One in 10 Americans have diabetes in the United States, totaling to over 37.3 million people – a staggering statistic. For health care-related costs, patients living with diabetes spend over two times as much compared to non-diabetic patients, or around $9,600 a year. This is where the 340B drug pricing program comes to the rescue.
The 340B program does more than access to affordable medications. Savings from the 340B program allow diabetic patients less worry about choosing between health care services or paying for essentials, such as food or rent.
The 340B program has been around for over 30 years and connects safety net providers to discounted medications. It also allows health centers to invest340B savings in programs and services that improve patients’ health and well-being.
340B – More Than Just a Drug Pricing Program
Health centers are a one-stop shop that provides accessible, affordable care to patients managing diabetes. The 340B program offers steep discounts to patients who otherwise could not afford the retail price of insulin that range high as $175 to $300 a vial. Treating diabetes, however, is more than just insulin; it requires a holistic, patient-centered coordinated approach to encourage improved health outcomes.
Health center clinical pharmacists are counted on to provide education and aid with medication management for patients living with diabetes. Clinical pharmacists also serve a critical role on the care team, collaborating with other providers to develop care plans an routine patient follow-ups. Because clinical pharmacists are not billable providers under Medicare or Medicaid, 340B savings make such services possible and boost patient health literacy and care coordination.
Additionally, 340B savings are used to fund roles like registered dieticians and certified diabetes nurse educators who provide support to patients living with diabetes. Health centers offer resources that can teach patients:
- Blood glucose monitoring
- Foot, skin, and dental care
- Stress management
- Exercise benefits and precautions
- Preventing, detecting, and treating diabetes complications
- Nutrition classes
The combination of these patient services lead to improved patient health and reduce long-term costs on the overall health care system. It’s also why health centers patients achieve better diabetes control compared to the national average. For all its benefits, the 340B program represents a tiny fraction of drug costs and help patients stay out of the emergency room and decrease readmissions.
Restrictions Threaten 340B’s Continuity
Over the course of the past few years, health center 340B savings have been unjustly and systematically taken away through contract pharmacy restrictions. The loss of 340B savings has hurt patients’ access to affordable medications that help manage their diabetes. Patients who were once connected to insulin through a sliding fee discount program at their local pharmacy now must either pay more for insulin or travel to a less convenient pharmacy or lose access all together. Health centers cannot afford to purchase insulin and other drugs without access to the 340B discounted price. Another compounding factor is that nearly 50% of health centers cannot afford to open their own in-house pharmacies. Contract pharmacies may the only way a health center patient can gain access to 340B priced medications. Restrictions to affordable insulin can trigger co-morbidities, increased emergency room visits, and higher health care costs. These restrictions to affordable insulin could lead to more co-morbidities, increased emergency room visits, and increased health care costs overall for patients. These restrictions to affordable insulin could lead to more co-morbidities, increased emergency room visits, and increased health care costs overall for patients. Contract pharmacy restrictions, along with Pharmacy Benefit Managers’ (PBM) discriminatory contracting practices, hurt patients’ health and well-being, as well as the health centers who serve them. Unlawful PBM practices such as decreasing reimbursement for 340B drugs and charging higher dispensing fees have taken away 340B savings from health centers for years, further exacerbating this dire situation.
It’s Time for Congress to Act
As Congress debates a legislative solution to cap the price of insulin for privately insured patients, 340B is the only program that provides affordable medications, like more affordable insulin, for uninsured and underinsured patients.
NACHC and health center leaders are pressing Congress to act NOW and pass legislation that strengthens and protects the 340B program. As time passes, more and more 340B savings are lost because of manufacturer restrictions, threatening patients’ access to affordable medications like insulin. Protecting the 340B program means protecting the patients and the safety net providers that rely on the program.