Sun Rx Overview Presentation


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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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Sun Rx Overview Presentation

  1. 1. 340B. <br />Simplified.<br />1<br />
  2. 2. Agenda<br /><ul><li>Industry Snapshot
  3. 3. 340B Program Details
  4. 4. The SUNRx Solution
  5. 5. Markets served and mutual opportunities</li></ul>2<br />
  6. 6. Overview<br /><ul><li>Savings for Providers and Patients: Health centers and hospitals can save up to 60% off the cost of medications for patients and employees.
  7. 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. 8. Challenges: Due to regulatory burdens and risk, many eligible entities have limited 340B programs, or none at all.
  9. 9. Opportunity: SUNRx simplifies 340B management and compliance, and enables health centers, hospitals, MCOs and patients realize the potential benefits.</li></ul>3<br />
  10. 10. 340B: Program Overview<br />Created in 1992 to:<br /><ul><li>Expand access to affordable medications for low income populations; and
  11. 11. Enable community health centers and disproportionate share hospitals to generate resources.</li></ul>4<br />
  12. 12. 340B: The Need<br />Prescription costs have increased 70% since 2000. <br />Because of the cost, over the past year…<br /><ul><li>21% of Americans have not filled a prescription
  13. 13. 15% have cut pills in half or skipped doses</li></ul>This prevents patients from getting the care they need and drives up healthcare costs for everyone.<br />Source: Kaiser Family Foundation<br />5<br />
  14. 14. 340B: Benefits<br />Benefits to Health Centers and Hospitals<br /><ul><li>Better patient care: Affordable medications increase patient compliance, decrease hospitalizations and improve outcomes
  15. 15. Expandedaccess: Contract and in-house pharmacy options provide patients with convenient access to medications
  16. 16. Increased funding: Health centers generate revenue to provide additional patient care services</li></ul>6<br />
  17. 17. 340B Program Overview<br />The 340B Savings Opportunity<br />66%<br />64%<br />58%<br />51%<br />42%<br />
  18. 18. 340B Program: Challenges<br />Formulary<br />Patient Eligibility<br />330 Grant<br />Requirements<br />Third Party Insurance<br />Program<br />Complexity & Risk<br />Inventory Management<br />Sliding Fee Scales<br />Contract Pharmacy Arrangements<br />8<br />
  19. 19. The 340B. Simplified. Solution <br />9<br />
  20. 20. SUNRx: 340B. Simplified.<br />Fully automated solution that allows health centers<br />and hospitals to:<br /><ul><li>Simplify 340B management and compliance
  21. 21. Expand access to affordable medications
  22. 22. Decrease costs and generate revenue to reinvest in patient care</li></ul>SUNRx makes 340B programs simple, cost effective and worry free.<br />10<br />
  23. 23. Pharmacy Arrangements<br />
  24. 24. 340B Simplified: The Pharmacy Network<br />SUNRx builds a network of eligible entities and pharmacies for MCO members to receive care and 340B medications.<br />Health Center Site<br />The Pharmacy<br />Network<br />Health Center Site<br />Health Center Site<br />
  25. 25. 340B. Simplified. Plan Design<br />We take the time to understand our clients and their patients and help them develop:<br /><ul><li>Formulary
  26. 26. Sliding fee scale
  27. 27. Pharmacy arrangements
  28. 28. Employee benefits programs
  29. 29. Administrative processes</li></ul>13<br />
  30. 30. 340B. Simplified. Eligibility<br /><ul><li>340B. Simplified. ensures only eligible patients receive 340B medications
  31. 31. Prescription cards adjudicate like 3rd party insurance
  32. 32. Convenient for patients
  33. 33. Convenient for pharmacies</li></ul>14<br />
  34. 34. Real Time Management Information:Inventory, Payments, Eligibility, Compliance<br />15<br />
  35. 35. 340B. Simplified. 100% 340B Compliance<br /><ul><li>Virtual inventory prevents drugs purchased at 340B prices from being diverted to ineligible patients.
  36. 36. Automated reporting features allow auditing down to the patient, provider or pill.
  37. 37. SUNRx monitors regulatory changes and updates programs to ensure our clients stay in compliance.</li></li></ul><li>Revenue for Eligible Entities<br />17<br />
  38. 38. The 340B Discount<br />340B Price has three components<br /><ul><li> Drug Price
  39. 39. Pharmacy Dispensing Fee
  40. 40. Admin Fee</li></ul>“Lower Of” Technology <br /><ul><li>Evaluates a prescription at the point of adjudication for the lowest cost to Payor, comparing Network, 340B, and U&C.</li></ul>Cost Savings Share<br />Network<br />Price<br />Average Savings:45-50%<br />340B Price<br />
  41. 41. Savings for Patients<br />Patients save up to 60%<br />SUNRx - 340B cost includes average admin fee and average dispensing fee. Prices may vary by pharmacy<br />19<br />
  42. 42. Markets Served by SUNRx<br /><ul><li>Federally Qualified Health Centers
  43. 43. Disproportionate Share Hospitals
  44. 44. Fee for Service and Managed Medicaid Programs
  45. 45. Other programs</li></ul>20<br />
  46. 46. Federally Qualified Health Centers<br /><ul><li>Expand access to affordable medications, improving outcomes and reducing healthcare costs
  47. 47. Ensure regulatory compliance
  48. 48. Reduce paperwork, allowing staff to focus on patient care
  49. 49. Provide revenue from cash payors and third party insurers</li></ul>21<br />
  50. 50. Case Study: Cornerstone Care<br />In the first 5 months of Phase I:<br /><ul><li>Nearly 8,500 340B scripts were billed to third party insurers
  51. 51. More than $100k in profit was generated for the health center
  52. 52. Cornerstone anticipates more than $250k in net revenues from 340B.</li></ul>Cornerstone<br /> Care<br />22<br />
  53. 53. Disproportionate Share Hospitals<br /><ul><li>Expand access to affordable medications
  54. 54. Ensure regulatory compliance
  55. 55. Improve the bottom line:
  56. 56. Generate revenue from cash payors and third party insurers
  57. 57. Reduce employee drug benefit costs
  58. 58. Reduce paperwork and administrative costs</li></ul>23<br />
  59. 59. Benefits to TPAs<br /><ul><li>Enhance community outreach efforts by partnering with health centers and hospitals to expand access to affordable medications
  60. 60. Highlight the local and regional strength of TPAs, compared to the large, national players
  61. 61. Provide additional value and services for hospital and MCO clients</li></ul>24<br />
  62. 62. Case Study<br />A DSH in Texas:<br /><ul><li>Hospital with 450 employees in San Antonio area
  63. 63. Using 340B for employees can save $155k annually – nearly 50% -- in employee prescription benefit costs
  64. 64. Using 340B for outpatient care for patients with third party insurances can generate additional revenue.</li></ul>25<br />
  65. 65. Fee-for-Service and Managed Medicaid<br />SUNRx builds a network of eligible entities and pharmacies for Medicaid members to receive care and meds at 340B prices.<br />Medicaid programs and eligible entities share savings<br />No disruption for members, providers or payors<br />Opportunities for savings in other programs:<br /><ul><li>Prisons
  66. 66. Hospices
  67. 67. Other</li></li></ul><li>Who is SUNRx<br />Dedicated to helping with safety net providers and payors expand maximize resources and expand access to affordable medications.<br />Innovation: Developed breakthrough technologies that scan all available programs and pricing and ensure medications are always dispensed at the lowest prices.<br />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.<br />Trusted: Community healthcare payors, providers and pharmacies nationwide rely on SUNRx.<br />
  68. 68. Innovation<br />Prescription Assistance Programs (PAP)<br />“Lower than” technology to ensure that patients, health centers and third party payors always pay the lowest available price.<br />28<br />
  69. 69. The Future of 340B<br /><ul><li>Program Expansion
  70. 70. More eligible entities
  71. 71. More funding
  72. 72. One to One pharmacy relationship may change allowing for pharmacy networks.
  73. 73. More regulation
  74. 74. Auditing and reporting requirements</li>