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Superb Critique of a Flawed 340B Study and its Unfounded Conclusions


 

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Madeline Carpinelli Wallack’s response to the recent study in Health Affairs on hospitals’ alleged misuse of 340B drug discounts scores a direct hit on a highly flawed piece of research.

We wrote about SNHPA’s and AHA’s reactions to the Health Affairs study earlier this month. Researchers Rena Conti and Peter Bach said they found that “that hospital-affiliated clinics that registered for the 340B program in 2004 or later served communities that were wealthier and had higher rates of health insurance compared to communities served by hospitals and clinics that registered for the program before 2004.”

“Our findings support the criticism that the 340B program is being converted from one that serves vulnerable patient populations to one that enriches hospitals and their affiliated clinics,” they concluded.

After reading the study, Carpinelli Wallack wrote, “I had two questions: First, how are the authors substantiating their conclusions? Second, what kind of sensational sound bites are going to come from this?”

“Simply put, the authors’ conclusions are not substantiated by the data collected,” Carpinelli Wallack said. “Conti and Bach say that they ‘found’ that hospitals ‘served communities that were wealthier and had higher rates of insurance’ and ‘generated profits.’ They did not find this.”

“At most, the researchers’ data supports the fact that there is a statistically significant difference in the socioeconomic status between the areas where the hospital is located and the areas where its affiliated clinics are located,” she continued. “This is a far cry from the headlines concluding that hospitals are ‘enriching’ themselves off a program intended to help the poor.”

Carpinelli Wallack said she was saddened that the study’s “misleading conclusions will only serve to support 340B critics’ mischaracterization of program intent.”

“Responsibility in research is important if we are to have accurate and fair discussions about policy issues like the 340B program,” she said. “The 340B program is complex and absolutely needs more structure and oversight, but it does not need misleading and loaded rhetoric like ‘enriching and profiting.’ That type of terminology might be common in the current attack of the program by the drug industry but I would expect a more nuanced viewpoint from a scholarly piece such as this.”

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