Transcript

Running the Theranostics Plan at Drug Margin Zero · Medsolve Dynamics

Yoel Bakas: Nobody tears up a program's business plan based on a proposed rule. And also, nobody signs capital before checking whether that plan still works if that rule sticks. Here is why that matters now. CMS just proposed paying 340B drugs at what hospitals actually acquire them for. Two drugs carry most hospitals' programs for theronostics, Pluvicto and Lutathera And the honest version is that for a lot of the programs out there, the discount is what made the program lucrative. Sure, the clinical case is real, but the margin came from the spread. Now, the rule is not final, but you have to lock your budget first. So the most important question you can ask right now. Is whether your program will stand if the spread goes away. So run the plan three different ways. Run it with today's rate, run it with the rules own fallback, and then run it with the rule as written. And don't forget to run the whole plan. Staffing, referral flow, site of care, the capital that's needed underneath it, not just the basic spreadsheet. If it stands on the clinical and the service line economics, you build it while weaker plans will stall. If it only stands on the spread, you better know that now in July than come January.