GTN Prism — Pharma Gross-to-Net Intelligence
A comprehensive financial modeling platform for pharmaceutical revenue analytics. GTN Prism translates list pricing into realized net revenue by modeling every mandatory and contractual deduction across all payer channels—giving commercial, finance, and market access teams a single source of truth.
Base Case
Represents a typical brand drug with a moderate commercial/government channel mix. Commercial rebates, chargebacks, and distribution fees are set at industry-average levels. Medicaid URA and inflation rebates reflect standard CMS formulas.
CMS Drug Pricing OverviewDeduction Breakdown
- •Distribution fees (2.5-4%)
- •Chargeback processing
- •Data sharing agreements
- •Performance rebates
- •Patient support services
- •REMS compliance
- •Cold chain logistics
- •Hub integration
- •Accreditation requirements
- •Prior authorization support
- •Adherence programs
- •Outcomes tracking
- •DIR fees
- •Network participation
- •Copay card acceptance
- •Immunization services
- •Contract compliance
- •Market share commitments
- •Administrative fees
- •Value-based arrangements
- •Formulary positioning
- •340B eligibility
- •IDN contracting
- •Outcome-based contracts
Channel Mix Optimization
Consider shifting 3-5% of commercial volume to specialty channels to reduce overall rebate burden while maintaining patient access.
340B Strategy
Current 340B penetration at 10%. Evaluate contract pharmacy arrangements and consider limited distribution if exceeding 15% threshold.
Chargeback Optimization
Chargeback-eligible percentage at 34%. Renegotiate wholesaler contracts to reduce eligible base by 5-10% through performance tiers.
Distribution Fee Review
Current distribution fee of 3% is at market benchmark. Consider volume-based tier negotiations.
| Parameter | Base case | Downside | Δ vs Base |
|---|---|---|---|
| Pricing | |||
| WAC per Unit | $1,200 | $1,200 | — |
| Total Units | 120,000 | 120,000 | — |
| Channel Mix | |||
| Commercial % | 52.0% | 48.0% | -4pp |
| Medicaid % | 16.0% | 18.0% | +2pp |
| 340B % | 10.0% | 12.0% | +2pp |
| MFP % | 8.0% | 10.0% | +2.0pp |
| Other Gov % | 14.0% | 12.0% | -2pp |
| Commercial | |||
| Rebate Rate | 22.0% | 29.0% | +7pp |
| Chargeback Rate | 7.0% | 10.0% | +3.0pp |
| Chargeback-Eligible % | 34.0% | 42.0% | +8pp |
| Distribution Fee | 3.0% | 4.5% | +1.5pp |
| Medicaid | |||
| AMP % of WAC | 72.0% | 68.0% | -4pp |
| Best Price % of WAC | 54.0% | 47.0% | -7pp |
| CPI Growth % | 14.0% | 9.0% | -5pp |
| Inflation-Eligible % | 18.0% | 24.0% | +6pp |
| MFP | |||
| MFP % of WAC | 68.0% | 52.0% | -16pp |
| Net Revenue Outputs | |||
| Gross Revenue | $144,000,000 | $144,000,000 | — |
| Commercial Rebates | -$16,473,600 | -$20,044,800 | +$3,571,200 |
| Chargebacks | -$1,782,144 | -$2,903,040 | +$1,120,896 |
| Distribution Fees | -$4,320,000 | -$6,480,000 | +$2,160,000 |
| Medicaid Rebates | -$4,147,200 | -$5,443,200 | +$1,296,000 |
| Medicaid Inflation | -$1,339,200 | -$4,547,520 | +$3,208,320 |
| 340B Discount | -$6,624,000 | -$9,158,400 | +$2,534,400 |
| MFP Discount | -$3,686,400 | -$6,912,000 | +$3,225,600 |
| Part B Inflation | -$595,200 | -$2,345,760 | +$1,750,560 |
| Part D Inflation | -$676,800 | -$3,141,120 | +$2,464,320 |
| Total Deductions | -$39,644,544 | -$60,975,840 | +$21,331,296 |
| Net Revenue | $104,355,456 | $83,024,160 | -$21,331,296 |
| Net-to-Gross % | 72.5% | 57.7% | -$0 |
Base Net Revenue: $104,355,456
| Variable | -10% | -5% | -1% | +1% | +5% | +10% |
|---|---|---|---|---|---|---|
| WAC per Unit | -$10,696,666-10.3% | -$5,348,333-5.1% | -$1,069,667-1.0% | +$1,069,667+1.0% | +$5,348,333+5.1% | +$10,696,666+10.3% |
| Total Units | -$10,435,546-10.0% | -$5,217,773-5.0% | -$1,043,555-1.0% | +$1,043,555+1.0% | +$5,217,773+5.0% | +$10,435,546+10.0% |
| Commercial Rebate % | +$7,488,000+7.2% | +$3,744,000+3.6% | +$748,800+0.7% | -$748,800-0.7% | -$3,744,000-3.6% | -$7,488,000-7.2% |
| Chargeback Rate % | +$2,545,920+2.4% | +$1,272,960+1.2% | +$254,592+0.2% | -$254,592-0.2% | -$1,272,960-1.2% | -$2,545,920-2.4% |
| Distribution Fee % | +$14,400,000+13.8% | +$7,200,000+6.9% | +$1,440,000+1.4% | -$1,440,000-1.4% | -$7,200,000-6.9% | -$14,400,000-13.8% |
| Medicaid Channel % | +$2,592,000+2.5% | +$1,296,000+1.2% | +$259,200+0.2% | -$259,200-0.2% | -$1,296,000-1.2% | -$2,592,000-2.5% |
| MFP % of WAC | -$1,152,000-1.1% | -$576,000-0.6% | -$115,200-0.1% | +$115,200+0.1% | +$576,000+0.6% | +$1,152,000+1.1% |
| AMP % of WAC | -$86,170-0.1% | +$199,526+0.2% | +$230,400+0.2% | -$230,400-0.2% | -$1,152,000-1.1% | -$2,304,000-2.2% |
| Base Net Revenue: $104,355,456 | ||||||