Explaining 340B to My Nephew


As I and the rest of the tangoRx team are getting set to join the 340B community in San Diego, I am up well before sunrise with the idea that I will use this quiet time to put down on paper my latest musing regarding the program. The plan was to discuss the current state of 340B, the latest risks, and what I hope to see in the coming year. Instead, after fiddling with my computer for several minutes, my mind began to wander. I found myself contemplating and second-guessing my response to a question posed to me during a family gathering last month. A college-aged relative asked me what I do and why 340B. What I hoped to convey was an ode to the complexity, subtlety, and impact of the 340B program. In retrospect, what came out was a meandering discussion of policy, politics, regulations, and our disparate healthcare system. I sensed eyes starting to glaze over and a polite shift of attention to my brother, an airline pilot. His response was much more concise and pleasing to a lay audience engaging in dinner conversation.

It had been the first holiday gathering in a long while, and the mood at the table was warm but highly contemplative. My family seemed to want to discuss meaningful topics – nothing felt like it was off the table. It was probably that very mood that led me astray as I dove right into the weeds on the politics, the policies, and the controversies associated with 340B. As I reflect, I now see my error. I forgot to consider my audience. People connect to stories of impact and purpose. What they most likely wanted to understand was what 340B may do for the people they know, their neighbors, the overall community they live in – how and why the program should matter to them or to somebody that they love.

By now, the sun was up, I was well into my second cup of coffee, and it was clear that I had fully abandoned my original intent. Instead, I found myself rehashing and trying to formulate a better response to the question of “why 340B”. Images of the people that we partner with and the many communities that I have visited where 340B has had a transformative impact came rushing to my mind. As I was contemplating just the right response, I recalled a small, grassroots project that tangoRx recently ran where we posed a similar question to several 340B leaders. I felt compelled to reread how these seasoned leaders responded. Sure enough – their responses were much more focused on local impact, even personal in nature.

To my nephew or anybody else who is asking, allow me instead to leverage the wisdom and experience of some of the most amazing and passionate people that I have had the privilege of working with as they answer the question of “Why 340B”:

  • “340B funding allows us to continue to focus on treating the medically underserved on our rural island community in Alaska, with less concern about how to pay for these services. The 340B program allows us to not worry about reimbursement for patients who are uninsured, homeless or those who can’t afford medications or co-pays.”
  • “Prior to 340B, we frequently saw patients who had challenges of whether to purchase food or medicine. Many took one pill instead of two as prescribed or took their meds every other day if they were in the position to purchase them to make the medicine last as long as possible.”
  • “Our center has started a $3.99 generic drug program to ensure that all patients we serve can obtain their medications. Additionally, we offer charity prescriptions for those patients undergoing extreme hardship who otherwise would not be able to afford their medications.”

As we sit down in San Diego to learn about the latest policies from the feds, the newest regulations being enforced by HRSA, and the freshest machinations from the drug manufacturers, I invite you all to also take a step back and consider why we are all in this in the first place. Now I just hope that I get another stab at answering that very same question during a future family gathering. I know exactly what I will say now, should anybody ever be brave enough to ask me again!

Sakeena Kazmi is Senior Manager, Customer Success at tangoRx Solutions. For questions, she can be reached at sakeena.kazmi@tangorxsolutions.com.

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