What is 340B? Exploring Pharmacist Contributions, its Important Role in Hospitals

It is indisputable that hospitals are indispensable providers of health care services under current complex circumstances and challenges facing our constantly evolving health care environment.¹ Despite its importance, the 340B program needs to receive more attention despite its essential role in supporting hospitals' financial stability.¹

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The 340B initiative was established in 1992 to ensure medication manufacturers offer more affordable drugs to covered entities.^1,2 Hospitals meeting specific criteria, such as catering to uninsured or underinsured populations, can qualify for lower-priced medications under this federally mandated initiative.²

Providing much needed medications at affordable prices is a crucial part of hospital operations because it enables them to manage limited resources efficiently and provide equitable access to necessary treatments, particularly for underserved communities who have difficulties affording treatments otherwise without undue economic hardship placed on them.^1,3

Considering these benefits, we must acknowledge just how important initiatives such as the 340B program are, especially when considering patients depending on prompt access to adequate medical care containing life-saving medication prescriptions, among other essentials.³ There is an increasingly vocal public push that recognizes how escalating drug prices have resulted in higher outpatient care demands.⁴

It is gratifying to see Medicaid expansion plus consolidation efforts for various health care industries leading more hospitals to receive qualified status from involvement with this exceptional national benefit scheme empowering beneficiaries struggling amid challenging times because drug costs continue rising.⁴ At the same time, incomes stagnate further still over time, and their plight elsewhere from affordability issues burden caregivers struggling to support multiple dependents amid health challenges thwarting retaining well-being suffer most setbacks.⁵

Participating hospitals enjoy the benefit of reducing medication costs, which can help patients struggling with affordability issues access necessary treatments.^4,5

By utilizing innovative approaches that promote affordable treatments, health care providers can improve patient outcomes and decrease readmissions.⁵ For instance, providing post-hospitalization delivery services for medications is one of many ways that pharmacists have leveraged the 340B initiative to reduce medication non-adherence rates significantly.⁵

Since it was launched in 1992, participant numbers initially started low, with only around 23.5% of hospitals in 2010 participating. Nearly one-third currently collaborates with outpatient pharmacies as beneficiaries can afford better access thanks to these programs altogether regardless of their original backstories.

All should be entitled to a reasonable quality standard of care without undue financial strain. The results are that underprivileged individuals are pushed toward getting healthy again by supporting populations who have traditionally faced medical deserts or chronic health inequalities, such as limited mobility or lack of safe living environments among other structural inequities.^4,6

Proper support and funding for 340B beneficiaries are critical if we are ever to close the accessibility gap and advance equitable distribution solutions. We must also continue to bolster hospital-level outreach initiatives that seek to promote patient well-being from adverse effects that arise from non-adherence because there is such a gap separating people wanting cost-effective medical intervention requirements amid deepening divisions within our society around issues such as drug costs and inadequate insurance coverage models near or below the poverty line altogether.⁶

Providing greater access to medication leads to better patient outcomes; however, much of this access depends on eligibility criteria for programs such as 340B.^6,7

Although debates about financial impacts continue in future decision-making regarding these programs, funds must be allocated accordingly.⁷ Current evidence suggests that hospitals have benefited from participating in this scheme to help offset drug price inflation despite concerns about funding criteria.¹

As medical costs increase nationally, the benefits of this program continue coming off as a critical lifeline providing additional revenue and allowing hospitals the resources to facilitate the provision of essential services and quality care without putting excessive strain on their budgets.^6,7

On a fundamental level, initiatives such as the 340B program are fundamental in today's health care environment, not only by supplying marginalized demographics with affordable medication, but also increasing outcomes and reducing readmission rates.^6,7 The success of the 340B program has allowed Medicaid expansion to provide more facilities access to this resource.⁴

Furthermore, as demand grows for affordable medication due to an aging population, pharmacists occupy a vital role in ensuring optimum implementation.⁷ Through participation in the drug pricing program, which furnish prescription drugs at lowered costs for entities committed to serving those in jeopardy, such resources become more accessible.⁷

Studies depict improvement rates for patients who benefit from pharmacist-administered pharmacy delivery services while the hospital admission process continues resulting in reduced readmission rates.^7,8

The general outcome of health care, including cost and intensity, has significantly increased according to recent research between 1996-2013.⁷ Programs such as 340B have revealed that it is essential to recognize financial benefits while offering high-quality health care, ensuring that every patient rightfully gains access to these programs and reducing costs on hospitals, empowering them with more resources.⁹

Pharmacists' positive impact on reducing medication expenses cannot be overstated as they leverage their medication management expertise within hospital settings through collaboration with the 340B program.⁹ Through such collaborations come affordable prescriptions available to underserved populations receiving care in these settings, which supports lessening their readmissions in future follow-up visits.²

Hospitals serving these populations also experience substantial financial benefits from participating in this pricing process, improving overall health care disparities. In line with this initiative's financial sustainability benefits, it remains a significant component of health care. Health care teams must recognize the importance of continued utilization of the 340B program to support those requiring lifesaving medication care.

References

1. Conti RM, Nikpay S, Buntin MB. Revenues and Profits From Medicare Patients in Hospitals Participating in the 340B Drug Discount Program, 2013-2016. JAMA Netw Open. 2019;2(10):e1914141. doi:10.1001/jamanetworkopen.2019.14141

2. Tomicki S, Dieguez G, DeStephano D, Chang M, Cockrum P. Costs by Site of Service for Commercially-Insured Patients with Metastatic Pancreatic Cancer Receiving Guideline-Recommended Chemotherapy: Comparing Community Oncology and Hospital Outpatient Settings. Scite.ai. Published October 1, 2022. Accessed [insert date]. Available at: https://scite.ai/reports/10.2147/ceor.s373316

3. Jones E, Linas BP, Truong V, Burgess J, Lasser KE. Budgetary impact analysis of a primary care-based hepatitis C treatment program: Effects of 340B Drug Pricing Program. Scite.ai. Published March 14, 2019. Accessed [insert date]. Available at: https://scite.ai/reports/10.1371/journal.pone.0213745

4. Li Y, Xu SH. Association of Beneficiary-Level Risk Factors and Hospital-Level Characteristics With Medicare Part B Drug Spending Differences Between 340B and Non-340B Hospitals. Scite.ai. Published February 18, 2022. Accessed [insert date]. Available at: https://scite.ai/reports/10.1001/jamanetworkopen.2022.0045

5. Lin JK, Li P, Doshi JA, Desai SM. Assessment of US Pharmacies Contracted With Health Care Institutions Under the 340B Drug Pricing Program by Neighborhood Socioeconomic Characteristics. JAMA Health Forum. 2022;3(6):e221435. doi:10.1001/jamahealthforum.2022.1435

6. Mulligan K, Romley JA, Myerson R. Access to the 340B Drug Pricing Program: is there evidence of strategic hospital behavior? Scite.ai. Published June 3, 2021. Accessed [insert date]. Available at: https://scite.ai/reports/10.1186/s13104-021-05642-4

7. Lee S, Kristen et al. A financial incentive program to improve appointment attendance at a safety-net hospital-based primary care hepatitis C treatment program. Scite.ai. Published February 11, 2020. Accessed [insert date]. Available at: https://scite.ai/reports/10.1371/journal.pone.0228767

8. Kamusheva M, Parvanova A, Rusenova Y, Vandeva S, Elenkova A. Do We Need a Specific Guideline for Assessment and Improvement of Acromegaly Patients Adherence? Front Public Health. 2021;9. doi:10.3389/fpubh.2021.693409

9. Safitrih L, Perwitasari DA, Ndoen N, Dandan KL. Health Workers' Perceptions and Expectations of the Role of the Pharmacist in Emergency Units: A Qualitative Study in Kupang, Indonesia. Pharmacy. 2019;7(1):31. doi:10.3390/pharmacy7010031