ECRM’s Post

Transcript

Welcome everyone. Joe with me, Sharam and I have with me today Andrew Becker from Fruth Pharmacy and he moderated the roundtable discussion on the 340B program. So we're going to discuss some of the takeaways from that roundtable. So thanks for joining us. And to start off, could you just give an overview of the topic of the Roundtable? Yeah, sure. Thanks, Joe. So we, we talked about the history of the 340B program and. Where it started and where it evolved to with contract pharmacies coming on after the Affordable Care Act and how that expanded. And then we went into the the importance and the strategies that at retail anyway that that we need to have for internal auditing for financial performance and risk mitigation with all those dollars flowing around. Then we talked about the evolution of this program through the past couple of years with the manufacturer restrictions where they have decided well, OK. You know we're we're going to let you buy this much or we're not going to let you buy that product or we're only going to let you have one contract pharmacy instead of you know all thirty of them that you've got or we're going to only let you do it for one location. And all those various things that happen with that and then where we're at now with. Kind of an evolution of a reaction to those manufacturing programs of what what are these 340 be covered entities and contract pharmacies going to do. So there are some alternative distribution models that are being discussed and actually active out there now. So how are you going to take that model and fit it with your previous auditing practices and data requirements and all the way down to store level operations? Where this is a different process. So now you've got to make sure you've got that data coming from the hospital instead of from the TPA because this is a different model or from the wholesaler. You've got to make sure you've got your DSCSA information. You got to make sure you've got all the EDI that you normally use in your other processes and bring that in to make sure that the program is performing for you and the hospital the best you can. OK, So what are some you know from your? Discussion with the participants on the Roundtable, what are some of the challenge challenges that they're facing and actually setting those strategies? Yeah, so the the biggest challenge is, is the program for contract pharmacy and with respect to covered entity hospitals, for most of these covered entity hospitals is meant a reduction and as much as 75% of the revenue they had, it's just gone. Not good. Yeah that's not good. So everybody scrambling and that affects retail too. You know that's that's revenue that's gone for us as well because we do you know we give the majority of all the revenue to the hospital, we keep it dispense fee expense fee is, is, is typically more than you would get from the prescription of retail because you have all these processes and auditing you have to do and you have the cost of floating that inventory you know with your line of credit and and so on and and auditing all that. So it sounds like there's a lot of different technology systems in place or involved in all of that. How is is it a challenge integrating all of that and making sure you have the right systems? Yeah, it's always a challenge. And when you've had this figured out over the years, you know, as best you can and making sure everything works when it's supposed to and you, you've got the product replenished for for the revenue you paid out and now this happens and it just throws a monkey wrench into everything and now. This is a different process. So it's not just technological issue that can be solved and and there are ways to do that. It's it's really comes down to you need to EDI information from the hospital and an alternative distribution model with the hospital is ordering the product physically, it's physically at the hospital and now you're going to transfer that inventory to the contract pharmacy. That's a whole different, whole different thing. You know it's not directly from the wholesaler. This is from the hospital. So now you've got to get their EDI files, get that into your system so that you can do all the things you were doing, but you also have the physical, OK that inventory needs to get to my pharmacy. OK. Physically, yeah. How you going to do that? So the data file, you have the data and the actual inventory moving. So there are different ways to do that. You know hospital concur you over to you, OK, you can do that. You could use delivery drivers. You know, for us we already have delivery drivers already out every day, so we can swing by the hospital and grab those totes. And then your physical process is is different because you know, this did come from a wholesaler. You check it in as you normally do, but one now this is from the hospital and it's, you know, I have an invoice, right? Because. Yeah, came from there. So you got to physically check that product in and and your EDI files should match your DSCSA information. DSCSA information of, hey, it's serialized. We can track this all the way back from the manufacturer to to us. So, so we're covered there. So that's the current, that's the current strategy model actually. Sounds like a lot of coordination it's gotta do. Yeah, yeah, it is excellent. Well, thank you again for moderating the roundtable and thanks for joining us at the session. Alright. Thank you.