Harvard Drug Policy Experts Write in JAMA About How Congress Could Fix 340B Contract Pharmacy Mess

screenshot of 340B drug pricing program article in JAMA
"Contract pharmacy restrictions are the latest problem with implementation of the 340B program that threaten to undermine its laudable goals," three Harvard drug policy experts say in an opinion article in JAMA.

A nationally prominent drug policy expert and two colleagues at Harvard Medical School have written in JAMA how Congress could end the fight over 340B contract pharmacy and enhance 340B program integrity.

“First, Congress could explicitly allow the participation of

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Drug Makers’ 340B Pricing Restrictions Hit Small Rural Hospitals Especially Hard, Survey Shows

This Hospital is closed sign
About two thirds (64%) of CAHs and one third (33%) of larger, more urban hospitals say their ability to keep their doors open would be affected if drug company 340B contract pharmacy restrictions become more widespread.

Small rural hospitals have lost on average 39% of their 340B contract pharmacy savings due to drug manufacturers’ conditions on 340B pricing while larger, mostly urban hospitals have lost on average 23%, a hospital group’s member survey shows.

The finding

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340B Sales Growth Rate Slowed in 2021, the First Year of 340B Contract Pharmacy Restrictions

Point of purchase scanner at pharmacy checkout
340B drug sales grew at a slower rate in 2021, the first year of 340B contract pharmacy restrictions, IQVIA reports.

Prescription drug sales at 340B-discounted prices grew 15.9% year-on-year from 2020 to 2021, drug industry consulting and contract research firm IQVIA reports, an annual growth rate below that for the two preceding years.

Last year, IQVIA reported that 340B sales

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Influential Drug Cost-Effectiveness Organization Endorses Partially Lifting 340B Orphan Drug Exclusion

Institute for Clinical and Economic Review wordmark
Policymakers should consider narrowing the 340B orphan drug exemption, ICER said today in a new report.

The exclusion of 340B pricing for some hospitals on drugs to treat orphan conditions and diseases could be partially eliminated to slow “the rapid growth in approved rare disease treatments” and “their cumulative affordability to the health system,” an influential

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CMS Projects that Drug Spending and Drug Prices Will Keep Rising Through 2030

graphic image of pills and $ on a scale
CMS predicts that U.S. retail prescription drug spending will grow 4.3% this year, with growth accelerating to 4.7% next year and to 5.1% in 2024.

Federal actuaries predict retail prescription drug spending in the United States will grow 4.3% this year, with growth accelerating to 4.7% next year and to 5.1% in 2024.

The Centers for Medicare & Medicaid Services (CMS) Office of the Actuary

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Conservative Massachusetts Think Tank Slams State’s 340B Hospitals over Charity Care and Calls for Reform

title page of Pioneer Institute white paper on 340B drug discounts
Charity care at five Massachusetts hospital groups declined at a time that 340B sales to the hospitals were rising, a new report by a conservative state think tank says. The state hospital association says the report distorts the 340B program.

Charity care has been declining significantly in some Massachusetts hospital systems, raising “a significant policy issue for the 340B program,” a free-market-oriented Massachusetts think tank whose donors include pharmaceutical manufacturers says in a new report.

The state hospital association said

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Economists Say 340B Hospital and Grantee Entities Use Contract Pharmacy for Different Reasons

pharmacist sorts pills
A new study finds that contract pharmacy growth patterns differ between 340B hospital and non-hospital entities.

Contract pharmacy growth patterns differ between 340B hospital and non-hospital entities, suggesting they may use 340B differently and should be subject to different 340B rules, new research in the American Journal of Managed Care concludes.

The authors, who previously have

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New JAMA Study Casts Doubt on CMS Reason for Cutting Hospitals’ Medicare Part B Payments for 340B Drugs

screenshot of JAMA Open access article about 340B
New research “raises doubt” about a major CMS reason for slashing hospitals’ Medicare Part B reimbursement for drugs purchased through the 340B program by almost one-third.

New research published in JAMA Network Open “raises doubt” about a major U.S. Centers for Medicare & Medicaid Services (CMS) justification for slashing hospitals’ Medicare Part B reimbursement for drugs purchased through the 340B program by almost one-third, the study’s

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Democratic Senator’s Illness Stalls Action on Drug Pricing Indefinitely

Sen. Ben Ray Lujan's (D-N.M.) recent stroke and absence makes it even less likely that Congress will pass Democratic drug pricing legislation any time soon.

Prospects for passage of Democratic drug pricing legislation as part of the Build Back Better (BBB) Act dimmed again last week with news that Sen. Ben Ray Lujan (D-N.M.) had a stroke on Jan 27.

Lujan’s chief of staff

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ICER Says Four Drugs Are Cost-Effective in Keeping COVID-19 Patients Out of Hospitals

The Institute for Clinical and Economic Review has tentatively concluded that four drugs have demonstrated effectiveness and value in reducing hospitalizations of COVID-19 patients.

The Institute for Clinical and Economic Review (ICER) has issued a draft report concluding four drugs have demonstrated effectiveness and value in reducing hospitalizations of COVID-19 patients. The independent nonprofit group evaluates prescription drugs and medical treatments’ cost effectiveness

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