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ICYMI: 340B: Good Intentions, Wrong Path

March 23, 2018
It’s been 25 years since Congress created the 340B Drug Discount Program – a program designed to provide uninsured and vulnerable patients with access to affordable prescription drugs. But these last 25 years of 340B have not gone exactly as planned – and there’s plenty of data to show it.  As Austin Frakt and Elsa Pearson discuss in a recent STAT News opinion piece… “there’s mounting evidence the 340B program has been exploited for profit under the guise of ‘doing good.’”

As envisioned, 340B requires drug manufacturers to provide discounts on outpatient medicines and treatments to select health care entities, often referred to as safety-net providers. Over the years, however, there has been growing signs that this program has expanded well past the intent of Congress, and that patients are not seeing the benefits they deserve. As the authors write:
“Part of the concern is that benefits are not being used for the intended populations. A report by the Alliance for Integrity and Reform of 340B shows that charity care spending in 2014 for nearly two-thirds of 340B hospitals was less than the national average for similar hospitals.”

Frakt and Pearson also point to several studies that suggest 340B plays a role in increasing the supply of certain drugs, some unnecessarily so, raises the cost of care, and some recipients pocket the profits rather than reinvest them into improving their care models. For example:
A study in the journal Health Services Research examined the impact of the 340B program on the cost of cancer care. It found that hospital participation in the program is associated with a shift of patients’ care from more affordable physician offices to more expensive hospital outpatient care centers, contributing to market-wide increases in per-patient spending.”

For the 340B to work properly, Congress must take significant steps toward increasing oversight and accountability of the program. That’s why BIO has supported the PAUSE Act in the House and the HELP Act in the Senate, both calling for reform of the current 340B program.

Read the full opinion piece here.