Nicolas Ferreyros: There Is Growing Recognition the 340B Program Is "Out of Control"

Growing bipartisan awareness of issues with the 340B drug pricing program will hopefully lead to reform, says Nicolas Ferreyros, BA, managing director of policy, advocacy, and communications at the Community Oncology Alliance.

With new investigations into the 340B drug pricing program, there is growing awareness of the issues and lack of transparency around where those drug discounts go, explained Nicolas Ferreyros, BA, managing director of policy, advocacy, and communications at the Community Oncology Alliance (COA).


Last fall, the New York Times published an investigation into how Bon Secours is allegedly misusing the 340B program. Since then, what signs of movement are you seeing to look into and reign in the 340B drug pricing program?

I think for the first time in a long time, you are seeing bipartisan recognition in the federal government that the 340B program is out of control. You are also seeing increasing awareness that hospitals aren't necessarily the good faith actors that they've always made themselves out to be. You see increasing amounts of media coverage around them going after debt and debt collection of their patients, the supposed “nonprofit” status of hospitals that increasingly are operating as sort of venture capital funds. They have incredible tax breaks and benefits. And then on top of all of that, you get the 340B program where we've done research—we put out research last year that showed that they're marking up the price of their drugs up to 5 times for uninsured or underinsured patients. And those discounts, nobody knows where those discounts go.

340B discounts, when they're in the grantee setting, there's pretty strict reporting and transparency requirements that are there. With the hospitals, it's a black hole. It could be a piano in the lobby, it could be free drugs, but nobody really knows. You’re starting to see increasing awareness that we need more understanding of what the 340B program is doing, where those discounts are going, and who they're benefiting.

For the first time in a long time, there's bipartisan awareness of that and a lot of discussion about that. The New York Times article that highlighted Bon Secours was, by far, one of the most eye-opening examples of that, but we know that that happens across the country in lots of different settings.

Also, we worked with the Wall Street Journal to help them gather data on hospitals, and they put out a great report right around the New Year also looking into this issue. And this is not the first time. There have been studies in Health Affairs and journals, and we've put out a lot of them examining 340B. And so hopefully in the next year, we will see a lot more movement on this issue and a lot more exploration of what 340B is doing.

And then we're really hopeful that it will be reformed. It remains to be seen what's going to happen, because that is a pretty big and dramatic step, but even just better understanding and baby steps towards transparency and accountability, and the program. COA strongly believes in 340B follow the patient. That means the discounts go to the people in need. We already have lots of means of testing things in health care in our country, and 340B could very easily be an added benefit to that to vary where it's going to the patient and not a hospital's bottom line.

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