Across the country, disparities wreak havoc on the health of minorities and underserved populations. Americans shouldn’t have to worry about prescription drug costs. Yet, patients nationwide who require medication to manage a complex disease or health condition are being left behind as hospitals and pharmacies reap the benefits of a federal drug program undermined by abuse.
To ensure prescription access and combat health disparities, federal lawmakers must focus on curbing abuse within the 340B Drug Pricing Program.
Congress created the 340B program 30 years ago to expand access to prescription drugs for uninsured and low-income communities. The program requires drug manufacturers to provide medications at discounted prices to eligible hospitals and covered entities within the program. Those same hospitals and clinics are then supposed to pass discounts on to vulnerable patients to help them access their medications.
While the concept of the longstanding drug program seems simple enough to improve treatment access and aid communities that have been harmed by access barriers and social determinants for decades, the story of how 340B has played out is complex, concerning and tragic for patients. Thirty years since its enactment, the 340B program still has no guardrails to ensure oversight of program activities and transparency of how hospitals and other covered entities within the program manage drug discounts.
Hospitals have zero obligation to use the savings from discounted 340B drugs to contribute to charity care or even report what they spend those savings on. Moreover, mounting evidence suggests 340B is wrought with abuse and stakeholders who have sought to increase profits from a program meant to serve the most vulnerable among us. A 2022 report found that more than 70 percent of private non-profit hospitals in the 340B program had a “fair share deficit,” meaning they spent less on charity care and community investment than they received in tax breaks. A 2021 study found that some hospitals within 340B charge uninsured patients nearly four times more for medications than the hospital paid.
A Johns Hopkins analysis found that three hospitals in Georgia charge patients five times the amount for care compared to how much it costs the hospital to provide the care. Exploiting a federal program and a system that lacks accountability ultimately harms patients who may have nowhere else to turn to for help.
Federal lawmakers should step forward and examine the necessary actions to preserve the intent of the 340B program and ensure the federal safety net is working as it was intended to benefit vulnerable and uninsured patients.
In the absence of federal action, marginalized patients will continue to be the victims of a program wrought with abuse. All Americans deserve better and affordable access to the prescription drugs and care they need.