Health-systems leaders fear that a scaled-back 340B Federal Drug Pricing Program would hurt the very patients it was designed to benefit.

The 340B program has come under increasing federal scrutiny. A 2011 report from the Government Accountability Office recommended that the Health Resources and Services Administration (HRSA) take steps to strengthen oversight over compliance with program requirements to ensure that funds are used in a manner that is consistent with the agency's intent. 

Earlier this month, HRSA submitted guidance to the federal Office of Management and Budget (OMB) regarding the 340B Program’s structure.
 
Although its public release depends on when the OMB completes its review, this proposed guidance is expected to include provisions that will make significant changes that may potentially decrease future 340B Program revenue and increase compliance obligations.
 
Yesterday, more than 500 health-system and hospital leaders from qualifying safety-net facilities sent a letter to Congress outlining the possible repercussions of scaling back the 340B Program.
 
“If the program were to be restricted, vital services to the underserved would be cut back,” they wrote. “Prescription drug costs for our patients would rise dramatically, and taxpayers would have to pick up the tab.”  
 
In a press telebriefing, Johns Hopkins Hospital and Health System president Ronald Petersen said one of the key strengths of the 340B Program is the discretion it affords hospitals to tailor services to the “unique needs of the population.”
 
In East Baltimore, for instance, some patients have a “lack of social capital” that affects their access to health services, Petersen said. Providing free care and medications through the 340B Program helps improve the quality of life of these patients, he argued.
 
Other health-system leaders stressed that certain services benefitting the uninsured are “completely funded” by savings generated by the 340B Program, so scaling it back would discontinue those services.
 
Erlanger Health System president and CEO Kevin Spiegel pointed out that one of the health-system’s pharmacies has “reduced the multiple barriers of medication availability, accessibility, cost, and management for low-income patients” through support from the 340B program.