As we’ve noted before, 2022 is the year when 340B turns 30! Its birthday is Nov. 4 to be exact, however, when it’s a milestone year, you celebrate all year long.

At the 340B Coalition Summer Conference, there were ‘90s-themed parties, fanny packs, Reeboks, roller blades and scrunchies, some of which are back in style here in the roaring 20’s! There were memorabilia – like the first 340 Coalition conference agenda and binder (yes, we used to receive a three-ring binder instead of a conference app for our smartphone). I also managed to dig up every 340B Coalition charity fun-run T-shirt and some articles from the first 340B University in 2011, when I was faculty.

A new venue, the Gaylord National Resort, attracted new attendees, and attendance rose to an almost record high of just under 2,000. Continuing a trend we saw at the Winter 340B Coalition, hospital attendance was dampened by policies on travel and staffing shortages, and in a new twist, there was equal representation from hospitals and grantees.

What did the conference tell us?

Don’t give up; 340B is a powerful tool to reduce the cost of prescriptions and our government recognizes the program’s purpose is to make sure all stakeholders are doing their part — covered entities and manufacturers. While the federal government wouldn’t directly comment on the 18 manufacturers who are breaking the law (it was 13 when we started the year), they did reinforce their determination to monitor the situation and continue to administer the program within their control.

The keynotes highlighted what is to come in 2023 and beyond, in addition to the real-world experiences from covered entities and other subject matter experts. Conference regular and pharma policy guru Michael McCaughan did a great job discussing the Inflation Reduction Act, powerful legislation that he predicted would pass without a hitch to bring drug-price negotiation to the Medicare program starting in 2026. The bill goes well beyond healthcare provisions, tackling tax and environmental changes.

Former Surgeon General Jerome Adams spoke of the critical need for 340B — and as the executive director for health equity initiatives at Purdue University’s College of Pharmacy and a board member for a 340B company, he knows the impact of the program better than the average physician. He said providers need to understand the business of healthcare because they are key to transforming it — a mission we share here at The Craneware Group. Thank you Dr. Adams for recognizing the importance of our providers not only caring for their patients, but also solving the biggest challenges ahead of us: funding care.

The energy and enthusiasm for the future and transforming the business of pharmacy is our pearl waiting to be discovered! Join us to transform the business of healthcare and find the pearl- 340B!

Federal engagement

Carole Johnson, the new Health Resources and Services Administration (HRSA) administrator, commended the enforcement actions of the Office of Pharmacy Affairs (OPA) against drug manufacturers and then introduced Lt. Cmdr. Dr. Emeka Egwim. He provided his “state of OPA” for the first time and had everyone’s ears perked when he spoke as a pharmacist hearing from patients who say, “I can’t afford my medications.” Egwim focused on the integrity of the program and expressed the need to share success stories from covered entities.

Dr. Egwim also discussed the letters sent to the Office of Inspector General related to the manufacturers’ contract pharmacy policies and hinted at ongoing efforts he could not speak to due to ongoing litigation. He emphasized HRSA’s yearslong efforts to gain regulatory authority and the importance of transparency to strengthen the relationship between covered entities and manufacturers. “People give purpose and value to this program — your teams and the people you serve,” he said.

Dr. Egwim cited Section 121 of the Consolidated Appropriations Act of 2022 as just one of the ways the office has supported 340B covered entities during the pandemic health emergency, with 40 hospitals re-instated into the 340B program in the first 30 days and 64 hospitals as of August across 32 states. They will continue to be implemented until the provision sunsets.

Pricing oversight by HRSA OPA has been consistent for 14 quarters. Lessons learned have included pricing spot checks, which have led to refunds to covered entities. There has been a reduction in allegations of incorrect 340B prices in the market with the OPA information system implementation. OPA recommends using the government contractor, Apexus, to access the necessary attestation forms and general inquiries. Apexus has updated the Medicaid tool that they launched a few years ago; check it out if you have state specific needs, as recommended by Michelle Wiest, newest Apexus senior leader for 340B Policy and Compliance.

Attendee engagement

Attendee engagement, when not in the plenary sessions, focused on the intersection of clinical care and 340B – from COVID-19, HIV, to clinical pharmacy services improving outcomes. Speakers addressed the role of 340B and meeting patients where they are— schools, home, and non-healthcare sites. The role of pharmacists in promoting health equity and directly addressing social determinants of health was a new addition this year.

Other topics included identifying areas of opportunity for 340B eligibility to offset the contract pharmacy exclusions. Tried and true audit and compliance, specialty and contract pharmacy, and inventory management related to data assisted covered entities enhance compliance and operational efficiencies to manage their 340B programs in a highly complex software-based solutions. Our team provided insights into how to use your electronic health records and purchasing records to perform data analytics to address 340B compliance and health outcomes.

It was nearly impossible to attend all the tracks, and the exhibit hall was buzzing with social activity. My favorites were the lessons from the field, which allow vendors from all sectors of 340B to share insights. Without a doubt, referrals, PBMs, vendor management and manufacturer challenges dominated, and I was fortunate to spend time looking back on trends in operations and legislation and what 2023 may hold based on the marketplace needs. I will be hosting this presentation on our Facebook 340B Pharmacists Moms Group — “Ladies who lunch and learn” — in September and again in October at The Craneware Group’s annual Performance Summit.

The general sessions were filled with speculation on drug pricing (it’s here), predictions on federal 340B legislation (not this year), and insights on the direction healthcare is heading from our nation’s top physician. There were additional breakouts and I was happy to co-lead one special interest breakout group — our 340B Pharmacist Moms Group for our second in-person get together. Contact me if you would like to learn more.

Now what?

The next step is to take the nuggets, the ideas, the relationships and build on them to prepare for the road ahead. Email the connection you made. Dig out those business cards and say “hi.” Join the forums and be part of the conversation, and enroll in webinars — like our monthly Wednesday offerings provided by our training team.

Continue to engage. Continue to learn. Continue to defend 340B.