Before we begin, we’re going to be honest with you. A significant component of VytlOne’s business is guiding 340B health systems through the process of building, accrediting, funding, launching and managing on-campus specialty pharmacies. Many times in this space, we’ve maintained that every 340B hospital should consider owning a specialty pharmacy. 

We’re currently in the development process with seven health systems and several FQHCs. The specialty pharmacy we helped build, fund and open last year — for a large regional Southeastern 340B hospital — began generating a monthly net income of $1 million within six months of launch. More importantly, that pharmacy began positively impacting the health system’s quality and scope of patient care months before it opened; an impact that has increased profoundly since then.

So let’s start with why you should NOT own a specialty pharmacy.

Owning a 340B specialty pharmacy is expensive.

• It’s expensive to build.
• It’s to accredit with URAC and ACHC.
• It’s expensive to staff.
• It’s expensive to stock.
• It’s expensive to operate and maintain.
• It’s expensive to grow.

Owning a 340B specialty pharmacy is complicated.

• It’s complicated and time-consuming getting accredited.
• It’s complicated and time-consuming getting in-network with payers.
• It requires a lot of internal committee and administrative oversight, and that requires dedicated administrative resources and interdepartmental coordination.
• It’s significantly more “regulated” than a retail pharmacy. Specialty pharmacies must comply with complex and frequently evolving requirements from HRSA, FDA, payers and accrediting bodies.
• It requires specialized technology and processes for everything from prior authorization and inventory management to outcomes tracking.
• It requires a significantly higher level of ongoing data collection and reporting.
• It’s subject to far more manufacturer restrictions, on average, than a retail pharmacy.

Given all those significant barriers to entry and successful ownership, you have to ask – – 

Why SHOULD you own a specialty pharmacy?

The simple answer is: It’s worth it. 

Clinical / service advantages of an onsite 340B specialty pharmacy:

• An in-house specialty pharmacy enables you to better pursue your mission, by ensuring alignment of your specialty pharmacy program with your providers.
• It enables you to keep specialty pharmacy in your hospital’s Continuum of Care, which is especially critical for treating conditions like oncology, HIV or transplant care.
• It streamlines your 340B patient care. Your specialty pharmacists can collaborate closely with your providers — ensuring that your patients receive personalized treatment plans.
• It enables your specialty pharmacists to engage patients in one-on-one counseling.
• It improves medication adherence among patients. Which is critical, since medication non-adherence is the number one cause of unnecessary patient readmissions.
• It enables your patients to fill all their prescriptions — specialty and retail — in a single place. 
• It significantly improves the patient experience, and your patient satisfaction ratings.
• It enables you to collect and analyze more valuable patient data, continually improving your patient care protocols while optimizing treatment outcomes.
• With greater control over data integrity, patient eligibility tracking and audit readiness, it reduces your risk of 340B violations — especially during HRSA or manufacturer audits.
• An onsite 340B specialty pharmacy enables your health system to participate in drug research — something manufacturers perpetually need, to confirm the efficacy of their most expensive drugs.

Financial advantages of an onsite 340B specialty pharmacy:

• It’s an excellent revenue driver. Some hospitals generate six times as much 340B revenue from specialty pharmacy prescriptions as they do from their retail pharmacy prescriptions.
• It enables your health system to capture a greater proportion of the pharmacy revenue that would otherwise be lost to outside pharmacies.
• It enables your health system to overcome manufacturer restrictions limiting 340B access to specialty pharmacies within 40 miles of your campus.
• In many states, where there is a legal workaround, it enables health systems to overcome the Single 340B Pharmacy manufacturer restriction.
• The 340B revenue you generate enables you to invest in expanding the scope of services you offer the community.
• By having direct access to 340B discounts, you can offer affordable access to essential drugs to a broader spectrum of patients. Particularly when coupled with outreach programs connecting patients in need with Financial Assistance programs.

We’ve said this before: The ultimate Win-Win in healthcare is increasing the quality of patient care, and getting paid well to do it. In short, experience has taught us that all of the additional costs and complications of owning an onsite 340B specialty pharmacy are more than offset by the benefits it offers to the “sickest of the sick” patients you serve.

And yes, it’s inarguable that working with offsite 340B contract specialty pharmacies costs health systems less, but the returns — clinical and financial — are much lower. After all, independent specialty pharmacies are, by necessity, more focused on supporting their business objectives than your own specialty pharmacy would be. 

Supporting your specialty pharmacy investment before you open the doors

When you partner with VytlOne to build a specialty pharmacy, we’ll get you in-network with payers long before your physical pharmacy opens — enabling you to generate additional 340B revenue to help pay for itself during the process. And while it’s true that many payers require a year of specialty patient data before they’ll contract with you, an additional solution is something we call Specialty Pharmacy Light: We’ll help you secure a contract to dispense “soft” specialty drugs — which you can prescribe through your retail pharmacy.

How soon can an onsite 340B specialty pharmacy pay for itself?

If you’ve implemented efficient workflow processes and leveraged your contract pharmacy network, and your patient population has sufficient demand for specialty pharmacy solutions, your investment can easily pay for itself within a few months. In general, larger 340B hospitals catch up quicker, because they have more opportunities for specialty pharmacy prescriptions and savings. 

FEATURE	ONSITE SPECIALTY PHARMACY	INDEPENDENT CONTRACT PHARMACY
Startup Cost	High	Low or none
340B Revenue Capture	High	Low to moderate
Care Coordination	Strong	Limited
Regulatory Control	High	Less visibility; dependent on contract terms
Payer Access	May face restrictions	Often broader due to network relationships
Operational Burden	High (staffing, compliance)	Low (outsourced burden)
Patient Experience	Tailored, integrated	Less consistent or customized
Business Incentive	Aligned with your hospital’s mission	Pharmacy’s incentives may diverge

Why we believe you should own a specialty pharmacy (summary)

Having an in-house specialty pharmacy allows your 340B hospital to ensure that high-risk, high-cost patients remain in its continuum of care — enabling better coordination, monitoring, and clinical outcomes. Onsite specialty teams can offer tailored support services — from financial assistance navigation, patient refill reminders and personalized side effect management, to real-time collaboration with prescribers — that external 340B contract pharmacies simply can’t match at scale.

Let VytlOne guide you through the specialty pharmacy process.

To learn how we can help your health system fund, launch and manage a successful specialty pharmacy — while integrating your 340B program throughout the continuum of care — contact Howard Hall any time. howard.hall@vytlone.com | 214.808.2700