Study: 340B drug pro­gram aids wealth­ier com­mu­ni­ties

Modern Healthcare - - NEWS - By Jaimy Lee and Adam Ruben­fire

Health­care or­ga­ni­za­tions that joined the fed­eral 340B drug dis­count pro­gram after 2004 were more likely than other pro­gram par­tic­i­pants to serve wealth­ier com­mu­ni­ties with higher rates of health in­surance, ac­cord­ing to a study.

The find­ing con­flicts with the pro­gram’s pur­pose of help­ing health­care providers de­liver bet­ter care for low­in­come or in­sured pa­tients by re­ceiv­ing dis­counts on cer­tain med­i­ca­tions.

It also should buoy op­po­nents of the pro­gram.

In­deed, last week, the Phar­ma­ceu­ti­cal Re­search and Man­u­fac­tur­ers of Amer­ica, the in­dus­try’s trade group, again filed suit to strike down a 2014 rule by the U.S. Health Re­sources and Ser­vices Ad­min­is­tra­tion that al­lows safety net hos­pi­tals to ob­tain dis­counts when pur­chas­ing so-called or­phan drugs when us­ing them to treat non-or­phan con­di­tions or dis­eases through the 340B pro­gram.

The 2014 rule al­tered the orig­i­nal statute drafted by Congress, declar­ing that only or­phan drugs des­ig­nated for a rare dis­ease or con­di­tion “and used to treat such rare dis­ease or con­di­tion” are ex­empt from the 340B pro­gram, PhRMA con­tends in its suit.

The 340B pro­gram al­lows cer­tain health­care providers, such as fed­er­ally qual­i­fied health cen­ters or dis­pro­por­tion­ate-share hos­pi­tals, to re­ceive dis­counts up to 50% on some out­pa­tient drugs as a way to help those providers stretch their re­sources.

How­ever, in re­cent years, law­mak­ers, phar­ma­ceu­ti­cal com­pa­nies and oth­ers have ques­tioned whether the sav­ings and rev­enue gen­er­ated by the 340B drug pro­gram are be­ing used as in­tended to im­prove care for those pa­tient pop­u­la­tions.

The au­thors of the study, pub­lished last week in the jour­nal Health Af­fairs, are Rena Conti, as­sis­tant pro­fes­sor of health pol­icy and eco­nomics at the Univer­sity of Chicago, and Dr. Peter Bach, di­rec­tor of Memo­rial Sloan Ket­ter­ing Can­cer Cen­ter’s Cen­ter for Health Pol­icy and Out­comes. Both au­thors have been crit­i­cal of the 340B pro­gram.

The Safety Net Hos­pi­tals for Phar­ma­ceu­ti­cal Ac­cess, a trade group for 340B hos­pi­tals, crit­i­cized the anal­y­sis.

“The fact re­mains that 340B DSH hos­pi­tals support heavy caseloads of Med­i­caid and low-in­come Medi­care pa­tients—re­gard­less of where their out­pa­tient clin­ics are lo­cated,” the as­so­ci­a­tion said in a writ­ten state­ment.

Newer par­tic­i­pants—those providers that joined 340B since 2004—serve com­mu­ni­ties with lower poverty rates and higher in­come lev­els than the providers that be­gan par­tic­i­pat­ing in 340B be­fore 2004, study au­thors Conti and Bach found.

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