By William M. Remak
The health of America’s most vulnerable should be a priority for everyone, not a bipartisan battle.
The 340B Drug Discount Program was created by congress in 1992 to help certain healthcare “safety-net providers” reduce outpatient prescription drug costs. It requires drug manufacturers to provide discounts to specified federally-funded clinics, and certain hospitals, as a condition of participation in the Medicaid program. The goal was, and is still, both admirable and necessary.
However, since the program’s inception, large hospitals had seen incredible financial benefit, while the patients the program is intended to serve have not.
In 2017, Rep. Scott Peters from San Diego co-sponsored the PAUSE Act, a bipartisan effort aimed at expanding required basic data reporting to all 340B participants. We have seen how valuable the 340B program is to Hemophilia Clinics and the Ryan White HIV/AIDS Program, where strict reporting shows us just how the revenue gains from discounted drugs are reinvested into patient care and treatment. For this vital program to continue, we must ensure that all 340B entities have the same reporting requirements, showing how and where they are using these dollars to the benefit of low-income and uninsured patients.
To that end, I want to thank Congressman Peters for his support of the 340B program in the way it was intended. I applaud his continued bipartisan efforts to get this important program back on track. Ensuring that the 340B program isn’t being used to pad the revenues of already well-funded hospital systems must be a top priority as we continue to see many uninsured and under-insured patients paying out-of-pocket for their medicines.
This program is intended to create better health outcomes for under-served patient communities with chronic illnesses by providing discounts to outpatient medications to federally qualified health clinics and select hospitals, also known as “covered entities.” These clinics, which include Ryan White AIDS clinics and hemophilia treatment centers, are required to reinvest 340B dollars into patient care and provide annual reports on spending.
Large hospitals that serve insured and financially stable patients are the biggest problem in the 340B fight. A glaring example of this is reflected in the harshly negative effects on California’s small cancer clinics after being acquired by larger 340B hospitals, which then force patients to pay upwards of 60 percent more in treatment costs.
These hospitals have abused the program far beyond the original intent of Congress and do not invest back into care for patients most in need. Reform is needed within this program to close loopholes that larger hospitals continue to jump through.
Thank you, Congressman Peters, for your fight to gain clarity and transparency in this program which helps so many Americans with chronic illnesses. We support your continued efforts to demand transparency, and ensure the sustainability of the program for those clinics and programs utilizing it in the way it was intended. It’s time for the rest of Congress to join you, and put the most under-represented and in-need patients before the continually-lined pockets of large hospitals.
William M. Remak is chairman and CEO of the nonprofit California Hepatitis C Task Force.
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