The 340B-program landscape has changed dramatically. For the 340B program’s first 28 years after its 1992 inception, the basic list of Best Practices for eligible entities remained largely unchanged — aside from the dramatically-increased importance of using specialized software. But since the June, 2020 introduction of 340B ESP — which has led to an avalanche … Read More
340B ESP and drug manufacturer restrictions are only part of the reason As we noted in a previous post, for 340B-eligible hospitals dealing with increasingly squeezed bottom lines, an in-house specialty pharmacy offers enormous savings and revenue potential. Some covered entities generate as much as 600% in specialty pharmacy revenue from 340B drugs as they … Read More
There’s an old saying that it’s better to be rich and guilty than poor and innocent. It’s a sad truth that accurately reflects the current state of 340B manufacturer restrictions, particularly in the wake of the January 30, 2023 decision by the U.S. Court of Appeals for the Third Circuit — which was largely in … Read More
It’s no secret that, for hospitals, one of the Affordable Care Act’s most far-reaching legacies is the impact that Value-Based Care has on the payments they receive. For many health systems, the lower their Value-Based Care scores, the lower the payments they receive from treating Medicare and Medicaid patients. What isn’t as commonly considered — … Read More
A ProxsysRx Team Member Speaks Out. I joined ProxsysRx in early 2021, and I’ve been devoted to 340B program management full-time since early 2022. I’m no stranger to heavily regulated programs. Nearly my whole professional career has been in some aspect of public health — preclinical, clinical and now post-clinical. I’m currently fully devoted to … Read More
Making the rich richer at the expense of the poorest and most vulnerable. Why was the 340B program created? Nobody’s ever put it better than the Association of American Medical Colleges (AAMC): “Congress created the 340B Drug Pricing Program in 1992 to protect safety-net hospitals from escalating drug prices by allowing them to purchase outpatient … Read More
ProxsysRx’s process for recovering lost 340B savings and revenue As we’ve noted in multiple earlier blog posts, 340B ESP is nothing short of a blatant, lawless tactic used by scores of drug manufacturers to disallow the discounts they are legally obligated to offer eligible entities. At the same time, a number of additional manufacturers are … Read More
A covered entity’s guide to selecting TPAs for its 340B program TPAs play a critical role in any covered entity’s 340B program. It’s their job to match contract pharmacies’ prescription claims with patient data provided by the health systems they serve, to determine 340B eligibility — and generate entity savings. Without those matches, no prescriptions … Read More
For 340B-eligible hospitals dealing with increasingly tight bottom lines (which essentially means all 340B-eligible hospitals), an in-house specialty pharmacy offers enormous savings and revenue potential. Some covered entities generate as much as 600% in specialty pharmacy revenue from 340B drugs as they do in traditional retail / outpatient or contract pharmacy 340B revenue. What is … Read More
As we noted in a previous post, 340B ESP is nothing less than a brazen and (in our opinion) unlawful ploy by the drug manufacturers to evade the discounts they are legally obligated to offer eligible entities — by placing extraordinary, and unnecessary, reporting burdens on hospitals submitting claims for 340B savings. That said, until … Read More
