Today's District Court decision out of the 8th Circuit striking down North Dakota's CP access law adds to a growing body of signals that intent matters, and execution matters just as much. A sustainable 340B framework requires more than statutory debate. It requires transparency that can be operationalized, accountability that can be measured, and infrastructure that helps all parties navigate complexity without losing sight of the patient.
Kalderos
Data Infrastructure and Analytics
Chicago, IL 7,541 followers
The drug discount platform designed for everyone.
About us
Kalderos delivers technology that solves the challenges facing the US healthcare system. We work with healthcare providers, drug manufacturers, payers, and government agencies alike to increase transparency and restore trust — lowering the cost of healthcare and enabling everyone to focus on improving the health of people.
- Website
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https://www.kalderos.com/
External link for Kalderos
- Industry
- Data Infrastructure and Analytics
- Company size
- 51-200 employees
- Headquarters
- Chicago, IL
- Type
- Privately Held
- Founded
- 2016
- Specialties
- Technology, Healthcare, Pharmacuticals, 340B Drug Discount Program, Medicaid, Rebates, PBM, Discounts, Drug Pricing, Data Infrastructure, Analytics, MDRP, and CMC
Locations
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Primary
Get directions
625 W Adams Street
Ste 20-146
Chicago, IL 60661, US
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Get directions
250 N Sunny Slope Rd
Ste 200
Brookfield, Wisconsin 53005, US
Employees at Kalderos
Updates
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Kalderos has submitted comments to Health Resources and Services Administration (HRSAgov), HHS on the proposed #340B rebate pilot, drawing on our years of experience working across manufacturers, covered entities, and the broader ecosystem. At the center of our perspective is a simple premise: transparency at the claim level is not optional; it is foundational. A rebate model has the potential to improve program integrity and streamline access, but only if it reflects how 340B actually operates today. That requires complete claims data, scalable infrastructure, and an approach that incorporates the complexity of the current system. This is not a theoretical exercise. Kalderos, alongside others, has already done meaningful work to define what works and what does not. As a healthcare industry, we have the opportunity to build on that foundation and deliver a pilot that drives clarity, participation, and measurable impact.
Yesterday, Kalderos submitted comments to Health Resources and Services Administration (HRSAgov), HHS, on the proposed #340B rebate pilot. The perspective we shared in our submission is not theoretical. Since 2019, Kalderos has advocated for greater transparency in the 340B program and for the merits of a rebate model in achieving that goal. One result of those efforts is that courts have made clear that, with or without a rebate mechanism, manufacturers can impose claims data requirements as a condition to accessing 340B pricing. We believe the rebate model brings greater integrity to how 340B operates and speeds access to 340B pricing for covered entities. Three points drove our submission: First, a rebate model can work, but only if it is built on complete, claims-level data, is designed for how the system actually functions, and considers the unique needs of a diverse set of players. Second, this work is already underway. For years, we have partnered across the ecosystem to pressure test what a viable model requires at scale. That experience should inform the pilot, not be sidelined in favor of narrower approaches. Third, HRSA’s decision to revisit the design is an opportunity. An opportunity to broaden participation to more drugs and more willing manufacturers. An opportunity to more accurately reflect how 340B actually operates. And an opportunity to leverage all the capabilities already in the market. That is how you generate a real proof of concept. Anything less risks more unintended consequences.
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A significant decision for the #340B landscape, and an important clarification for the industry. The 4th Circuit reinforces what has long been at the center of program integrity: claims data is essential to audit, oversight, and compliance. This is not about adding requirements. It is about enabling the system to function as intended. Our CEO, Angie Franks breaks down the implications and what comes next.
Yesterday, the U.S. 4th Circuit Court of Appeals provided a "Path to Clarity" for the 340B program. By blocking West Virginia’s S.B. 325, the court didn't just rule on a state law—it affirmed the contractual necessity of claims data. The opinion is clear: States cannot strip away the data tools manufacturers need to ensure program integrity. Denying this data "frustrates the operation of the audit mechanism" that Congress established to protect the system. Standardizing claims data isn't an "extra" requirement; it is how we "safeguard the efficacy" of the 340B bargain. Check out the carousel below for excerpts from the opinion that clarify the road ahead. 👇 #340B #HealthcareIntegrity #PharmaCompliance #LegalUpdate
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As overlapping programs and policy pressures create more opportunities for duplicate discounts and operational friction, manufacturers need more than assumptions or after-the-fact reconciliation. They need visibility. Our latest PharmaVoice piece explores why claims-level utilization data is increasingly central to compliance, risk management, and the future of 340B operations. Read more: https://lnkd.in/eRp9gKuA
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As pricing, reimbursement, and policy complexity continue to grow, manufacturers are being asked to manage duplicate discount and diversion risk without always having the visibility they need. The real question isn’t just which model the industry prefers. It’s whether manufacturers have the facts needed to make defensible, auditable decisions. In this new PharmaVoice article, Angie Franks shares why “do nothing” is no longer a viable strategy — and why claims-level utilization data is becoming foundational to how manufacturers manage 340B exposure. Read the article: https://lnkd.in/eRp9gKuA
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In the Maximum Fair Price era, de-duplicating discounts requires dispense-level visibility. Aggregate reporting can’t reliably support duplicate-discount prevention at scale. Claims-level transparency is becoming a practical foundation for program integrity—across both pharmacy and medical benefit workflows. Are you prepared for claims-level submission workflows? Here’s a readiness checklist to help guide your work: https://lnkd.in/e9qxynQG.
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Three practical takeaways as the ecosystem moves toward claims-level expectations: 1) Source-of-truth: align pharmacy and medical claim sources early 2) Cadence: establish a predictable upload schedule (plus resubmission handling) 3) Exceptions: reversals, adjustments, and duplicates need a clear operating playbook Readiness checklist: https://lnkd.in/e9qxynQG
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Novo Nordisk announced it will require claims-level data submission for 340B dispenses beginning April 1, 2026, including in-house and contract pharmacies, to support program integrity and duplicate-discount/Maximum Fair Price de-duplication. Are you prepared for claims-level submission workflows? Here’s a readiness checklist to help guide your work. Access the checklist here: https://lnkd.in/geYjiw4w
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We’re excited to sponsor the 2026 Model N Rainmaker Conference! Members of the Kalderos leadership team will be on-site discussing how we help manufacturers manage drug pricing complexity, eliminate gross-to-net waste, and create a single source of truth, enabling them to operate with confidence and data-driven precision. 📩 Contact us to schedule a 1:1 meeting: https://lnkd.in/ei9dVpQX 📍Visit us at Booth #4 See you in Orlando! #Kalderos #Truzo #ModelNRainmaker #DrugPricing #HealthcareInnovation #GrossToNet #DataDriven
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