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340B Outlook For 2024: Change. Change. And More Change.

What we’ve learned. What it means for your 340B program.

Between late 2019 and the end of 2023, ProxsysRx’s 340B Support program went from Zero to more than $500 million in savings generated for the hospitals and health systems we serve. And yet, if there is one thing that our 340B Team members agree-on unequivocally, it’s this: There is no such thing as a 340B Expert. Which is why the one 340B prediction we can make for 2024, unequivocally, is repeated three times in this post’s headline.

Two potential 340B developments for 2024

In an article dated January 5, the subscriber-only website 340B Report projected that “In 2024, congressional gridlock and election year dynamics will likely slow momentum on any comprehensive 340B program reform package.”

At the same time, regulatory changes are being made at the state level. Arkansas, for instance, recently struck a deal with Novo Nordisk — restoring 340B contract pharmacy discounts while both sides await a forthcoming Appeals Court ruling. Other states, including Louisiana, have moved to shut down manufacturer restrictions. In any case, we see even more confusion coming, where 340B manufacturer restrictions are concerned.

How covered entities should prepare for 340B changes in 2024

Build a qualified 340B team.

It sounds obvious, but the first thing your health system should do is invest in the resources and the personnel necessary to optimize your 340B program results. In our experience, most hospitals’ 340B teams are comprised of the Director of Pharmacy and a Pharmacy Tech — both of whom have full-time jobs, in addition to their 340B program responsibilities. Speaking from our own experience, that never works, and it never will.

Streamline processes, strengthen analytics and 340B program oversight.

Whatever software platform you use to manage your 340B program should streamline your process by minimizing the unnecessary detail-work your team-members have to undertake on a daily basis. 

“The ultimate challenge of the 340B program,” says ProxsysRx 340B Team leader Heather Brooks, “is taking all the moving parts, and pulling them together. What we’ve seen from every covered entity that's tried to manage its own 340B program,” she notes, “is that everything comes to them in pieces, but they don't have all the pieces pulled together. A single hospital can easily have five TPAs and 70 contract pharmacies. We've standardized our system so that we can put all of the players in one place. That’s really helped us leverage our knowledge to create better processes.”

Optimize, and scrutinize, your 340B contract pharmacy and TPA networks.

Another thing that we’ve found with every health system ProxsysRx serves is how much room they have for expanding and improving their contract pharmacy networks. The average number of quality 340B contract pharmacy relationships we’ve added to the networks of health systems we serve is five to ten. For one health system in South Carolina, we added nearly thirty contract pharmacies in two years.

That said, your health system should also subject all of your 340B program TPAs to serious scrutiny. “Over the years,” says Heather, “we’ve encountered far too many contract pharmacies who just aren’t aligned with the mission of the hospitals we serve — even more so with TPAs. 

“While we were onboarding one health system’s 340B program, we came-across a TPA that was charging them a percentage of every prescription matched. We got their service contract changed from a percentage basis to a flat fee, which saved the hospital $400,000 in one year. And here’s the thing: The hospital had no idea a flat fee was an option.”

Collaborate with other 340B covered entities.

“Honestly, I don’t see how any single health system can possibly know, and apply, everything we’ve learned from serving so many different 340B hospitals every day. Which is why I can’t recommend this strongly enough: If your health system is committed to managing its own 340B program, you should build a network of covered entities that you can regularly share ideas with. Otherwise, you’re missing countless opportunities to optimize your 340B revenue and, more importantly, improve the overall quality of healthcare you're giving your patients.”

Understand, and master, your 340B specialty pharmacy opportunities.

The 340B revenue potential of specialty pharmacy is staggering. Some covered entities generate as much as 600% in revenue from 340B specialty drugs as they do in traditional retail / outpatient pharmacy 340B prescriptions. By the same token, mastering 340B specialty pharmacy opportunities enables your health system to provide critically-needed care to your sickest patients. The best possible strategy for optimizing 340B specialty-prescription revenue and patient outcomes is to build your own in-house specialty pharmacy. To learn how you can do just that, please refer to this article — or feel free to reach-out to us anytime.

ProxsysRx is here to help, if you have questions. 

For more information on any of the topics discussed in this article, contact Howard Hall. C: 214.808.2700 | 

To read our original, unedited blog post, Click Here.

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