Faces of 340B

MICHAEL LESSARD, SYSTEM DIRECTOR FOR PHARMACY CONTRACTING AND SUPPLY CHAIN, DARTMOUTH-HITCHCOCK HEALTH, NH

Dartmouth-Hitchcock Health is a small but vital health system serving some very rural areas of northern New Hampshire and Vermont. Despite its relatively remote region, the system is home to a renowned academic medical center, a cancer institute, and the only level 1 trauma center in New Hampshire. Through 340B participation by Mary Hitchcock Memorial Hospital, the system’s covered entity, Dartmouth-Hitchcock can offer a wider range of services and support that its communities need. These include a retail pharmacy offering discounted medications to people without prescription drug coverage and substance use disorder counselors embedded in the emergency department – a potential lifesaver in an area of the country hit particularly hard by the opioid crisis. Cutbacks in 340B savings would force program changes at Dartmouth-Hitchcock, which in the recent past has seen a year with a negative operating margin. It has grown its 340B program to achieve savings of about $45 million a year, but that is against a total of about $130 million a year in care the system provides patients for free through charity programs, indigent care, and uncompensated Medicaid care.