by Maureen Testoni
February 24, 2020– For the 340B drug pricing program, 2020 doesn’t just mark the end of a decade in which the program experienced significant change. It also launches a new decade of great opportunity for using 340B to meet the needs of patients with low incomes and those who are living in rural areas.
The promise of the next 10 years was on the minds of many of the nearly 2,000 attendees at the recent 340B Coalition Winter Conference in San Diego. Professionals from hospitals, health centers, and a variety of clinics convened to expand their knowledge and skills, take stock of how far the program has come, and recommit to working together toward its healthy future. In my opening address to attendees, I took a moment to reflect on how heeding the lessons of the past decade has made 340B a more vital element of the nation’s health care safety net.
The important, bold, and exciting directions in which we all hope to take the 340B program in the future were evident throughout the nine brand-new sessions that the Coalition offered this year. The sessions acknowledged how 2020 will be a big year for the drug pricing debate, with the upcoming elections, pending federal legislation, and rural health challenges looming particularly large. But they also looked well beyond this year and into a future in which we expect 340B covered entities to be instrumental in helping address health care access and affordability challenges throughout the system.
Tackling Big Problems
A pair of new sessions highlighted the fact that the 340B program is expected to play an outsized role in an ambitious national initiative to end the HIV/AIDS epidemic in the U.S. by the end of this decade.
Pre-exposure prophylaxis (PrEP) is a daily regimen of anti-viral medication to reduce the risk of acquiring HIV. President Trump has set a goal of effectively ending the U.S. HIV epidemic by 2030 by reducing transmission by 90 percent, in large part through expanding PrEP access to many more patients who need it.
One new conference session focused on how 340B savings enable hospitals, health centers, and clinics to expand use of this therapy. Speakers discussed ways to utilize 340B savings to provide these drugs at low or no cost to patients and to provide the wrap-around services associated with treatment, including HIV testing and physician check-ups.
Another session explored how Ryan White Centers are a key source of care for people already living with HIV and AIDS, especially those with low incomes. 340B discounts bring down the very high cost of many HIV drug treatments, allowing the centers to care for those in need and provide crucial wrap-around services.Clinicrepresentatives described best practices and lessons learned from internal and external 340B audits.
340B and the safety-net providers who use the program are capable of truly remarkable things, and I look forward to seeing this be one of the program’s next major success stories.
Engaging on New Fronts
As the need for 340B grows and changes, so too must our efforts to stand up in support of the program.
State-level legislative and regulatory activity on 340B has been growing in recent months and shows no signs of slowing. A pair of new conference sessions focused on this shift in the debate as well as the possible benefits and pitfalls for 340B providers.
In one, experts discussed trends in multiple states that include movements to prohibit discriminatory reimbursement for 340B drugs, require 340B hospital reporting, adjust Medicaid payment policies that intersect with 340B, and establish state drug importation programs that have potential 340B impacts. Speakers also addressed how they were able to advocate successfully for more pro-340B policies with state policymakers.
The debate over proposed 340B-related policy changes in California also was the focus of a special session. California 340B providers gathered to learn about the status of the state’s Medicaid (Medi-Cal) pharmacy benefit transfers, the implications for covered entities, and advocacy efforts to mitigate its impact on safety-net patients.
340B debates on new fronts have increased the need for new types of 340B champions, including the executives who take the lead on establishing a health system’s patient mission and connecting it to the drug pricing program. A new conference track brought together such executives to discuss how they might learn from each other’s examples.
In one such session, I moderated a very insightful discussion involving two hospital CEOs and the chief financial officer of a federally qualified health center. They addressed how their organizations have developed their 340B programs, how they have used their 340B benefits to serve patients better, and how they have learned the importance of C-suite involvement in managing and supporting an organization’s 340B program.
Meeting Specific Community Needs
In order to keep fulfilling their patient missions, 340B hospitals will continue adapting to the evolving and growing needs of their communities and the patients they serve. One new conference session demonstrated how several 340B hospitals are doing this in innovative ways.
Kansas-based Ascension Via Christi, for example, uses its Community Cares program to provide comprehensive health care services in the home setting to patients whose health conditions make it hard to travel to medical appointments. Patients learn to manage their diseases in their own home, and caregivers can uncover social and lifestyle issues that may affect their disease progression.
This is just one of the many 340B hospitals that are looking beyond their own facilities in determining how to get patients the care they need in the most effective settings. I am among the many conference attendees who were inspired by how these hospitals work to improve patient health.
Optimism for 340B’s Future
These remarkable and inspiring stories left me with a feeling of great optimism at the end of our three days together at the 340B Coalition Winter Conference. Dedicated health providers are bringing in new ideas, implementing best practices, and advocating effectively for the future of 340B. The lives of millions of patients who rely on this program will be measurably improved for years to come because of this investment in the future.
Maureen Testoni is the President and Chief Executive Officer of 340B Health