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Community Health Center leaders are pushing back at recent moves by drug manufacturers to dismantle the federal 340B drug discount program, an effort that will force vulnerable people further into poverty, disease, and put countless lives at stake. Health centers care for nearly 30 million patients nationwide and have provided life-saving medicines and services to low-income patients through the federal 340B program established by Congress in the 1990s. At a press briefing today hosted by NACHC, health center leaders from around the country described how a recent series of actions by drug companies will threaten patient access to discounted prescription drugs and will divert savings away from patient care and into corporate pockets, ultimately tying the hands of health center doctors and other care providers in the midst of the COVID 19 pandemic. View press conference video.
Gina Moore, a patient with diabetes at PrimaryOne Health in Columbus, OH, is among the millions of patients who will be affected by drug manufacturers no longer shipping certain 340B prescriptions to Contract Pharmacies. She described how the highly concentrated insulin she relies on to stay alive will no longer be available on October 1st unless the health center complies with a specific drug manufacturer’s onerous and impossible data reporting requirements. Given her income circumstances, Moore is eligible for PrimaryOne Health’s prescription assistance program, which uses 340B savings to discount the costs of her prescriptions. With the help from PrimaryOne Health, Moore’s cost is substantially less than the drug manufacturer’s 340B discount. Moore is able to pick up a 90-day supply of her insulin for less than $15 at a 340B Contract Pharmacy for a drug that would cost more than $1,000 elsewhere—a price beyond what Moore, or any average consumer, can afford. “I am a Type 1 insulin-dependent diabetic and my pancreas does not work,” said Moore. “I need insulin every day and without it my kidneys will shut down. I will die.”
Panelist Sue Veer, President and CEO of Carolina Health Centers in South Carolina, outlined the actions that are drawing widespread concern:
“First, there are manufacturers that have made the unilateral decision to refuse to provide the statutorily required 340B pricing to eligible covered entities like health centers if those health centers are providing access to affordable medication through contract pharmacy arrangements – despite the fact that the contract pharmacy model has proven over the last 10 years to increase access to affordable medication and save lives,” said Veer. She also cited efforts among a group of manufacturers that are forcing health centers to turn over data that will be used to deprive them of critically needed 340B savings and converting the discount pricing for safety net providers – established by Congress – to a model where rebates will have to be requested and approved by the manufacturer’s 3rd party agent.
“I characterized these developments as a critical threat to the health and well-being of the people we serve because access to affordable prescription medication is one of the key drivers of improved health outcomes,” said Veer.
Kimberly Chen, Director of Pharmacy at North Country HealthCare in Flagstaff, AZ, described the importance of contract pharmacies in ensuring access to medications, noting that “requiring a patient who is receiving care at our homeless shelter or mobile medical unit to travel 10 miles to our in-house pharmacy when there is a contact pharmacy on the nearest corner does not align or meet the mission of health centers.”
NACHC Board Chair Lathran Woodard cited the growing concern from Capitol Hill about pharmaceutical companies’ actions. “We are deeply appreciative of the leadership shown on Capitol Hill among bipartisan Members of Congress in support of the 340B program and ongoing access to affordable prescription drugs for our patients. In particular, I wish to thank Representatives Cindy Axne (D-IA) whose letter to Health and Human Services Secretary Azar has generated more than 100 cosigners. We also thank Representatives David McKinley (R-WVA) and Diana DeGette (D-CO) for their letter of support to HHS on behalf of safety-net providers that use 340B savings to ensure access to care for low-income and rural patients.”
Protecting the 340B drug discount program, and the benefits it provides for low-income and medically vulnerable patients has emerged as a top priority for NACHC and its membership. The organization is preparing to take legal action should efforts to harm the program continue and is communicating with supporters in Congress to protect the program which gives health centers access to medication discounts that they could not negotiate on their own.
Established in 1971, the National Association of Community Health Centers (NACHC) serves as the national voice for America’s Health Centers and as an advocate for health care access for the medically underserved and uninsured.