Posted: February 19th, 2022

Implementation of Strategy

Implementation of Strategy
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340B Drug Pricing Program
Any form of medication is important since human being may require taking some at different times in their lives. The biggest concern as brought out, in this case, is that most people are not being able to access the medication. In 1992, the Congress came up with the 340B drug pricing program which was a statutory scheme aimed at reducing the high-costs of pharmaceuticals for the people they represent generally, the 340B pricing program oversight entailed a set of guidelines that obliges pharmaceutical companies to offer a discount on medications to authorized safety net providers. The program was conducted by the Office of Pharmacy Affairs that is in the Health Resources and Services Administration (HRSA). The primary aim of coming up with the program was to eradicate the rising costs of medications and help the low-income patients access medication at a discounted cost (Kantarjian, 2015). The program demands that the manufacturers of drugs and participating in the Medicare Part B should provide at least 20% discounted pricing to all outpatients drugs to participating healthcare providers(Baer, 2015).. This will also include healthcare facilities that receive federal grants and the safety-net hospitals. This paper will discuss the implementation of strategy, analysis of case 340B, and health implementation of drug pricing.
Implementation of Strategy
Implementation of any strategy is usually done after planning and it’s the backbone of any program. Implementation can be referred as the steps required in order to bring any strategic plan in action and this helps you to achieve your objectives. However, the implementation process is not always easy and fast (“From Strategy to Execution: How to Create a Sustainable, Repeatable Implementation Plan,” 2019). The whole process can take between 2 to 5 years and normally involves multiple corrections and a lot of decision making. The steps need to be followed thoroughly so that the organization can achieve its desired sustainability. During the implementation process, it’s prudent to involve different stakeholders in the organization and this includes the implementers of the project. The stages of implementation include;
1. The scope/ exploration stage: in this particular stage, those implementing the outlined strategy are supposed to take time and assess if the different aspects of the program fits in the community. The implementers are also assessing the available resources in the community to find out if they are fit to continue with the project. This stage involves different stakeholders during the decision making process. The objective of the scope stage is to have a clear plan with the necessary timeline so as to facilitate the work breakdown and the initial implementation of the project (Overview of the Stages of Implementation, n.d.). In case 340B, the oversight authority took time to educate people about the project and assessed if it would be of benefit to them.
2. Breakdown/ Installation stage: This stage prepares implementers and stakeholders for the start of the implementation. At this stage, the resources that will be used in the project are assembled. Implementers are then allocated their responsibilities and duties which must be completed in a specific timeline. It is also at this stage that committee is formed, supervisors are hired and the budget for the project is submitted for approval. At this stage, a detailed analysis of the duties as outlined by the stakeholders (McLaughlin, 2014). The important dates are also marked though they may or not be achieved. The oversight authority set out a detailed plan of how the project would be undertaken. The stakeholders were the pharmaceutical companies were also involved.
3. Initial implementation. In this stage, all elements of cost of the program are laid down and assess if additional funding may be required to complete the project. Risk management is also done at this stage and various stakeholders must assess the potential risk that can occur while running the project, It’s also paramount to ensure that there will not be shortage of resources since this can put the project at halt thus affecting the success of the project. According to McLaughlin (2014), it’s important to understand the potential risks as they may present the project with “unplanned surprises”, which may also affect the implementation of agencies.
4. Full implementation stage: In this final stage of program implementation process, implementers actively work on their roles and duties. Stakeholders are also actively involved. At this stage, the whole organization is getting used to the new policies involved.
Analysis of implementation of 30B
The HRSA was the oversight authority for the 340B program. The integrity of the 340B program has been in doubt even though the program boasts of huge success. There are various elements that were not considered throughout the implementation of the program. For instance, the scope stage was not thoroughly done and this might be the main reason to as why the integrity of the program is in question. The integrity is in doubts as various stakeholders’ feels that the intended populations (low-income earners) are not benefiting from the program and it’s only benefiting the hospitals that are participating. The management of this program also failed to provide clear procedures and policies that were required in the implementation. However, the management assessed the members of the community to find out if there was need for this program.
In the second stage of implementation stage, the program has outlined the various duties and responsibilities of stakeholders and implementers involved in the program. However, there should have been a critical program review to ensure that all guidelines and compliance have been followed. The HRSA oversight agency stated that they largely relied on self-policing in participants in order to conduct an audit and to ensure that there is compliance with the requirements of the program. This may result to lack of compliance to the participants.
One of the problems presented in the third stage is that the HRSA doesn’t have the legal mandate to conduct audit on the covered entities. The agency should have appointed a committee to ensure that there is compliance even though there is a clause that warns against discrimination. Although the discounts allowed on 340B medications are more than enough, the agency should ensure that they should only be available to the intended persons. The program should have conducted audit on the entities that are covered.
Health Implementation strategy in Drug Pricing
Various pharmaceutical companies in the United States have started implementation of reference pricing. The pharmaceutical companies are now facing a lot of competition for tactics that reduce cost, which is caused by the shift of the pharmaceutical medication spending. According to Robinson (2017), most pharmacy managers, employers, and insurers negotiate for price discounts from the manufacturers and this creates a link between patient’s copayments with the price of a single drug. The tired strategies are now steering patients towards the generic medications option. Those involved in the health implementation strategy should always be familiar with the new trends in pharmaceutical pricing. This will enable them to control the costs related in drug-pricing.
Conclusion
Implementers in health implementation strategy should understand the various characteristics of pharmaceutical market so that they are able to control the pricing of drugs. Implementation of 340B program should include clear policies and ensure that there is compliance with the set guidelines. There is also need for a proper planning of the project in each stage to identify mistakes that can halt the program.

References
Baer, C. J. (2015). Drugs for the indigent: A proposal to revise the 340B Drug Pricing Program.
William and Mary Law Review, 57(2), 637-673
From Strategy to Execution: How to Create a Sustainable, Repeatable Implementation Plan. (2019, January 28). Retrieved from https://www.smartsheet.com/implementation-plan
Kantarjian, H. (2015, November 01). Value of the 340B Drug Discount Program. Retrieved from
https://jamanetwork.com/journals/jamaoncology/article-abstract/2430477
McLaughlin, C. P., & McLaughlin, C. D. (2014). Health Policy Analysis: An interdisciplinary
approach (2nd ed.). Retrieved from https://content.ashford.edu
Overview of the Stages of Implementation. (n.d.). Retrieved from
https://sisep.fpg.unc.edu/guidebook/level-one/stages-implementation
Robinson, J. C. (2017). Association of Reference Pricing with Drug Selection and Spending. The New England Journal of Medicine, 377(7), 658-665.

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