Based on our experience, it’s a claim we can make with 100% certainty.
Since 2019, when ProxsysRx launched its 340B Support Services division, we’ve managed the 340B programs of 18 health systems. We’ve generated more than $500 million in 340B Savings and Revenue. And yet, we’ve never served (or seen) a 340B health system with adequate in-house resources to optimize the quality and number of its 340B eligible contract pharmacies.
The typical number of quality 340B contract pharmacies we’ve added to the networks of health systems we serve is five to ten, and with those increased numbers has come an increase in 340B contract pharmacy revenue.
Factors to consider for your 340B contract pharmacy network
Pharmacy fees
For starters, you have to consider the fees a pharmacy charges to process your 340B prescriptions. Pick a pharmacy mismatched to your hospital’s dispensing patterns, and you could easily end-up spending more in fees for them than they generate for you in 340B savings.
TPA fees | TPA compatibility with your 340B contract pharmacies
In addition to pharmacy fees, TPAs often charge for simply attempting to process 340B prescriptions — whether they’re eligible or not. Now imagine you have a TPA like that, and their processing procedures are badly mismatched for a pharmacy in your network — where thousands of otherwise-eligible 340B prescriptions aren’t being allowed every month.
340B manufacturer restrictions
Many manufacturer restrictions limit 340B replenishment for certain medications to just one pharmacy per health system. Pick the wrong 340B contract pharmacy for a particularly costly manufacturer-restricted 340B drug that your providers routinely prescribe, and the consequences for your savings and revenue can be catastrophic.
Negotiated pricing for specialty drugs
Fees from specialty pharmacies also vary for 340B prescriptions. Some charge cost-plus percentage, some charge flat rates. If your health system has a strong buying history with a specialty pharmacy, you may be able to negotiate with them for better pricing.
PBM relationships. One example.
Most specialty pharmacies are owned and operated by PBMs. And if, for example Caremark is your PBM, you have to go to a CVS specialty pharmacy to get 340B savings on specialty drugs. A lot of hospitals don’t realize that — and again, it’s because they simply don’t have access to the data we’ve collected using our resources.
Educating your physicians on best practices
In addition to all the challenges hospitals have in identifying and partnering with eligible contract pharmacies, they simply don’t have the human resources necessary to educate their physicians about which pharmacies to use for which patients — and which prescriptions (all of which adds up to untold thousands, if not millions, in lost 340B savings and revenue). Once again, ProxsysRx provides that service for the health systems we serve.
Analytics + Manpower + Know-How = Buying Leverage
The number of contract pharmacies is critical to optimizing your hospital’s 340B savings and revenue, but clearly, there is a LOT more to the equation than just pharmacy numbers. All of which begs the question: How confident are you that your health system’s contract pharmacy network is everything it should be?
Capturing 340B savings with onsite pharmacies — retail and specialty
ProxsysRx has built-and-owned or managed hospital pharmacies since 2014 — many of them for health systems whose 340B programs we manage. When we sign a combined 340B / pharmacy contract with a hospital, we can place a pharmacist (specialty and/or retail) in their facility, and — practically from Day One — start filling 340B prescriptions that the hospital has been missing.
What’s more, our pharmacies are operated with the intent to supplement health systems’ existing 340B prescription volumes — without sacrificing net 340B revenue and savings from other contract pharmacies. Our ultimate goal is always the health system’s optimal net benefit from our services.
ProxsysRx is here to help, if you have questions.
There are so many ways to optimize your 340B drug program savings & benefits. For more information, contact Howard Hall. 214.808.2700 | howard.hall@proxsysrx.com
