Challenges for Managed Care from 340B Contract Pharmacies.

Area of Science:

• Health policy
• Pharmacy practice
• Health economics

Background:

• The federal 340B Drug Pricing Program has seen significant expansion.
• Providers increasingly use contract pharmacies to extend 340B pricing benefits.
• In 2014, 25% of U.S. pharmacy locations served as contract pharmacies for 340B entities.

Purpose of the Study:

• To analyze the impact of 340B program growth on managed care pharmacy.
• To discuss the effects on formulary rebates, prescription profits, and pharmacy networks.
• To highlight the need for managed care engagement and policy proposals.

Main Methods:

• This is a commentary discussing observed trends and potential impacts.
• Analysis of the effects of 340B expansion on managed care pharmacy practices.
• Review of the implications for formulary rebates, profits, and generic dispensing rates.

Main Results:

• 340B growth impacts managed care pharmacy through formulary rebates and profits.
• Disruption of retail pharmacy networks and reduced generic dispensing rates are observed.
• Contract pharmacy utilization has become widespread.

Conclusions:

• Managed care pharmacy faces challenges due to 340B program expansion.
• Increased engagement and policy proposals are needed from managed care organizations.
• Objective research on the 340B program's costs and benefits is urgently required.