Apexus Contracting
340B GPO Prohibition and Wholesaler WAC Account Load Options
A Feb. 7, 2013 HRSA Policy Release1 provided clarification for hospitals subject to the Group
Purchasing Organization (GPO) Prohibition. Apexus is providing this document to facilitate 340B
compliance in the marketplace; the information contained in this document is not legal advice.
Key Messages
1. Establishing an outpatient non-GPO (i.e., PVP Non-340B) account provides a compliant
method for obtaining covered outpatient drugs for non-340B eligible outpatients of these
hospitals. Such an account is useful if the hospital elects to carve-out Medicaid or uses
replenishment in mixed-use areas.
2. For entities using a replenishment model, replenishment orders may result in a physical
inventory in the mixed-use area that is composed of a variety of contract purchases. The
following should be met:
• 340B accumulation occurs only for 340B eligible patients;
• 340B ineligible outpatients generate accumulation only for orders on an outpatient nonGPO/WAC account and
• Hospitals maintain auditable records of policies, procedures, and transactions.
HRSA expects that covered entities will comply with the GPO Prohibition as soon as possible prior to
the August 7 deadline.
3. HRSA expects hospitals to establish compliant practices in accordance with the GPO Policy Release
by August 7, 2013.2 Hospitals should immediately move toward compliance with this requirement, and
go forward with these compliant practices.
• Effective August 7, 2013:
- Hospitals may use up existing GPO inventory.
- If the hospital is unable to establish compliant practices in accordance with the GPO Prohibition,
the hospital should self-report3 to HRSA.
- If a covered entity is unable to be in compliance by August 7, the covered entity must immediately
notify HRSA, and will be terminated from the program.
- No new inventory for ineligible 340B outpatients should be purchased through a GPO.
1
2
3
http://www.hrsa.gov/opa/programrequirements/policyreleases/prohibitionongpoparticipation020713.pdf
http://www.hrsa.gov/opa/faqs/index.html#GPO
See 340 University Tool “Self-Reporting Non-Compliance”: https://www.340bpvp.com/resource-center/other-resources/other-tools/
Contact Us!
Apexus | 340B Prime Vendor Program
888.340.2787 | ApexusAnswers@340BPVP.com
www.340BPVP.com
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To
bring value to hospitals subject to the GPO Prohibition, Apexus has
worked with wholesalers to make the non-340B contracted products and
Apexus generic source contracts available in the non-GPO/WAC account.
Account Load Options
Outpatient
Contracts
or Pricing
Definition
Wholesaler
Account:
Wholesaler
Account:
340B
Primary
Non
GPO/WAC
340B/PHS
Manufacturer calculates prices for 340B covered outpatient drugs according to the
340B statutory formula
YES
NO
Apexus PVP
Sub-340B
Reflects pricing that is negotiated with branded and/or generic manufacturers
offering sub-340B pricing.
YES
NO
Apexus PVP
Sub-WAC
Apexus PVP sub-WAC contracted pricing allows entities to order covered outpatient
drugs in situations that would otherwise require the entity to pruchase at WAC
pricing. This pricing is negotiated without regard to 340B pricing; use of this pricing
is GPO Prohibition compliant. Pricing is negotiated for outpatient covered drugs at
sub-WAC or GPO-similar.
NO
YES
Apexus ValueAdded
Other value-added contracts are for non-covered drugs such as vaccines, blood
glucose monitoring supplies, prescription vials and labels, discounts on service
contracts such as pharmacy automation hardware and software and so on.
YES
YES
YES
YES
YES
YES
NO
NO
NO
NO
Apexus Generics Apexus provides a generic source portfolio for outpatient covered and non-covered
Portfolio (AGP) drugs; this portfolio provides discounted contract pricing that has no reference to
the 340B ceiling pricing, although it can be lower than 340B. It is subcontracted to
wholesalers and extended to Apexus participants un the AGP.
Individual
Hospital
Agreement
A hospital obtains discounts based on the individual hospital’s negotiation with a
manufacturer (single entity contract).
Name
Name
GPO Non-Acute GPOs obtain discounts from vendors on outpatient drugs based on the collective
buying power of the GPO members.
GPO or
Wholesaler
Generic Source
GPOs and wholesalers obtain discounts from manufacturers based on the
collective buying power of the GPO or wholesaler members/customers.
Quick GPO Self-Assessment
Our hospital2 should be able to answer NO to all of the following:
1. Use GPO purchased covered outpatient drugs for 340B ineligible outpatients in OPA-registered participating
clinics?
2. Have systems (or vendor systems) set up to use GPO purchased covered outpatient drugs for 340B ineligible
outpatients?
This information is provided only as a reference to encourage 340B program integrity. This information has not been endorsed by the HRSA and is not dispositive
in determining compliance with or participatory status in the 340B Drug Pricing Program. 340B stakeholders are ultimately responsible for 340B program
compliance and compliance with all other applicable laws and regulations. Apexus encourages each stakeholder to include legal counsel as part of its program
integrity efforts.
Contact Us!
Apexus | 340B Prime Vendor Program
888.340.2787 | ApexusAnswers@340BPVP.com
www.340BPVP.com
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