Insights

Herolind Jusufi, Angie Amado and Joe Cesarz 

The number of manufacturer 340B contract pharmacy exclusions is increasing. As a result, health systems have a renewed focus on the value of an internal specialty pharmacy program. To mitigate 340B contract pharmacy losses, organizations should work to understand leakage and develop solutions to recapture these prescriptions. Here are four steps you can take to get started: 

1. Review the manufacturer landscape and current restriction categories.  Conduct a comprehensive review of your third-party administrator(s) (TPA) to identify top drugs by volume and savings opportunity. This review will help prioritize internal program efforts based on where current and anticipated future losses are occurring. You can also analyze prescribing and pharmacy dispensing data to reveal current capture rates across key products and clinics to help set targets for what can be internalized based on payer and drug access. 

2. Evaluate your operational capabilities for referrals and prescription fulfillment.  Assess your capacity to provide internal medication access services and your ability to secure referrals for products requiring prior authorization and financial assistance. Pharmacy technology may also help to capture prescription refills or medications that do not require prior authorization. Pharmacy leaders should also consider proactive prescription drug shortage management, improved logistics capabilities, and downstream staff and space needs. Further efforts may be needed to centralize and streamline your medication access processes to make them seamless for providers and patients.

3. Reduce administrative burdens on providers and promote the value of specialty pharmacy to patients. Develop collaborative practice agreements for refill management or product interchange and consider targeted efforts to improve patient outcomes. These services promote holistic patient care and increase collaboration with clinic providers, reinforcing the value of your specialty and retail pharmacy programs.

4. Don’t limit your specialty pharmacy program to traditional high-cost drugs. Many non-specialty products are on the market where patients would benefit from the higher-touch services offered by specialty pharmacies. These medications can significantly mitigate contract pharmacy losses and support the patient’s total care. 

To learn more, read our full summary of the top 10 issues facing health system pharmacy in 2024. 

Here at Visante, we help health systems accelerate strong financial and operational performance through pharmacy. Our team’s deep expertise and innovative approach can help you optimize your fully integrated health system pharmacy program. Contact us to learn more about how we can meet your unique needs. Email solutions@visanteinc.com or call (866) 388-7583 to speak to one of our team members.