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Sun Rx Overview Presentation


SUNRx can lower the cost of drugs for patients and generate profit and cash flow for 340B eligible entities such as FQHC\'s and DSH Hospitals). We also have a Payor model which provides savings to …

SUNRx can lower the cost of drugs for patients and generate profit and cash flow for 340B eligible entities such as FQHC\'s and DSH Hospitals). We also have a Payor model which provides savings to Medicaid Managed Care organizatins. Contact me for more details!

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  • 1. 340B.
  • 2. Agenda
    • Industry Snapshot
    • 3. 340B Program Details
    • 4. The SUNRx Solution
    • 5. Markets served and mutual opportunities
  • 6. Overview
    • Savings for Providers and Patients: Health centers and hospitals can save up to 60% off the cost of medications for patients and employees.
    • 7. Savings for Payors: State Medicaid and managed care organizations can save up to 25% off the cost of drug benefits by partnering with eligible entities
    • 8. Challenges: Due to regulatory burdens and risk, many eligible entities have limited 340B programs, or none at all.
    • 9. Opportunity: SUNRx simplifies 340B management and compliance, and enables health centers, hospitals, MCOs and patients realize the potential benefits.
  • 10. 340B: Program Overview
    Created in 1992 to:
    • Expand access to affordable medications for low income populations; and
    • 11. Enable community health centers and disproportionate share hospitals to generate resources.
  • 12. 340B: The Need
    Prescription costs have increased 70% since 2000.
    Because of the cost, over the past year…
    • 21% of Americans have not filled a prescription
    • 13. 15% have cut pills in half or skipped doses
    This prevents patients from getting the care they need and drives up healthcare costs for everyone.
    Source: Kaiser Family Foundation
  • 14. 340B: Benefits
    Benefits to Health Centers and Hospitals
    • Better patient care: Affordable medications increase patient compliance, decrease hospitalizations and improve outcomes
    • 15. Expandedaccess: Contract and in-house pharmacy options provide patients with convenient access to medications
    • 16. Increased funding: Health centers generate revenue to provide additional patient care services
  • 17. 340B Program Overview
    The 340B Savings Opportunity
  • 18. 340B Program: Challenges
    Patient Eligibility
    330 Grant
    Third Party Insurance
    Complexity & Risk
    Inventory Management
    Sliding Fee Scales
    Contract Pharmacy Arrangements
  • 19. The 340B. Simplified. Solution
  • 20. SUNRx: 340B. Simplified.
    Fully automated solution that allows health centers
    and hospitals to:
    • Simplify 340B management and compliance
    • 21. Expand access to affordable medications
    • 22. Decrease costs and generate revenue to reinvest in patient care
    SUNRx makes 340B programs simple, cost effective and worry free.
  • 23. Pharmacy Arrangements
  • 24. 340B Simplified: The Pharmacy Network
    SUNRx builds a network of eligible entities and pharmacies for MCO members to receive care and 340B medications.
    Health Center Site
    The Pharmacy
    Health Center Site
    Health Center Site
  • 25. 340B. Simplified. Plan Design
    We take the time to understand our clients and their patients and help them develop:
    • Formulary
    • 26. Sliding fee scale
    • 27. Pharmacy arrangements
    • 28. Employee benefits programs
    • 29. Administrative processes
  • 30. 340B. Simplified. Eligibility
    • 340B. Simplified. ensures only eligible patients receive 340B medications
    • 31. Prescription cards adjudicate like 3rd party insurance
    • 32. Convenient for patients
    • 33. Convenient for pharmacies
  • 34. Real Time Management Information:Inventory, Payments, Eligibility, Compliance
  • 35. 340B. Simplified. 100% 340B Compliance
    • Virtual inventory prevents drugs purchased at 340B prices from being diverted to ineligible patients.
    • 36. Automated reporting features allow auditing down to the patient, provider or pill.
    • 37. SUNRx monitors regulatory changes and updates programs to ensure our clients stay in compliance.
  • Revenue for Eligible Entities
  • 38. The 340B Discount
    340B Price has three components
    • Drug Price
    • 39. Pharmacy Dispensing Fee
    • 40. Admin Fee
    “Lower Of” Technology
    • Evaluates a prescription at the point of adjudication for the lowest cost to Payor, comparing Network, 340B, and U&C.
    Cost Savings Share
    Average Savings:45-50%
    340B Price
  • 41. Savings for Patients
    Patients save up to 60%
    SUNRx - 340B cost includes average admin fee and average dispensing fee. Prices may vary by pharmacy
  • 42. Markets Served by SUNRx
    • Federally Qualified Health Centers
    • 43. Disproportionate Share Hospitals
    • 44. Fee for Service and Managed Medicaid Programs
    • 45. Other programs
  • 46. Federally Qualified Health Centers
    • Expand access to affordable medications, improving outcomes and reducing healthcare costs
    • 47. Ensure regulatory compliance
    • 48. Reduce paperwork, allowing staff to focus on patient care
    • 49. Provide revenue from cash payors and third party insurers
  • 50. Case Study: Cornerstone Care
    In the first 5 months of Phase I:
    • Nearly 8,500 340B scripts were billed to third party insurers
    • 51. More than $100k in profit was generated for the health center
    • 52. Cornerstone anticipates more than $250k in net revenues from 340B.
  • 53. Disproportionate Share Hospitals
    • Expand access to affordable medications
    • 54. Ensure regulatory compliance
    • 55. Improve the bottom line:
    • 56. Generate revenue from cash payors and third party insurers
    • 57. Reduce employee drug benefit costs
    • 58. Reduce paperwork and administrative costs
  • 59. Benefits to TPAs
    • Enhance community outreach efforts by partnering with health centers and hospitals to expand access to affordable medications
    • 60. Highlight the local and regional strength of TPAs, compared to the large, national players
    • 61. Provide additional value and services for hospital and MCO clients
  • 62. Case Study
    A DSH in Texas:
    • Hospital with 450 employees in San Antonio area
    • 63. Using 340B for employees can save $155k annually – nearly 50% -- in employee prescription benefit costs
    • 64. Using 340B for outpatient care for patients with third party insurances can generate additional revenue.
  • 65. Fee-for-Service and Managed Medicaid
    SUNRx builds a network of eligible entities and pharmacies for Medicaid members to receive care and meds at 340B prices.
    Medicaid programs and eligible entities share savings
    No disruption for members, providers or payors
    Opportunities for savings in other programs:
  • Who is SUNRx
    Dedicated to helping with safety net providers and payors expand maximize resources and expand access to affordable medications.
    Innovation: Developed breakthrough technologies that scan all available programs and pricing and ensure medications are always dispensed at the lowest prices.
    Independence: Other companies are side businesses of drug wholesalers or pharmacy chains. SUNRx is the only company dedicated exclusively to reducing drug costs for low income and underserved populations.
    Trusted: Community healthcare payors, providers and pharmacies nationwide rely on SUNRx.
  • 68. Innovation
    Prescription Assistance Programs (PAP)
    “Lower than” technology to ensure that patients, health centers and third party payors always pay the lowest available price.
  • 69. The Future of 340B
    • Program Expansion
    • 70. More eligible entities
    • 71. More funding
    • 72. One to One pharmacy relationship may change allowing for pharmacy networks.
    • 73. More regulation
    • 74. Auditing and reporting requirements