December 23, 2011—An organization of over 800 non-profit and public hospitals that participate in the 340B program has written to drug manufacturer Sanofi-Aventis to express concern over the discontinuation of its institutional patient assistance program as well as the termination of its free drug program for the anti-coagulant Lovenox.
In the letter, Safety Net Hospitals for Pharmaceutical Access (SNHPA) argues that Sanofi’s decision could have a “devastating effect” on public and non-profit hospitals and their many patients who rely on the availability of the company’s medications for their survival. Without easy access to these many lifesaving drugs, some patients have found themselves with no other viable alternative, SNHPA said.
SNHPA’s letter to Sanofi comes on the heels of another sent out on Nov. 22 by the National Association of Free Clinics (NAFC), a group representing free and charitable health clinics across the country. In it, the organization asked that Sanofi consider reinstituting limited bulk replenishment of certain drugs, such as Lantus and Apidra, in addition to allowing for more time to transition patients to the traditional PAP which requires patients to complete forms individually. Sanofi responded to NAFC’s request in a Dec. 6 call with the organization by stating that at this point and time they had no plans to alter their current strategy.
As reported in a recent Monitor article on the drug company’s decision, hospitals and clinics are concerned that Sanofi’s move to discontinue institutional and traditional PAP coverage for drugs such as Lovenox will require them to shoulder the full cost in order to continue providing these medications to their patients. This major change for hospitals comes at a time when most have already finalized their budgets for the upcoming fiscal year. As a result, many health facilities could now potentially face, as in the words of some pharmacy managers, budgetary shortfalls of $100,000 or more, forcing them to have to juggle the adoption of clinically acceptable alternatives while still maintaining the highest quality patient care.
Sanofi has pointed out that their products that have no generic versions “are still covered under the (traditional) PAP, which continues and covers more than 30 medicines.” Moreover, Lovenox, the most high profile drug affected by the program discontinuation, is currently available at a 340B price, but according to one outpatient pharmacy manager at a large metropolitan health system, “doesn’t have much competition in the market so it’s pretty expensive even at that price.”
Sanofi’s decision to also do away entirely with its institutional patient assistance program (IPAP) has raised additional concerns throughout the health care community. According to SNHPA, ‘termination of the institutional program will also create a significant increase in demand for the individual program, which hospitals are not equipped to meet.” Some pharmacy managers are worried that Sanofi’s timetable for its changes won’t leave them with enough time to complete the paperwork necessary to transfer patients to the traditional PAP. In addition, SNHPA argues that the individual model is less efficient than the institutional model, forcing patients to overcome multiple bureaucratic hurdles before they can receive their medication.
In its letter, SHNPA stated that it was willing to work with Sanofi to develop a viable solution for both its members and the drug manufacturer.