We are deeply concerned about recent efforts to restrict and undermine the sanctity and integrity of the 340B Drug Pricing program (340B). The 340B program is necessary for qualified hospitals and covered entities to provide low-cost and no-cost medications and services to some of our nation’s most underserved and needy. Recently, attacks on the program could result in a widening of the healthcare equity divide. In our work, we witness the multitude of patients needing treatment, with many having to choose between medication and food. Patient assistance programs are not enough to offset the vast needs of individuals experiencing financial hardships and managing chronic disease diagnoses and treatments.
The truth is that poverty is a reality for many in America, and our safety net continues to grow. In fact, 37.5 million people fall below the federal poverty line. People of color are the population most significantly impacted and remain at risk for increased disparities in healthcare, nutrition, treatment options, and much-needed medical services.
As front-line providers, our voices as pharmacists amplify the needs of our patients; from hospitals to community pharmacies, we serve tirelessly and give voice to those in need of medication access and healthcare. Notably, we continue to work and advocate for patients amidst a national pharmacy crisis riddled with workforce shortages and employment conditions plagued by stress and despair.
Today, we are most concerned about the Congressional investigations into the 340B program jeopardizing the health of millions of Americans. There should never be an option to compromise the clinical frontline workforce. Black and brown communities remain the most vulnerable.
Pharmacists and hospital pharmacy services are necessary to treat America. Let’s face it – with gratitude – hospitals saved us. We, the pharmacists, are the trusted voices who provide and administer immediate solutions for the healthcare ecosystem. The 340B program supports covered entities as the safety net lifeline for America.
This safety net must survive. For 30 years, the 340B program has required drug manufacturers to sell products at a discount to qualifying clinics and Disproportionate Share (DSH) hospitals as a regulatory imperative to prioritize high-volume Medicare and Medicaid providers and ensure poor and rural America realizes more equitable healthcare.
As trusted pharmacists, we understand the despair of diagnosis and the burden of treatment; thus, the crucial role of medication access is tantamount to preserving quality of life. Without compromise, 340B enables clinicians to provide substantially discounted medication and services to individuals living with a panoply of chronic conditions, including but not limited to cancer, HIV/AIDS, diabetes, hepatitis, and mental illness. As pharmacists, we ensure that chronic disease treatment and services are administered with integrity, accuracy, and uncompromising care.
340B hospitals remain at the forefront of advancing health equity through targeted initiatives and services for underserved and historically marginalized communities. Community interventions that need our protection include Doula programs, lactation support, free health screenings, medication management, and disease education. However, these interventions are at risk if pharmaceutical manufacturers continue to augment their profits by undercutting the 340B program and restricting vital contract pharmacies (which consist of community retail and specialty pharmacies) as a vital avenue for 340B covered entities to access savings and serve patients needing care. The restrictions imposed by drug manufacturers have already removed roughly $8.4 billion from the healthcare safety net. This egregious conduct has a direct impact that may lead to additional reductions in patient support as manufacturers continue to eliminate pharmacy services.
Congressional efforts to dismantle the 340B program are primarily an issue of equity. Shrinking the 340B program has unintended consequences that would diminish the services hospitals can provide, and fewer services mean less care.
If we have learned anything from the pandemic years, it is that change to our existing safety net comes at a premium, and the cost ultimately is the price of human life. Regarding the 340B program, we must be cautious not to undo the tremendous good it has provided millions of people who cannot pay for life-saving treatment. We support patient care, survivorship, and protecting access to treatment and services for those in greatest need – America’s safety net.
Kenneth Schell, PharmD, RPh, CIPP, Director (Retired) Sharp Grossmont Hospital, Pharmacist in Chief (Retired) Rady Children’s Hospital, and Board Advisor, Association of Black Health-system Pharmacists; John Clark, PharmD, MS, Past President of the Association of Black Health-system Pharmacists and Associate Professor, Department of Pharmacotherapeutics & Clinical Research, University of South Florida; Anthony Jackson, PharmD, MBA, Board Advisor, Association of Black Health-system Pharmacists.