Since the advent of 340B ESP in 2020, drug manufacturers have imposed a raft of unlawful restrictions on 340B program savings. Nowhere have those restrictions been more punitive than with specialty pharmacy medications; drugs which typically represent the most expensive (and profitable) in manufacturers’ product lines.
340B restrictions from the drug manufacturers’ perspective
That said, we’ll admit 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 (plus patient-monitoring and prescription-data reporting resources) that a lot of 340B health systems lack. 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 manufacturers in their efforts to ensure that they receive 340B reimbursement for many of their most expensive 340B specialty drugs.
Giving drug manufacturers their due
The level of 340B reimbursement manufacturers receive is dependent on the proven efficacy of their drugs — and many of their most expensive specialty drugs require ongoing usage and outcome data to support their efficacy claims. This is the kind of data that ProxsysRx’s specialty pharmacy professionals provide in prescribing, dispensing and monitoring 340B eligible specialty drugs for the health systems we serve.
Best practices for dispensing 340B-eligible specialty drugs
The most important step you can take to increase specialty-drug reimbursement is to build an onsite specialty pharmacy staffed by professionals available to work closely with your providers.
Providing clinical-assessment support for 340B specialty pharmacy patients
Ideally, your providers should always have access to specialty pharmacists, who 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.
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. They should also proactively deliver that monitoring support to your providers, ensuring that all of your patients’ compliance and outcome data is accurately reported back to the accrediting bodies.
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
ProxsysRx’s unique approach to specialty pharmacy provides health systems with a financial glide path to help fund the undertaking. We’ve done it for hospitals that had no 340B program in place, and we’ve done it for hospitals with existing 340B programs.
Funding your 340B specialty pharmacy with retail pharmacy revenue
ProxsysRx has developed processes you can use for setting-aside your hospital’s retail-pharmacy revenue to fund a specialty pharmacy. With our Meds To Beds program, we’ll help you capitalize on the increased prescription revenue we generate for you. We’ll also help you increase the number of health system employees filling prescriptions at your on-campus retail pharmacy.
Finally, we’ll optimize opportunities for your hospital’s clinics to affordably fill your patients’ prescriptions, using your hospital’s retail pharmacy. Altogether, that can mean millions of dollars in new revenue for your health system.
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 | howard.hall@proxsysrx.com
URAC Accredited
The ProxsysRx specialty pharmacy team is accredited by URAC (Utilization Review Accreditation Commission), the medical profession’s gold standard for third-party validation of high-quality health care.
ProxsysRx is the only accredited company that offers hospitals a comprehensive range of consultative and hands-on pharmacy-related support services.
The single greatest benefit URAC’s validation offers your health system is a significant reduction in the calendar time, and in the personnel time-investment, required to earn the accreditation you need to own a successful specialty pharmacy.
