Research tracks the variety of pharmacies taking part in discounted drug pricing program

For greater than 30 years, part 340B of the Public Well being Service Act has required drug producers to promote outpatient medication at discounted costs to sure safety-net hospitals and well being care organizations that serve uninsured or low-income sufferers. 340B-eligible well being care suppliers (known as “lined entities”) contract with pharmacies to dispense the discounted medication—a mutually useful relationship that will increase income for suppliers and pharmacies. As we speak, about 40% of retail pharmacies throughout the nation have at the least one contract with a 340B-eligible well being care supplier.

A brand new research from the College of Minnesota College of Public Well being (SPH) examines latest tendencies within the relationship between pharmacies and 340B-eligible lined entities (CEs). The research takes an in-depth have a look at pharmacies’ relationship with well being care suppliers by creating new measures to explain different types of contract pharmacy progress past easy participation charges.

Particularly, the research checked out how pharmacies’ involvement with 340B has modified between 2009 and 2022 in three key metrics developed by the researchers:

• Depth, which measures the variety of contracts every pharmacy within the U.S. holds.
• Unfold, which measures how far pharmacies are geographically from the lined entity.
• Security-net composition, which is the proportion of a pharmacy’s contracts which can be with lined entities which can be “important group suppliers,” as measured by the Medicaid and Kids’s Well being Insurance coverage Program Cost and Entry Fee.

The research, revealed in JAMA Well being Discussion board, discovered:

• The general variety of pharmacies taking part in 340B elevated dramatically, from 789 in 2009 to 25,775 in 2022. In 2009, 1.3% of retail pharmacies participated in 340B, in comparison with 40.9% in 2022.
• Depth elevated. In 2009, 81% of retail pharmacies had just one contract, and by 2022, 40% had one, 23% had two, 27% had three to 5, 7% had six to 9, and three% had 10 or extra.
• Unfold additionally elevated. In 2009, the farthest CE was throughout the similar zip code for 48% of pharmacies. By 2022, solely 9% of CEs have been in the identical zip code.
• Security-net composition decreased. In 2009, 95% of pharmacies contracted solely with safety-net hospitals and clinics. By 2022, solely 54% of pharmacies contracted solely with safety-net amenities, and 16% contracted with no safety-net amenities.

“The 340B Drug Pricing Program goals to enhance entry to look after sufferers who depend on the well being care security internet,” stated Sayeh Nikpay, SPH affiliate professor and lead creator of the research. “Traditionally this program has concerned the hospitals and their clinics that take part in this system. Nevertheless, our research paperwork that pharmacies are taking part in a rising position in this system. Whether or not this rising participation furthers this system’s targets of accelerating entry to the look after sufferers who depend on the safety-net has but to be seen.”

Limitations of the research embrace the shortage of knowledge on the amount of 340B medication disbursed by means of retail pharmacies, which might have allowed the researchers to distinguish contracts by profitability. Additionally, the research’s deal with retail pharmacies meant that information on mail-order and specialty pharmacies was not included. Nikpay is at the moment engaged on analysis that might tackle specialty and mail-order pharmacies.