Reform to drug pricing program for kidney disease needed
More than 12,000 Wisconsinites are living with kidney failure. Without treatment — dialysis or a transplant — this condition is fatal. Treating kidney failure and its comorbidities is a fulltime job — most dialysis patients are too sick to work.
In 1992, the 340B Drug Pricing Program was created to help safety-net clinics and hospitals provide affordable medications to low-income patients. Prescription drug manufacturers provide deep discounts to qualified entities with the understanding that the savings from those discounts are used to ensure the continued success of the safety-net providers and the communities they serve. However, 30 years into the program it has become clear that the initial design was woefully inadequate, and lacked clear definitions of what patients would qualify for these discounts and how the qualifying entities could utilize those dollars.
When it comes to kidney disease nationwide, there are higher rates in lowincome and racial/ethnic minority groups. These are the same populations that disproportionately rely on safetynet programs, like 340B, to obtain the treatment they need to survive.
Sadly, recent articles have highlighted several issues at Wisconsin 340B covered entities, which should be providing care to their local underserved communities, but are instead falling below the national average in terms of annual charity care. What’s worse, some entities have engaged in aggressive debt collection practices with patients who can’t afford to pay their medical bills. This is the opposite of what architects of the 340B Drug Pricing Program intended.
A new partnership of community health centers, biopharmaceutical leaders, and patients and consumer advocates have come together to create the Alliance to Save America’s 340B Program, or ASAP 340B. This is a remarkable partnership, and it underscores the urgency for action. ASAP 340B is calling on elected officials to act to ensure that the 340B program supports safety-net providers to help the low-income and vulnerable populations it was meant to when it was first created.
ASAP 340B supports a 10-point policy plan to get the program back on the right track to helping patients and supporting critical community health centers. Simple reforms such as ensuring low-income patients receive 340B prescriptions at a discount, strengthening 340B covered entity eligibility requirements, and prohibiting aggressive debt collection practices are just a few of the actions our elected officials could take to make 340B more effectively work for vulnerable patients and their caregivers. Policy makers can act now to improve access for vulnerable patients – like chronic kidney disease patients – across the country.
Michael A. Crowley, CEO, National Kidney Foundation of Wisconsin