Pharmaceutical Suite

Taking the Risk Out of Revenue

The convergence of accelerating competitive pressure and increasing government regulatory oversight presents pharmaceutical manufacturers with an unprecedented level of complexity in managing sales and revenue. These challenges are magnified by disjointed revenue life cycle processes and systems that are spread across multiple departments in the organization. As a result, it is common to find poor hand-offs between pricing, contracts, and settlements processes, and gaps in regulatory monitoring that — especially when combined — lead to significant revenue leakage and regulatory compliance exposure.

Model N Revenue Management Suite for Pharmaceuticals

The Model N Revenue Management Suite for Pharmaceuticals introduces a new solution to the current challenges facing leading pharmaceutical manufacturers today. The suite links the currently disparate processes of pricing, contract creation, performance, management, and payment of settlements through a combination of industry best practices and breakthrough software technology. Sharing a common technology platform, the applications in the suite control all the critical processes across the Revenue Management life cycle, from pricing through payment of chargebacks, rebates, and fees, as well as providing integrated regulatory compliance processes and controls. With advanced analytical capabilities, the suite enables users to explore the wealth of data in the system and perform predictive modeling to provide critical business insights.

Reducing Regulatory Exposure and Revenue Leakage

Few activities are as important to business as the creation of pricing, negotiation and management of contracts, and the execution of incentives programs. Unfortunately, these key determinants of corporate revenue are the last bastion of the world of spreadsheet automation, file cabinets, and “swivel chair” integration — literally, the reentry of data from one computer to the next.

The Model N Revenue Management Suite introduces the ability to manage the revenue life cycle as an integrated, end-to-end process. The Model N solution is designed for use across multiple departments including sales, finance, and marketing, providing shared process flows and access to common data across all applications. Applications in the suite address specific functionality such as creating pricing policies, developing contracts, managing membership and eligibility, validating and processing chargebacks and managed care incentives, calculating and reporting government best price, and automating Medicaid claims processing. In addition, the individual applications share data and services, and extend process functionality across application boundaries.

The suite also provides powerful workflow management, alerts, and notifications, reducing administrative burden and enabling business to manage by exception. The same infrastructure also provides comprehensive functionality for recording actions, approvals, and versions of documents, providing a complete audit trail across the revenue life cycle.


Revenue Planning and Intelligence
Perform unparalleled revenue impact and risk assessment driven by seamless integration with revenue management solutions and legacy ERP systems.

Price Management
Define and publish price lists, pricing policies, discounts, and incentive programs; track price history, performance, and program results to develop and improve pricing strategy; provide real-time price lookups directly or via an ERP system with the ability to automatically resolve overlapping contract, membership, and price combinations.

Contract Management
Develop and administer contracts, a contract repository, and all associated approvals and administrative tasks, including membership and eligibility management, with closed-loop integration to Model N pricing and settlements applications.

Contract Compliance
Automate set up, tracking, and reporting on customer contract commitments; eliminate costly and time-consuming manual tracking and analysis; and facilitate better pricing strategy and decision making for future contracts.

Chargebacks
Process indirect sales data, validate against contracts and terms, manage approvals, resubmissions, and reversals, and integrate with ERP systems for payments.

Institutional Rebates
Create sophisticated incentive programs that receive and validate sales claims, determine eligibility, track incentives, perform net revenue calculations, automate approvals, and manage recalculations, reversals, and submission of payments to ERP systems.

Admin Fees
Process sales data to calculate, validate, manage, and analyze fees due to third-party organizations for value-added services.

Government Pricing
Manage both the data and calculations required for government pricing compliance and reporting, including price threshold alerts, approvals, and the creation of an audit trail.

Medicaid Claims Processing
Establish Medicaid and state supplemental formulas with a flexible expression builder; manage validations, approvals, processing, and reporting for all claims.

Managed Care
Handle and automate all key incentive program elements, including qualifications, benefits, and payment details.

FSS Compliance
Define and manage FSS compliance easily and efficiently while maintaining full transparency and auditability.

Fee-for-Service
Process indirect and direct sales data to calculate and generate fees due to wholesalers; improve channel relationships.

Quick Links
Model N not only has demonstrated a deep understanding of the current Medicaid issues, but its integrated suite of applications will provide us a with a revenue management platform that can accommodate our growth both in the commercial and government sector.

Associate Director
Distribution and Reimbursement
Actelion Pharmaceuticals