Detect Pharmacy Copay Misuse Before It Erodes GTN

Pharmaceutical manufacturers already know their affordability dollars are under pressure. What far fewer realize is how much of that pressure comes from a single, quiet source: the way copay claims are processed at the pharmacy counter. This webinar will explore how pharmacy-level copay misprocessing creates hidden gross-to-net (GTN) leakage and how manufacturers can identify, address and reduce that exposure.
Many organizations identify obvious warning signs, but they often miss the thousands of smaller manipulations that compound month over month into billions of dollars in industry-wide leakage. Roughly one in ten pharmacies engages in some form of copay misprocessing, and the exposure is almost always larger than manufacturers expect.
This session moves past the theory and into the mechanics. Drawing on frontline pharmacy experience and hundreds of thousands of audited claims, the featured speakers will walk through exactly how misprocessing happens - from covered-claim markups to coverage-code and rejection-code switching - and why these behaviors accelerate as reimbursement pressure on pharmacies intensifies. They'll also examine why the newest wave of self-pay and direct-to-patient purchasing channels widens the same exposure, and why automated, pre-payment flagging alone consistently falls short against a problem that is fundamentally operational and human. Finally, the discussion will show what actually changes pharmacy behavior. A combination of real-time claim analysis and PharmD-led intervention is what turns detection into recovered dollars.
Attendees will leave understanding where copay leakage originates, why traditional retrospective audits fail to stop it and how manufacturers can protect GTN performance while keeping affordability programs working the way they were designed to - reaching the right patient, at the right time.
Register for this webinar to learn how pharmacy copay oversight can uncover misuse, recover affordability spending and strengthen GTN performance.

Who Should Attend
This webinar will appeal to:
Directors and Senior Managers, Market Access and Managed Markets
Directors, Patient Access and Patient Support Programs
Directors, Pricing, Contracting and Reimbursement
Directors and Senior Managers, Commercial Finance and Revenue Management
Directors, Commercial Operations and Commercial Excellence
Brand and Product Management leaders responsible for affordability program performance
Business Development and Partnership Leaders (Access & HEOR)

What You Will Learn
Attendees will gain insight into:
How pharmacy-level copay misuse actually works - the specific misprocessing levers (markups, coverage-code and rejection-code switching and invalid BIN usage) that quietly drain affordability programs
Why the scale of exposure is larger than most manufacturers estimate, and how emerging self-pay and direct-to-patient channels widen the same risk
Why automated, pre-payment detection alone falls short, and what pharmacist-led intervention adds that algorithms can't
How real-time analysis paired with PharmD-to-pharmacy engagement converts detection into measurable recoupment and stronger GTN performance

Register free on Xtalks:
https://xtalks.com/webinars/detect-pharmacy-copay-misuse-before-it-erodes-gtn/