340B Pickleball Battle - Score Update
There have been some intense rallies on the net since posting my original blog in Oct 2021-
A Different Kind of Drug War: 340B Drama and Pickleball. (https://www.consultingwithtjs.com/post/a-different-kind-of-drug-war-340b-drama-and-pickleball)
As a reminder this is an intense battle over 340B discounts drug manufacturers are required by law to provide “covered entities” (CE ). CEs are safety net providers like not for profit hospitals, children's hospitals, cancer treatment centers and AIDs etc . The issue being fought over is the discounts for drugs dispensed by community pharmacies contracted with the “covered entities”. These are not tax payer dollars, however if CE lose out on this revenue they will need to discontinue programs that serve the low income high risk communities. The consequences are a reduction in care services, exacerbation of health inequity and worse health outcomes for these individuals which will ultimately cost taxpayer dollars.
Summary as of some of the match highlights - Feb 2022 (it continues to evolve):
14 manufacturers refusing 340B discounts to contracted community pharmacies ( 14 out of 700 manufacturers )
Legal battles being fought in higher courts
Congress bill HR 4390 offering 340B protection is stalled
Health and Human Services - puts manufacturers on notice
“Covered entities” battling discriminatory reimbursement by PBM’s (Pharmacy Benefit Managers) in court.
States fight back. For example New Mexico and New York addressing the conflict head-on
Cross winds - CMS drops reimbursements for “covered entities” CE 30% in 2022.
There is still no clear winner. Ultimately having congress take action would be the quickest path to resolution - the barrier is public awareness to the battle and impact.
No matter which side you are rooting for the root cause and cure needs to be unification around an overhaul of the healthcare insurance system.
Interesting references :
1- More Court Battles Ahead for 340B in 2022: https://340binformed.org/2022/01/more-court-battles-ahead-for-340b-in-2022/
2- Unlawful Drug Company Limits on 340B pricing are Causing Big Losses for Safety-Net Hospitals - Richard Sorian - 340B Health - January 27 - 2022.
3- Safety-Net Hospitals See Losses from 340B Drug Discount Limits- Victoria Bailey2/8/22 Revcycleintelegence.com
4- Bristol Myers Squibb becomes 12th drug maker to announce 340B contract pharmacy restrictions. By Robert King Jan 19, 2022 https://www.fiercehealthcare.com/hospitals/bristol-myers-squibb-becomes-12th-drug-maker-to-announce-340b-contract-pharmacy
5 - Baker's dozen: Pfizer joins 12 peers in restricting sales of discounted drugs under a federal program Zachary Brennan- Senior Editor 2/1/2022
6- Statement on Federal Court Decision in AstraZeneca’s 340B Community Pharmacy Lawsuit. 2/16/22- Richard Sorian