequent to the enrollment of the payer for the at least one selected rebate offer, claim transaction information associated with one or more pharmaceutical claims made for services provided by the payer to its customers;

comparing, by the rebate marketplace aggregator system, at least a portion of the collected claim transaction information to the one or more conditions associated with the at least one selected rebate offer for which the payer is enrolled; and

determining, by the rebate marketplace aggregator system based at least in part on the comparison, whether the one or more conditions associated with the at least one selected rebate offer have been satisfied.

5. The method of claim 4, wherein collecting claim transaction information associated with one or more pharmaceutical claims made for services provided by the payer to its customers comprises collecting claim transaction information in real time or near real time as the one or more pharmaceutical claims are routed between the payer and a point of sale device.

6. The method of claim 4, further comprising:

generating, by the rebate marketplace aggregator system, one or more reports based at least in part on the determination of whether the one or more conditions associated with the at least one selected rebate offer have been satisfied; and

communicating, by the rebate marketplace aggregator system, the one or more generated reports to at least one of the drug manufacturer or the payer.

7. The method of claim 1, further comprising:

collecting, by the rebate marketplace aggregator system subsequent to the enrollment of the payer for the at least one selected rebate offer claim transaction information associated with one or more pharmaceutical claims made for services provided by the payer to its customers; and

electronically auditing, by the rebate marketplace aggregator system, at least a portion of the collected claim transaction information based at least in part on one or more audit parameters associated with at least one market condition for a pharmaceutical product.

8. A system operable to facilitate the establishment of pharmaceutical rebate agreements, the system comprising:

at least one memory operable to store information associated with a plurality of available rebate offers, each rebate offer associated with one or more pharmaceutical products manufactured by one of a plurality of drug manufacturers, the stored information for each rebate offer comprising one or more respective conditions established by a relevant drug manufacturer for receiving rebates in association with the rebate offer;

at least one communications interface operable to receive and transmit communications over one or more networks; and

at least one processor operable to;

receive, via the at least one communications interface, the information associated with the plurality of rebate offers;

direct presentation, via the at least one communications interface, of at least a portion of the plurality of rebate offers to a payer of pharmaceutical benefits; and

receive, via the at least one communications interface from the payer, a selection of at least one presented rebate offer; and

facilitate, based at least in part upon the received selection, enrollment of the payer for the at least one selected rebate offer.

9. The system of claim 8, wherein the at least one processor is further operable to:

receive, via the at least one communications interface from the payer, one or more search criteria associated with available rebate offers; and

identify the at least a portion of the plurality of rebate offers for presentment based at least in part on the received one or more search criteria.

10. The system of claim 8, wherein the one or more respective conditions for one of the plurality of rebate offers comprise one or more of a condition associated with listing a pharmaceutical product as a preferred pharmaceutical product, a limitation on a number of pharmaceutical products that may be offered by the payer as preferred pharmaceutical products within a therapeutic class, or a condition associated with a co-payment differential between a preferred pharmaceutical product and one or more non-preferred pharmaceutical products.

11. The system of claim 8, wherein the at least one processor is further operable to:

collect, subsequent to the enrollment of the payer for the at least one selected rebate offer, claim transaction information associated with one or more pharmaceutical claims made for services provided by the payer to its customers;

compare at least a portion of the collected claim transaction information to the one or more conditions associated with the at least one selected rebate offer for which the payer is enrolled; and

determine, based at least in part on the comparison, whether the one or more conditions associated with the at least one selected rebate offer have been satisfied.

12. The system of claim 11, wherein the at least one processor is operable to collect claim transaction information associated with one or more pharmaceutical claims made for services provided by the payer to its customers in real time or near real time as the one or more pharmaceutical claims are routed between the payer and a point of sale device.

13. The system of claim 11, wherein the at least one processor is further operable to:

generate one or more reports based at least in part on the determination of whether the one or more conditions associated with the at least one selected rebate offer have been satisfied; and

direct communication, via the at least one communications interface, of the one or more generated reports to at least one of the drug manufacturer or the payer.

14. The system of claim 8, wherein the at least one processor is further operable to:

collect, subsequent to the enrollment of the payer for the at least one selected rebate offer, claim transaction information associated with one or more pharmaceutical claims made for services provided by the payer to its customers; and

electronically audit at least a portion of the collected claim transaction information based at least in part on one or more audit parameters associated with at least one market condition for a pharmaceutical product.

15. A computer-implement method for facilitating the establishment of pharmaceutical rebate arrangements, the method comprising:

receiving, by a rebate marketplace aggregator system comprising one or more computers and via one or more networks, an offer for an available rebate arrangement associated with one or more pharmaceutical products of a drug manufacturer, wherein one or more conditions are associated with the rebate arrangement;

presenting, by the rebate marketplace aggregator system via the one or more networks, information associated with the offer to a payer of pharmaceutical benefits;

receiving, by the rebate marketplace aggregator system via the one or more networks, an indication of acceptance of the offer by the payer;

facilitating, by the rebate marketplace aggregator system, the enrollment of the payer in the rebate arrangement based at least in part on the received indication of acceptance;

collecting, by the rebate marketplace aggregator system subsequent to the enrollment of the payer in the rebate arrangement, claim transaction information associated with one or more pharmaceutical claims made for services provided by the payer to its customers;

comparing, by the rebate marketplace aggregator system, at least a portion of the collected claim transaction information to the one or more conditions associated with the rebate arrangement; and

determining, by the rebate marketplace aggregator system based at least in part on the comparison, whether the one or more conditions associated with the rebate arrangement have been satisfied.

16. The method of claim 15, further comprising:

receiving, by the rebate marketplace aggregator system via the one or more networks, an acceptance of the one or more conditions by the payer.

17. The method of claim 15, wherein the one or more conditions comprise one or more of a condition associated with listing a pharmaceutical product as a preferred pharmaceutical product, a limitation on a number of pharmaceutical products that may be offered by the payer as preferred pharmaceutical products within a therapeutic class, or a condition associated with a co-payment differential between a preferred pharmaceutical product and one or more non-preferred pharmaceutical products.

18. The method of claim 15, wherein collecting claim transaction information associated with one or more pharmaceutical claims made for services provided by the payer to its customers comprises collecting claim transaction information in real time or near real time as the one or more pharmaceutical claims are routed between the payer and a point of sale device.

19. The method of claim 15, further comprising:

generating, by the by the rebate marketplace aggregator system, one or more reports based at least in part on the determination of whether the one or more conditions associated with the rebate arrangement have been satisfied; and

communicating, by the by the rebate marketplace aggregator system, the one or more generated reports to at least one of the drug manufacturer or the payer.

20. The method of claim 15, wherein receiving an offer for an available rebate arrangement associated with one or more pharmaceutical products of a drug manufacturer comprises receiving a plurality of offers for a plurality of available rebate arrangements, and further comprising:

receiving, by the rebate market aggregator system from the payer, a selection of one of the plurality of offers,

wherein facilitating the enrollment of the payer in the rebate arrangement comprises facilitating the enrollment of the payer in the selected one of the plurality of offers.