Navigating the New World of 340B Contract Pricing Restoration

By: Heather Easterling

Read time: 6 minutes

A growing number of drug manufacturers have tightened their rules for 340B purchasing for Covered Entities’ contract pharmacies, leaving health systems to find their way to 340B contract pricing restoration.

The Road Back to 340B Contract Pricing

For many health systems, access to the 340B Drug Pricing Program is essential to their ability to provide quality care to vulnerable populations. The 340B Drug Pricing program provides covered entities a financial cushion that allows them to care for uninsured patients, operate community clinics, or offer other programs to make healthcare more accessible.

Over time, as specialty care hospitals and free-standing clinics increased in number, 340B purchases multiplied — and some manufacturers began to require contract pharmacies to submit claims data to guard against duplicate discounts. The process to submit claims and to subsequently monitor restoration of pricing requires significant time and resources. Some health systems are not sure that jumping through hoops for 340B pharmacy pricing is worth the trouble. If you’re among those who are weighing your options, McKesson can assist you with the next steps to 340B contract pricing restoration.

Register on 340B ESP

Registering on 340B ESP is an important step in 340B contract pricing restoration. The 340B ESP platform has three registration options:

• Wholly owned contract pharmacies, which are exempt from manufacturers’ requests for claims data, but must each be registered through 340B ESP. You must have a 340B-specific HIN (Health Industry Number) as the first step in this process. Your Account Executive will help you obtain the HIN.
• A single contract pharmacy arrangement, which is also exempt from claims data submission and can be registered through 340B ESP. Like the wholly owned exemption above, you must have a 340B-specific HIN (Health Industry Number) as the first step in this process as well. Your Account Executive will help you obtain the HIN.
• Multiple contract pharmacies, which are subject to claims submission requirements and can sign up to report data through 340B ESP. A HIN is NOT needed for each contract pharmacy for which you are submitting data.

Submit Your Data

Twice monthly upload de-identified 340B contract pharmacy claims data to 340B ESP™. Discuss with your TPA available reports they recommend for this purpose.

Once 340B ESP has your data, the platform performs data integrity checks and submits the verified claims to the manufacturer.

Monitor Your Contract Pharmacy Accounts

Each manufacturer has a different process for unlocking 340B pricing. Even if you are certain that you meet the criteria for 340B contract pricing, you must continually verify your status and pricing. Given the time and resources required for restoring and maintaining 340B contract pricing, finding a balance may seem overwhelming.

Whether you are a large healthcare system or a small community pharmacy, McKesson understands the intricacies and can help you navigate the complexity of the 340B Drug Pricing Program to find the right strategy to preserve your resources and restore funding through this valuable program. McKesson can offer you a comprehensive report containing all your contract pharmacy accounts, all manufacturers that have notified us to restore your pricing, and the effective date of that restoration. You may reach out to your account executive to obtain this report

You may also view catalog pricing in Connect at any time. Please note that there may be medications in your 340B contract pharmacy accounts from these manufacturers that do NOT have 340B pricing. The pricing is full WAC price. To stop these purchases from happening, contact your TPA and contract pharmacy partner to ensure these medications are blocked from the contract pharmacy arrangement.

For a detailed walk-through of the New World of 340B Contract Pharmacy, view our webinar. To apply for a HIN, contact your McKesson Account Executive. If you have begun submitting data and want a comprehensive report of your restoration status by account, please contact your McKesson Account Executive.

To learn more about 340B consulting options for contract pharmacies, contact McKesson.