A validation pilot is a limited, source-traceable review of public pharmacy
reimbursement and benchmark data. It is designed to let an authorized agency, payer, counsel,
or program-integrity team test Adrastia's method against concrete NDC-level records before
deciding whether to expand the work.
Published 28 July 2026 · Last updated 30 July 2026
Pilot objective
The pilot answers a narrow question: can public reimbursement records be matched to public
acquisition-cost and product-reference files in a way that produces reproducible review
candidates worth validating against the customer's own records?
The output is decision support. It is not an allegation, audit finding, legal opinion,
actuarial certification, clinical recommendation, or final agency determination.
Typical scope
Element
Typical pilot boundary
Reason
Dataset
One state, one carrier, or one defined NDC portfolio
Keeps validation concrete and reviewable
Records
Ranked candidate file plus controls
Shows whether the method handles high, low, and neutral records
Sources
CMS NADAC, Medicaid SDUD, Medicare Part D public files, FDA NDC Directory, and related public references where applicable
Allows independent reproduction from public data
Time period
A stated quarter, year, or source vintage
Prevents mixing reimbursement periods and benchmark files
Customer data
None for the standard pilot unless separately authorized in writing
Limits privacy, procurement, and security scope
Deliverables
A pilot package commonly includes:
a ranked candidate file showing NDC, source vintage, reimbursement unit price, NADAC unit price, variance percentage, multiple, and supporting source row references;
a method memorandum describing matching, normalization, exclusions, unit-basis handling, and limitations;
control records that demonstrate the method is not selecting only high-variance examples;
an executive summary for procurement, legal, or program-integrity review; and
a validation log identifying questions for the customer to resolve against internal claims, contracts, fee schedules, or other non-public records.
Validation steps
Confirm authority and scope. Identify the agency, payer, program, state, carrier, portfolio, period, and permitted use.
Freeze source vintages. Record the exact public files used so results can be reproduced later.
Normalize product identity. Convert NDCs to a common 11-digit format and validate product identity against FDA reference data.
Align unit basis. Confirm that reimbursement and benchmark prices are compared on the same denominator.
Compute variance. Calculate percentage variance and benchmark multiple for matched records.
Select controls. Include high, low, and neutral records so reviewers can test the method rather than only inspect outliers.
Review limitations. Label data gaps, exclusions, specialty/340B concerns, dispensing-fee assumptions, and vintage sensitivity.
Customer validation. The customer checks candidates against its own claims, contracts, fee schedules, audit authority, and legal process before any external action.
What a pilot does not require
The standard pilot does not require Protected Health Information, member-level claims,
patient identifiers, clinical records, third-party system credentials, or production access to
a customer's private systems. If a later engagement requires any restricted data, the parties
should define that scope in a written agreement before transmission and use the necessary data
protection terms.
What success looks like
A successful pilot does not mean every candidate becomes a recovery or enforcement action.
It means the customer can confirm that the method is reproducible, the source rows are
traceable, the limitations are explicit, and the candidate list is useful enough to justify a
deeper internal review.
Pilot outputs identify analytical review candidates. Adrastia does not decide whether a price
was improper, whether a party acted wrongly, whether money is recoverable, or whether any
government, legal, contractual, clinical, or enforcement action should be taken.