Cynthia Hwang, Co-Founder & SVP
Riparian’s platform helps biotech and pharmaceutical manufacturers manage their price reporting and discount obligations with the government programs that provide coverage for their drugs. Riparian took a user-centric approach when designing its software, with the objective of providing users with advanced analysis capabilities and with it, the ability to derive powerful insights from their voluminous sales and discounts data.
For many biotech and pharmaceutical manufacturers, securing coverage of prescription drug therapies by federal and state government payers is critical to their commercial success. However, any manufacturer that wants their drugs covered by federal and state healthcare programs must agree to provide discounts to those programs, and report certain pricing metrics that are the basis for those discounts. For this reason, these programs are commonly referred to as the Government Pricing (GP) Programs.
The U.S. prescription drug supply chain is comprised of a complex network of players, each having a stake in the various types of arrangements that govern drug distribution, and pricing. The arrangements between such players are varied and increasingly diverse as pressures stemming from patient access, risk-sharing, and competition continue to mount. These circumstances set a high bar on the subject matter expertise and systems necessary to comply with the GP Programs price reporting requirements.
GP is in Riparian’s DNA
Given the level of precision required when reporting GP pricing metrics, the financial significance of those prices, and the relatively short reporting timelines, it is critically important for manufacturers to have the technology that empowers them to achieve their goals and objectives.
Unfortunately, the reality for many manufacturers is that a significant amount of resources is spent on merely validating the accuracy of the calculations performed by their GP systems and/or manual work-arounds in response to certain system limitations. Although these tasks are necessary to provide assurance to their calculation certifiers as to the accuracy of the pricing metrics, they often leave little time for manufacturers to perform the analysis of their pricing that may inform future strategies. Further compounding the challenge is that for many manufacturers, the reporting functionality of their GP calculation systems are often limited or not well-suited to their needs. Thus, a frustration voiced by many manufacturers is that their systems fall short of answering the questions that may be solved by applying the right analysis to their data.
Having each spent nearly 20 years advising clients on a variety of GP calculation compliance matters, Cynthia Hwang and David Chan, the co-founders of Riparian, knew that these pain points had to be addressed head-on when they began development of their own GP calculation software. Drawing inspiration from the structure formed by DNA molecules, the software is aptly named “Helix” in recognition of the fact that advising clients on GP-related matters was a fundamental and distinctive characteristic of the work that shaped their professional lives.
“The foundation to a manufacturer’s ability to analyze their GP pricing metrics is having a calculation methodology that not only complies with the manufacturer’s interpretation of the regulatory requirements, but also one that is well-suited to its particular distribution and discounting arrangements,” say Cynthia.
Our many years of experience hearing feedback from clients has given us the ability to create a better experience, where users can learn from our software, sharpen their professional skills, and excel at their jobs
Helix is designed so that any business user can configure much of the system using a series of highly-customizable and visually intuitive “building blocks” that guide a user through various approaches for smoothing lagged transactions, factoring discounts, and establishing the discount reallocation parameters and rules for “bundled sale” arrangements. Helix’s methodology configuration design provides transparency as to how each GP pricing metric is calculated, giving business users the visibility they need to understand each aspect of the calculations without having to have a grasp of programming language.
As for its reporting capabilities, Helix provides visualizations that provide business intelligence on the data used to calculate the pricing metrics—including the relative share of sales through the channel vs. direct to customers, price distribution of sales, and a view of discounts by type and over time – all of which may be used to provide additional insights that may be shared with the organization. Helix empowers users to tell stories with data through its “Storyboarding” functionality, whereby users may curate and combine visualizations for presentation to upper management.
“Our approach to design and development makes us a disruptor, because we are intimately familiar with the goals and objectives of our users. Our many years of experience hearing feedback from clients has given us the ability to create a better experience, where users can learn from our software, sharpen their professional skills, and excel at their jobs,” explains Cynthia.
Ion and the Road Ahead
Riparian is now working on developing another module, named Ion, for adjudicating Medicaid rebate claims determined on the basis of pricing metrics calculated by Helix. “In nature, ionic bonds are created when an atom transfers an electron to another atom. This transfer actually creates a bond between the two atoms. Medicaid is similar in that there is a transfer of funds to the less fortunate, but that transfer creates a societal bond. Likewise, drug manufacturers transfer Medicaid rebates to states and there is an undeniable bond between states and manufacturers,” says Cynthia. Riparian’s plan is to complete the development of Ion by the end of Q3 2019 and move on to complete its full platform.
Value Proposition for Growth-Phase Manufacturers
Manufacturers that are in a nascent stage of growth generally do not have the internal resources necessary to comply with the pricing calculation, data reporting, and claims adjudication requirements that are a pre-condition of participating in the GP programs.
Riparian provides a distinct value proposition to these clients, because the Helix and Ion systems are designed for Riparian to use both when providing business process outsourcing services to these clients, as well as for clients with their own internal GP department to license in a software-as-a-service (SaaS) model.
“Over time, as our managed service clients seek to change from an outsourced model to an in-sourced model, the transition process is seamless. They are saved from the additional effort of licensing and implementing a system from a different software vendor which can take a significant amount of time, cost, and resources,” remarks Cynthia.