340B Drug Program
The federal 340B Drug Pricing Program allows qualifying hospitals and clinics that treat low-income and uninsured patients to buy outpatient prescription drugs at a discount of 25-50%.
What is the 340B drug pricing program?
The 340B drug pricing program is a federal program that requires pharmaceutical companies to provide discounted prices on outpatient drugs to certain hospitals and healthcare providers serving a large number of uninsured or underinsured patients.
How did the 340B program get started?
The 340B program was established in 1992 through the passage of the Public Health Service Act. It was signed into law by President George H.W. Bush.
Who is eligible to participate in the 340B program?
Initially, the program was primarily available to safety net hospitals and their outpatient clinics, as well as community health centers. However, the program has since been expanded to include other types of healthcare providers, such as children's hospitals, outpatient cancer centers, and rural providers.
How does the 340B program work?
Pharmaceutical companies are required to provide discounted prices on outpatient drugs to covered entities as a condition of participating in Medicaid. The discounted drugs are then provided to uninsured or underinsured patients.
How much does the 340B program cost taxpayers?
The 340B program does not cost taxpayers any money. The discounts on drugs are provided directly by pharmaceutical companies to their providers.
How much does the 340B program cost pharmaceutical companies?
The 340B program represents less than 3% of total US drug sales, and pharmaceutical companies have been able to maintain profit margins between 15-20% even as the program has grown.
Why is the 340B program getting so much attention?
Pharmaceutical companies have argued that the number of covered entities should be limited, but limiting the number of covered entities would reduce the number of patients and communities served and could put other components of the healthcare safety net at risk.
How Do I Get My Prescription Discount?
As a patient of Northeast Missouri Health Council, you automatically qualify for the 340B drug program. All you have to do is ask your provider to use the 340B prescription form and send your prescription to a qualifying pharmacy. That's it! Instant savings.
Do All of My Prescriptions Qualify For This Program?
No. Eligibility determinations are made on a prescription-by-prescription basis, as opposed to a patient-by- patient basis. In other words, under current Office of Pharmacy Affairs (OPA) guidance, the fact that an individual is clearly a Federally Qualified Health Center (FQHC) patient does not mean that every prescription he or she receives is eligible to be filled with drugs purchased under 340B. Rather, each of that individual’s prescription must be separately evaluated against OPA standards to determine if it may be filled with 340B drugs.
High dollar medications covered by 340B include Ozempic, Trulicity, Annovera, Jardiance, Advair, Xarelto, Novolog, Linzess, Januvia, Combivent, Vraylar, and Myrbetriq, just to name a few. One of the most noticeable improvements resulting from this program has been for patients with diabetes. Of the high-cost meds listed, five are medications utilized by diabetics.
“I was able to take my insulin cost from $450 a month to now $70 a month with the help of 340B and Northeast Missouri Health Council." - Betty S.