Preparing for the Rebate Model While Maximizing Current Savings
The 340B program landscape is shifting dramatically. With manufacturer restrictions limiting contract pharmacy access, HRSA’s rebate model launching in January 2026, and fees continuing to erode savings, smaller covered entities need to rethink their 340B strategies. Office dispensing offers a compelling alternative that addresses both current challenges and future regulatory changes.
Current State: The Contract Pharmacy Fee Trap
Let’s be honest about what smaller covered entities face with contract pharmacy today:
- Manufacturer Restrictions: Many high-value drugs are no longer available through contract pharmacy
- High Per-Prescription Fees: Contract pharmacies charge 20% average plus $15-25 minimums per prescription, totaling 20-25% of savings
- TPA Administration: Another 10-15% goes to third-party administrators
- Complex Tracking: Multiple parties mean complicated compliance and audit risk
- Lost Revenue: True-ups, orphaned accumulators, and coordination failures
For a typical small entity with $500,000 in 340B savings potential, you’re losing $150,000-$200,000 to fees and inefficiencies. You keep barely 65 cents on the dollar.
The 2026 Game Changer: HRSA’s Rebate Model
In January 2026, HRSA launches the 340B rebate model—a fundamental shift in how the program works. Instead of upfront discounts, manufacturers will provide rebates after dispensing, requiring covered entities to:
- Submit detailed claims data through the Beacon platform
- Track and reconcile rebate payments
- Coordinate data between pharmacies, TPAs, and HRSA systems
- Manage a more complex reimbursement cycle
This adds layers of complexity to contract pharmacy arrangements. Every additional party—every TPA, wholesaler, and contract pharmacy—becomes another potential point of failure in the data chain.
Office Dispensing: Simpler, More Profitable, Better Positioned
RxFusion Office Dispensing addresses both current fee problems and future rebate model challenges:
Lower Fees, Higher Retention
- Comprehensive service fee up to 75% lower than contract pharmacy
- Retain up to 90% of your 340B savings instead of 60-70%
- For a $500,000 program, that’s $115,000+ more per year
Rebate Model Ready
- Direct control over dispensing data makes Beacon submissions simpler
- Fewer coordination points mean fewer errors
- Single integrated platform for claims, tracking, and reporting
- RxFusion handles Beacon platform compliance and support
No Manufacturer Restrictions
- Office dispensing is not subject to the contract pharmacy limitations
- Full access to all 340B drugs, including high-cost brands and lite-specialty medications
- No missing out on your most profitable prescriptions
Patient Benefits
- Same-visit dispensing improves adherence and satisfaction
- No separate pharmacy trip required
- Immediate counseling and medication education
Real-World Impact: The Numbers
Consider a small FQHC that dispenses just 10 specialty medications per day (approximately 50 prescriptions per week), 5 days per week:
- Volume: 2,600 prescriptions annually (10 per working day)
- Program Value: Approximately $5 million in total drug revenue (depending on drug mix)
- Contract Pharmacy Net: $3.25 million (35% fees)
- RxFusion Office Dispensing Net: Up to $4.5 million (significantly reduced fees)
- Additional Annual Savings: $1.2 million+
That’s real money that can fund expanded services, hire more staff, or reduce patient costs.
Implementation is Easier Than You Think
Many covered entities assume office dispensing requires massive infrastructure. With RxFusion, that’s not the case:
- Use your existing EHR system—no need to change
- No new 340B TPA required (or you can keep your current one)
- Work with your existing wholesaler
- Leverage your current clinical staff with minimal additional training
- Complete implementation typically takes 90-120 days
The Strategic Decision
As we head into 2026, smaller covered entities face a choice: continue with high-fee contract pharmacy arrangements that will become even more complex under the rebate model, or transition to office dispensing that offers:
- Dramatically lower fees (up to 75% less than contract pharmacy)
- Simpler rebate model compliance
- Full access to all 340B drugs
- Better patient outcomes
- Direct control over your 340B program
The math is compelling. The timing is right. And with 25 years of pharmacy and 340B expertise, RxFusion has the proven track record to make your transition successful.
Ready to explore office dispensing for your covered entity?
Contact: hello@rxfusion.com | www.rxfusion.com