340B Impact

Overview

The Orphan Optimization page provides orphan drug performance metrics and identifies potential opportunities to improve the rate of 340B orphan purchases. The metrics and opportunities provided on this page are specific to McKesson accounts that split purchases through Macro Helix for hospital PIDs. Retail and contract pharmacies' data are excluded. 

These metrics only include PIDs from entity types subject to the Orphan Drug Exclusion and orphan drugs. The menu option Orphan Optimization will not display for health systems that do not have at least one covered entity subject to the Orphan Drug Exclusion.

Opportunities are identified based on consideration of the following factors:

• The percentage of charges for each NDC which are tested in 340B Architect as both non-Medicaid and outpatient over the past 90 days, indicating potential eligibility for 340B accumulation
• Total purchase volume over the past 90 days adjusted by the Non-Medicaid Outpatient Charge Ratio, indicating the potential purchase volume that could have been purchased at 340B
• Actual 340B purchase volume for each NDC over the past 90 days
• Current pricing for each NDC

This analysis can help determine if there are potential missed savings due to charge data and purchase data not aligning. The cause of the potential opportunity cannot be identified directly by 340B Impact. Additional investigation will be required to understand the discrepancy between the charge data and purchase data.

Potential reasons for the variance could include:

• Eligibility exclusions, including:
  • Do Not Order and/or 340B-eligibility exclusions
  • The drug is set up to split to GPO only
  • The drug is not on the Orphan Exception list in 340B Architect, excluding it from qualifying to 340B
• Waste is not being accumulated, causing purchase volume to exceed charge volume
• Crosswalk issues, including:
  • CDMs and charge quantities are not consistent across different areas
  • BUPPs are set incorrectly
  • Unmatched charges
• Purchases bypassing the split process
• Negative current 340B accumulation balance
• Missing utilization data

Realized Savings

Realized Savings is a cumulative amount of the total dollar benefit for taking advantage of orphan opportunities. For every opportunity in the Current Opportunities list, the system is tracking and comparing the new and baseline 340B purchase ratios over time. As the percentage of 340B purchases increases, improvement is quantified by comparing 340B and GPO or WAC account prices, where applicable. By default the Realized Savings amount displayed is the sum of all PIDs with tracked opportunities. This amount will automatically update when a PID is selected from the Savings Opportunity by PID table. 

Orphan Drug Gross Savings by Contract Type

This graph shows the Gross Savings overtime for orphan drugs. Gross Savings is the amount saved on orphan 340B purchases compared to the GPO catalog prices.  By default the data is displayed by 340B Contract. From the drop-down you can choose to view the data by the following contract types:

• 340B Contract: Contracts McKesson continued to extend 340B pricing to after consultation with the manufacturer.
• Orphan Contract: Contracts the manufacturer offered a voluntary 340B price for an orphan drug.
• No Contract: Contracts where no significant savings are present compared to GPO.
• All: Shows all options. 

Savings Opportunity by PID

This table displays PIDs with active Potential Savings Opportunities. A PID must be selected to view the opportunities in the sections below. By default, this table is sorted by highest value of Potential Savings Opportunity. Once a PID is selected all other tables will update. For parent-child PID relationships, the table only lists the parent PID and name, but the Potential Savings Opportunity amount is for all PIDs in the relationship.   

PID Details

After selecting a PID from the Savings Opportunity by PID table, the PID and account details are displayed here. For parent-child relationships, the parent and child PIDs, names and accounts will be displayed here.

Current Opportunities

An opportunity is an item with potential missed savings due to charge and purchase data not aligning. This is determined by analyzing orphan drugs that potentially could have been purchased on 340B considering total purchase volume compared to the non-Medicaid outpatient charge ratio. In 340B Impact, an orphan drug is based on the list compiled by the McKesson 340B Solutions team. There may be discrepancies when compared to 340B Architect's orphan drug list. This table shows the current orphan opportunities for the selected PID or parent-child PID relationship. Opportunities are listed in descending order by the Potential Savings.     

• Each opportunity considers the data from 90 days prior to the Date Realized.
• Orphan data is recalculated weekly and new opportunities may be added if they exceed the Potential Savings value of those currently presented.
• The table can be viewed by Top 25 or Show All.  

Realized Savings by Drug

This table displays the active opportunities that are being tracked for contribution to the Realized Savings, based on the PID selected. The same NDCs may be present in both the Current Opportunities and Realized Savings by Drug tables. However, while data for the Current Opportunities is updated on a weekly basis, the metrics displayed in this table represent the original baseline data from the Date Identified. This baseline is compared to changes in the 340B purchase ratio over time to calculate Realized Savings.