At Kalderos, we are on a mission to solve problems in the healthcare system, enabling everyone to focus on the health of people. With that in mind, we were grateful for the opportunity to leverage our expertise and respond to a Congressional request for input on improving the 340B Drug Pricing Program.
In an Oct. 9 press release, House Energy and Commerce Committee Republican Leader Greg Walden (R-OR) and Senate Health, Education, Labor and Pensions (HELP) Committee Chairman Lamar Alexander (R-TN) requested comments and recommendations from all stakeholders involved in the 340B program.
The press release cited “significant confusion about the program’s requirements and lack of data necessary for effective oversight to maintain the integrity of the program,” stating that “Congress, as well as those that participate in the program, must be open to updating 340B so that it best serves our seniors and most vulnerable patients, while also protecting the valuable services offered by health care providers, hospitals, and clinics.”
With combined decades of industry expertise, our Kalderos team knows the 340B space well. As a company, we’ve dedicated several years to studying the challenges in the 340B program, engaging in hundreds of conversations with program stakeholders and, using our platform solutions, applying machine learning to more than half a million drug discount claims.
Through that work, we’ve identified the underlying causes of the noncompliant discounts that are fueling program conflict — and how to solve them.
In our Oct. 31 letter to the committees, we elaborated on that perspective, highlighting a few key points:
- Incompatible systems between providers, state Medicaid offices, wholesalers and manufacturers mean that even though covered entities apply their best efforts to preventing noncompliant discounts, they still happen.
- The replenishment model used by most covered entities and all contract pharmacies is driving much of this incompatibility. A rebate model, like that already used by AIDS Drug Assistance Programs, would virtually eliminate noncompliant discounts.
- The good news: the 340B program doesn’t need a big redesign or a congressional overhaul. It just needs a technologically up-to-date platform to better serve all stakeholders.
- We built Kalderos’ platform solutions to meet that need, drawing on feedback from covered entities, manufacturers and state Medicaid systems, along with federal agencies such as HHS, HRSA and CMS.
The 340B program is an essential support for vulnerable patients and the providers that care for them. We look forward to collaborating with all stakeholders to ensure its sustainability now and for the future.