September 10, 2014— Officials from four hospitals traveled to Capitol Hill today to make the case for preserving what they say is the 340B program’s historic mission of reducing safety-net providers drug costs so they can serve more patients and provide more comprehensive services. They spoke at a briefing for congressional staff members organized by the American Hospital Association.[ms-protect-content id=”2799″]
If the 340B program were scaled back, St. Thomas Midtown Hospital in Nashville, Tenn., says it would have to scuttle plans to open a free pharmaceutical dispensary for the poor and uninsured.
The Johns Hopkins Hospital says it would have to cease medication assistance, hospital-to-home transitional care, and other services for low-income patients in east Baltimore, Md.
Providence Hood River Memorial Hospital, a 25-bed rural facility east of Portland, Ore., says it would have to stop offering free or reduced-cost drugs and comprehensive pharmacy services to patients with cancer.
And the University of Utah Hospital and Clinics says any reduction in 340B savings would compromise its ability to keep providing highly specialized services for a vast region that includes Idaho, Wyoming, Montana, western Colorado, and much of Nevada.
According to David Neu, director of pharmacy for the St. Thomas Health system in Tennessee, 340B savings have allowed St. Thomas Hickman Hospital in Centerville, Tenn., to provide outpatient behavioral health services, including drugs at low or no cost through a local contract pharmacy. “Being one of the poorest counties with one of the highest suicide rates, that’s extremely helpful,” he noted.
St. Thomas Midtown in Nashville, meanwhile, uses 340B saving to help decrease medication costs for uninsured and uninsured patients. Examples include a patient with colon cancer who cannot afford her 20 percent prescription drug co-pay and another whose insurance stopped paying for his treatment with Remicade because it was being used off-label, Neu said
Daniel Ashby, senior director of pharmacy for The Johns Hopkins Hospital, said if Hopkins’ 340B savings are cut back or eliminated, a program that provides uninsured patients short-term access to prescription drugs while helping them obtain sustained drug coverage would be one of the first things to go.
“We started with psychiatry, a really under-served patient population, to keep that patient out of the hospital – to keep them functioning, keep them working,” he said. “It was the right thing to do, but we we realized going in that this was going to cost millions of dollars to keep going.”
“This program brings significant value to the patients in the Hopkins community,” Ashby continued. “If it didn’t exist, if it was cut back, it would create significant problems for Hopkins and the people who live in the east Baltimore area.”
According to Ed Freisinger, CEO of Providence Hood River Memorial Hospital in Hood River, Ore., “Access to care is part of fulfilling our mission. 340B is helping us increase access to care in our community.”
He said 340B savings helped the hospital create a medication assistance program for the uninsured, including patients with cancer who were referred to the hospital by oncologists. 340B savings also enabled the hospital to place a clinical oncologist in its oncology program to help patients understand “what medications they are taking, what their effects might be, what to do if they see certain side effects,” he added.
David Entwistle, CEO of the University of Utah Hospitals and Clinics, says his health system’s four hospitals are trying to cope with reimbursement cuts and reductions in federal assistance. “Psychiatric care is a real challenge,” he said. “We have invested heavily in this program despite the fact that … every psychiatric patient who comes through the door we lose money on. But we know if we don’t provide the resource, it won’t be available in our community.”
340B savings, Entwistle said, “allows us to keep the programs open and really provide the resources back to the community.”[/ms-protect-content]