The constant aches and pain some people feel in their joints are a daily obstacle. As a rheumatologist, I witness these patients’ struggles with pain compounded by the hurdles they have to clear to gain access to the medications they need to manage their symptoms. This is not unique to my practice; more than half of Illinoisans have at least one chronic condition.
The federal 340B Drug Pricing Program is a safety net for vulnerable patients that requires pharmaceutical manufacturers to provide substantially discounted prices on outpatient drugs to specific hospitals, community health centers and other providers, known as “covered entities” and “contract pharmacies.” However, there are no requirements that these covered entities pass the savings along to patients or report how they use these discounts to help eligible patients.
In recent years, some covered entities have been pocketing the difference between the amount they are reimbursed through the 340B program and the 340B price they paid for the medicine — earning billions in the process. One report found that the average profit margin on 340B program medicines dispensed through contract pharmacies was 72%, compared with just 22% for non-340B medicines.
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Today, the 340B program is a broken promise to Illinois’ neediest patients. Our health care system has a finite number of resources, and it’s concerning that 340B program drug discounts, intended to aid underserved communities, are being misdirected toward wealthier communities, straining the system’s ability to provide equitable care. In Illinois, only 21% of 340B program contract pharmacies are in low-income areas, and 59% of 340B hospitals are below the national average for charity care, while the proportion of 340B contract pharmacies in the wealthiest neighborhoods has risen.
The 340B program has also accelerated health care consolidation, threatening private physician practices and their patients. Covered entities gain a competitive edge by purchasing drugs at a 20% to 50% discount through their 340B program status, providing a revenue and cash flow advantage that physician practices like mine and outpatient clinics cannot match. Large 340B program hospitals are historically responsible for 80% of hospital acquisitions, directly impacting access to rheumatologists and other providers in rural and underserved communities, forcing these practices to close or merge with more expensive sites of care.
House Bill 3350 would further exploit the 340B program and accelerate health care consolidation without placing any guardrails to prevent abuse or ensure low-income Illinoisans benefit. Without patient-centered reforms, the 340B program will only continue to grow without serving the most vulnerable patient populations.
Erin Arnold, M.D., board member, Coalition of State Rheumatology Organizations, Skokie
American horror story
President Donald Trump has compared his first 100 days to those of President Franklin D. Roosevelt, who, during the Great Depression, implemented multiple executive actions. However, Trump is mistaken on one key point. Roosevelt famously calmed a nervous nation by famously saying, “The only thing we have to fear is fear itself,” while Trump has many Americans feeling that the only thing we have to fear is Trump himself.
Paul L. Newman, Merion Station, Pennsylvania
Laugh bag
Thanks to Sun-Times reader Felicia Carparelli for her letter about U.S. Homeland Security Secretary Kristi Noem having her purse stolen with $3,000 in it. I had a good laugh. Who carries that much cash? Noem sounds like an airhead.
Virginia Dare McGraw, Naperville