Feds aren’t enforcing lifesaving drug discount program
A federal program created in the 1990s that requires drug manufacturers to distribute significantly discounted medications to health care providers and pharmacies serving low-income patients is under attack.
Several of those manufacturers are refusing to ship critically important, lifesaving drugs to pharmacies. This means that patients served by safety-net providers, like our community health centers, can’t get affordable medications.
This program, Section 340B of the federal Public Health Service Act, is mandatory. Yet, drug manufacturers are getting away with noncompliance because the federal government is turning a blind eye.
Over 270,000 patients are served by our eight health centers across 95 sites spanning the East and South Bay. For our patients, 340B discounts make medications and services affordable. When drug companies do not ship the discounted medications to pharmacies, patients are denied their prescribed medications.
In response, the patient or the pharmacy must notify the health care provider, who must figure out a substitute medication and send a new prescription back to the pharmacy. The patient must then be notified and make another trip to the pharmacy to pick up the substitute medication, which can cause unnecessary delays in taking critical medicines.
Those delays can lead to life-threatening risk of heart attack, stroke and diabetic shock. Additionally, patients often remember pills by their unique size, color and shape; substituting medications can lead to serious errors and health risks.
The differences in cost can be shocking. For example, medications Basaglar and Lantus were being used to control diabetes until they were no longer available under 340B pricing. Purchasing Basaglar through a pharmacy without the 340B discount would cost $84 more than it would with a contracted 340B vendor. The Lantus Vial would end up costing hundreds of dollars as opposed to mere cents without a 340B discount. As a result, our providers are left scrambling to find longlasting insulin at 340B discounts; this often resulted in delays in filling this lifesaving prescription.
For many of our patients, providers were unable to change medications, and our clinics ended up paying 100 times the 340B cost of a medication, making our already limited resources stretch even further. Community health centers are nonprofits that are missiondriven to provide quality, affordable care to all patients, regardless of insurance status or ability to pay. Without the discounts, health centers are struggling to afford the drugs their patients need.
Lack of affordable prescription drugs disproportionally affects uninsured patients and seniors on fixed incomes. Taking away this program can easily push them further into poverty and disease and even lead to death. Timely diagnosis and early, easy access to medications allow for better health and avoid deterioration, emergencies and hospitalizations.
A pandemic, which has already taken a heartbreaking toll on our communities, is the worst possible time to threaten this lifesaving, critical program that makes medicines affordable. With more people suffering income insecurity and grappling with managing chronic conditions safely, now is not the time to stop complying with the federal obligation to offer discounted drugs.
That is why hospitals and clinics across the nation are suing the federal government for not enforcing 340B drug discounts. Additionally, on Dec. 14, California Attorney General Xavier Becerra joined 29 attorneys general from other states in demanding that Health and Human Services Secretary Alex Azar enforce the 340B drug discount pricing rules. This bipartisan support showcases a strong need for this drug discount program to continue.
We strongly urge the federal government to enforce the drug discounts of this essential program. Action must be taken before further harm falls on people who cannot access the vital medications they need to survive.