The 340B Drug Pricing Program was intended to help our most vulnerable citizens access medicines and care when they are sick by providing steep discounts on outpatient drugs to qualifying healthcare entities that are supposed to pass the savings to patients.
There is growing concern that the federal program’s lack of oversight is allowing bad actors to turn around and charge patients higher prices and pocket the difference or use the profits to invest in unrelated programs. As they fund their own special interests, the most vulnerable patients are left unable to afford their medications. This is contrary to the program’s intended purpose.
The 340B program was enacted with bipartisan support by Congress in 1992 to help safety-net health care providers. In fact, manufacturers participating in Medicaid agree to provide outpatient drugs to covered entities at significantly reduced prices. The expectation is that those entities will use those savings to stretch their financial resources to reach more financially vulnerable patients and deliver comprehensive services.
More than 2,600 hospitals, including 69 in Missouri, were participating in the 340B Program as of January 2023. To be eligible for the program, hospitals must meet various criteria, which may include treating disproportionate numbers of low-income Medicare and Medicaid patients.
The lack of requirements for how 340B participants use the discounts they receive to help low-income patients has allowed this program to balloon in growth. Since 2010, the program has grown by almost 500 percent, and it is now estimated that over 25,000 contract pharmacies participate in the 340B program.
Access to affordable medicines is critical, especially to the impoverished in underserved communities that the 340B program was intended to help. Patients on the receiving end of this program already face significant barriers to care, including being able to afford treatments, residing in rural communities with fewer care facilities and various adverse health outcomes. When discounts don’t reach patients, the program is not functioning as it should.
Various reforms to help limit these unintended consequences and encourage hospitals to use the drug discounts to advance the program’s goals are being proposed by federal and state lawmakers.
We should all agree that patients of all economic backgrounds must be afforded the opportunity to receive the high-quality care they need, when they need it. Therefore, it’s imperative that our elected officials keep the interests of Missouri’s most vulnerable patients at the forefront of all discussions concerning the 340B program because it is a lifeline for many impoverished citizens in our state.
Executive director of Patients Come First-Missouri, a consumer movement aimed at putting patients and consumers back at the forefront of healthcare through advocacy, science, education and collaboration.
