For 340B-eligible hospitals dealing with increasingly squeezed bottom lines, an in-house specialty pharmacy offers enormous savings and revenue potential. Some covered entities generate as much as 600% in specialty pharmacy revenue from 340B drugs as they do in traditional retail / outpatient pharmacy 340B revenue.
The significant new problem, for 340B health systems serving a substantial number of patients in need of specialty drugs, is the growing number of drug manufacturers now honoring 340B prescriptions from only a single contract pharmacy and/or pharmacies within a 40-mile radius of their primary campuses.
The first obvious problem with the 40-mile restriction is that the vast majority of specialty pharmacies serving 340B Covered Entities are located outside that radius.
The good news is, there’s a workaround for 340B hospitals forced to select a single pharmacy for manufacturers’ 340B pricing — and it’s legal in many states. Hospitals can operate specialty pharmacies alongside their retail pharmacies. As long as the two operations are physically in their own spaces (working under separate Pharmacists-In-Charge), and there is no procedural, functional or personnel overlap between the two.
In some states, you can combine specialty and retail, but the retail operation is subject to the heavy policy and process requirements of specialty accreditation — which is an onerous burden for a retail pharmacy. Regardless of prevailing state laws, ProxsysRx can can help health systems navigate the best options for dealing with state guidelines, maximizing available space, and meeting patient needs.
The not-so-good news for 340B hospitals is: Opening a specialty pharmacy is extremely challenging — particularly given the effort required just to get access to purchase specialty meds, and then to get “In Network” with PBMs. Payers and manufacturers control the players in Specialty, so newcomers need significant support and guidance navigating the process. That doesn’t even account for how hard it is accrediting and running a Specialty Pharmacy.
ProxsysRx is currently in the process of opening a specialty pharmacy for a major Southeastern regional health system. During that time, we’ve learned how to work within their system — and streamline our process, without cutting corners.
How ProxsysRx makes it easier for 340B hospitals
We guide the health systems we serve through the process steps that they’re required to participate in. Fortunately, those steps tend to be the least burdensome in the process. We handle the rest of the process — painstakingly documenting everything we do, and reporting back to the health systems at every critical step.
Serving 340B hospitals as their pharmacy partner
If you choose ProxsysRx to build-and-own or manage your specialty or retail pharmacy, we only pay ourselves from the revenue and savings we generate on your behalf. Profits which never come at the expense of patient service or satisfaction — in fact, our management philosophy emphasizes the exact opposite approach.
We take-on all the risk, so our clients are never exposed to even the potential for loss. Moreover, when we build, own and manage pharmacies ourselves, we become a tenant in your facility — generating additional revenue through the rent payments we make to you for our space.
ProxsysRx is here to help, if you have questions.
For more information on how to build a successful specialty pharmacy, or for more information on any of the pharmacy-support services we offer, contact Howard Hall. C: 205.588.0946 | email@example.com