Tag: Industry Insights

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The Origin and Evolution of Specialty Pharmacy

Commencing in the early 1970s, specialty pharmacy was originally intended for patients requiring unique therapies for various conditions. Initially this included mainly infusions for hemophilia, cancer, or malnutrition^[i]. Most of these offerings came with high costs (many of which can now be offset by copay assistance programs), and special storage and/or shipping requirements^[ii].

Specialty pharmacy has since expanded rapidly, and Merck’s launch of indinavir (Crixivan®) in 1996 marked a significant milestone. As the third approved protease inhibitor for HIV treatment, the launch followed a record setting fast-track FDA approval. The decision to dispense Crixivan® exclusively through Stadtlanders specialty pharmacy^[iii] set the tone for the limited distribution networks that we see today.

Between 1970 and 2000, most specialty medications were covered as a medical expense. However, a shift occurred in the early 2000s, with specialty transitioning to the pharmacy benefit. Today,

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Location: Gaylord National Resort & Convention Center

Start your 340B Coalition Summer Conference with the latest developments in the 340B program. Verity Solutions will be hosting a panel discussion at the Gaylord Resort in National Harbor with some of the most respected long-term experts on the 340B program. Join us for an up-to-the-minute report on hot button topics related to the legislative, compliance, and regulatory aspects of the 340B program.

Among the topics to be covered:

• Developments on the 340B contract pharmacy legal situation
• Updates on 340B legislative efforts in Washington, D.C. and the states and potential impact
• Discussion about alternative replenishment models
• Latest on HRSA policies including off-site clinic enrollment

Space is limited and only open to 340B covered entities.

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The 340B drug pricing program, which allows eligible healthcare providers known as covered entities to purchase medications at a reduced price, has been an incredibly valuable tool for providing affordable healthcare to underserved populations. However, the benefits of the 340B program go beyond just reducing the cost of medications. Covered entities that also act as pharmacy benefit managers (PBMs) for health plans in their community can leverage the program to create a circular healthcare economy that benefits not just the covered entity, but the entire community.

When a covered entity acts as a PBM for health plans in their community, they are able to negotiate lower prices for pharmaceutical products on behalf of their health plan clients. These lower prices can be passed on to patients, as health plans can offer lower out-of-pocket costs for prescription drugs. Moreover, by serving as a PBM, the covered entity is able to increase its

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Many people have been losing sleep thinking about how they should move forward in the current 340B environment. Over the last 18 months, it has felt like an external force is around every corner, pushing or pulling covered entities into new areas of discomfort.

During these turbulent times, it can help to find partners who have experience as covered entities and have weathered storms historically. As a wholly owned subsidiary of a covered entity, Hudson Headwaters 340B helps covered entities navigate the complexity of the current 340B environment and assists in developing strategies and technology solutions to minimize the discomfort and uncertainty of today.

Below are three things we suggest to improve the value and efficiency of your organization’s 340B program.

1. Automate Your ESP Data Submission

Hudson Headwaters 340B knows first-hand the challenges of reporting data to Second Site ESP. We have worked with ESP over the last several months, building

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Many covered entities are not aware of the opportunity to capture referral prescriptions. This includes ones that were initially determined to be non-eligible by your TPA but after a closer look in your EMR are deemed to be eligible. Don’t miss out on this valuable source of revenue for your 340B program by overlooking referral prescriptions. You may be overpaying inflated fees by outsourcing. However, you can easily learn to capture these prescriptions yourself—before they expire—or another round of manufacturer exclusions is announced. With the recent increase in manufacturer blocks, maximizing your 340B savings wherever possible is more important than ever.

This session will be valuable for both PharmaForce Covered Entities and non-PharmaForce Covered Entities. Join us to learn about the potential of referral prescriptions and how to capture them in-house.

We’ll show you how to use the NEW PharmaForce Referral Claims Manager Platform to:

1. Maximize referrals and implement a compliant