340B Comes Under Fire During House E&C Health Subcommittee Hearing
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Three influential members of Congress—Reps. Renee Ellmers (R-N.C.), Tim Murphy (R-Pa.), and Bill Cassidy (R-La.)—voiced concerns about the 340B program during a House Energy and Commerce Health Subcommittee hearing yesterday, May 21.
Although the hearing was on Medicare payment reform, the three Representatives made observations and asked questions about 340B that echoed what the drug industry and private cancer physicians have been saying about the program: namely, that hospitals are profiting from 340B but not passing along savings to disadvantaged patients; and that 340B is driving up the cost of cancer care to patients and driving private oncology practices out of business. In addition, all three lawmakers implied that 340B hospitals have an unfair advantage over private doctors and for-profit clinics.
Here are examples of the types of statements that were made and questions that were asked:
“Are those dollars [340B savings] going… to the care that those patients who require charity care? Is a hospital, a hospital that is a 340B hospital…Are those dollars truly going where they are supposed to go?…Certainly not ever thinking that a hospital would be playing games, but I think if there is a wide and a very gray area there I think that a hospital will utilize them as they need to.” – Rep. Ellmers
“One of the concerns that I frequently hear about the 340B program, first of all its a great program and I support it strongly in many instances, but we also hear some are claiming there’s some abuses of that program where hospitals—well, some centers—will purchase drugs at discount but then they’ll sell them at the mark up again and get this money.” – Rep. Murphy
“In the last few weeks a report by the IMS on global oncology trends as well as other things shows that there is a different cost for Herceptin at different sites of service. That if you have a 340B hospital oncology based program that the delta between what they are charging and paying is such that it creates a competitive advantage relative to community oncological services.” – Rep. Cassidy
Click here for longer excerpts from the hearing.
This is not the first time that Reps. Cassidy and Ellmers have raised questions about 340B. Rep. Cassidy proposed legislation to curb drug shortages in 2012 that would have exempted the vast majority of generic injectable drugs sold in the U.S. from 340B discounts. He has written a number of letters to 340B hospitals questioning their use of the program. Also, in 2012, he and Rep. Joe Pitts (R-Pa.) sent a letter to HRSA Administrator Mary Wakefield stating that that 340B needs a new patient definition that “that ensures the program’s eligibility is for those truly in need and curbs any misuse of the program.”
Rep. Pitts chairs the Energy and Commerce health subcommittee that held yesterday's hearing. Just last week, Citizens Against Government Waste's website The Swine Line quoted him saying that recent government reports “raise important questions about the degree to which the 340B program may be fully accomplishing its core mission of helping the uninsured access prescription drugs.”
During an Energy and Commerce health subcommittee hearing on drug shortages in February, Rep. Ellmers expressed concern that 340B discounts might be discouraging drug manufacturers from remaining in the sterile injectable market and continuing investments in production facilities. The “explosion of the 340B discounts is reducing margins for generic manufacturers” and “pushing them to stop producing low-cost generic injectables,” she added.
Yesterday's hearing was a powerful reminder about why you need to reach out to your lawmakers and tell them in your own words what will be lost if 340B is curtailed or discontinued. 340B Health can provide you with all the support and documentation you need. But you need to be the ones who reach out to your lawmakers for our message about 340B to carry real weight. It's far easier for a member of Congress to tune out an association than it is for him or her to tune out a constituent. Make your voice heard today.
Also, we hope you will join us in Washington, D.C., July 16-17 for our summer Lobby Day at the conclusion of the 340B Coalition annual conference. Click here to register both for the conference and Lobby Day at the same time and here if you want to participate in Lobby Day only.
Please contact 340B Health Policy and Advocacy Manager Kathryn DiBitetto at kathryn.dibitetto@340bhealth.org or (202) 552-5855 if you have any questions. Also, please contact 340B Health Senior Director of Communications Randy Barrett at randy.barrett@340bhealth.org or (202) 536-2285 for help writing a letter to the editor or op-ed for your local newspaper or to pass along contact information for a patient to profile in our Faces of 340B series.
Thank you for your hard work and support!