2019 Ryan White HIV/AIDS Program CLINICAL CONFERENCE

340B Discount and Program Income Basics

WAC/AMP Price InsurancePayment

PROGRAM INCOME

FROMMANUFACTURER

DISCOUNT

340BCeilingPrice

Voluntary Sub- ceilingADAP Price

DISCOUNTorREBATE

FROMMANUFACTURER

ADAPs

RWHAP Providers

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340B Program Income Over Time

InsurancePayment

URA 23.1%

InsurancePayment

URA 23.1%

InsurancePayment

CPI Penalty

URA 23.1% ADAP suppl

CPI Penalty

PROGRAM INCOME

PROGRAM INCOME

ADAP suppl

PROGRAM INCOME

LAUNCH: $100.00

YEAR10:$175.00

YEAR5:$140.00

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Challenges to 340B Program Income

 Any legislation or regulations that directly or indirectly lower “AMP” or “Best Price”  Legislation or regulations that alter 340B Drug Pricing Program, including entity and patient definitions  Legislation, regulations, or policies allowing payers to reimburse 340B discounted drugs at lower rates  Competition that lowers list prices, AMP, or Best Price  Patent cliffs and commercialization of generic drug products

Slide24of31FromTHorn,MS atNewOrleans,LA,December4-7,2019,RyanWhiteHIV/AIDS ProgramCLINICALCONFERENCE, IAS  USA.