Thriving with HIV: How a Compassionate Pharmacy Technician Made All the Difference

SPONSORED CONTENT by Tyler Curry-McGrath, Avita Pharmacy

A patient newly diagnosed with HIV can often feel as if the cards are stacked against them before they even begin. Overcoming the fear and stigma of telling loved ones, finding the right doctor, navigating the insurance process, starting and staying in care—the journey ahead can seem like an impossible one. Even the smallest obstacles along the way can lead to non-adherence to treatment, dropping out of care, and worse health outcomes.

Hearing the words from my doctor’s mouth, you have HIV, was gut wrenching. Waiting for my first doctor’s appointment after my diagnosis, I honestly can’t remember what I was thinking. All I can remember is the fear.

My doctor was wonderful, patiently answering my frantic questions one after the other. Slowly my breathing normalized, my mind stopped racing, and I was ready to start my treatment. I left with a prescription and a co-pay card in hand and went straight to the closest pharmacy in my neighborhood.

Still

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Evolving Payor Strategies to Control Spending on Specialty Medications

SPONSORED CONTENT by Jerry Buller

The challenges that ‘white bagging’ poses for patients and providers are gaining attention as more health plans mandate these policies. ‘White bagging’ disrupts traditional ‘buy-and-bill’ practices for provider-administered drugs, creating patient safety concerns, operational problems, and financial challenges for covered entities.

Impact of ‘White Bagging’ Policies on Covered Entities

In the traditional ‘buy-and-bill’ model, covered entities maintain control of the drug and its integrity from end-to-end, managing purchasing, storage, and medication administration. With ‘white bagging’ policies however, covered entities are required to receive the drug from an outside specialty pharmacy designated by the patient’s health plan – often, that same pharmacy is also owned by the health plan. This external process inhibits covered entities from ensuring both the quality and integrity of the medication to be administered, and it can cause delays in therapy when drugs are not received on time. The pharmacy management challenges ‘white bagging’ creates are significant, requiring people and resources to address.

Payor-mandated ‘white

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HRSA’s Order for 340B is a Win for Rural Accountable Care

SPONSORED CONTENT by Dr. LeeAnn Scheer, Caravan Health

Safety net facilities are celebrating the May 17 HRSA letters to six drug manufacturers affirming they must provide drugs to covered entities through their contract pharmacies at the 340B ceiling price. This decision will help these facilities, many of them rural, stretch this federal program to improve their financial sustainability and continue to provide excellent care in their communities. This is especially great news for rural facilities that participate in an accountable care organization (ACO).

In an ACO, a group of health providers band together to take responsibility for the costs and quality of care delivered to a defined population of patients. ACOs can include physician practices, hospitals, and health clinics, including covered entities such as critical access hospitals and federally qualified health centers. The ACO can earn a share of savings if it reduces the costs of care below a designated threshold. Creating these savings while maintaining quality of care for patients requires commitment from

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“Need to Know” – Visante’s Series of Key Takeaways for HRSA Grantees

SPONSORED CONTENT by Kristin Fox-Smith and William Wood, Visante

Those of us actively engaged in the 340B Program are well aware of the scores of issues faced by participating hospitals and it’s not surprising since they account for an exceptionally large percentage of all HRSA audits. But, what about other types of Covered Entities (CEs), such as the Specialty Clinics and Grantees? These important CEs are also subject to HRSA audits and face the same severe penalties for non-compliance, including the possibility of repayments to manufacturers.

Over the last decade, Visante‘s industry-leading 340B Program Assessment and Integrity Audit Readiness program has been successfully implemented in virtually all types of grantees.  As a result of our experience in this specialized area, we are pleased to provide our “Need to Know” series of key takeaways for grantees.

HINT: You may want to start by reading our Visante Insider blog titled Manufacturers Create Chaos For the 340B Program which can be found here.

Ready? Here is our

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What Covered Entities Should Know About Contracting with Specialty Pharmacies

SPONSORED CONTENT

By: Diana Sierra, MPH, VP, Contract Pharmacy Partnership & RVS Operations, Sentry Data Systems

For years, covered entities generated savings from the 340B program largely by contracting with retail pharmacies. Brick-and-mortar storefronts in their local communities, many of them trailblazing independent pharmacies, provided the most benefit for covered entities in the early years of the program.

In the past five or six years, however, there’s been a significant uptick in hospitals contracting with specialty pharmacies. That’s coincided with a rapid growth in the number of high-priced specialty drugs, which comprised about 36% of the overall prescription-drug market in 2019, up from 29% in 2015, according to Drug Channels Institute, making them the fastest-growing and largest category of medications.

Provided you have a solid grasp of sometimes complex specialty drug dispensing fee models, contracting with specialty pharmacies is a smart and relatively low-risk way to maximize your 340B benefits. But specialty drugs and the relationship between covered entities and specialty pharmacies

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Podcast: Dynamics of 340B Program Spotlight the Value of Strong Pharmacy-Finance Partnerships

SPONSORED CONTENT

The devastating double-whammy of Medicare Part B payment cuts and COVID-19 has again highlighted the 340B program’s significance to hospital finance. Once relegated to the hospital’s basement pharmacy, the 340B program is increasingly a topic of boardroom and C-suite discussions.

In the latest episode of Omnicell’s The Future of Pharmacy podcast, learn how health systems can leverage a vibrant, pharmacy-finance partnership to drive successful 340B programs, and allow pharmacy staff more time to focus on patient care. Find out why 340B program management has evolved, the program challenges that health systems still face, and the data and operational complexities that necessitate a cross-functional approach.

Host:

Ken Perez, Vice President, Healthcare Policy and Government Affairs, Omnicell

Guest experts:

  • Eric Iorfido, PharmD, 340B Program Manager, Penn Highlands DuBois
  • Charles Hirner, RPh, Senior Director, Omnicell 340B Operations
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Key Factors To Consider To Ensure Effective Management of a 340B Pharmacy Program

SPONSORED CONTENT by Ross Halsne

It’s becoming increasingly difficult for Covered Entities (CEs) to effectively manage their 340B pharmacy programs.  Often times understaffed relative to the task of handling the myriad of challenges that come with managing a 340B program, they face a seemingly constant barrage of maneuvering and attacks aimed at reducing their 340B benefit.  In response, many Covered Entities are evaluating new strategies to strengthen or reinvigorate their program. If your Covered Entity is taking a fresh look at its 340B program, make sure you are considering the following:

Evaluate The Merits of an Onsite Pharmacy Strategy

For CEs that can support this model, an onsite pharmacy can be an attractive option for a number of reasons.  Often, CEs will seek the assistance of a third-party to help them evaluate, launch, and manage an onsite pharmacy program.  If you are thinking about starting or growing an onsite pharmacy program, here are some considerations to keep in mind:

  • The vendors in this space have important differences to their service models that can make apples-to-apples comparisons difficult.  Cheaper doesn’t
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Optimizing 340B Savings Through Referral Capture

25% – 35%
of a hospital’s contract pharmacy opportunity lies in referral prescriptions

There are several ways to enhance, boost, and optimize 340B savings. This white paper looks at how capturing referrals can benefit a covered entity’s 340B program savings and mission.

HRSA GUIDELINES REGARDING REFERRALS

According to HRSA guidelines, a covered entity may send a patient to an outside clinic not registered with 340B and consider the patient 340B-eligible only if that patient receives care from a healthcare professional who is either employed by the covered entity or provides healthcare under contractual or other arrangements (e.g., referral for consultation) such that the responsibility for the patient’s care remains with the covered entity. If the covered entity can document that it retained responsibility for the services provided to the patient, then that individual may be eligible to receive 340B drugs from the covered entity.1

To meet these criteria, the covered entity’s medical record must show the referral order by the eligible provider in an eligible clinic, as well as a summary of the diagnosis and care provided

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The Patient Journey: Are You Missing Something?

SPONSORED CONTENT

Do you provide clinical care for patients living with or at risk of HIV? If so, you know how important it is to consider their needs beyond the clinic visit.

The patient journey is not linear. Social stigma, family issues, mental health challenges, financial hardship, and fear of discrimination are only a few obstacles patients may face. When individuals come to your clinic for care, it is often just the first step in a complicated journey to better health. Although accessing your services is a crucial step towards engaging in a patient’s own sexual wellness, keeping them adherent to their medications often presents a separate set of challenges.

Clinics like yours do so much to treat patients and help them stay adherent. However, an important resource in the care continuum is often underutilized: the pharmacy team.

Patients and health care providers alike sometimes assume that one pharmacy is as good as the next when it

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A Recap of the Acentrus Specialty Conference

SPONSORED CONTENT

Acentrus Specialty hosted its first Acentrus Specialty Conference on January 12-13, 2021, which brought together pharmacists, manufacturers, and suppliers to examine the challenges, opportunities, and best practices in advancing health system specialty pharmacy practice. A pharmacy paradigm shift is under way, as Integrated Delivery Networks (IDNs) are partnering to grow their specialty pharmacy operations.

“The conference highlighted the collaborative potential of our client network,” says George Zula, RPh, MBA, CSP, Acentrus Specialty Vice President. “It provided a valuable forum for specialty pharmacy leaders to network, share best practices, and focus collectively on working together to produce the data and operational insights that will drive excellence in patient care and outcomes.”

It is increasingly important for health system specialty pharmacies (HSSPs) to participate with a network administrator such as Acentrus, which allows data exchange to create metrics that demonstrate positive patient outcomes and cost-effectiveness.
—Chris Hatwig, RPh, MS, FASHP, Apexus President

Today, one in four hospitals operate specialty pharmacies, a ratio that increases to nine in 10

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