Leading Drug Pricing Experts - Legacy Health Endowment and Powers Law - Collaborate on Series of Issue Papers: Initial Paper Focuses on Intersection of PBMs and the 340B Drug Pricing Program

TURLOCK, Calif., June 29, 2021 /PRNewswire/ -- Americans spend more on prescription drugs than anyone else in the world and the cost of prescription drugs rose by 50 percent from 2009 to 2018.  Few Americans are aware, however, that the federal 340B drug pricing program is already providing relief from high drug prices for safety net providers and the communities they serve.  Many people also do not know that the 340B program is under attack from both the drug manufacturers selling 340B drugs and the pharmacy benefit managers (PBMs) paying for them.

To help shine a light on this critically important program, Legacy Health Endowment, a nonprofit health organization in Turlock, Calif., and Powers Pyles Sutter & Verville PC, a Washington D.C. law firm that specializes in healthcare law and policy, have produced a White Paper that examines the relationship between PBMs and the 340B program.  It is the first in a series of papers they will publish over the next year that delves into the intricacies of this important program that supports federally qualified health centers, Ryan White clinics, inner city and rural hospitals and other safety net providers responsible for delivering a disproportionate level of care to the uninsured and underinsured.

"The 340B program and PBMs are two inextricably linked pieces of the U.S. healthcare system," said Jeffrey Lewis, President, and CEO of Legacy Health Endowment.  "Their relationship is complex but vitally important to understand.  Over the next year, we hope to educate people as to how this program works, how it can be improved, and why its long-term sustainability is crucial to the American healthcare system and nonprofit healthcare providers.  To that end, Jeffrey Lewis and William von Oehsen have come together as two advocates with federal healthcare policy expertise to explain the importance of the 340B program and how to protect the program today and tomorrow."

Enacted in 1992, the 340B drug program operates on the principle that drug manufacturers must do their part to address uncompensated care in the U.S. as a condition of Medicaid and Medicare covering and reimbursing their products.  As a result, targeted nonprofit and governmental healthcare providers that are highly dependent on taxpayer support receive discounts on the drugs they purchase.  This, in turn, helps them offset the cost of being unreimbursed or under-reimbursed for patient care, benefitting the communities that they serve.

But the program is under attack.

PBMs and other payers are singling out 340B drugs and pharmacies for reduced reimbursement, which undermines the intent of the 340B program by transferring the program's benefits from safety net providers to for-profit payers.  Safety net providers use 340B savings in a variety of ways to benefit the vulnerable patients they serve.  They use the program not only to reduce the costs of rising drug prices, but also to offset losses incurred from treating low-income patients and to help pay for pharmaceutical and clinical services and linkage to care, such as case management, to facilitate access to appropriate care.  Hence, reduced reimbursement and other discriminatory contracting practices by PBMs ultimately rob patients of services that are only available and affordable by virtue of the 340B program.

To read the entire White Paper, please click on the following link: https://legacyhealthendowment.org/news/wp-content/uploads/2021/06/PBMs-and-340B-White-Paper-June-29-2021.pdf

About Legacy Health Endowment
Legacy Health Endowment is a nonprofit healthcare grant-making foundation that works solely within Merced and Stanislaus counties in California's Central Valley. LHE is not a hospital or healthcare services provider www.legacyhealthendowment.org

About Powers Law
Powers Pyles Sutter and Verville PC is a leading Washington, DC-based healthcare, education, and government relations law firm with a nationwide practice.  The firm's drug pricing practice is led by William von Oehsen, one of the architects of the 340B program.  He and others within the practice advocate for the interests of safety net hospitals, federally qualified health centers, Ryan White HIV/AIDS clinics, their pharmacies, and others.

SOURCE Legacy Health Endowment

Related Links

http://www.legacyhealthendowment.org