Seven U.S. representatives—five Democrats and two Republicans—lauded the 340B program on the House floor Tuesday night during an hour of speeches organized by Rep. Abigail Spanberger (D-Va.) and co-hosted by Rep. John Rose (R-Tenn.).
The event was postponed twice before earlier this year due to scheduling conflicts. Under a House custom, a member can book time with the House speaker to talk about whatever they choose for up to 60 minutes after a day’s legislative business is through. Known as “special orders” or “special order speeches,” the member reserving the time can speak alone or share the hour with fellow representatives.
Spanberger, a former CIA officer in a tough re-election fight in a central Virginia swing district, kicked off Tuesday’s special orders on 340B noting that, “since the summer of 2020, at least 16 pharmaceutical companies have announced or implemented restrictions on 340B pricing.” News that a 17th manufacturer, Exelixis, had joined the list was just starting to circulate as Spanberger spoke.
The Biden and Trump administrations both “found these restrictions to be unlawful, yet HHS
has taken no serious enforcement action to prevent or penalize these illegal actions,” she said. “Let me be very clear: Every time a pharmaceutical company withholds a 340B discount from an eligible pharmacy, that company is unlawfully overcharging the healthcare safety net and withholding resources from the most vulnerable patients in our communities. And, in response, we need to defend 340B.”
“I commend HHS for its commitment to protecting the integrity of the 340B program, but I urge the agency to penalize the companies that refuse to comply with federal law,” Spanberger said. “It is the right thing to do for the people we serve.”
Yesterday morning, Spanberger tweeted, “Last night, @ExelixisInc became the 17th pharma company to announce it would be breaking the law and withholding 340B prescription drug discounts. And they had the nerve to do it as we were on the House floor calling out these companies and calling on @HHSGov to #Defend340B.”
Spanberger has taken an active role in 340B causes including spearheading a letter to the U.S. Department of Health and Human Services with over 200 lawmakers calling on the agency to penalize drug makers for restricting access to 340B pricing in the contract pharmacy setting. Spanberger and Rep. David McKinley (R-W.Va.) are the lead sponsors of the 340B Protect Act, which is intended to prohibit PBMs from discriminatory practices against 340B providers as well as to establish a government-appointed third-party clearinghouse to address Medicaid duplicate discounts in the 340B space.
Rose, the next representative to speak, said 340B “is often a lifeline of financial support for the small, rural hospitals in middle Tennessee and across the country.”
“These very same hospitals are often the only source of care for communities in expansive geographic areas,” he said. “I have no other word to describe it other than ‘unconscionable’
that companies founded to help sick patients by providing lifesaving medication deliberately undermine a law to increase affordable access to their lifesaving medications. It is truly disgraceful.”
Rep. Tom O’Halleran (D-Ariz.) said there are eight 340B hospitals in his congressional district, more than in any other in Arizona.
“These hospitals need our help now,” he said. “That is because, currently, several drug manufacturers are unlawfully withholding or limiting discounts from 340B-covered entities—I personally do not understand this at all—including safety-net hospitals and community health centers. Anybody that lives in rural Arizona knows the critical need for hospitals and community healthcare centers and that they are suffering.”
Rep. Glenn (GT) Thompson (R-Pa.), who is the ranking Republican on the House Agriculture Committee, also focused on the 340B program’s importance to rural healthcare providers. “I can’t tell you how many times … I have seen the 340B program be the difference between a red, losing year, where you bleed money, you lose money—and you can do that for only so long until a hospital has to shutter its doors and lay people off—and perhaps
breaking even or even just a slight margin.”
Rep. Chris Pappas (D-N.H.), who represents a large swath of New Hampshire including Manchester and the White Mountains, appealed for passage of Spanberger and Rep. David McKinley’s (R-W.Va.) 340B PROTECT Act, which would prohibit various forms of pharmacy benefit manager discrimination against 340B providers. “This is one area where I think Republicans and Democrats can come together and pass something meaningful,” he said.
Rep. Danny Davis (D-Ill.) said he represents “a large, urban, low-income community with 23 hospitals, many of which are safety net.”
“I think I may have more hospitals than any single area,” he said. “A discount for the individuals who use these institutions will be more than helpful to them, so I urge that we continue the program, but I really urge that we enforce and make sure that they do what they were designed to do.”
Rep. Chuy Garcia (D-Ill.), who serves the 4th district of Illinois in Chicago, gave the final speech.
Garcia, the first Mexican-American to serve in the Illinois Senate, said “Community health centers are under tremendous pressure to keep their doors open while caring for the most impacted. The timing could not be worse for pharmaceutical manufacturers to undermine such a critical program. The 340B program provides lifesaving medication for nearly 1.5 million patients of Illinois community health centers as well as housing, transportation, care management, and more. We must defend this crucial program. It is literally a lifeline for communities like mine.”