340B hospitals provide “a significantly higher average number” of medication access (MA) services—such as free or discounted drugs or free delivery—than comparably sized non-340B hospitals, a new academic study shows.
The study was conducted by the University of Illinois Chicago (UIC) with funding from Community Voices for 340B (CV-340B), a nonprofit group that works to increase awareness about and support for the 340B program. It was published online on March 20 by the journal Research in Social and Administrative Pharmacy.
The study asked pharmacy directors at 500 general acute care hospitals if their institutions had at least one full-time employee assigned to each of the following services:
- Help with prior authorization approval for medicine
- Providing discharge prescriptions to patients at bedside
- Free immunizations for those who can’t afford them
- Free drug delivery for those who can’t go to the pharmacy
- Providing select discharge prescriptions for free in the emergency department
- Free or discounted outpatient medications for patients who don’t qualify for manufacturer assistance
- Medication therapy management
- Helping patients enroll in manufacturers’ assistance programs
- Helping patients transition to new health care settings
“For all nine medication access services, a higher percentage of 340B hospitals reported providing the service at their hospitals compared to non-340B hospitals,” the study found.
The difference was significant for help with prior authorizations (89.7% versus 63.0%), discharge prescription services (85.3% versus 44.4%), free immunizations (58.8% versus 33.3%), free or discounted outpatient medications (83.8% versus 48.2%), medication therapy management (52.9% versus 11.1%), and patient assistance programs (83.8% versus 51.9%).
The study also found that 340B hospitals were significantly more likely than non-340B hospitals to provide two of four general health care access services: drug/alcohol outpatient treatment services (37.5% versus 9.5%) and HIV/AIDS outpatient services (39.3% versus 9.5%).
“Many of the programs offered through medication assistance services have been shown to improve medication access and patient outcomes” said Dr. Isha Rana, the study’s lead author and current Pharmacy Administrative Specialist at Houston Methodist in Texas. “Unfortunately, payers generally do not provide direct reimbursement for most of these necessary services, making it difficult for health systems without a guaranteed funding stream to invest in medication assistance programs. This study shows that access to 340B savings could be a key factor in underwriting the cost of offering non-reimbursable services which in turn, improve medication access for vulnerable patient populations, just as Congress intended.”
“As changes to the 340B Program continue to be deliberated, the UIC study provides valuable, first-of-its-kind insight into the constellation of medication and healthcare access services provided at 340B versus non-340B hospitals,” CV-340B said. “The study’s findings suggest that the 340B program is working as Congress intended—to free up covered entity resources to provide more comprehensive services, many of which are non-reimbursable and would likely not be furnished absent the additional resources generated from the program.”
CV-340B provided funding of gift cards for questionnaire respondents, and a stipend for independent statistical analysis. The organization said “it did not participate in the study design, data collection, interpretation, or analysis of results in any way.”
The study’s release comes on the heels of another report published by the consulting firm Avalere that found that non-340B hospitals have uncompensated care cost rates comparable to, if not higher than, 340B hospitals. Avalere’s report was funded by the Federation of American Hospitals, the trade group for for-profit hospitals.
Soon after the UIC study was published, Health Affairs published a study by The Johns Hopkins University that found that found that nonprofit hospitals spent $2.3 of every $100 in total expenses incurred on charity care, which was less than government ($4.1) or for-profit ($3.8) hospitals. That study was study was supported by the Commonwealth Fund and Episcopal Health Foundation.
