340B reports
New: 340B Hospitals Advancing Health Equity
As 340B hospitals serve a disproportionate share of underserved populations, these hospitals are well positioned to make significant strides toward health equity. 340B providers respond to the unique needs of the communities they serve through a wide range of targeted programs aimed at addressing health inequities. They include data-driven applications of targeted health services and support, programs to address social determinants of health (SDoH), and internal initiatives on diversity, equity, and inclusion (DEI). This report builds on past work and provides additional case studies demonstrating the efforts of 340B hospitals in addressing health inequities and improving health for all populations. Read the report.
Drugmakers Pulling $8 Billion Out of Safety-Net Hospitals
As of June 1, 2023, a total of 21 drugmakers have imposed restrictions on community and specialty pharmacies with which 340B hospitals contract to dispense 340B drugs to eligible patients, and many of these have significantly tightened the restrictions since March 2023. More have announced restrictions since this analysis was completed. New data on 340B sales for 2020 and 2021 obtained from the Health Resources & Services Administration (HRSA) through a Freedom of Information Act (FOIA) request combined with member data on 340B savings at the national drug code (NDC) level has allowed 340B Health to estimate the total 340B savings associated with community and specialty pharmacies for the first 21 manufacturers in 2023 dollars as well as analyze specific patterns of manufacturer behavior. Read the report.
340B Health Annual Survey 2022: Vital 340B-Supported Patient Services Threatened as Manufacturer Restrictions Cut Into Savings
In November and December 2022, 340B Health conducted its annual survey of hospital members to learn about how they use their 340B savings to support care for patients with low incomes and living in rural areas. The survey also explored program operations and finances, including the impact of manufacturer restrictions on 340B savings through community and specialty contract pharmacies. Nearly half of 340B hospitals faced declining savings as manufacturer restrictions on 340B discounts at contract pharmacy expanded. These reductions made it more challenging for 340B hospitals to use the program savings as intended, which is to leverage scarce federal resources to support programs and services for patients with low incomes and living in rural areas Read the report.
Restrictions on 340B Contract Pharmacy Increase Drug Company Profits but Lead to Lost Savings, Patient Harm, and Substantial Burden for Safety-Net Hospitals
Drug company restrictions on 340B discounts for drugs dispensed at community and specialty contract pharmacies have harmed patient care by stripping billions of dollars from safety-net hospitals since 2020. An analysis of 340B sales data from the Health Resources & Services Administration (HRSA) finds that hospitals’ 340B savings for the first five of the 21 companies to restrict discounts decreased by an estimated $1.1 billion from 2020 to 2021 alone. An accompanying survey of 600 hospitals details the care disruptions these cuts have caused to patients in need. Read the report and see our infographic summarizing the key findings.
340B DSH Hospitals Serve Higher Share of Patients with Low Incomes
340B disproportionate share (DSH) hospitals treat greater numbers of Medicaid patients and Medicare beneficiaries with low incomes than their non-340B counterparts. These 340B hospitals provide the preponderance of the hospital care received by Medicaid patients and are more likely to offer essential community services and other programs focused on health and social needs. Read the report and see our infographic summarizing the key findings
340B Hospitals Provide Care for High Percentages of Historically Underserved Patients
Hospitals participating in the 340B drug pricing program are treating higher percentages of patients who historically have encountered difficulties accessing care when needed. Patients seeking care at 340B hospitals are significantly more likely to be dually eligible for Medicare and Medicaid, be eligible for Medicare because of a disability, or to identify as Black than those seeking care at non-340B hospitals and physician offices. Read the report.
340B DSH Hospitals Increased Uncompensated Care in 2020 Despite Significant Financial Stress
In 2020, the COVID-19 pandemic disrupted the delivery of health care services across the U.S. Nationwide, hospitals and health systems ended the year with significant reductions in volume and outpatient revenues while expenses increased. 340B DSH hospitals experienced a sharp decline in their average operating margin, which already was negative, of 2.6 percentage points or 74%. At the same time, 340B DSH hospitals increased their average provision of uncompensated and unreimbursed care by nearly 10%. For non-340B hospitals, the average operating margin increased by 21% while the average level of uncompensated and unreimbursed care remained flat. This pattern provides important evidence that 340B DSH hospitals are continuing to fulfill the program’s purpose as set out by Congress in 1992. Read the report.
340B Hospitals Remain on the Front Lines of the National Campaign to Pursue Health Equity
Hospitals participating in the 340B drug pricing program play important roles in advancing health equity in the U.S. These safety-net providers serve the largest percentages of patients in need, including members of communities that historically have been underserved by the broader health care system. A new report from 340B Health profiles seven hospitals and health systems that are pursuing health equity by deploying health access and quality improvement initiatives. 340B savings are an essential source of support for these providers. Read the report.
Contract Pharmacy Restrictions Represent Growing Threat to 340B Hospitals and Patients
Unlawful drug company restrictions on 340B drug pricing program discounts are causing growing financial losses for safety-net hospitals as more companies impose such limits and increasingly target discounts on costly specialty drugs. A new 340B Health survey of more than 500 hospitals finds the estimated annual financial impact from these policies has more than doubled since the end of 2021. The addition of more drug companies to the list has rapidly exacerbated the problem for safety-net hospitals and the patients they serve. Drug companies’ increased focus on limiting discounts for costly specialty drugs that hospitals must obtain for their patients using multiple specialty pharmacy partners is helping feed the rapid growth in losses. Read the report and see our infographic summarizing key findings.
2021 340B Health Annual Survey: 340B Continues to Support Essential Programs and Services in the Face of Significant Financial Stress on Hospitals
In November and December 2021, 340B Health conducted its annual survey of hospital members to learn about how 340B hospitals are using their 340B savings to support care for patients with low incomes and/or living in rural areas and other features of program operations and finances, including the impact of manufacturer restrictions on community and specialty contract pharmacies. Despite the enormous financial pressures of responding to the COVID-19 pandemic and restrictions on 340B discounts imposed by a growing group of drug companies, all 340B hospitals continued to use savings from the program to pay for expanded access to vital services including free and low-cost drugs, uncompensated care, and programs to improve health outcomes. Read the report and see our infographic summarizing key findings.
Unlawful Drug Company Limits on 340B Pricing Are Causing Big Losses for Safety-Net Hospitals
Hospitals participating in the 340B drug pricing program are losing significant resources due to the unlawful actions of a group of drug companies that are limiting the availability of 340B discounts for drugs dispensed by community pharmacies. A new report quantifies the loss of savings and demonstrates these losses are particularly acute for the nation’s network of small, rural hospitals. Read the report.
340B Hospitals Are Directing Savings Toward Their Communities’ Unique Needs
Hospitals and health systems participating in the 340B drug pricing program provide a wide variety of targeted services to their patients and communities using the savings created by drug discounts. These 340B savings provide needed resources to safety-net hospitals to create programs that meet the specific demographic and disease-specific challenges of these communities. A new report profiles 10 safety-net hospitals and health systems that have identified community-specific health care needs and use a range of strategies to direct 340B resources toward meeting those needs. Read the report.
Diabetes Drugs Heavily Impacted by Drugmakers' 340B Policies
People with diabetes and the safety-net providers who care for them are bearing the brunt of the actions by a small group of drug companies to deny or limit 340B discounts to hospitals that partner with community pharmacies. A new report finds the three major manufacturers of insulin in the U.S. are reaping additional profits due to their 340B policies. The federal government has told the companies that their actions are unlawful, but they are challenging those determinations in federal courts. Read the report.
Comparison of Medicare Beneficiaries Treated in 340B Hospitals, Non-340B Hospitals, and Independent Physician Offices
Hospitals participating in the 340B drug pricing program treat significantly higher percentages of Black, disabled, and low-income patients living with chronic medical conditions than do non-340B hospitals or private physician offices. A new report commissioned by 340B Health examines care for 27 chronic conditions to determine the characteristics of patients treated in these settings. Researchers from KNG Consulting examined Medicare claims data from 2017-2019 for a host of conditions that require ongoing care. Read the report.
340B Health Annual Survey: 340B Hospitals Use Savings to Provide Services and Improve Outcomes for Low-Income and Rural Patients
This year’s 340B Health survey documents the multiple programs and services made possible by the savings the 340B program provides to safety-net and rural hospitals. By offering care and assistance such as free and reduced-price medications, medication therapy management, and comprehensive oncology programs, 340B hospitals are using 340B savings to meet a wide variety of community needs, especially for populations with low incomes or who live in rural communities. 340B savings are helping many 340B hospitals respond to COVID-19. Without the 340B program, critical programs would need to be scaled back. In some cases, loss of 340B funding could lead to closure. Read the report, see our infographic summarizing key findings, and see more details on the effect of drug company restrictions on 340B community pharmacies.
340B Hospitals in Pursuit of Health Equity
340B hospitals are on the front lines of building a more equitable health care system. They serve populations that are more diverse and provide the safety net for people living with low incomes. This set of best practices illustrates how 340B hospitals are pursuing health equity. Featured hospitals have undertaken a range of activities, including creating diversity in leadership and hiring, collecting data on race and ethnicity, measuring outcomes for different groups, addressing social determinants of health, partnering with the community to make change, and many other strategies. Read the report and see our infographic summarizing the key findings.
The Role of 340B Hospitals in Serving Medicaid and Low-Income Medicare Patients
340B DSH hospitals treat higher levels of Medicaid and low-income Medicare patients than their non-340B counterparts, provide three-quarters of hospital care received by Medicaid patients, have lower margins, and are more likely to provide highly specialized services, essential community services, behavioral health services, and services to promote community health, wellness, and access. Read the report and see our infographic summarizing the key findings.
Characteristics of Cancer Patients Receiving Drugs at 340B DSH Hospitals, Non-340B Hospitals, and Physician Offices
Disproportionate share (DSH) hospitals participating in the 340B drug pricing program treat larger percentages of cancer patients who are living with low incomes, are disabled, or are members of racial/ethnic minority populations than non-340B hospitals or physician offices, according to a new issue brief. Read the brief.
Addressing the Challenge of Diabetes with 340B Program Savings
Safety-net hospitals use 340B drug pricing program savings to help patients with diabetes afford insulin and to support a wide range of other programs to meet their needs for medical care, education, and disease management. This report provides examples of the direct links between 340B and caring for patients with diabetes. The seven hospital and health system case studies profiled represent a snapshot of the types of diabetes programs that 340B supports and the improved patient health outcomes it achieves. Read the report and see our infographic summarizing the key findings.
340B Program Savings Improve Patient Health Outcomes
Hospitals across the U.S. are using savings from the 340B drug discount program to improve health outcomes for patients living with chronic conditions and reduce overall costs. This report profiles the work of nine hospitals to improve health through a variety of approaches that include help paying for costly drugs, medication management, and assistance with adherence to treatment regimens. Read the report and click here for an infographic summarizing the key findings.
A Comparison of Characteristics of Patients Treated by 340B and Non-340B Providers
340B hospitals provide more care to the nation’s underserved populations compared with non-340B hospitals and private physician offices. Using FY2016 Medicare claims data, researchers at L&M Policy Research find that 340B hospitals treat more patients who are disabled, dually eligible for Medicaid and Medicare, or of certain ethnic/racial minorities. Read the report and click here for an infographic summarizing the findings.
340B Hospitals on the Front Lines of Addressing the U.S. Opioid Epidemic
The United States is currently facing an opioid epidemic that has resulted in more than 700,000 deaths between 1999 and 2017 and cost the economy an estimated $1 trillion since 2001. As safety-net providers, 340B hospitals have been on the front lines of this issue by establishing targeted programs and services to address the epidemic and prevent further cases of opioid use disorder in their community. This report seeks to better understand the specific role 340B hospitals are playing to address the crisis within their communities, the nature of the programs and services implemented, and how 340B program savings are helping them in their efforts. Read the report and click here for an infographic summarizing the key findings.
Evaluating the Impact of Raising the DSH Adjustment Percentage Threshold for 340B Program Eligibility on DSH Hospitals and their Low-Income Patients
A recently released Congressional proposal seeks to raise the minimum Medicare disproportionate share (DSH) adjustment percentage required for DSH hospitals to participate in the 340B program from 11.75 percent to 18 percent – a 53 percent increase in the DSH adjustment percentage. Such a change would lead to the termination of 573 DSH hospitals or 51 percent of all DSH hospitals currently enrolled in the program. These hospitals provided roughly $10.8 billion in uncompensated and unreimbursed care in 2016. Losing access to 340B savings would affect the ability of these hospitals to continue providing this high level of care to low-income patients. Nearly 75 percent of states would see 50 percent or more of their DSH hospitals cut from the program, with five states having all of their DSH hospitals cut from the program. Read the report.
Medicare Part B Cuts Fact Sheet
This two-pager provides basic facts about the 340B program, how it works, the damage the CMS CY 2018 OPPS final rule would do, and legislation to stop the cuts from taking effect. Click here for a fact sheet.
Medicare Part B Cuts Hurts 340B Hospitals and Patients
The CMS CY 2018 OPPS final rule does not lower drug prices, does not save Medicare money, and does not reduce patients’ drug costs. But it harm hospitals serving low-income communities, forces hospitals to reduce services and layoff staff, and hurts patients. Click here for an infographic.
Analysis of 340B Disproportionate Share Hospital Services to Low-Income Patients
340B disproportionate share hospitals provide higher levels of care to patients living with low incomes than non-340B hospitals. This analysis used FY 2015 data to determine that 340B DSH hospitals treat more low-income patients, provide more uncompensated and unreimbursed care, and are more likely to provide specialized health care services that are critical to low-income patients but are often underpaid. 340B DSH hospitals provide 60% of all uncompensated and unreimbursed care despite making up only 38% of all acute care hospitals. Read the report and see our infographic summarizing the key findings.
Assessing the Financial Impact of the 340B Drug Pricing Program on Drug Manufacturers
340B Health commissioned the research firm Dobson DaVanzo & Associates to assess the financial impact of 340B discounts on drug manufacturers and evaluate the plausibility of claims that the 340B Program is a cause of pharmaceutical price increases, cost shifting, and reductions in private sector research and medical discovery. The analysis found that the 340B Program cannot plausibly be a major driver of U.S. drug spending or a major cause of cost shifting by drug manufacturers to make up for 340B discounts. Read the report and click here for an overview of the report’s findings, and click here for an infographic summarizing the findings.
Financial Challenges Faced by 340B Disproportionate Share Hospitals In Treating Low-Income Patients
340B Health commissioned the research firm Dobson DaVanzo & Associates to evaluate the financial challenges faced by disproportionate share (DSH) hospitals participating in the 340B drug discount program due to their characteristics as safety net hospitals and their unique patient populations. Read the report.
Analysis of the Proportion of 340B DSH Hospital Services Delivered to Low-Income Oncology Drug Recipients Compared to Non-340B Providers
340B Health commissioned the research firm Dobson DaVanzo & Associates to evaluate whether 340B disproportionate share (DSH) hospitals treat a higher proportion of low income oncology drug recipients than do non 340B providers. Read more.
HRSA's Proposed Omnibus Guidance Would Jeopardize 340B Hospitals: Results from a Survey of 340B Health Members
The Health Resources and Services Administration’s 2015 proposed guidance on the 340B Drug Pricing Program may have intended to cut through previous confusion in the administration of the program, but a survey of 340B Hospitals indicates the proposed guidance would cause significant harm to hospitals that rely on 340B to provide critical care in their communities. Read the report.