Dec. 23, 2022— The examples of worsened health outcomes for patients from drug company restrictions on 340B pricing to safety-net hospitals continue to mount. At Riverside Regional Medical Center in Virginia, one discharged patient with diabetes was readmitted to the hospital within days due to delayed access to an insulin medication for which drug companies had restricted 340B pricing.
Prior to the drug company 340B restrictions, the patient paid less than $10 out of pocket for insulin he received at the hospital’s community pharmacy, according to Cynthia Coffey, Riverside’s director of retail pharmacy. Once the 340B restrictions went into effect, the patient’s out-of-pocket cost for insulin skyrocketed to $191 each time he filled his prescription at the community pharmacy located in the hospital. That price was just too much for the patient.
“The patient chose to not fill the medication,” Coffey said. “Unfortunately, two days later, the patient was readmitted into the hospital due to uncontrolled blood sugars.”
Coffey shared this patient’s story as one of our newest Faces of 340B profiles. The story is an example of the barriers the hospital’s patients face from 19 drug companies’ unlawful restrictions on access to 340B pricing. It is not the only example of harm that Riverside Health System’s patients have experienced from these actions.
Disruptions to Medication Regimens
Riverside Shore Memorial Hospital is another hospital in the Riverside Health System. Located on the Eastern Shore of Virginia, the hospital serves a community that is physically separated from the rest of Virginia by a bay. The only way to access the Eastern Shore by land is to travel over an 18-mile bridge/tunnel that includes a toll. The hospital also serves a high percentage of patients living with low incomes.
340B savings for Riverside Shore Memorial fund the hospital’s comprehensive oncology services, including radiation and infusion treatments. If the hospital did not offer these services, patients on the Eastern Shore would need to drive 90 minutes to access these vital services. The hospital notes that without access to 340B savings, the hospital would be at risk of closing its doors due to its razor-thin operating margins.
The 340B community pharmacy restrictions have reduced these savings for Riverside Shore Memorial and harmed patient access to medications. David Jones, MD, the chief medical officer at Riverside Shore Memorial, is another of our newest Faces of 340B profiles. He notes that given the geographic barriers Eastern Shore patients face, the hospital’s 340B community pharmacy partnerships enable patients to fill their prescriptions much closer to home. This access improves medication adherence.
Jones specializes in pulmonary medicine and cares for many patients with asthma and chronic obstructive pulmonary disease (COPD). After the drug company 340B restrictions started, he saw his patients run into barriers to affording vital inhaler medications.
“I have a patient with COPD and because he is underinsured, he is unable to afford the basic maintenance inhalers he needs,” Jones said. “Due to the restrictions, he was unable to obtain one of those medications that he had previously been on. As a result, he had increasing symptoms of shortness of breath, wheezing, he required additional office visits, and we had to supplement his medications with other medications that had increasing side effects and were not as effective for him.”
More Emergencies on the Horizon?
340B community pharmacy partnerships are critical to Riverside Health System’s efforts to provide comprehensive care to uninsured and underinsured patients, Coffey said. Many of the patients who receive low-cost medications dispensed at Riverside Regional Medical Center’s community pharmacy cannot access the medications through drug company assistance programs. She and Jones are both concerned about what will happen to their patients if drug company restrictions on 340B pricing continue and worsen in 2023.
“I feel certain that patients that have relied on these discounts to obtain the most basic of medications won’t have access to it,” Jones said. “This will result in increasing emergency department visits and most likely hospitalizations. The access to the 340B discount program is really essential.”