How Office Dispensing Changes the Economics of Small 340B Programs
For smaller 340B covered entities—FQHCs with a few sites, rural health clinics, or specialized medical centers—the promise of 340B savings often doesn’t match the reality. By the time you factor in TPA administration fees (10-15%) and contract pharmacy dispensing fees (15-25%), you’re left with only 60-70% of your potential 340B savings.
The Contract Pharmacy Fee Problem
Contract pharmacy arrangements made sense when they were the only way to access 340B savings for outpatient prescriptions. But for smaller covered entities, the math often doesn’t work anymore. Here’s what happens to a typical $500,000 340B program using contract pharmacy:
- TPA Administration Fees: $50,000 – $75,000 (10-15%)
- Contract Pharmacy Dispensing Fees: 20% average plus $15-$25 minimum per prescription ($75,000 – $125,000 total)
- True-Ups and Orphaned Accumulators: Additional thousands in lost revenue
- Rebate Drug Carve-Outs (starting January 2026): Even more complexity
- Total Fees: $150,000 – $200,000 or 30-40% of your savings
That means you’re only keeping $325,000 of your $500,000 program—barely 65% of potential savings.
Office Dispensing: A Better Model
RxFusion Office Dispensing eliminates contract pharmacy fees entirely and dramatically reduces administrative costs. Instead of 30-40% in total fees, covered entities can cut their fees by up to 75% with a comprehensive service package that includes:
- Complete implementation and training
- PBM network contracting and ongoing negotiation
- 340B policy development and compliance monitoring
- Claims processing, split-billing, and reconciliation
- Integrated software platform with 340B tracking
- Direct 340B drug purchasing coordination
- Patient assistance program integration
- Ongoing support and program optimization
- Beacon platform support for the 340B rebate model (launching January 2026)
With the same $500,000 program, office dispensing fees can be reduced dramatically—allowing you to retain up to 90% of your potential savings instead of just 60-70%. That’s an additional $115,000+ per year (35% or more retained value) compared to contract pharmacy.
Ready for the 340B Rebate Model
With HRSA’s 340B rebate model launching in January 2026, office dispensing offers significant advantages. The rebate model requires covered entities to submit detailed claims data through the Beacon platform. With office dispensing, you have:
- Direct control over your dispensing data
- Simpler setup than managing multiple contract pharmacies
- Fewer coordination points and potential errors
- Built-in Beacon platform support from RxFusion
Who Should Consider Office Dispensing?
Office dispensing isn’t for everyone, but it’s ideal for smaller covered entities that:
- Want to maximize 340B savings without high contract pharmacy fees
- Dispense high-cost brand drugs with high per-fill fees (PrEP, GLP-1s, migraine meds, etc.)
- Value patient convenience and same-visit dispensing
- Want simplified compliance and direct program control
- Need access to all 340B drugs without manufacturer restrictions
- Already use an existing EHR system (no need to change)
The Bottom Line
If you’re a smaller covered entity losing 30-40% of your 340B savings to fees, office dispensing deserves serious consideration. With RxFusion’s comprehensive service model that can cut fees by up to 75%, you can keep significantly more of your 340B value while gaining better patient outcomes and simplified compliance.
Contact: hello@rxfusion.com | www.rxfusion.com