Brian Nyquist
Updated: April 18, 2022
Viewpoint
Viewpoint: Cost-saving drug program needs transparency
By Brian Nyquist
Massachusetts’s policymakers have a history of fighting to end discrimination in health care and empower patients across our state to access the medicines and care they need.
As elected officials continue these efforts, they should look no further than the second-most costly drug pricing program in America behind only Medicare Part D. Outdated, unregulated, and growing exponentially, the 340B Drug Pricing Program has steered off its original path to help vulnerable patients access their care in Massachusetts and around the country. It’s time Massachusetts Attorney General Maura Healey and other elected leaders take notice and bring transparency and accountability.
Congress created the 340B Drug Pricing Program in the 1990s to help stretch limited resources to allow Medicaid and uninsured patients to access life-saving health care. Hospitals and clinics qualify for 340B by serving a predetermined percentage of those patients. Those qualifying hospitals and clinics can purchase their prescription drugs at significantly discounted prices from drug manufacturers. These savings are meant to offer a critical safety net to help Massachusetts patients access their care.
But for the 1.5 million Massachusettsans who depend on the 340B program to help cover the cost of their care, the question remains: is 340B actually providing affordable access to necessary treatments, or is it allowing those eligible hospitals to pocket those drug discounts? The data reveals this safety net is failing patients in Massachusetts.
Today, no serious legal or regulatory oversight exists to require hospitals and clinics to pass savings on to patients or report transparently on those efforts. This gap has allowed what some have referred to as bad actor hospitals, clinics, pharmacy benefit managers, and health insurers to take advantage of the program. In fact, evidence shows 340B hospitals in states including Massachusetts provide significantly lower levels of charity care compared to the average hospital (1.04% as compared to 2.03%). The same report found 340B hospitals were almost twice as profitable as the average hospital.
Mass. regulators and lawmakers should bring greater oversight and transparency to 340B and modernize this outdated program. Massachusetts representatives like Congressman Jim McGovern (D-Worcester) have already proven themselves to be champions for protecting and expanding patient access to affordable care and addressing 340B loopholes is a crucial aspect of that effort. The work to improve 340B begins with pulling back the curtain on how exactly participating hospitals in Massachusetts are passing their 340B savings to their patients. Absent any transparency or reporting requirements, the 340B program will continue to put profit over people.
Brian Nyquist is the executive director of Texas nonprofit Infusion Access Foundation, which provides support to patients at 65 infusion centers throughout Massachusetts.
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