Hospitals groups have issued strong rebuttals of a new study in the journal Health Affairs that its authors say supports criticism by the drug industry and others that disproportionate share hospitals increasingly use 340B savings to help themselves at the expense of the poor.
In a reply article published in Health Affairs, Safety Net Hospitals for Pharmaceutical Access says the study “neglects an essential point: compared to non-340B DSH hospitals, 340B DSH hospitals provide over twice as much care to Medicaid and low-income Medicare patients, and almost twice as much uncompensated care.”
“340B DSH hospitals across the board provide high levels of uncompensated care,” SNHPA’s response continues. “For these and other reasons … the article does not support the criticism that 340B DSH hospitals are no longer serving vulnerable patients.”
The American Hospital Association also took strong issue with the study. In its AHAStat blog, the group said the report “does a real disservice to this important program that has a proven track record in helping patients get the medicines they need.”
The study in Health Affairs, by Rena Conti of the University of Chicago and Peter Bach of Memorial Sloan Kettering Cancer Center, is entitled “The 340B Drug Discount Program: Hospitals Generate Profits by Expanding to Reach More Affluent Communities.” In a May 2013 opinion article in JAMA, Conti and Bach said some hospitals were earning “windfall” profits on cancer drugs purchased through 340B ” that might not be directly benefiting the poor.” Conti was a featured speaker at the drug industry-led group AIR 340B’s “national summit” on the drug discount program this past June.
Also in June, Health Affairs published a different study that helped to explain why 340B will continue to be needed after the Affordable Care Act is fully implemented. It found that, despite health care reform, safety-net hospitals’ uncompensated care costs and Medicaid shortfalls will keep climbing in California and the states that do not expand Medicaid.