Over the past several months, Advocates for Community Health (ACH) has grown increasingly concerned by the attacks on the 340B program at both the federal and state level. The program has long faced scrutiny, yet over the years, Congressional hearing after hearing has verified the record of health centers in leveraging the program appropriately – putting resources back into the communities they are serving. And just last week, another piece of bad news – HRSA’s Administrative Dispute Resolution panel dismissed a complaint on a technicality, taking health centers’ right to dispute pharmaceutical manufacturers’ restrictions on contract pharmacies. Big pharma continues to encroach on the right to 340B discounts, and we are out of tools to stop them. This is why we created our 340C proposal, which creates a new provision under the 340B program in which pharmaceutical companies participating in the Medicaid program offer discounts to covered entities. Covered entities include those that commit to requirements around reinvestment of savings.
We need Congress to urgently protect this much needed program. Protecting 340B means protecting the nation’s most important safety net that offers high quality, cost-saving primary care to 30 million Americans every year.
The Health Resources and Services Administration (HRSA) recently reported that in 2021, covered entities purchased $43.9 billion in covered outpatient drugs under the 340B Program. Of that, federally qualified health centers (FQHCs) represent 5%, or $2.2 billion, in purchases. Just 5% of the total 340B program — all while delivering a massive return on investment for underserved patients around the country.
Since our inception, protecting 340B has been a top priority for ACH. Our members and leadership came to the decision that health centers and the patients they serve must be protected as reforms to the 340B program are under consideration. With clear recognition that the program must evolve, ACH and member health centers are committed to transparency and to maintaining the integrity if the 340B program as it was intended, specifically that funds be reinvested back into communities and patients in need.
ACH is advocating with key stakeholders and Hill offices at the forefront of 340B reform, those who have expressed support for health centers, and key leaders in a position to influence the future of the 340B program. We welcome an opportunity to work with all of you to do the same, and to do targeted advocacy outreach on the Hill. We must ensure health centers and the patients they serve are protected as the 340B program will undoubtedly evolve.
Health centers should be proud of the ways they have leveraged the 340B program to meet its original intent – to stretch scarce federal dollars to serve the country’s most vulnerable communities. There is no defensible reason to sweep FQHCs into the “reform” of the 340B program, particularly given that health centers are already required to reinvest any program revenue into patient services. Health centers are held accountable to that standard by both their community-led boards and the HRSA.
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