Session

Enhancing Pharmacy Value with 340B:

Implementing Medication Synchronization and Free Medication Delivery Services

Dr. Adetoro Oriaifo PharmD, MBA, 340B ACE

Chief Pharmacy Officer
Total Health Care, Inc. #340BCONF
Disclosure of Integrity
& Independence Statement
Adetoro Oriaifo declares no relevant financial relationships or commercial
interests in any product or service mentioned in this activity, including grants,
employment, gifts, stock holdings, honoraria.

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Today’s Agenda
• Introduction to pharmacy Value Added Services (VAS)
• Medication Synchronization (Med-Sync)
• Free Medication Delivery (FMD)
• Impact of VAS on patients and pharmacy
• Challenges and overcoming challenges to implementing VAS
• Outcomes from the synergy of both Med-Sync and FMD as VAS
• Conclusion

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Learning Objective(s)

At the conclusion of this activity, participants should be able to:

• Identify pharmacy Value Added Services (VAS)
• How to fund pharmacy VAS
• Discuss two pharmacy VAS: Medication Synchronization and Free
Medication Delivery
• Impact of pharmacy VAS on patients and the pharmacy
• Discuss challenges to Implementing pharmacy VAS and how to overcome
them

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Assessment Question
Benefits of implementing pharmacy VAS such as Medication
synchronization and free medication delivery include:
(select all that apply)

A. Reduced healthcare costs

B. Improved medication adherence metrics
C. Reduction in pharmacy phone calls
D. A,B, only
E. All of the Above

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Total Health Care, Inc.
• Greater Baltimore, Maryland
• ~24,000 patients annually (2024 UDS Data)
• 8 Clinics
• 6 in-house pharmacies
Services provided
 Medication Synchronization
 Medication Delivery
 Medication Therapy Management
 Mobile and Website Refill
 Specialty Pharmacy

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What are Value Added Services (VAS)?

Features, benefits, or supplementary offerings that a company provides to

customers beyond the core product or service1.

Key characteristics of VAS1:

• Enhance/complement
• Not part of the core business activities
• Potentially generate additional revenue stream

Main purpose of VAS1:

• Improve customer experience and satisfaction
• Competitive advantage against competitors
• Strengthen customer relationships to increase loyalty and retention

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How to Fund Pharmacy VAS
• Intent of the 340B program is to enable Covered Entities (CE):
• To stretch scarce federal resources
• Reach more eligible patients
• Provide more comprehensive services
• Pharmacy VAS are types of comprehensive services that benefit and
improve patient outcomes.
• Pharmacy VAS can be funded by the reinvestment of pharmacy 340B
savings to provide free pharmacy VAS.

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Medication Synchronization (Med Sync)
Aligns a patient's prescription refills to be due on the same day each month.
• Chronic/Maintenance medications

Benefits2:
• Improved medication adherence
• Time and cost savings
• Reduced Errors
• Enhanced patient and pharmacy communication

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Free Medication Delivery (FMD)
Convenient same day or on demand delivery of prescription medications at
no additional cost to the patient.

Benefits:
• Increased accessibility
• Convenience
• Improved medication adherence

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Impact of VAS on Patients
• Improves patients’ overall pharmacy experience and satisfaction
• Enhanced convenience
• Improved medication adherence
• Overall better health outcomes

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Improvement in Patient Satisfaction
FY2022 FY2024 YTD
(Baseline) FY2023 March
Survey
Question Responses 1247 1973 1150
Q8a (Speed of
Service) % Good 77% 90% 96%
%Very Good
Q8b (Quality of
Service) % Good 85% 89% 95%
%Very Good
Q14 Yes 75% 96% 98%

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Improvement in Missing Refills
ALL DRUGS
FY %Early %On-Time %Late %MissingRefills
2018 10.5 9.9 53.8 25.7
2019 13 11.9 54.2 20.9
2020 14 11.4 53.9 20.6
2021 20.1 15.3 47.9 16.6
2022 20 20.8 43.7 15.5
2023 20.1 20.7 45.3 14
2024 22.3 22 40.4 15.3
FY18vs FY24 11.8 12.1 -13.4 -10.4

MAINTENANCE DRUGS
FY %Early %On-Time %Late %MissingRefills
2018 12 11.4 58.9 17.7
2019 14 13.2 57.7 15.2
2020 14.9 12.6 57.1 15.3
2021 22.3 16.8 49.6 11.4
2022 22.2 22.8 44.8 10.1
2023 22.4 22.8 46.2 8.7
2024 25.2 22.9 41.9 10

FY18vs FY24 13.2 11.5 -17 -7.7

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Impact of VAS on Pharmacy
• Improved medication adherence metrics
• Reduction in patient drug abandonment aka Return to stock (RTS)
• More efficient pharmacy workflow
• Optimize inventory management
• Reduction of on-demand prescription refills
• Higher patient retention and loyalty

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 Improvement in Adherence metrics
FY2024
HOW WE YTD
METRIC Baseline Baseline Baseline Baseline FY2024 YTD AVG
MEASURE Final Goal Performance
(08/2020) (06/30/2021) (06/30/2022) (06/30/2023) GOALS (MARCH 2024) vs Baseline
8/2020
Rolling data from
past 9 months
based on data for all
CMS Star rating 0.4 1.3 1.3 1.3 2 5 2 1.60
patients from MDM

PDC Diabetes (Medicare D) 86.00% 87.99% 87.99% 86.30%

PDC Diabetes 28.16% 53.48% 83.00% 78.00% 87.99% 87.99% 80.59% 52%
PDC Hypertension (Medicare D) 89.00% 89.99% 89.99% 90.52%
PDC Hypertension 41.99% 54.05% 78.00% 82.00% 89.99% 89.99% 84.13% 42%
PDC Cholesterol (Medicare D) 87.00% 87.99% 87.99% 89.59%
PDC Cholesterol 29.84% 52.04% 78.00% 79.00% 87.99% 87.99% 82.63% 53%
PDC Statin Use in Diabetes
85.00% 82.99% 82.99%
(Medicare D) 88.15%
PDC Statin Use in Diabetes 74.50% 77.11% 77.00% 78.54% 82.99% 82.99% 81.82% 7%
"Refills on Time"
report in MDM for % Maintenance Scripts refilled 69.10% 81.10% 76.00% 81.00% 85% 85% 86.90% 18%
maintenance drugs

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Decrease in Drug Abandonment (RTS)
FY Total RTS RX RTS Lost Savings
FY18 5537 $1,104,234.92
FY19 4173 $997,878.71
FY20 3370 $664,106.20
FY21 2631 $553,587.12
FY22 9254 $711,942.50
FY23 3812 $223,997.30
FY24 (YTD March) 2405 $68,674.98

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Increase in Number of Pharmacy Patients

PATIENTS
FY # Patients # Rx # New Patients
2019 12,491 111,788 9,012
2020 12,500 112,165 5,856
2021 9,389 99,568 3,173
2022 10,498 112,782 3,901
2023 11,184 119,455 3,979

FY21 vs FY23 1,795 19,887 806

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Challenges of Implementing VAS
• Buy-in and staff engagement
• Creating patient awareness
• Creating workflows, protocols (excluded drugs) and incorporating VAS into
current workflow
• Payer reimbursement challenges: Refill Too Soon
• Patient financial barriers
• Determining success

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Overcoming VAS Implementation Challenges
• Workflows and protocols: Don’t reinvent the wheel
• https://www.aphafoundation.org/appointment-based-model
• https://www.ncpa.co/pdf/smm/SMM_PharmacyManual.pdf
• Tried-and-tested medication synchronization program3
• Advertising to create patient awareness4
• Prioritize patient enrollment
• Provider engagement4
• Staff recruitment and training
• Address financial barriers
• Set measurable goals and determine your Key Performing Indicators (KPI)

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KPI- Med Sync Enrollment %

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Outcomes of Synergy of VAS

• Combining medication synchronization and free delivery creates maximum

value for patients

• Patients get the convenience of synchronized refills delivered to their door

• Pharmacies benefit from improved adherence and loyalty from patients

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Conclusion

• 340B program allows covered entity pharmacies to provide pharmacy

value added services using 340B savings.
• Services such as Med-Sync and free medication delivery align with
program intent to expand services that benefits the patient.
• Numerous benefits of VAS to patients, pharmacy and providers.
• Implementing VAS comes with challenges that can be easily overcome
with careful planning and process development.

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CE Question
Benefits of implementing pharmacy VAS such as Medication synchronization
and free medication delivery include:
(select all that apply)

A. Reduced healthcare costs

B. Improved medication adherence metrics
C. Reduction in pharmacy phone calls
D. A,B, only
E. All of the Above

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CE Question
Benefits to implementing pharmacy VAS such as Medication synchronization
and free medication delivery include:
(select all that apply)
A. Reduced healthcare costs
B. Improved medication adherence metrics
C. Reduction in pharmacy phone calls
D. A,B, only
E. All of the Above

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 References
1. Unknown. “What Are Value Added Services?” Service Lobby, 25 Jan. 2023, service-
lobby.com/en/value-added-services/. Accessed 06 May 2024.
2. Ferreri, Stefanie P. “Incorporation of Medication Synchronization in Community
Pharmacy Workflow Enhances Delivery of Patient Care Services.” Pharmacy Times, 2
Nov. 2021, www.pharmacytimes.com/view/incorporation-of-medication-synchronization-
in-community-pharmacy-workflow-enhances-delivery-of-patient-care-services. Accessed
06 May 2024.
3. Unknown. “Top Challenges and Solutions for Starting a Med Sync Program.” PBA
Health, 27 Feb. 2018, www.pbahealth.com/elements/top-challenges-and-solutions-for-
starting-a-med-sync-program/. Accessed 06 May 2024.
4. Hughes TD, Cutrell S, Minshew LM, Brown P, Ferreri SP. An exploration of barriers,
facilitators, and practical solutions for adopting medication synchronization into
community pharmacies: A qualitative analysis. Explor Res Clin Soc Pharm. 2022 Feb
3;5:100111. doi: 10.1016/j.rcsop.2022.100111. PMID: 35478527; PMCID: PMC9030300.

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Additional Questions?

Dr. Adetoro Oriaifo

Chief Pharmacy Officer
Total Health Care
1510 Division Street
Baltimore, MD 21217
4107107406
aoriaifo@totalhealthcare.org
aadey002@gmail.com

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