03 Apr 340B Winter Conference: In Comes the Pink Elephant

The Winter 340B Coalition conference was more like “Spring” from a timing perspective, and we associate springtime with new growth, vibrant colors, and hope for dark days to end and brighter days ahead.  While San Diego is a great backdrop for sunshine and bright days, this year’s event was filled with a certain amount of darkness and instead of sunshine on the last day, as people returned home—it rained.  Literally and figuratively.

The pre-conference event helped first-timers with audit, compliance, and basic 340B knowledge.  This year also brought a conversation on knowing your “why” and that tied nicely to the press release of 340B Matters and our “why” 340B Matters campaign.

The opening day of the conference historically starts with a welcome by the “340B Coalition.”  The coalition has 13 organizations today – ranging from hospital groups to grantee groups-including the National Association of Community Health Centers. The pink elephant in the room enters. This year’s welcome had 340B Health’s CEO, Maureen Testoni, and the Joe Pugliese of the Hemophilia Alliance. The front of the room had 11 empty chairs. Maureen introduced conference statistics with an amazing number of attendees reaching pre-pandemic levels with hospitals making up 24% of the attendees and grantees making up 37% of the attendees for a total of 60% of attendees being from a covered entity. The remaining attendees came from service providers like contract pharmacies, pharmacy benefit managers, manufacturers, consultants, and IT technology companies like The Craneware Group. Joe Pugliese did an opening statement in support of hemophilia treatment centers and provided context to ASAP 340B with a firm position that this group was not on the side of the providers.

What was evident from this welcome, was that the National Association of Community Health Centers (NACHC), while present, was not on the stage. This signals a tremendous gap in the 340B covered entity community—which was not spoken directly—the pink elephant in the room.

The discussions ranged from the Inflation Reduction Act, specialty pharmacy, the hardships of the manufacturer restrictions, and operational conversations surrounding best practices in audit and compliance. The tracks provided opportunities to learn about the multitude of patient programs offered by covered entities and how expanding access to quality care is central to 340B covered entities. The Craneware Group’s team was able to provide insights into our functionality to support the Inflation Reduction Act, in addition to the Outpatient Prospective Payment System requirements for modifiers.

Our lesson from the field “The upside-down world of 340B” highlighted  the association with Stranger Things, a science fiction horror series that describes “The Upside Down parallel universe morphed into a world where only remnants of our known reality existed and a monster ruled the universe.” Who is the monster in the 340B Stranger Things series?  Manufacturers. To combat the monster, the moral of the story is to advocate.  We described the multiple ways that can be done and later participated in a social media session and facilitated a round table discussion on social media.

Once more was the noticeable energy around advocacy and the important role covered entities, in addition to other stakeholders play in telling their story and their patients telling their stories. Round tables provided covered entities to break out into round tables and discussions related to their specific program. In comes the pink elephant- again. During the community health center breakout, a protest was conducted by Let It B, a group managed by the Aids Healthcare Foundation. Known for being hard-hitting on congressional members for targeting 340B, as well as manufacturers. They turned their attention to community health centers, which NACHC was in attendance, to voice their distaste for the odd bedfellow’s agreement to restrict access to 340B and put more money in “greedy pharma’s” pockets.

With The Craneware Group’s press release, we also provided 10 principles to set the record straight. We believe the 340B program needs stability, equity, and transparency for covered entities, Medicaid and Medicare (when legally required), Manufacturers, Pharmacies, and Pharmacy Benefit Managers/insurers.

Let’s SET the record straight.

We released a survey to collect feedback on how the principles resonate with attendees from the conference, in addition to providing to our customers and other stakeholders. We will publish those results and provide in our next newsletter. The overwhelming response…340B Matters is great and the principles align across hospitals and grantees. As part of our campaign, we asked visitors to our exhibit booth “Why 340B Matters?” The visitors’ reactions to that question were deep and personal.  From “I came from a low-income family. It has helped people get care, like me”, “bridges gaps in insurance/Medicaid/Medicare”, “provides significant non-tax dollars to care for uninsured” and “keeps our hospital financially viable”…”our doors would close”.  We know it’s true. You know it’s true. 340B Matters. We will continue to demonstrate the manufacturer’s attempts to derail 340B from its intent as they continue to pad their pockets.

The pink elephant in the room at the conference—not one manufacturer presenter, including the third party that supports the majority of manufacturers, carries out their restrictions. On the final day of the conference, as attendees made their way home, AbbVie sent a letter to covered entity inboxes on their expanded restrictions to all their drugs and placed a 40-mile radius restriction with only one contract pharmacy for access.

Unreal. We all woke up on Wednesday to rain, cloudy skies, and AbbVie raining on our parade.

With renewed energy, advocacy becomes even more imperative. Let advocacy be your umbrella. It is advocacy that will protect you from the storms ahead until the sun shines again. We will see you in Washington, D.C. at the Summer 340B Coalition conference. We will continue to be an umbrella for covered entities. Rain or shine.

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