Pharma · Diagnostics
Patient acquisition spend ran above what reimbursement paid.
This marketing & margin audit identified $71k in wasted annual spend in a Pharma business, evidenced, senior reviewed, and delivered in 7 days.
The business
A diagnostics and lab business ran direct to patient acquisition for certain tests, spending on marketing to bring patients in. The tests were reimbursed at set rates, but acquisition and reimbursement were managed by different teams, so whether the cost of acquiring a patient actually stayed below what reimbursement paid was never reconciled per test.
What triggered the audit
Volume grew while margin didn’t, a mismatch that points to acquisition cost outrunning reimbursement. The audit reconciled patient acquisition cost against the reimbursement received per test, testing whether the marketing spend to bring each patient in was actually covered by what the test paid.
What the audit found
For certain tests, the business was spending more to acquire a patient than reimbursement returned. Because acquisition and reimbursement sat with separate teams, nobody had put the two numbers side by side per test, and when the audit did, several high volume tests showed a patient acquisition cost that exceeded their reimbursement rate, so every patient marketed in on those lines lost money. The growth looked like success, which made scaling it feel right, when in fact scaling deepened the loss. Because the two figures lived in different silos, the shortfall was structurally invisible. Reconciled per test, the below reimbursement acquisition was costing roughly $71k a year.
What we changed
Reconciled patient acquisition cost against reimbursement per test, exposing exactly which lines were being acquired below what they actually paid.
Capped or cut acquisition spend on the tests whose reimbursement simply can’t cover the cost of bringing a patient in.
Concentrated marketing on the tests where acquisition genuinely clears reimbursement with real margin to spare.
Made acquisition versus reimbursement a monitored metric per test, so below water spend can’t scale unnoticed across the separate acquisition and reimbursement teams the way it had before this was put right.
The result
The published chart shows acquisition cost per test moving from 122% of reimbursement to 78%, a 44 percentage point decrease. Reimbursement, acquisition cost and delivery cost are separate boundaries; the chart does not by itself establish margin after delivery. $71k a year recovered by ensuring patient acquisition stays below what reimbursement pays, an annual figure equal to 12× the $5,950 Audit + Sprint fee. For any diagnostics or healthcare provider, siloed teams are the trap: acquisition and reimbursement managed separately means nobody sees when the cost to bring a patient in exceeds what the test returns. If you’ve never reconciled the two per test, growth may be deepening a loss. A fixed fee audit reconciles it in days, before more volume compounds the shortfall.
From kickoff to signed off findings: 7 days, inside our fixed 5–7 day window.
What the client said
$71k a year of wasted spend cut in 7 days
Acquisition cost vs reimbursement per test: 122% → 78%
“Acquisition and reimbursement sat with different teams, so nobody compared them. Cristian reconciled cost per patient against reimbursement per test: several high volume tests lost money on every patient we marketed in. We capped those.”
Cristian BragauSenior Auditor · signed this audit off