Discount Prescription Drug Program Pads Profits, Fails to Help Uninsured or Under-Insured

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To the Editor:

We are blessed to live in this beautiful part of Connecticut.  From beaches to quaint main streets, the Connecticut shoreline is classic New England.

However, amongst the bustling tourism business and big companies that are huge economic drivers, it’s important to remember that we still have a large population that live with food and financial insecurity, and struggle to make ends meet. 

For 50 years, our organization has proudly served the older adults who live in our shoreline communities—many of whom need this type of assistance.  From Westbrook to Essex to Old Lyme, we help our clients live their best lives by providing nutrition services, help getting to and from appointments and free, preventative health services.

Our organization like many others benefits from state and federal funding to help provide some of our support services.  We take pride in using those dollars in the most efficient ways to get the best bang for our buck for the clients we serve.

That’s why it’s disappointing to hear about one federal program, that while intended to provide prescription medication at discounted rates to those in need, is instead raking in profits for hospitals and other healthcare facilities. 

The 340B program as it’s known was enacted in 1992 with good intentions—to get medication to Americans in underserved communities that are uninsured or under-insured. 

Under the program’s design, designated healthcare facilities are allowed to purchase prescription medications from manufacturers at a steep discount.  From there, the facilities are supposed to pass those savings on to patients by charging little or nothing for the medication.

However undersized regulation and oversized expansion of which facilities can purchase medications at a discounted price has led to gains in the bottom line of these healthcare facilities, but has not helped patients get the discounted medications they need.

In 2010, the government changed the parameters of what type of entity could purchase medications at a discounted rate — leaving the number of these ‘contract pharmacies’ to skyrocket more than 4,000 percent in the next 10 years.  And though one might assume that more pharmacies would mean more access points for patients, that’s not how the situation has played out.  In fact, 57 percent of hospitals reported to the Government Accounting Office (GAO) that they did not provide discounted drug prices to low-income, uninsured patients filling prescriptions at the covered entity’s contract pharmacy.

340B is now the second largest federal prescription drug program in the country – second only to Medicare Part D. 

This past legislative session in Hartford, proposals were on the table to expand those numbers—forcing pharmaceutical manufacturers to ship to more facilities—not to expand access to patients, but to continue the profit margin serve for hospitals and other entities in the healthcare system.   This includes shipping to facilities well outside of Connecticut—so how is that helpful to the patient populations we serve?

Other states where this type of expansion has been proposed by state legislatures are now facing legal challenges.  Arkansas for example has a similar law that is now bogged down in lawsuits.

Connecticut residents will be better served by our local lawmakers passing legislation that expands access to affordable treatments here at home.

Mingione is the Executive Director of The Estuary, an organization based in Old Saybrook that provides a variety of nutrition, transportation, social services and activities to adults aged 50 years and older along the Connecticut shoreline