Gross-to-net accruals with every rebate and chargeback reserve rebuilt from source and cited
Every reserve assumption cited to its contract, lag curve or payer mix
See one case, screen by screen ↓Software that estimates the reserves between a drugmaker's gross sales and its net revenue — commercial and Medicaid rebates, Medicare Part D, 340B, chargebacks, fees and copay — and supports them for the close and the audit. Gross-to-Net Accruals adds six agents that rebuild every program from source, cite each assumption and check it against an independent estimate, for the revenue controller to decide and sign.
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Rebates, chargebacks and fees take roughly half of a U.S. brand's gross sales. Each quarter the gross-to-net team estimates them program by program — commercial PBM, Medicaid, Medicare Part D, 340B, chargebacks, GPO and distributor fees, copay — from contracts, ERP sales, 852 and 867 channel data and invoices that arrive months after the sale. The schedules live in spreadsheets, and the assumption behind each number is in someone's head or last quarter's memo.
The risk sits in what changed and nobody saw: a contract amendment signed in June that raises a rebate rate from July 1, a Medicaid share that has outgrown its four-quarter average after a state formulary change, a negotiated-price refund with nine months of history. It surfaces a quarter later as a prior-period true-up that moves net revenue. Auditors often report these reserves as a critical audit matter, and every request on their list comes down to one question: where did this number come from?
Estimated split of the reserve work in one quarter-end close, by hand and with the solution: working day 9 today, working day 6 as the target. Review and decisions stay with the people who own them.
Six agents read the contracts, fit the payment lags, rebuild and check every reserve, then write the memo and the audit responses; the revenue controller decides and signs.
Northwind Bio closes Q3 2026: $6.84B of gross sales across Veltrimab, Talmirex and Corventa, seven reserve programs, working day 5 of 7, reserves lock Thursday Oct 8 at 17:00. Here is what happens next, screen by screen, in the working solution.
Lena's home screen is the gross-to-net waterfall: $6.84B gross steps down through seven programs to $3.27B net. Each step is marked your decision, ready to sign or signed. Commercial PBM, Medicaid and Medicare Part D wait on her, 340B and chargebacks are ready, GPO and fees and copay were signed on Oct 6. Below it, the reserve roll-forward from Jun 30 to Sep 30 and the auditor's open requests.
“3 steps need your decision · 2 ready to sign · 2 of 7 signed · 257 of 262 assumptions tied to a source.”
The Reserve Builder rebuilt each program from source and the Lag Curve Analyst produced an independent estimate from 12 quarters of payments. The Variance Checker compared the two: commercial PBM $1,420.0M against $1,439.4M, Medicaid $684.0M against $701.7M, Part D $612.0M against $623.4M — all above policy RA-12's threshold, so all three are routed to Lena. The other four agree within $1.2M.
“Review threshold: $5.0M or 2% of the program provision, whichever is lower.”
The build opens under the bridge: 91,000 eligible units on Crestline Rx exclusive plans × $7,120 WAC × a 41.0% base rebate = $265.7M for Veltrimab. The rate is flagged — its source says 44.0%. Beside it, every assumption with its document — 64 of 66 tied to a source — and the clause itself: Crestline Rx Amendment No. 3, §4.2, signed Jun 24, 2026.
“Effective July 1, 2026, for Plans in which the Product is placed on an Exclusive Preferred position, the Base Rebate shall be forty-four percent (44%) of WAC for each Eligible Unit dispensed.”
91,000 units × $7,120 × 3.0 points is $19.4M. Lena chooses “Use the contract rate — 44.0%”. The Reserve Builder updates the schedule and the roll-forward at once: the step becomes $1,439.4M, ready to sign, and net revenue drops to $3.25B. Keeping the schedule rate was the other option — with a reason.
“Commercial PBM provision now $1,439.4M — net revenue $3.25B; ready for your signature.”
The signing screen shows the Q3 provision, the Sep 30 reserve of $2,646.4M, the independent estimate, her decision and the evidence: 64 of 66 assumptions cited. She signs with the meaning “I reviewed this reserve and its evidence and approve it”. The program locks; a later change needs a new version and a reason.
“Signing locks the program. A later change needs a new version with a reason; both stay in the audit trail.”
Talmirex's Medicaid share has risen four quarters running, to 38.7% on Q2 state invoices, and two states made Talmirex preferred on July 1. The schedule still uses the 36.4% four-quarter average. Lena sees three options with their effect: use 38.0% (+$17.7M, recommended), use 37.5% weighted over three quarters (+$12.1M), or keep 36.4%. The URA of $986.00 matches the Q3 pricing file.
The Q2 memo allows a departure from the average for a known formulary change — the agent cites it rather than assuming it.
Corventa's negotiated-price refund claims for Q3 are 445,000 units against a run-rate model of 412,000, at $344 a unit (WAC $612 less the $268 negotiated price). With nine months of history, the policy books the higher end of the range so a significant reversal is not probable: +$11.4M. Every agent step that built the number is shown, with its time.
“Short history flagged: 9 months for negotiated-price refunds.”
Lena's decision makes the RA-12 memo draft stale. The Memo Writer redrafts it: section 4.1 now records Amendment No. 3, the 41% the schedule had used and the $19.4M increase to $1,439.4M, decided by the Revenue Controller on Oct 7. Medicaid and Part D still show as waiting, not guessed. All 41 numbers are linked to a source passage and re-checked.
The Memo Writer never guesses a pending decision — it shows it as waiting.
Hartwell & Lane LLP sent 12 requests, due Oct 14. PBC-03 asks for the commercial rebate agreements and amendments effective in Q3. The Audit Pack Assembler has already attached Amendment No. 3 and the contract listing and confirmed the listing is complete against the contract system (20 of 20). Once commercial PBM is signed, it drafts the response. Priya reads it and sends it.
“Six amendments were effective in Q3; one changed a rate used in the reserve — Crestline Rx Amendment No. 3, 44% of WAC from July 1.”
The dashboard tracks prior-period true-ups as a share of provision — 0.73% this quarter against 1.4% in Q4 2025 and a target under 0.5% — with payment lag curves for Medicaid (168 days), commercial PBM (118) and Part D (74), and true-ups by program. Medicaid's +5.3% shows where the earlier estimate was furthest off.
The same quarter, seen by the five people who carry it — how the close felt before, and what it looks like now.
Six agents read the contracts, fit the payment lags, rebuild and check every reserve, then write the memo and the audit responses; the revenue controller decides and signs.
Reads rebate agreements and amendments and extracts rates, tiers, plans, fees, price protection and effective dates with their clause, then compares each term in force during the quarter with the rate used in the accrual schedule.
Fits payment lag curves from 12 quarters of paid invoices and produces an independent run-rate estimate for each program.
Rebuilds each program's accrual from source — units, shares, rates and channel inventory — carries a citation on every assumption and keeps the reserve roll-forward.
Compares each schedule with the independent estimate, writes the cause with citations, proposes options with their dollar effect and routes variances above the RA-12 threshold to the Revenue Controller.
Drafts the reserve memo from template RA-12 out of the signed schedules and decisions, rewrites only what changed and re-checks every number against its source before signing.
Matches each auditor request to its evidence, runs completeness and accuracy checks on every report used and drafts a short response for the audit liaison.
Decides above threshold, signs. The agents propose; a named person decides.
Ask about a program, an assumption, the memo or the audit pack — or say what to change. Every answer points to its source.
Why is the PBM reserve $19.4M higher?
Crestline Rx Amendment No. 3 raised the rebate for Veltrimab on exclusive plans from 41% to 44% of WAC from July 1, but the Q3 schedule still used 41%. Eligible units 91,000 × WAC $7,120 × 3.0 points = +$19.4M.
Show the Medicaid utilization trend
Talmirex's Medicaid share has risen four quarters running: 34.6% in Q3 2025, 35.9%, 36.5%, then 38.7% in Q2 2026. The schedule uses the 4-quarter average, 36.4%. Two states made Talmirex preferred on July 1, so the agent recommends 38.0% (+$17.7M).
How long is the Medicaid lag?
Medicaid pays about 168 days after sale and 87% of a quarter is paid by Q+2; commercial PBM is 118 days (95%), Medicare Part D 74 days (97%), 340B 21 days (100%). Medicaid holds the most judgement — 13% of a quarter is still unpaid after two quarters.
Add a rule: send me any estimate with under 12 months of history
Done. Any estimate resting on under 12 months of claims now routes to you, whatever its variance. Today that covers Corventa negotiated-price refunds and the 340B pilot rebates. The rule is on in Settings and in the audit trail.
12 screens from the working solution, on its sample data. Pick one to see it large.
The threshold, the approvers, the estimation methods and the rules every reserve is checked against are settings, and every change is on the audit trail.
| Setting | Default | Choose from |
|---|---|---|
| Dollar threshold | $5M | Step up or down, $1M at a time |
| Percent of program provision | 2% | Step up or down, half a point at a time · the lower of the two applies |
| Approvals | Lena Ortiz for every program group · Dana Okafor for unit rebate amounts · Priya Raman for auditor responses | Any of the five people on the team, per program group |
| Medicaid utilization | 4-quarter average | 4-quarter average · Weighted last 3 quarters · Latest 2 quarters |
| Lag curve history | 12 quarters | 8 quarters · 12 quarters · 16 quarters |
| Short-history constraint | On — book the higher end of the range when history is under 12 months | On · Off |
| Wholesaler inventory flag | Above 3.0 weeks | On · Off |
| Route any variance above the threshold to the Revenue Controller | On | Required by policy RA-12 — cannot be switched off |
Every figure is labelled: a target the solution is built to, an estimate, a typical published result, or a proven one.
“demo” = seen in the working solution, on its sample quarter (Northwind Bio U.S., Q3 2026) · “target” = the design goal, measured in the live solution · “estimated” = our estimate · “typical” = published figures (published gross-to-net industry analyses, which put reductions at roughly half of U.S. brand gross sales). People, companies, products, contracts and the audit firm named on this page are fictional — characters and sample data in the working solution.
Software that estimates the reserves between a drugmaker's gross sales and its net revenue — commercial and Medicaid rebates, Medicare Part D, 340B, chargebacks, fees and copay — and supports them for the close and the audit. Gross-to-Net Accruals adds six agents that rebuild every program from source, cite each assumption and check it against an independent estimate, for the revenue controller to decide and sign.
The Reserve Builder rebuilds the accrual as a formula — for commercial rebates, eligible units × WAC × contract rate — with a source on every factor. The Lag Curve Analyst produces a second estimate from 12 quarters of payments, and the Variance Checker explains any difference above the threshold and proposes options with their dollar effect.
Yes. The Contract Terms Reader compares every term in force during the quarter with the rate in the schedule. On the sample quarter it found Crestline Rx Amendment No. 3, which raised the exclusive-plan rate from 41% to 44% of WAC from July 1 — a $19.4M difference — and cited the clause.
The Lag Curve Analyst states the history length behind every estimate and flags anything under twelve months. With the short-history constraint on, the reserve books the higher end of the range, and the memo's variable consideration section under ASC 606 records it.
The Audit Pack Assembler matches each request to its evidence, runs completeness and accuracy checks and drafts the response. Only signed programs go out, and the audit liaison sends each response — the agent never does.
Yes. The agents rebuild, compare and draft; every variance above the threshold goes to the Revenue Controller, who decides and signs each program with the meaning of the signature. Signed programs lock, and every decision is on the audit trail.
The Agentic Solution Engine builds and deploys it from your requirements and documents — your contracts, feeds, policy and prior memos — and it goes live once every quality gate has passed.
The target is signed reserves by working day 6 instead of 9, with close effort falling from 670 to 315 hours a quarter as the agents assemble the evidence. Review time stays with the people who decide.
Every accrual line tied to its contract, change order and invoice.
1-min demoMedicaid Rebate Invoice ValidationSuspect units disputed with claim-level evidence, and the dispute letter drafted.
1-min demoAlliance Profit-Share AccountingEach quarterly allocation traced to the ledger and the agreement clause
1-min demoWe'll run Gross-to-Net Accruals on a past quarter of your own contracts, feeds and schedules.