340B Vigilance

340B Vigilance is a software product from Model N designed for pharmaceutical manufacturers. It addresses the risk of paying duplicate third-party payer rebates on prescriptions that were purchased at a 340B Drug Pricing Program discount, helping manufacturers avoid situations where discounts are paid to multiple entities for the same drug transaction.

The core problem the product targets is the absence of a simple linkage between sales and dispensing transactions, which makes it difficult to determine whether drug stock was acquired at 340B prices. Payers may submit rebate claims for transactions dispensed by pharmacies using product already acquired at 340B discounts, and with heavy discounting or penny pricing, manufacturers can end up paying more in combined discounts than the drug's original price across multiple entities.

Key Benefits

• Revenue optimization: Reduces revenue loss caused by duplicate discounts occurring between 340B and payer and/or Medicaid claims.
• Compliance monitoring: Continuously monitors compliance with the 340B Drug Pricing Program.
• Insights and control: Provides visibility into 340B discounts and policy to support informed decision-making.

Product Features

• Third-party integrations: Integrates with leading 340B vendors to identify duplicate discount script transactions.
• Definitive transaction data submissions: Notifies covered entities of any instances of duplicate Medicaid rebates and gives them the opportunity to correct actions and improve 340B program integrity.
• Enhanced checks and reporting: Expands the validation capabilities already available within Validata, enabling more accurate identification of ineligible rebate claims.

Related Products

• Validata: A script-level validation tool used alongside Payer Management to ensure rebates are only paid on eligible dispensed products.
• Payer Management: Supports risk reduction in payer and pharmacy benefit manager contracting processes.
• Medicaid: Supports accurate and timely Medicaid claims processing, including addressing 340B overpayments.

Available Resources

• A case study documenting how a pharma manufacturer used 340B Vigilance to prevent duplicate discounts.
• A whitepaper covering best practices for complying with 340B, including improving the chargeback process, generating an audit trail, and ensuring correct 340B pricing.
• A product brief for Validata focused on reducing overpayments by validating payer script data.

340B Vigilance is part of Model N's broader pharma product suite, which includes Payer Management, Medicaid, Government Pricing, and other revenue and compliance tools. It is positioned as a complement to Validata, extending that product's validation capabilities specifically to address 340B-related duplicate discount scenarios.