Hospital outpatient pharmacy leaders cite staffing shortages, managing multiple vendors, and navigating insurer red tape—specialty drug referrals and prior authorization requirements, specifically—among top workplace challenges, a new survey finds. As 340B providers continue to grapple with pharmaceutical manufacturer contract pharmacy restrictions, most respondents said they plan to boost their in-house pharmacy capabilities.
The survey, commissioned by 340B pharmacy management company Maxor 340B and conducted by healthcare consultancy Sage Growth Partners, was released on July 18 and carried out in early 2022. It drew responses from 101 leaders “involved in or serving as influencers in hospital pharmacy decisions/management,” according to the report. Over half (53%) of survey respondents worked in acute care hospitals, 33% in critical access hospitals, and 14% in other facilities.
Mirroring their colleagues in other areas of healthcare, workforce issues were the top challenge reported by hospital pharmacy leaders. Eighty-one percent of survey respondents said staffing was among their top three challenges, and 53% said their number one challenge was staffing. This was largely attributed to the repeated COVID-19 surges, according to the study. Finding partners with “robust national recruiting capabilities” offers one potential solution to that challenge, according to the report.
Hospital pharmacy leaders also report challenges managing multiple moving parts in different systems, whether it’s fulfilling insurer coverage requirements such as specialty drug referrals or prior authorizations, managing disparate fee structures, or dealing with multiple vendors. Three quarters of survey respondents say managing multiple vendors is either moderately or extremely challenging, and 91% “believe offering a comprehensive suite of pharmacy solutions has value,” says the report.
When considering vendors to help manage pharmacy operations, hospital pharmacy leaders felt the following factors were most important: compliance with professional accreditation and regulatory requirements (36%), total value creation (35%), account management and responsiveness (12%), and specialty expertise (12%).
Growth in In-House Pharmacies Continue
Paralleling the results of another Maxor 340B survey of community health center executives also conducted early this year, 71% of hospital pharmacy leaders reported their facility offered at least one in-house outpatient and/or specialty pharmacy and over half of those lacking such a pharmacy said they planned to open one at some point. The majority (56%) of community health center executives also said their facility had an in-house pharmacy, with one third reporting they planned to open one in the next three years.
This trend toward 340B covered entities offering in-house pharmacy services—to the extent that they don’t already offer them—likely reflects growing efforts by drug manufacturers to restrict the use of contract pharmacies and limit 340B discounts to those drugs dispensed by in-house or wholly owned pharmacies.
“Those [entities] who can open on-site pharmacies and better capture revenue from specialty referrals are likely to be better positioned to weather the future of 340B,” says the report.
“Given today’s environment, it’s not surprising the importance that onsite pharmacies play for 340B hospitals, and that hospital pharmacy leaders want to partner with organizations that can not only help them optimize their onsite pharmacy strategy, but also create value through a comprehensive suite of pharmacy solutions. These survey results very much align what we are seeing in the marketplace more broadly, said Ross Halsne, Maxor’s Vice President of 340B Solutions.
The report can be accessed here. Maxor is a sponsor of 340B Report.