Drug Ordering System Using Late Attribution for 340B Pricing
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Solution Overview
Problem
Conventional drug ordering systems face challenges in attributing dispenses to correct container sizes and sellers, leading to difficulties in identifying eligible 340B pricing, resulting in unnecessary purchases at higher WAC prices and inefficient processing resources, especially for healthcare facilities that commingle drugs for inpatients and outpatients.
Innovation Solution
A software and hardware facility that uses late attribution and price optimization, allowing drug reordering at 340B prices by incrementing a drug-specific counter and attributing outpatient dispenses only at the time of ordering, automatically identifying sellers based on current price schedules and dispensed doses, and optimizing orders for Central Drug Distribution Centers across member hospitals.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If conventional drug ordering systems attribute dispenses to container sizes and sellers immediately, then pricing eligibility can be determined quickly, but processing resources are inefficiently consumed and attribution errors occur
Solution Approach 1:
The system performs preliminary actions by maintaining a running tally of dispensed doses for each drug at the time of ordering, rather than waiting for immediate attribution. This allows the system to prepare and optimize pricing eligibility determinations in advance, reducing real-time processing burden while improving accuracy.
Solution Approach 2:
The system implements feedback mechanisms where dispense data is continuously fed back into the ordering system to update drug counters and pricing eligibility status. This ongoing feedback loop ensures accurate attribution while allowing batch processing of attribution tasks, improving both precision and resource efficiency.
2Ease of operation
If healthcare facilities commingle drugs for inpatients and outpatients, then inventory management is simplified, but identifying eligible 340B pricing becomes difficult
Solution Approach 1:
The system segments the drug tracking by maintaining separate counters for inpatient and outpatient dispenses of the same drug. This segmentation allows the system to distinguish between patient types while still managing commingled inventory, enabling accurate 340B pricing eligibility identification for outpatient drugs without complicating inventory management.
Solution Approach 2:
The system applies local quality tracking by maintaining drug-specific counters that track dispenses according to patient type (inpatient vs. outpatient) for each drug. This localized tracking approach allows precise pricing eligibility determination for specific drug-patient type combinations while maintaining overall inventory simplicity.
3Loss of time
If the system attributes outpatient dispenses immediately at the time of dispensing, then pricing benefits can be captured quickly, but processing resources are wasted on unnecessary attributions
Solution Approach 1:
The system performs preliminary action by maintaining a running tally of dispensed doses at the time of ordering, rather than waiting for immediate attribution. This allows the system to prepare pricing eligibility determinations in advance, reducing real-time processing burden while capturing pricing benefits timely.
Solution Approach 2:
The system applies partial action by attributing only the necessary dispense data required for pricing eligibility determination, rather than performing complete immediate attribution. This selective attribution approach captures essential pricing benefits while reducing processing resource consumption on unnecessary detailed attributions.
Data Source
AI summary
A facility for managing distribution of a drug is described. The facility generates an order for the drug on behalf of one or more purchasing hospitals, the order specifying each purchasing hospitals' identity and a quantity of the drug ordered on its behalf. The facility selects the specified identities of the purchasing hospitals and the specified quantities of the drug in a manner that takes advantage of opportunities that one or more distinguished hospitals among the purchasing hospitals have to order the drug at a discounted price. The facility reimburses each purchasing hospital for the drug ordered on its behalf at an undiscounted price. The facility causes the ordered quality of the drug to be physically distributed to one or more consuming hospitals, and causes each consuming hospital to be charged for the distributed quantity of the drug at the undiscounted price.