Everyone can agree that vulnerable patients should be able to access medications they might not be able to afford. The 340B Drug Pricing Program was designed to help with just that. Since 1992 manufacturers have provided billions of dollars in steep discounts on outpatient medicines to safety-net clinics and qualifying hospitals expecting that those entities would use the savings to ensure vulnerable patients have access to needed medicines. But the 340B program has strayed far from its safety net purpose. Instead, it has become less about patients and more about boosting the bottom lines of hospitals and for-profit pharmacies. How? Large hospitals buy deeply discounted 340B medicines and then turn around and charge both uninsured patients and insurance companies higher prices, pocketing the difference with little to no evidence they use that money to help patients. The New York Times provided a case study about exactly this – a hospital system in Virginia is abusing the 340B program to increase its profits and harming vulnerable patients in the process. Sadly, this is just one example of the countless hospitals taking advantage of a program originally created to be a safety-net for disadvantaged patients.
340B hospitals and their many contract pharmacies are found in every state. How much charitable care are 340B hospitals in your state providing as compared to the national average? Are 340B hospitals in your state contracting with local pharmacies, or are they profiting from contracts with pharmacies nationwide? Explore the interactive map below and select a state to access state-specific data on 340B.
The 340B program suffers from lax rules and oversight that enable large, wealthy hospitals and chain pharmacies to gain financially, often at the expense of patients. An analysis published in the New England Journal of Medicine found no evidence hospitals invest their 340B profits into safety-net care. Similarly, a study published in the Journal of the American Medical Association concluded: “Nonetheless, our work adds to a growing body of evidence questioning the degree to which 340B program growth serves vulnerable communities.” Here are some ways Congress can fix 340B.