The View From the Nation’s Capital



Guest Contributor: Ted Slafsky
June 28, 2019

Below is part two of the ‘Clearing Off the Desk’ series. Read part one here.

Clearing Off the Desk…

As we prepare for a busy period in Washington before the August recess, it is an excellent time to touch on a few newsworthy topics impacting 340B stakeholders.

More Refunds Headed to 340B Providers

Although it is only June, there have already been a whopping 14 announcements on HRSA’s Office of Pharmacy Affairs (OPA) website of instances where drug companies either owe money to 340B entities for overcharges or have implemented limited distribution plans. For the entire 2018 year, there were only eight notices posted. Medicines Company is the latest manufacturer to announce it has recalculated 340B ceiling prices for several products over a two-year period and will be issuing refunds.

My hunch for the uptick in manufacturer notices: When HRSA announced it would move forward on the rule giving the agency the ability to impose civil monetary penalties against drug manufacturers and to post prices on the OPA web site, drug manufacturers took a closer look at the prices they have been charging. Purdue Pharma has posted two different notifications this year alerting covered entities that they will be receiving credits through their wholesalers for overpayments. The drugs include many of its opioid products, including OxyContin, and span a number of years. In its announcement, Purdue acknowledges that it miscalculated the price charged to the Medicaid program and therefore owes refunds to the 340B entities. Both the Medicaid rebate program and the 340B program use the same discount methodology.

Purdue and many other drug companies who have announced repayments in 2019 are working with Apexus, the 340B prime vendor, to process the refunds. Purdue says Apexus is validating wholesaler pharmacy account information for each affected entity. “Once validated, Apexus will work with the wholesalers to facilitate the processing of credit for overpayments that the Covered Entity was charged during the specified periods. If no active wholesaler account can be found, Apexus will work to issue payment directly to those affected Covered Entities,” says Purdue.

With the number of manufacturer notifications growing, it is important to review the Manufacturer Notice page on OPA’s website regularly. While many of the notifications on the site are not dated, it is worth bookmarking. Some manufacturers, like The Medicines Company, appear to be handling the matter on their own. In its announcement, the New Jersey-based company said it will be contacting the authorizing official at affected covered entities unless the amount owed is less than $1,000. In those instances, your institution will need to contact Marisa DeChiaro at 973-290-6032 or [email protected]

The Man Who May Have Single-Handedly Saved 340B

Robert Pear, the renowned New York Times reporter known as the Dean of Health Care Journalism, passed away last month at the age of 69. Pear, whose byline appeared in more than 6,700 articles during his 40-year career at the Times, was the go-to reporter when a healthcare story needed covering.

Pear was a quiet, unassuming man who avoided appearing on Sunday-morning TV. Yet, “He was the most important reporter in Washington you have never heard of,” said Alan Dodds Frank, a veteran journalist who was quoted in Pear’s obituary in the Times.

One of the most diligent and fair scribes in the business, Pear worked hard to hear both sides and include various perspectives. While he did not perceive his purpose as making or changing policy, he played an instrumental role in protecting the 340B program at its most vulnerable time. It was 1995, and Newt Gingrich and his revolution had hit Washington. Gingrich and his colleagues had come to Washington promising to shake things up. Unfortunately, one of the bills that his caucus drafted was to make the 340B program voluntary for drug manufacturers.

It was an idea pushed by the drug industry, and it looked like it was certain to pass the House and potentially the Senate. It was panic time for the 340B community. 340B Health founder Bill von Oehsen made a call. That Sunday, there was a front-page story in the Times describing this giveaway to big Pharma. NBC Nightly News soon picked up the story, and suddenly, von Oehsen received a call from the staff director of the House Energy and Commerce Committee informing him that the provision would be dropped from the bill.

Pear continued to make his mark and wrote several stories about 340B developments during the next 24 years. He was particularly engaged during our long battle to expand 340B discounts to children’s and rural hospitals. I will never forget his unique 202 area code phone number. When it lit up on my screen, I always picked up the phone regardless of how busy I was. He will be dearly missed.

Join Me in DC for a Breakfast Forum on Drug Pricing Developments

While hospitals await a final court decision on Medicare Part B cuts, as well as potential regulatory changes to the 340B program, lawmakers and the administration are poised to act on healthcare legislation as soon as this summer. Voters are particularly concerned about the high cost of care, which remains the top issue on the minds of Americans – ahead of immigration, the economy, national security, climate change, and other hot button topics.

Get the latest on the fast-moving developments affecting 340B stakeholders during a breakfast forum hosted by PSG on July 15 from 7 to 8 a.m. at the Marriott Wardman.

Registration for this event is now closed.

The forum addressed:

  • Key 340B developments on Capitol Hill and at the state level
  • The administration’s next moves on drug pricing
  • Efforts to drive pricing transparency for covered entities
  • How the dynamic PBM landscape is impacting your organization and your patients
  • A new 340B grassroots group and its game plan for protecting the program

Speakers included three healthcare leaders and observers in drug pricing policy and cost management:

Dave Borden, Chief Executive Officer, Pharmaceutical Strategies Group
Ted Slafsky, Founder & Principal, Wexford Solutions LLC
Peggy Tighe, Principal, Powers Law, Ryan White Clinics for 340B Access

 

Other “View From the Nation’s Capital” Posts from Mr. Slafsky:

 
Clearing Off the Desk (Part One)
A Welcome Addition to the 340B Debate
Be Vigilant on State 340B Activity



Ted Slafsky, a long-time health and pharmaceutical policy thought leader, is Founder & Principal of Wexford Solutions. Wexford, a consulting firm based in Washington, D.C., provides government relations, communications, and business development services. Wexford is proud to have PSG as one of its clients. You can follow Mr. Slafsky on Twitter at @tslafsky or reach him at [email protected] or 703-517-1325.