Q & A with 340B Expert Lyssa Limbrecht
Q: How do independent pharmacies benefit from 340B relationships?
Independent pharmacies can obtain an enhanced dispensing fee on 340B claims, helping to stabilize margins on some prescriptions
Can have greater options to save self-paying patients on prescription costs
Can reduce retail drug spend
Helps out the local Covered Entity (340B hospital/health center) with allowing them to also obtain benefits to provide your mutual patients with better services and care.
Q: How do patients benefit?
Patients can directly benefit when they’re self-pay patients with a 340B cash program through the local covered entity and contract pharmacy network.
Patients indirectly benefit from the Covered Entities ability to utilize their program savings to offer expanded care options and services.
Q: 340B is changing, what do you think the program will look like in a year? In 5 years?
340B is always changing, and always will be evolving as technology and medications change. I however do not believe 340B is going away anytime, much less anytime soon.
I believe that with the current stressors of manufacturers attempting to pull their products out of things like contract pharmacy relationships, and force other products to be directly priced to patients, this will likely result in major lawsuits over the coming year. I however believe that if HHS does the right thing and backs up the intent of the 340B Drug Pricing Program against these blatant attempts to undermine, that the 340B program will win.
Even without lawsuits or the manufacturers backing down, there is still a huge potential for both covered entities and contract pharmacies alike to obtain savings, properly, from the 340B Drug Discount Program.
Q: What can covered entities do to maximize savings from the program?
If you don’t have your EHR/EMR records integrated with your 340B claims processor (TPA), DO IT!
Check claims on a monthly or quarterly basis to see where you might be having missed opportunities and solve those problems
Check your eScript system(s) to see where the majority of your scripts are being sent to, if you aren’t already contracted with all the top pharmacies, get the contract review started now.
Shop around for other TPAs, especially in the past few years there have been newer 340B Claims processors come into the market, many with expanded capabilities and better customer service, AND with better contract pricing. Don’t be unwilling to change just because it’s what you’ve always had, or what you’re used to.
If you don’t have contract pharmacies, get some reviews, your scripts are going somewhere, might as well benefit everyone and increase your program reach in your community.
If you don’t have an in-house, mixed-use(split-bill) program, and you haven’t already checked on doing it, I’ve seen typical savings there alone of about 20%-30% on annual drug spend.
Covered entities can contact us at Optimal340B for a customized plan around your 340B program. We can do the work so you don't have to!
Q: How can someone contact you to learn more?