340B: Where Are We Now After a Hectic Week?

This week has been jam-packed full of 340B activity, but there still doesn’t seem to be a consensus on the program going forward. On Monday, the head of the Health and Human Services Department, Alex Azar, gave his two cents about the program—which largely focused on the need for transparency and oversight over the program.

At a Pew Charitable Trusts event Tuesday, a Texas correctional health specialist spoke about the money his state is saving by using 340B to buy drugs for prisoners. He says Texas saved $90 million last year alone through the program.

By Wednesday, politicians were all warmed-up for a House Energy and Commerce Health subcommittee hearing about the program and how it can be improved. Not only was this the longest 340B hearing I’ve been to, but it was also the most hectic.

Topics of discussion bounced from who should be eligible for the program, what reporting requirements are necessary, the relationships between contracted pharmacies and 340B hospitals, whether hospitals are inappropriately pocketing the savings, and much more. Rep. Buddy Carter (R-Ga.) even brought up a memo stating Botox had been discounted for a movie star in Hollywood.

Sprinkled in between criticism was Democratic pleas to not ax huge shares of the programs’ patient population.

Here are some of the major issues we’re still facing:

Patient definitions: Right now the definition for who falls under the program is nebulous.

Reporting requirements: Hospitals aren’t currently required to report how they’re using the savings from the drug discounts.

Audits: Democrats frequently bring up that it’s mostly hospitals that have gotten audited rather than drug manufacturers. It’s also not clear exactly what an audit of a drug manufacturer entails, one Government Accountability Office representative said at the July 11 hearing.

Contract pharmacies: the amount of pharmacies that partner with 340B hospitals has grown quickly since 2010. That means more patients are getting discounts, but also means there’s more potential to abuse the system.

What’s certain is this isn’t the last time we’ll be hearing debates about the program.

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