Rhiannon discusses the growing collaboration between manufacturers and covered entities regarding 340B discount claims. She goes on to describe the Kalderos Discount Hub solution that reviews claims that have a high likelihood of being a duplicate discount.
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Read on for Rhiannon’s insights.
It's Not All Bad News: Data Shows There's a Collaborative Future for 340B
By Rhiannon Naslund, Chief Marketing Officer, Kalderos
Certainly these issues are newsworthy and must be resolved to enable the 340B Drug Pricing Program to successfully support vulnerable communities for the long term. But these conspicuous headlines also obscure equally consequential news: a more collaborative future between manufacturers and covered entities is possible, and it could be here sooner than you think.
At Kalderos, we've had a front-row seat to growing engagement and collaboration between stakeholders, who are partnering to make drug discount programs such as 340B work better for everyone. In the last year, our platform has seen an encouraging leap in the number of covered entities who are actively reviewing discount claims to collaborate with manufacturers on the good faith inquiry process.
Through our Kalderos for Covered Entities portal, covered entities use our Discount Hub solution to review claims with a high likelihood of being a duplicate discount (caused when state payers unintentionally request a rebate on a 340B dispense). Claims are highlighted automatically, using Kalderos' machine learning technology to give other stakeholders useful validation on compliance-related data.
Since our founding, we have seen more than 830,660 individual claims reviewed by covered entities. That work has led to a massive discovery of verified duplicate discounts from the work of covered entities—a dollar total of $103,451,508. All due to the efforts of covered entities who are dedicated to ensuring the long-term integrity of 340B.
Considering the friction that is sometimes seen between stakeholder groups, and that covered entities are voluntarily participating, this increasingly successful collaboration between providers and manufacturers is newsworthy.
When it comes to all the recent 340B controversy, a fair amount has surrounded a third-party data-upload service called 340B ESP. While the service’s goal of increased transparency is a laudable one, some industry observers have reported concerns about cumbersome operations that create challenges for covered entities who rely on contract pharmacy partners.
Still, that doesn't mean that all collaborative data-sharing is off the table. In fact, a new McKesson study revealed that covered entities are willing to participate in data collaboration as long as patient data is protected and the process is straightforward and not disruptive to pricing. In the study’s survey of covered entities, 72 percent of respondents said they were not sending data to 340B ESP, but a sizable 44 percent of the "no" respondents would consider data sharing if they had the resources—"either they definitely will report or are considering reporting data but that resources are a barrier.”
As this study shows, the challenges to attaining more transparency in 340B are not ideological, but logistical. The vast majority of covered entities are highly invested in the integrity of 340B. They just need to know that their valuable time is being used wisely and that their efforts are making a verifiable impact.
We have seen this at Kalderos, where we have learned from discussions with covered entities that some see using Discount Hub to review claims as a helpful validation on their work. Some have even expressed being open to reviewing claims with more frequency or greater volume. Through ongoing conversations with covered entities, we’re constantly refining our product so that it’s easier for them to use and better serves their needs.
So what learnings can tech innovators take away to inspire better solutions for 340B?
For drug discount programs like 340B to work as intended, collaboration between all stakeholders is key. And to enable that collaboration, solutions should be accessible, equitable and efficient for all parties—especially the covered entities who the program was created to support in their mission of serving vulnerable patients.
Wherever the resources and technology come from, it is terrific to see that covered entities are willing to participate in collaborative and data-driven efforts to reduce duplicate discounts. More cooperation to make these programs work better for everyone is a worthy goal for all stakeholders, because it will ultimately lead to really good news for patients.
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