Safety Net in Jeopardy for Both Patients and Hospitals

A safety net for patients – one that can help them access highly expensive drugs – is in jeopardy. This could ultimately have a dire impact on patients who need medicine they can’t afford. It also could jeopardize operations at hospitals that provide the care that these and other patients need. 

This life-saving financial buffer is known as 340B, and you may be hearing a lot more about it in the coming months. It’s a federal program that was created 30 years ago by Congress to help lower-income patients, with or without insurance, and other patients who cannot afford high-priced medicines they need when they are seriously ill or suffer from chronic conditions. 

Certainly, you don’t need to be considered low-income to not be able to afford a cancer-treating drug that costs $12,000 a month. 

The name “340B” comes from the section of the U.S. Public Health Service Act of 1992, and it requires pharmaceutical manufacturers who participate in Medicaid to sell outpatient drugs at a discount to healthcare organizations, such as UH, that provide care for many uninsured or under-insured patients. There is no cost to taxpayers.

The program passes the discount onto hospitals, which lowers our costs of purchasing the drugs. That savings can then be directed to the care we deliver to patients. At UH, that care is offered in a number of ways. 

At our Hemophilia Treatment Center, it allows us to provide lifesaving clotting factor infusions to patients. Patients with this genetic condition require lifelong infusions, and clotting factor is very expensive and necessary to prevent bleeding complications. It is 340B savings that allow us to fund this treatment. 

At our Specialty Pharmacy, we are able to acquire expensive medications at a reduced cost. In addition, we are able to offer a variety of patient safety and service programs that are especially geared toward patients whose conditions require complex medications, while also focusing on affordability. 

As an example, if a patient cannot afford an expensive cancer drug, our patient advocacy team will look for discounts and/or grants that will ease the financial burden for patients and allow them to initiate life-sustaining treatment that otherwise would be delayed or inaccessible. There is also an assistance fund for uninsured or underinsured patients who meet the financial criteria. 

A patient outreach team then follows the patients throughout the course of treatment, monitoring them to make sure they are tolerating their medication and scheduling the next refill so no doses of the crucial medicine are missed. The patient’s health outcome can depend on all this.

If all the programs funded by 340B would disappear, UH’s costs would rise more than $300 million, nearly overnight. And our revenue would stay the same. That essentially means a $300 million loss for operations annually. This would come even as we are working to recover financially from the effects of high inflation and dramatically increased supply chain costs.

Our government relations team is working hard to ensure that 340B remains intact. Pharmaceutical companies, who are making record profits, aim to increase those profits further through the cuts or elimination of the 340B program. 

They answer to their shareholders; we answer to our patients and the wider community. 

The lives of patients and the health of those who live in our communities should not be at risk because pharmaceutical manufacturers want to eliminate a program that has been saving lives for 30 years.