We’re disappointed to again see a discussion of the 340B Drug Pricing Program based on fiction and unsupported assertions, rather than the plain facts about this vital program for vulnerable patients.
Case in point: an article in the current issue of Health Affairs. Like critiques before it, the article dismisses the good work at hundreds of essential hospitals nationally that use 340B exactly as designed: to stretch scarce resources and support a broad variety of services that benefit low-income and other disadvantaged people.
It’s troubling the article uses a respected, peer-reviewed platform to perpetuate a harmful and pervasive misconception about 340B: that hospitals must pass on program savings directly to the poor. But nothing in the congressional record or in subsequent review by regulators supports this claim. In fact, the General Accounting Office has said the program works as intended.
What 340B allows hospitals to do, aside from providing the vulnerable with low- and no-cost medications, is to create lifesaving access to primary and preventive care; specialty treatment, such as cancer care; and other services often beyond the reach of the less fortunate. And the 340B program does this at no cost to taxpayers. Zero.
As the program’s detractors often do, the article’s authors make much of the growth in the number of 340B hospitals and clinics, particularly in areas better off than those typical for the program. But they fail to support in any meaningful way their premise that this growth has shifted 340B from a program that benefits the poor to one that “enriches” hospitals. The article does not bother to venture beyond cold Census data to explore the reality of essential hospitals, the pockets of poverty that can exist in otherwise affluent communities, the socioeconomic challenges of the patients it does reach.
It also ignores the simple fact that growth in 340B largely follows congressional expansion of the program to rural and small urban hospitals, certain free standing children’s hospitals, and other important points of access to care for those in need. The authors miss other key changes: a shift toward outpatient care and hospital-physician collaboration, especially in the context of care coordination to reduce avoidable readmissions.
If the forces aligned against 340B have their way, communities across this nation will be much poorer for the effort. At no cost to taxpayers, 340B ensures those in greatest need can count on the health care services they need to remain healthy and productive. Essential hospitals put 340B savings to good use for the vulnerable and, in turn, the well-being of entire communities. Could we reasonably expect the same if these savings reverted to drug companies? Could we afford that outcome?