Faces of 340B

Courtney Riddle, APRN, Adult Gerontology Primary Care and Family Care, Magnolia Regional Medical Center, Ark.

Magnolia Regional Medical Center is a 49-bed hospital in a rural community in Southwest Arkansas. More than a quarter of the community Magnolia serves lives below the poverty level, and Magnolia cares for many patients who are uninsured or covered by Medicaid. Courtney Riddle is a family nurse practitioner at the hospital’s rural health clinic. Magnolia created the clinic using 340B program savings, and it ensures patients do not have to travel far to access vital health care services, including through such innovations as psychiatric telehealth services. The hospital also uses its 340B savings to provide steep discounts on drugs to patients who are struggling to afford their medications. Patients access their drugs through a partnership that Magnolia has with a family-owned pharmacy that has been in operation in the community since 1962. Without the pharmacy partnership, patients would have to travel farther to access their medications. Courtney had a patient who was on the diabetes drug Jardiance to help lower blood sugar levels. However, when Eli Lilly and Boehringer Ingelheim became two of the companies denying 340B pricing to safety-net hospitals on drugs dispensed at community pharmacies, the patient’s out-of-pocket cost for a monthly supply of Jardiance went from $16 to $556. The patient is on a limited income and could not afford this huge price increase. Courtney had to work with the patient to prescribe her a different medication that would still help lower her blood sugar level and that also would not interact poorly with the other medications she is on for a separate chronic medical condition. This challenge took extensive time to navigate, putting the patient’s health at risk. Courtney is concerned that if drug companies continue to deny 340B discounts, it will lead to adverse medication reactions and worsened patient health outcomes.