Friday, June 26, 2015

340b: A Peculiar little Designation that is Worth $$$

By: David W. Poole, Director of Legislative Affairs, Southern Bureau, AIDS Healthcare Foundation

“340b” is a simple 3 digit number with one letter of the alphabet attached that represents so much more than what this peculiar little designation might imply. Since 1998, Section 340b of the Veterans Care Act of 1992 (Public Law 102-585) has ensured that millions of dollars in life-saving treatments purchased by eligible federally funded entities under the Ryan White CARE Act of 1990, as amended, are priced at a much reduced level that is calculated and prescribed clearly in law and policy.

For the purposes of this editorial we are focusing only on the HIV/AIDS universe inclusive of the benefits to the patients and their providers, although the overall 340b program extends well beyond the Ryan White eligible world to other healthcare providers that serve many different patient populations beyond HIV/AIDS.

The 340b program is under serious scrutiny for change by many stakeholders, most notably the pharmaceutical and biologics industry who resist and reject anything such as federal law that erodes their profit margins. Make no mistake about it, their interest in seeing the 340b program “brought under control” is all about profits. “Abuses” can be cited as the reasons for wanting change; however, abuses can be addressed in many effective ways that do not require legislation.

Pill capsule with the words "340b" on it
Source: Rx Showcase
The 340b program provides much more than better pricing to the eligible Ryan White entities; it provides an opportunity for these non-profit agencies to generate revenue that is reinvested back into the HIV/AIDS community in the form of expanded care and treatment capacity. This benefit extends to state Departments of Health (via the AIDS Drug Assistance Programs), hundreds of AIDS Service Organizations and clinics, and their patients nationwide that are already dealing with a ridiculously complex healthcare payer landscape where the Affordable Care Act (ACA) and Ryan White intersect, especially in states where Medicaid expansion has not and is NOT likely to occur anytime in the near future.

In addition, assurances of long term and sustained care and treatment funding from the Health Resources and Services Administration (HRSA) appears to be over or at the very least in serious jeopardy. HIV/AIDS is no longer the public health priority it once was and we must speak out loudly when a threat to stable funding resources such as 340b becomes imminent – and it should be noted that this funding is on the backs of healthy and robust for-profit industry giants.

Again, our voices must be heard and we must not succumb to the influence of an industry that wants to see their profit margins protected. We are the first to acknowledge the excellent simple antiretroviral treatment regimens and options that have been introduced by the pharmaceutical industry starting in the summer of 2006; however, we must also cite this industry for some of the highest profit margins realized by any business sector. So let’s make it known through very effective advocacy that the 340b section of the Veterans Care Act as it pertains to Ryan White eligible entities should be OFF-LIMITS!

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates. 

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