Faces of 340B

Robert Chapman, MD, Henry Ford Health System, Detroit, MI

Detroit is America's most impoverished city, with nearly 40 percent of its citizens living below the poverty line. Twenty-one percent of Detroiters under age 65 lack health insurance and 16 percent have a disability. More than 80 percent of residents are African American. They have the highest death rates and shortest survival of any racial or ethnic group for most cancers, and they are far more likely than whites to be diagnosed with their cancer already progressed to the Stage IV. Detroit also lacks a public hospital. Henry Ford Health System, a nonprofit healthcare network with an 800-bed hospital in the heart of the city, shoulders much of the burden of caring for all in Detroit regardless of their economic circumstances. The system provides more than $230 million in uncompensated care annually. Robert Chapman, MD, a practicing oncologist and director of Henry Ford's Josephine Ford Cancer Institute, says the $87 million the system saves on outpatient prescription drugs through the 340B drug discount program "takes some of the sting" out of the expense of its safety-net mission. "I see first-hand the circumstances that people who benefit from 340B program live in," Chapman says. "This is a program that makes a difference in people lives." Among other areas, 340B savings help make it possible for Henry Ford to provide cancer services at its four hospitals and at four oncology clinics across metropolitan Detroit. Without 340B savings, Henry Ford probably would not be able to sustain a patient education and monitoring program for those who take their cancer drugs by mouth at home as opposed to getting them infused under close supervision. "Without the 340B program, we almost certainly couldn't have put this very crucial safety mechanism together," says Chapman.