The Joplin Globe: Time to reform drug discount program

By Connie Farrow, Patients Come First Missouri Executive Director

We all lose when our most vulnerable citizens cannot access the medicines and care they need to be healthy. It spills over into the economy, affecting workforce productivity, financial stability and the ability of families to thrive.

The 340B Drug Pricing Program was designed to help underserved individuals when they are sick by providing steep discounts on outpatient prescription medications to qualifying health care entities that are supposed to pass the savings to patients.

Unfortunately, the current 340B model creates obstacles that limit access, enable dishonest practices and allow providers to exploit the system by withholding discounted medications from patients while pocketing the price difference. This is contrary to the program’s intended purpose and leaves some of our most vulnerable patients unable to afford their medications.

The Health Resources and Services Administration has introduced a voluntary 340B Rebate Model Pilot Program. It allows drug manufacturers selling certain Medicare-negotiated drugs to provide rebates instead of upfront discounts as long as the hospital verifies the discounted medicines actually reach the patient. The pilot is expected to begin in January.

While the pilot is limited to select drugs, it is welcome news to patients, consumers and advocates who have long called for transparency and accountability mechanisms within the pharmacy supply chain to prevent bad actors from pocketing drug rebates. A recent national survey by Patients Come First shows 83% of Americans support reforming the program to ensure that savings directly benefit patients.

If the rebate system functioned as it should, and as expected, patients would notice a reduced price for their medications when paying at the pharmacy. It’s why Patients Come First underscored the strong step forward these reforms represent in its comment to HRSA on the 340B pilot rebate program.

The proposed initiative emphasizes oversight and genuine cost savings through more data collection mechanisms. We view this as a positive step toward improving transparency and integrity within the hospital system. However, more work is needed. This includes requiring eligible health care entities to verify that eligible patients actually receive the lower-cost drug before qualifying for a rebate.

This could be life changing for thousands of Missourians, especially considering one in five Missourians have been without health insurance at some point in the last year. Even when patients can find care, affordability remains a significant hurdle, according to Missouri Foundation for Health. The high cost of insurance premiums, deductibles and copays often puts care out of reach and stresses household budgets.

Read the full op-ed in the Joplin Globe here.