Commentary

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Every day, I see patients who can not afford the healthcare and medications they deserve and the long-term impacts. That is why we need to reform the poorly run the federal 340B Drug Pricing program

Prescription drugs sit on a pharmacist’s counter (Photo by John Moore/Getty Images/The Ohio Capital Journal).

By Sanul Corrielus

The Rev. Dr. Martin Luther King Jr. once said that “of all the forms of inequality, injustice in healthcare is the most shocking and inhumane.”

As a board-certified cardiologist in a community-based private practice, I have dedicated my career  to improving healthcare outcomes for vulnerable communities.

Every day, I see patients who can not afford the healthcare and medications they deserve and the long-term impacts. That is why we need to reform the poorly run the federal 340B Drug Pricing Program.

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The program was founded with the best intentions – to help uninsured and low-income patients get the care they need and support hospitals providing a lot of charity care. It requires drug manufacturers to provide outpatient drugs to qualifying 340B hospitals at drastically discounted prices. However, as the program has expanded, the oversight has not kept pace to maintain the program’s integrity.

Many of these 340B hospitals are not using their discounts to offer patients subsidized care, and in fact, most are making huge profits from the program, and are only giving away minimal charity care.

A recent national study of 340B hospitals by the Pacific Research Institute (PRI) found that not only do “non-profit” 340B hospitals make 37% more in profits compared to the average of all hospitals, but these 340B hospitals that are supposed to provide charity care give 22% less of their net patient revenue to charity care than all hospitals.

Both uninsured and insured patients pay the cost of these 340B hospitals making more money and giving away less in charity care.

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According to CAO-cited data from the Office of Inspector General, more than 60 percent of hospitals did not offer the reduced 340B prices to uninsured patients, and these hospitals charge uninsured patients up to three times more than what hospitals pay for the drugs. To make matters worse, even insured patients pay more for prescriptions.

As a doctor who serves vulnerable populations, I know that these practices only discourage individuals from seeking health care with long-term implications.

The 340B program can be an invaluable resource for community and safety-net providers if used correctly. I have seen this firsthand. A few years ago, I worked to help HIV/AIDS patients get the cardiac care they deserve at a federally qualified health center. I recently learned that this center is funded by the 340B discounts that the hospital received.

This is a health equity question. If the 340B program is stopped because of bad actors, the patients, and communities, like the individuals, I served at the health center, suffer the most.

As hospitals and drug companies fight this out in the courts, the most at-risk patients are left without the care they need. Congress must act. There have been over 50 bills introduced in Congress to reform the program, but zero have passed.

Reforms that could help the program include regulating contract pharmacies, increasing penalties for 340B violations, stricter reporting requirements, and increasing the number of audits on participating hospitals.

For the sake of justice in healthcare for our low-income and uninsured patients, Congress needs to reform the 340B program and close any loopholes swiftly.

Dr. Sanul Corrielus is a board-certified cardiologist at Corrielus Cardiology in Philadelphia. He is the founder of Community Cardiovascular Initiative, a non-profit organization that focuses on providing integrated cardiovascular health and wellness education to underserved communities to improve cardiovascular health disparities and the quality of health delivery in underserved communities in the Philadelphia area.

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