Low-income patients, rural communities and safety-net hospitals have been disadvantaged by restrictions placed on 340B discounts for drugs dispensed at community and specialty contract pharmacies, a new report said.
"Since July 2020, a growing number of drugmakers have imposed or tightened their restrictions on 340B discounts when a hospital purchases a drug and dispenses it to its patients at community or specialty pharmacies," a news release shared with Becker's said. "Both the Trump and Biden administrations have determined these restrictions violate the law, but the legal challenges by drug companies have made their way to several federal appeals courts."
As of March 2023, 21 companies have placed these kinds of restrictions on 340B discounts, which affects 340B Health's association of more than 1,400 hospitals that participate in its pricing program. The restrictions placed by drug companies allow them to avoid penalty fees even when they hike drug prices at a faster pace than inflation. They are also able to dodge paying discounts on high-cost specialty drugs that account for close to 50 percent of U.S. drug spending, according to the release.
On top of that, nearly 67 percent of the hospitals surveyed reported adverse patient outcomes due to "delayed access or logistical difficulties in obtaining their medications," since the restrictions began.
"Manufacturers are making it as difficult as possible to obtain 340B pricing and even when you do, they create reasons to remove it that are not reasonable," an anonymous hospital spokesperson said in the report.
Further analysis of 340B sales data from the Health Resources and Services Administration found that "hospitals' 340B savings for the first five of the 21 companies to restrict discounts decreased by an estimated $1.1 billion from 2020 to 2021 alone," the release said. "An accompanying survey of 600 hospitals details the care disruptions these cuts have caused to patients in need."
The lost savings have also resulted in 20 percent of 340B hospitals being forced to cut certain health services.