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Missouri community healthcare centers face 340B uncertainty

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Thursday, September 28, 2023   

While large hospitals and pharmaceutical manufacturers battle over drug costs, Missouri community health centers see themselves as collateral damage.

Section 340B of the 1992 Public Health Service Act, allows small community health centers and hospitals to buy pharmaceuticals at highly discounted prices.

Colleen Meiman, national policy adviser for the State Association of Community Health Centers, said the centers use the savings to support other community support services like dental, behavioral health or opioid treatment programs, all without taxpayer dollars.

"We don't have any negotiating power. We're stuck having to pay full price because we've got this tiny little nonprofit community entity up against a giant drug company," Meiman pointed out. "The law was meant to equalize that a little bit and then enable us to get the drugs at a discount."

Drug manufacturers are concerned about the misuse and fast expansion of the 340B program. Hospital and pharmacy drug provider sites increased from 8,100 to 50,000 between 2000 and 2020. An August 2022 report by the Health Resources and Services Administration found discount drug purchases through 340B increased 16% between 2021 and 2022 to $44 billion.

Meiman noted 340B can be helpful in Missouri where she lives, but added current restrictions limit the number of contract pharmacies in a given area of the state, which can create hardships for patients.

"In Missouri it can be hard to get around in the wintertime," Meiman explained. "If suddenly you have to drive a really long distance to get your medications, either because that's the only way you can get them discounted enough to afford them, because you're low income uninsured, or because you were trying to support your health center."

Meiman added health centers across the country have been forced to reduce staff or curtail services because they have lost access to 340B savings.


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