The 340B Drug Pricing Program is a federal initiative designed to assist sure healthcare suppliers, generally known as “lined entities,” stretch their assets to higher serve weak and underserved affected person populations. Created in 1992, this system requires pharmaceutical producers to promote outpatient medicine at considerably discounted costs (sometimes 25% to 50% off) to eligible hospitals, clinics, and well being facilities that look after numerous uninsured and low-income sufferers. These lined entities can then use the financial savings from these discounted drug purchases to supply extra complete providers, attain extra eligible sufferers, and provide further packages that improve affected person care and entry of their communities. Proponents of the 340B program declare that it improves entry to look after underserved populations with out utilizing taxpayer cash (since all funding comes from obligatory reductions from drug producers).
Whereas the 340B program was focused to lined entities treating underserved populations, in recent times the scale of this system has grown. In line with a report by Masia (2024), the variety of hospitals collaborating in 340B has elevated by 31% within the final decade. Whereas this will look like a big quantity, every grantee now’s extra more likely to increase their attain by working plenty of sub-sites or sub-grantees. Utilizing this definition, hospital websites elevated by 126% (grantee website elevated by 61%) over the past decade. There at the moment are almost 200,000 340B contract pharmacies within the US.
Masia then examines the impression of 340B on Medicaid value:
Our regression estimates counsel that the rise in 340B hospital and grantee participation from 2014 to 2021 elevated total Medicaid spending by $391 per enrollee, or over $32 billion per yr. This implies that 340B-driven spending might account for roughly 10% of total Medicaid spending, considerably growing the price of this system to taxpayers.
Why would 340B enhance value? The creator posits that 340B-driven market consolidation, website of care selection, selection of remedy might all be impacting the outcomes. As an illustration, 340B hospitals might choose to prescribe branded as in comparison with generic drugs underneath 340B for the reason that revenue they make off branded medicine is far bigger. Whereas 340B lined entities get reductions for these medicine, payers reimburse the lined entities at full value.
You possibly can learn Neal Masia’s full paper right here.