340B Duplication Discount Prevention for Pharmaceutical Manufacturers
Despite the deployment of several technologies and mitigation strategies, drug manufacturers continue to grapple with challenges, resulting in excessive payments for 340B duplicate discounted rebate claims. These challenges are multifaceted and ever-evolving.
Challenges
- Year-over-Year 340B sales have surged by 23% to reach $54B ($100B WAC), even amidst contract pharmacy restrictions imposed by manufacturers. As the program expands, so do the associated challenges.
- State Medicaid agencies maintain a passive stance on compliance with federal legislation aimed at preventing duplicate discounts.
- The Genesis Healthcare, Inc. v. Becerra ruling has broadened the definition of a 340B patient, potentially increasing script volume and complicating 340B identification.
- The Inflation Reduction Act complicates the landscape for Manufacturers, CEs, and Pharmacies, necessitating navigation of Medicare MFP and 340B duplication.
- States like Arkansas, Louisiana, and Michigan are beginning to push back against contract pharmacy restrictions.
Our Solution
- RxParadigm’s Duplicate Discount Prevention Product boasts robust pre identification and post auditing capabilities, proficiently scrutinizing claim submissions to discern 340B claims originating from Payers and PBMs.
- It also delivers comprehensive insights and reports crucial for validating and maintaining rebate rejections.
- Tungsten+ PLUS ™ provides a holistic solution, expertly identifying 340B claims and streamlining communication and rebate payment processes
Case Studies
Click the links below to delve into our case studies to see the tangible difference we’ve made in assisting clients to prevent duplicate discounts