Ryan White Clinics for 340B Access has announced it opposes the drug industry’s joint plan with community health centers to restructure the 340B program, saying it will increase manufacturers’ “already astronomical profits at the expense of safety net providers.”
Hemophilia Alliance President and CEO Joe Pugliese, meanwhile, said last week in his group’s March newsletter, “We are extremely concerned about what we’ve heard so far” about Pharmaceutical Research and Manufacturers of America and the National Association of Community Heath Centers’ plan.
At the 340B Coalition annual winter conference in California this week, 340B third party administrator The Craneware Group is promoting a set of nine guiding principles for 340B as an alternative to the 10 that PhRMA and NACHC co-wrote. 340B Report Publisher and CEO Ted Slafsky, in his latest column for 340B third party administrator Verity Solutions, said PhRMA and NACHC’s proposals “would severely undermine the nation’s health care safety net and patient care.”
PhRMA and NACHC stunned the 340B community this month with their announcement they were collaborating on 340B reform and had written 10 guiding principles to guide federal legislation. Last week, a longer confidential version of the plan began circulating among 340B provider stakeholders. The proposed reforms reportedly would cut the number of 340B disproportionate share hospitals in half, limit the remaining ones to just five contract pharmacies, eliminate discounts on specialty pharmacy and mail order medicines for DSH hospitals, and prohibit DSH hospitals from accessing 340B discounts on referrals. Health centers, other grantee entities, and rural hospitals would get a number of 340B program protections.
Hospital groups denounced the plan quickly, as did AIDS Healthcare Foundation. Other grantee groups at first responded cautiously or not at all. RWC-340B’s strong opposition and Hemophilia Alliance’s negative review is a setback for PhRMA and NACHC’s outreach efforts to providers that participate in 340B.
PhRMA and NACHC created a group, ASAP 340B, to “reflect the voices of a broad range of safety-net providers who support” their joint agenda. But so far, apart from NACHC no major associations of providers enrolled in 340B have joined.
“After carefully considering the ASAP 340B discussion draft and accompanying materials, RWC-340B is opposed to the proposal as written,” RWC-340B President Shannon Burger said in a March 23 statement.
“We are especially concerned that the proposal misinterprets and reformulates the intent of the program and undermines the reach of the 340B Drug Pricing Program, favoring drug manufacturers who are making astronomical profits at the expense of safety net providers. The 340B Drug Pricing Program is essential to assist Ryan White clinics (RWCs) in achieving their mission of caring for low-income and vulnerable patients living with HIV/AIDS and stopping transmission of HIV. We commit to working with all covered entities to protect the 340B Drug Pricing Program, opposing any threats to the program that jeopardize our patients’ access to care and quality of life.”
RWC-340B also on March 23 separately issued a “340B Statement of Principles” covering topics including 340B intent, accountability, eligibility, state laws on 340B, contract pharmacies, and pharmacy benefit managers. “RWC-340B strongly opposes any attempts to change the reach of the 340B program because the program is working as it was intended for RWCs,” the group said.
Hemophilia Alliance Comments
Hemophilia Alliance leader Pugliese said in the group’s latest newsletter that PhRMA and NACHC’s joint 340B agenda could pose “several harms to the bleeding disorders community.”
“Why was all of this done in secret, without the involvement of other grantees” like hemophilia treatment centers, Pugliese asked “Why are organizations with a long history of opposing 340B part [of] ASAP 340B? Why did PhRMA not reach out to HTCs for input? It seems counterintuitive at best. As we learn more about this group it is clear they either don’t know or do not care about the negative impact their proposals would have on our community.”
Craneware and 340B Matters
It addition to promoting its alternative to PhRMA and NACHC’s guiding principles for 340B, Craneware disclosed in a news release yesterday that it underwrites the information campaign 340B Matters. Sentry Data Systems, which Craneware acquired in 2021, launched 340B Matters in 2016. Who paid for 340B Matters and who produced its content was previously unknown.
Slafsky’s Latest Column
340B Publisher and CEO Slafsky in his new column for Verity said NACHC “should be applauded for pushing the ball forward and beginning what will be an inevitable negotiation with the drug industry over various aspects of the 340B program.”
“However, while ASAP 340B’s proposals may be well-intentioned, many aspects of its 10 principles (and a subsequent more detailed document that recently began to be circulated) would severely undermine the nation’s health care safety net and patient care,” he continued.
“ASAP 340B’s efforts fall far short of what is needed for a détente in the ongoing battle between the pharmaceutical industry and 340B providers,” Slafsky said. “But the creation of this alliance will hopefully motivate hospital groups and Congress to be more proactive in trying to end the contract pharmacy impasse.”