It’s no secret that the 340B Drug Pricing Program has been a lifeline for eligible health systems, enabling them to fill-in the massive revenue gaps inherent to the non-profit-hospital business model — and, in the process, support their mission of providing quality care to our nation’s most vulnerable patients. At the same time, it’s no secret that, since the advent of 340B ESP in 2020, the drug manufacturers have imposed a raft of restrictions on 340B program savings that, we believe, exist far outside the letter of the law as written by Congress in 1992.
That said, we agree that manufacturer restrictions on some 340B specialty drugs is understandable, and here’s why: In order to effectively produce positive outcomes, many of those restricted specialty drugs require diagnostic and dispensing skills (not to mention patient-monitoring and prescription-data reporting resources) that a lot of 340B health systems lack.
All of which is why, since 2021, ProxsysRx has invested heavily in offering comprehensive specialty pharmacy support services to 340B hospitals. It’s also why we’re using our expertise to work with, and support, manufacturers in their efforts to ensure that they receive 340B reimbursement for many of their most expensive 340B specialty drugs.
The first and most important step a 340B eligible health system can take in increasing its rate of specialty-drug reimbursement is to build an onsite specialty pharmacy staffed by professionals available to work closely with your providers. Every specialty pharmacy patient you serve should be monitored by a clinic pharmacist.
Providing clinical-assessment support for 340B specialty pharmacy patients
Ideally, your providers should have easy access to a specialty pharmacist, who can be present during patients’ initial assessments. They have the training to help your specialty-drug patients (and/or their caregivers) provide full and accurate reports of the medications they’re currently taking, and what side effects they’ve experienced. With that information, the pharmacist can then work hand-in-hand with your providers — making sure that the medication regimens they’ve prescribed are appropriate, up to date, and are the most accurate regimens for your patients and their disease states.
Continuous monitoring & reporting of 340B patient data
In addition to providing ongoing monitoring during treatment, your specialty pharmacists should monitor patients annually — reviewing any side effects they may have experienced, or any other issues they’ve had in taking their medication — and they should proactively deliver that monitoring support (as well as the patient data it generates) to your providers.
Ensuring patient satisfaction with their specialty pharmacy’s support 340B specialty pharmacy Patient Satisfaction Surveys are also required as part of the process. What’s more, those surveys must be conducted by independent third parties — to ensure that your pharmacists uphold the standards required of all specialty pharmacies.
Ensuring patient satisfaction with their specialty pharmacy’s support
340B specialty pharmacy Patient Satisfaction Surveys are also required as part of the process. What’s more, those surveys must be conducted by independent third parties — to ensure that your pharmacists uphold the standards required of all specialty pharmacies.
Building your specialty pharmacy with 340B revenue
It’s entirely possible that a number of readers with 340B-eligible hospitals are thinking, “Great ideas, but how could my struggling health system possibly afford to build its own 340B specialty pharmacy?”
ProxsysRx’s unique approach to specialty pharmacy provides health systems with a financial glide path to help fund the undertaking. It starts with optimizing your 340B network. We use our experience, and our proprietary software platform, to help health systems develop programs that optimize their 340B revenue. We’ve done it for hospitals that had no 340B program in place, and we’ve done it for hospitals with existing 340B programs.
For more information on any of the topics discussed in this article, contact Howard Hall. C: 214.808.2700 | howard.hall@proxsysrx.com
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ProxsysRx offers hospital systems proven solutions for optimizing pharmacy services’ positive impact on the continuum of care; solutions ranging from management of their 340B prescription-savings programs, Retail and Specialty Pharmacy operations, to Prescription Benefits program management, and patient financial assistance.
This post is related to:
340B Solutions, 340B Management Systems
