NextGen GTN™ · Knowledge Library
Where the Money Goes
Gross-to-Net doesn't go wrong in the calculations. It goes wrong in the assumptions. These are the assumptions, examined one at a time.
10,000 patients. $100 WAC. What reaches net.
A worked example at illustrative scale, built on a real patient cascade. Gross sales indexed to 100. Above the line is demand never converted to a prescription. Below it, channel deductions as a percentage of gross sales.
Sourced: the cascade percentages. Among US adults with hypertension, 59.2 percent are aware of their condition and 51.2 percent are taking medication, so 40.8 percent are never diagnosed and a further 8 percent are diagnosed but never started. CDC NHANES, August 2021 to August 2023, NCHS Data Brief No. 511, October 2024. Illustrative: the scale. 10,000 patients and a $100 WAC are round numbers chosen to make the arithmetic legible, and the six deduction rates are representative rather than measured. No real product is modeled and no client data is used. The proportions above the line are real. The dollars are a worked example.
Articles
Filed by Layer
Every article sits in one of the Five Layers of GTN™. The layer tells you where the problem was created, which is rarely where it was noticed.
The framework
The 5 Layers of GTN™
Friction accumulates across the commercialization ecosystem.
New articles, when there are new articles
No cadence promises and no drip sequence. You get an email when something is worth your time.