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The federal 340B Drug Pricing Program, which requires pharmaceutical manufacturers participating in Medicaid to sell outpatient drugs at discounted prices to healthcare organizations that care for many uninsured and low-income patients, is facing intense scrutiny and calls for reform. The program’s intent has always been to stretch limited federal resources to reduce the price of outpatient pharmaceuticals and expand health services to our most vulnerable communities. In too many cases, that’s just not what’s happening, and in recent weeks, the media has been shining a spotlight on some of the most cynical deployment of these funds towards profits over patients.
I am the co-founder of a healthcare company that focuses on ensuring quality healthcare access for our most vulnerable populations. As such, we are proud 340B participants, and we applaud this heightened focus on transparency for the program. However, I am concerned that companies deploying 340B in the spirit intended will be victims of “tossing the baby with the bath water” in the event that 340B becomes severely restricted (or even abolished) by the policymakers currently evaluating its future.
In this spirit, I’ve outlined three absolute principles that I believe all 340B participants should adhere to:
Your healthcare services are targeting our most underserved communities. Let’s always remember the patients who the intended beneficiaries of 340B treat: low-income, uninsured or underinsured individuals, and those residing in “healthcare deserts” (communities with a paucity of healthcare providers, typically in rural settings). The program also focuses on providers that are utilized by people with serious conditions (cancer, HIV/AIDS, Hepatitis C) and/or chronic conditions (diabetes, heart disease, COPD) – those whose lives depend on access to specialty medications and specialty-focused care. 340B program benefits should be focused on improving care for those who often have nowhere else to turn.
A majority of the 340B funds are redistributed back into the underserved community with the intent of improving population health. Our company leadership’s roots stem from the very communities we are serving, and we are vigilant about reinvesting 340B savings back into our vulnerable communities. Some examples include mobile clinics and telehealth services offering preventative primary care; free testing for HIV and Hepatitis C; and mental health services. We strive to create a foundational cycle for our underserved brethren, whereby we provide the initial 340B-funded testing and services to those patients in need and then reinvest the remaining funds into programs that prevent others from reaching the stage of serious or chronic disease.
The overall cost of providing your healthcare services totals ZERO to the federal government. You ensure that patients can access care while saving taxpayers money. When administered correctly, a 340B program becomes self-sustainable, as detailed above, and is no longer dependent on taxpayer support. We work to ensure that our patients can afford the care they need through low-cost and no-cost services. The discounts that drive the program cost taxpayers nothing. The result is quality, often free, healthcare that benefits everyone. In fact, we use the program to reduce future taxpayer burdens by improving the overall health of our sickest communities.
Healthcare policy makers should be evaluating 340B participants and use cases by the criteria above. If a healthcare service provider can answer “Yes” across the board, their eligibility should remain intact. If a provider is falling short, we welcome acts of reform.
Photo: gerenme, Getty Images
Clifford W. Knights is Co-Founder and CEO of HealthyMD, a community-focused healthcare services company whose mission is to end the HIV and Hepatitis C epidemics in underserved communities, improve overall health outcomes, and save the U.S. health system potentially trillions of dollars in the process.This post appears through the MedCity Influencers program. Anyone can publish their perspective on business and innovation in healthcare on MedCity News through MedCity Influencers. Click here to find out how.