In a Dec. 14 letter, more than two dozen state attorneys general urged HHS to address drugmaker policies denying 340B discounts to hospitals that use contract pharmacies, including issuing fines.
The attorneys general argue in the letter, addressed to HHS Secretary Alex Azar and Health Resources and Services Administration Administrator Thomas Engels, that the refusal to provide discounts to hospitals using contract pharmacies is unlawful and that HHS has the authority to enforce drugmakers to follow the 340B statute.
They wrote that while they applaud HRSA's recent rule establishing a panel to settle disputes between 340B hospitals and drugmakers, "HHS needs to provide immediate relief to the health centers and hospitals that have already lost significant cost savings, by making immediate determinations that manufacturers' actions violate the terms of their participation in the Medicare Part B and Medicaid Programs." They mention that HHS is allowed to charge up to $5,000 for each individual medication order.
Drugmakers are required to participate in the 340B drug pricing program in order to have their drugs covered by Medicaid and Medicare Part B.
The panel also won't begin its work until Jan. 14, so the attorneys general wrote that "each day that drug manufacturers violate their statutory obligations, vulnerable patients and their healthcare centers are deprived of the essential healthcare resources that Congress intended to provide."
"During a national public health crisis, these actions are especially egregious and cannot be ignored," the letter states.
The attorneys general said that since 1996, HRSA has stated that the 340B statute expressly allows 340B hospitals to contract with pharmacies to fill prescriptions. In 2010, HRSA released guidance making clear that hospitals can use multiple contract pharmacies, they wrote.
The attorneys general urged HHS to issue guidance articulating that the 340B statute requires drugmakers to make payments to hospitals that use contract pharmacies.
Read the full letter here.