December 340Buzz: Things we are thankful for

Welcome back from your turkey torpor as we dive straight into the holiday season! Those of us in 340B can have extra reason to be thankful this year: While it attracted little fanfare, the program turned 30 years old on Nov. 4.

As readers of the Buzz know, the program has been mired in legal disputes with drugmakers and withering assault from Big Pharma and its allies. As covered entities tally their financial losses from the contract pharmacy restrictions of 18 manufacturers, and the federal appeals cases drag on, it hardly feels like time to celebrate. But 340B has given us much to be thankful for.

Since its inclusion in Section 340B of the Public Health Service Act as part of the larger Veterans Health Care Act of 1992, our favorite safety net discount drug program has had many accomplishments we can be proud of. I’ll highlight three:

     • Enhanced integrity. In the early days of 340B, there was no such thing as a program audit from the Health Resources and Services

       Administration. Since it instituted them in 2012, HRSA has conducted nearly 1,800 audits of covered entities. This has lent an important

       check and balance to the program.

     • Expanding to include rural hospitals. Community hospitals have important but incredibly difficult missions. Since 2005, 183 rural

       hospitals have closed their doors. The Affordable Care Act of 2010 expanded 340B eligibility to critical access and other rural

       hospitals, providing a critical financial and safety net lifeline to many of them. Without 340B benefits, the total number of closures

       would probably be higher.

     • It helps patients. If anything, we don’t talk enough about how the program benefits patients, who qualify to receive discounted drugs

       they otherwise wouldn’t be able to afford, or access services for at-risk patients that covered entities otherwise would not be able

       to offer. At a time when 340B is under constant attack, this is a drum we need to beat loudly.

And in fact, that’s the gist of a new report from the American Hospital Association that says the manufacturer policies restricting access to 340B pricing at contract pharmacies are harming access to critical care for patients. The report says the average annualized financial losses range from $507,000 for critical access hospitals to nearly $3 million for disproportionate share hospitals. Read More >>