Faces of 340B

David Jones, MD, chief medical officer, Riverside Shore Memorial Hospital, Va.

Riverside Shore Memorial Hospital is a 52-bed disproportionate share hospital that serves the Eastern Shore of Virginia. In addition to caring for a high percentage of patients with low incomes, the hospital and its patients face the challenge that its community is physically separated from the rest of Virginia by a bay. The only way to access the Eastern Shore by land is to travel over an 18-mile bridge/tunnel that includes a toll. The hospital’s 340B partnerships with community pharmacies enable patients to receive their medications close to home, David Jones says. This improves patient medication adherence, which leads to better health outcomes. When drug companies restricted 340B discounts to Riverside on drugs dispensed at community pharmacies, Jones saw firsthand the adverse effects on patients, including one of his patients with chronic obstructive pulmonary disease (COPD). The patient is underinsured, and 340B discounts to Riverside enabled the patient to afford the maintenance inhaler medications he needed to manage the disease. Restrictions on 340B pricing meant that the patient no longer could afford one of his inhaler medications. This resulted in the patient experiencing shortness of breath, requiring additional office visits, and needing to take alternative medications that were less effective and had side effects. Jones feels certain that his COPD patients will have increases in emergency department visits and hospitalizations if drug company 340B restrictions continue.