The Honorable Alex Azar, Secretary
\nU.S. Department of Health & Human Services
\n200 Independence Avenue, SW
\nWashington, D.C. 20201<\/p>\n
Dear Secretary Azar,<\/p>\n
The 340B Drug Pricing Program was created in 1992 to help qualifying hospitals and safety net clinics get access to discounted prescription medicines for uninsured or vulnerable patients. While this program was created to be a small component of the nation\u2019s safety net, the lack of adequate oversight has led to exponential growth in the 26 years since its enactment, leading to increased spending across the health care system and allowing many participating hospitals to prioritize profits over patients. We are writing to you today to applaud actions the Department of Health and Human Services (HHS) has already taken on the 340B program and request that HHS continue using its authority to fix the 340B program so patients, not hospitals, are the ones benefitting.<\/p>\n
The undersigned organizations represent thousands of patients, providers, community advocates and taxpayers who are committed to fixing the 340B program. We recognize the important role the program plays for true safety net facilities such as federally qualified health centers, Ryan White HIV\/AIDS clinics, black lung clinics, and other federal grantees and are dedicated to ensuring the program reaches the vulnerable or uninsured patients it was intended to help. Our organizations believe in fixing 340B so patients and true safety net facilities are the ones benefitting.<\/p>\n
The 340B program has seen outsized growth in recent years, far surpassing the scope and size of the program as it was originally envisioned by Congress. It has grown from $6.9 billion in sales at the 340B price in 2012 to $19.3 billion in 2017, a nearly 200 percent increase in just 5 years.i From 2013 to 2017, the number of hospital entities participating in the program tripled.ii In 2017, 340B represented nearly 8 percent of branded outpatient drug sales.iii This growth has not been accompanied by evidence that patients are more likely to benefit from the 340B discounts. In fact, the program\u2019s growth is not associated with 340B hospitals providing additional safety-net services.<\/p>\n
This explosive growth is set against a backdrop of historically weak oversight and lax program rules, which have allowed hospitals and middlemen to profit without any requirement that they help low-income patients. In contrast, grantees are required to redirect revenue from programs like 340B back to their grant services to the patients they serve. These lax standards for 340B DSH hospitals, which represent 80 percent of program sales,v are not only diverting money away from vulnerable patients, but are allowing the 340B program to drive up health care costs and cut off convenient options for care.<\/p>\n
Economists writing in the Journal of the American Medical Association found the 340B program may cause a \u201cshift toward more expensive drugs because profit margins will in general be larger,\u201dvi due to the \u201cspread\u201d hospitals can make on the program. Additionally, the Community Oncology Alliancevii has shown that to generate more profit through increased 340B prescriptions, 340B hospitals are acquiring independent community practices at an alarming rate and consolidating care into the costlier hospital setting \u2013 where treatment is 60 percent more expensive than in a community clinic.viii This trend results in patients being forced to pay more in a hospital setting and having to incur higher cost sharing.<\/p>\n
By utilizing the authority the administration already has to provide the needed oversight that the HHS Office of the Inspector General and Government Accountability Office agree the program needs, this administration has a chance to protect patients from rising drug prices and an ineffective bureaucracy.<\/p>\n
The 340B program must be fixed to ensure that it is helping and not hurting patients within DSH hospital settings and is protecting community providers. The administration has taken an important first step towards lowering Americans\u2019 drug prices through the 340B policies outlined in the \u201cAmerican Patients First\u201d blueprint. We urge the administration to take action and consider reforms to the 340B program as part of their plan. Economists have specifically recommended that \u201clawmakers could lower the price of prescription drugs by reforming the federal 340B Drug Pricing Program.\u201d<\/p>\n
Our organizations are dedicated to fixing the 340B program so it can benefit the patients it was created to serve. We hope HHS will harness its current authorities to provide increased oversight of the 340B program via guidance or other means, and clarify the program\u2019s vague rules so that it operates in the best interests of patients, not hospital profits.<\/p>\n
We are happy to answer any follow-up questions from your office and would be more than willing to meet to discuss this important issue.<\/p>\n
Sincerely,<\/p>\n
AIDS Response Seacoast
\nAlzheimer’s Texas
\nAmericans for Tax Reform
\nArizona Bioindustry Association, Inc.
\nArthritis Associates PLLC
\nAsthma and Allergy Foundation of America – New England Chapter
\nBiocom
\nBioForward WI
\nBioNJ
\nBioscience Association of North Dakota
\nCalifornia Association of Area Agencies on Aging
\nCalifornia Health Collaborative
\nCalifornia Hepatitis C Task Force
\nCancerCare
\nCitizens Against Government Waste
\nColorado BioScience Association
\nColorectal Cancer Alliance
\nCutaneous Lymphoma Foundation
\nGlut1 Deficiency Foundation
\nHERO House
\nIllinois Biotechnology Innovation Organization
\nINDUNIV Research Center, Inc\/Bio Alliance PR
\nInternational Association of Hepatitis Task Forces
\nInternational Cancer Advocacy Network
\nInternational Foundation for Autoimmune & Autoinflammatory Arthritis
\nIowa Biotechnology Association
\nKentucky Life Sciences Council
\nLog Cabin Republicans
\nLupus and Allied Diseases Association
\nLupus Foundation New England
\nLupus Foundation of America
\nMedical Oncology Association of Southern California, Inc.
\nMental Health Association of Middle Tennessee
\nMichBio
\nMontana BioScience Alliance
\nNational Grange
\nNational Infusion Center Association
\nNational Taxpayers Union
\nNew Mexico Biotechnology & Biomedical Association
\nNorthwest Parkinson\u2019s Foundation
\nOne in Four Chronic Health
\nPrescription Drug Assistance Network
\nRetireSafe
\nRheumatoid Arthritis Support Group of Central Oregon
\nRheumatology Nurses Society
\nSC Manufacturers Alliance
\nSCBIO
\nScleroderma Foundation Washington Evergreen Chapter
\nSherie Hildreth Ovarian Cancer Foundation
\nSouth Carolina Cancer Alliance
\nSoutheast Alabama Sickle Cell Association, Inc.
\nTexas Healthcare and Bioscience Institute
\nThe ALS Association Evergreen Chapter
\nTransplant Recipients International Organization of the Pacific Northwest
\nValley AIDS Information Network
\nWashington State Alliance for Retired Americans
\nWashington State Oral Health Coalition
\nWyoming Epilepsy Association<\/p>\n","protected":false},"excerpt":{"rendered":"