The Need for Reform in the 340B Drug Discount Program and the Expansion of Comprehensive Care for Chronic Kidney Disease

The Need for Reform in the 340B Drug Discount Program and the Expansion of Comprehensive Care for Chronic Kidney Disease

Introduction:

The 340B Drug Discount Program, created by Congress in 1992, aimed to address the issue of overreaching government price controls in the Medicaid drug benefit program. The program requires pharmaceutical companies to provide discounts to certain federally funded healthcare facilities and disproportionate share hospitals (DSH) known as "covered entities." However, due to unclear legislation, questionable guidance, and expansion under the Affordable Care Act, the program has experienced exponential growth and is vulnerable to abuse. On the other hand, leading health and well-being company Humana Inc. has recently partnered with Interwell Health to expand comprehensive care for individuals living with chronic kidney disease (CKD). This article explores the need for reform in the 340B program and the importance of comprehensive care for CKD patients.

The Growing Concerns Surrounding the 340B Drug Discount Program:

The 340B program was designed to provide access to prescription drugs for patients of covered entities and stretch federal resources. However, the program's rapid growth and lack of clarity in legislation and guidance have led to unintended consequences. A report by BRG highlighted how the shift in oncology care from physician offices to hospital outpatient settings has increased healthcare costs. In fact, profit margins on physician-administered oncology drugs purchased at a 340B price rose from 40 percent in 2010 to 49 percent in 2015, creating financial incentives for hospitals to expand oncology services. Furthermore, the program's discounted prices have skyrocketed from $9 billion in 2014 to $38 billion in 2020, indicating a 322 percent increase within six years. The recent IQVIA study also revealed ongoing misuse of funds by hospitals and contract pharmacies, undermining the program's intended benefits for patients.

The Need for Reform:

Given the program's significant growth and vulnerability to abuse, it is crucial to implement reforms to ensure its effectiveness and accountability. Clearer legislation and guidance are necessary to address the loopholes that have allowed the program to be exploited. Additionally, there should be stricter oversight to prevent excessive profit margins and ensure that the savings generated through the program are genuinely benefiting eligible patients. By addressing these issues, the program can fulfill its original purpose of providing affordable access to prescription drugs for those in need.

The Importance of Comprehensive Care for Chronic Kidney Disease:

While the 340B program requires attention and reform, it is equally important to recognize the significance of comprehensive care for individuals living with chronic kidney disease. Leading health and well-being company Humana Inc. has entered into a value-based care agreement with Interwell Health to provide enhanced care for both Medicare Advantage HMO and PPO members with CKD and those with end-stage kidney disease (ESKD). This agreement spans across 13 states and aims to improve the quality of life for these individuals by offering specialized care and support. By focusing on comprehensive care, Humana and Interwell Health aim to address the complex needs of CKD patients, ensuring they receive the appropriate treatment and management to maintain their health and well-being.

Actionable Advice:

• 1. Enhance Transparency and Accountability: To reform the 340B Drug Discount Program, it is crucial to establish clearer legislation and guidance that address potential loopholes and prevent misuse of funds. Stricter oversight should be implemented to ensure that the program delivers on its intended purpose of providing affordable access to prescription drugs for eligible patients.

• 2. Foster Collaboration and Innovation: The partnership between Humana and Interwell Health highlights the importance of collaboration in delivering comprehensive care for chronic kidney disease patients. Encouraging similar partnerships between healthcare providers, insurers, and specialized care organizations can lead to more effective and tailored approaches to managing chronic conditions.

• 3. Prioritize Patient-Centered Care: Comprehensive care for chronic kidney disease should prioritize the individual needs of patients. By focusing on patient-centered care, healthcare providers can ensure that CKD patients receive personalized treatment plans, ongoing support, and education to empower them in managing their condition effectively.

Conclusion:

The 340B Drug Discount Program requires an overhaul to address the issues of exponential growth and abuse. Clearer legislation, guidance, and increased oversight are necessary to ensure the program's effectiveness and accountability. Simultaneously, partnerships like the one between Humana and Interwell Health demonstrate the importance of comprehensive care for individuals living with chronic kidney disease. By prioritizing patient-centered care and fostering collaboration, healthcare providers can offer specialized support to improve the quality of life for CKD patients. Through these actions, we can work towards a healthcare system that provides affordable access to medications and comprehensive care for those in need.