340B Drug Pricing Program

Helping Indiana hospitals keep patients and communities healthy

Thousands of Hoosiers struggle to pay for health care, whether they are uninsured or underinsured or suffer from chronic conditions that drain their resources with each prescription or treatment.

For these vulnerable people, safety net providers—supported by the 340B Drug Pricing Program—make all the difference.

Since its enactment in 1992, the 340B Drug Pricing Program has enabled safety net health care providers to access discounted drugs, allowing them to stretch their resources and provide more comprehensive services to their vulnerable patients. The 340B program requires pharmaceutical manufacturers participating in Medicaid to sell outpatient drugs at discounted prices to hospitals and other organizations that care for many low-income and uninsured patients or that serve isolated rural communities.

The program is a vital lifeline for safety net providers, supporting critical health services in communities across Indiana. Indiana hospitals use 340B savings to provide:

  • Increased access to care
  • Clinical pharmacy services
  • Community outreach programs
  • Free vaccinations
  • Transportation to follow-up appointments

If 340B disappeared today, the impact would be devastating to patients and far reaching for hospitals. Share with lawmakers the success of the 340B program to patients in your community. Visit IHAconnect.org/IHA-advocacy to find your lawmakers and their contact information.

340B IN ACTION: ST. CATHERINE HOSPITAL, EAST CHICAGO

  • 82% of patients are on Medicaid and/or Medicare or lack health insurance
  • Designated HPSA (Health Professional Shortage Area) in primary care
  • 31% DSH (Disproportionate Share Hospital) percentage

St. Catherine Hospital has provided compassionate, high-quality care to the community of East Chicago and neighboring cities for nearly a century. St. Catherine Hospital, a 211-bed hospital that received five-star ratings in 2016-17 from the Centers for Medicare & Medicaid Services, offers a wide range of services in specialty areas ranging from acute, cardiac and cardiovascular care and behavioral health services to diagnostic imaging, interventional radiology and radiation therapy.

St. Catherine Hospital participates in the 340B program by virtue of its high volume of Medicaid, self-pay and low-income Medicare patients and its dedication to serving a diverse population in a designated health professional shortage area. English is a second language for many who live within the hospital’s service area.

“We rely on 340B savings to provide free services to low-income patients and to expand the hospital’s services, especially in outpatient settings. The 340B savings also enable the hospital to put programs and services in place to help prevent readmissions, promote good health and keep health care costs down,” said Koula Tsahas, director of pharmacy at St. Catherine Hospital.

340B Savings Support

  • Free health screenings and assessments to determine risk for cardiovascular disease and diabetes
  • Diagnostic services, treatment, medication and physician consultation at no-cost or low-cost to patients
  • Community education, lectures and preventive care programs
  • Transportation to the hospital, outpatient treatment settings and wellness activities or events
  • Continuity of care to the community

Why 340B

“Without the 340B program, St. Catherine Hospital may not be able to operate the hospital’s Infusion Clinic, which provides oncology services to low-income and underinsured/uninsured patients,” said Tsahas.

Doctors also refer patients to the Infusion Center for antibiotics, central line care, blood products, injections, dressing changes and infusion therapy for treatment of Crohn’s disease, chronic pain and genetic, pulmonary, kidney and liver disorders.

As a safety net provider, St. Catherine Hospital uses 340B savings to stretch thin resources, keeping patients out of the hospital and ultimately reducing health care costs. Without 340B savings, the hospital would be forced to cut back drug access, clinical and preventive health care programs to residents of East Chicago and the neighboring communities the hospital serves.

340B IN ACTION: PERRY COUNTY MEMORIAL HOSPITAL, TELL CITY 

  • 66% of patients on Medicaid and/or Medicare or lack health insurance
  • $540,000 approximate 340B savings last year
  • Designated HPSA (Health Professional Shortage Area) in primary care and mental health services

Founded in 1950, Perry County Memorial Hospital (PCMH) is a full-service health care facility located in Tell City that serves Perry and Spencer counties in Indiana and Hancock County in Kentucky. The critical access hospital provides inpatient, outpatient, in-home and emergency services. A safety net provider, PCMH serves as a local economic anchor while also treating the community’s most vulnerable patients.

340B Savings Support

  • Recruitment of primary care physicians, expansion of clinic hours and the addition of a new telepsychiatry clinic

Why 340B

  • With the addition of these services funded by the 340B program, PCMH expects to document a reduction in the number of patients needing emergency psychiatric intervention as services are now provided on a regular clinic schedule
  • PCMH has already documented a reduction in volume of urgent care visits seen in the emergency department related to the opening of evening clinic hours. This is moving patients from a high-cost, episodic setting in the emergency department to a more affordable option for basic medical services in the clinic setting.
  • Without the 340B program, the provision of these new services and much-needed staff would not be possible. Cutting the program would further erode hospital operating margins.

“Providing low-volume services for our community, in particular the vulnerable and aging population, becomes challenging with the tight reimbursements paid and with tighter preauthorization policies,” said Brian Herwig, president and CEO of PCMH. “The 340B program helps our hospital stretch scarce health care dollars, expand patient access and deliver high-quality services to those who need it most in Perry County and surrounding areas.”

340B IN ACTION: ST. VINCENT-JOSHUA MAX SIMON PRIMARY CARE CENTER, INDIANAPOLIS 

In 2015:

  • The center served more than 68,000 patients
  • 90% of patients served were uninsured, underinsured or eligible for public assistance programs
  • Center pharmacists filled more than 42,000 prescriptions; all were eligible for 340B pricing

St. Vincent’s Joshua Max Simon Primary Care Center participates in the 340B Drug Pricing Program to help fulfill its mission of serving the poor and vulnerable throughout the Indianapolis metropolitan area.

Patients served at the Joshua Max Simon Primary Care Center are charged on a sliding scale for drugs based on their income. Most of those served pay only 20 percent of the 340B discounted price; the remainder of the cost is covered by St. Vincent.

“This low cost for prescriptions makes it easier for patients to be compliant with the medication regimens they need,” said Tony Antonopoulos, RPh, MBA, FACHE, executive director of regional pharmacy services at St. Vincent Hospital.

340B Savings Support

  • Clinical pharmacists who educate medical residents and serve patients through disease-specific education, medication therapy management and anticoagulation services
  • Clinical pharmacists who help manage patients’ care through collaborative drug therapy management protocols, helping physicians manage a greater workload while providing excellent care to patients
  • The hospital’s MedSync prescription coordination system, which automates manual processes in the pharmacy to encourage improved health outcomes for patients with multiple, ongoing medical conditions
  • Education for pharmacists-in-training on providing the best care to the poor and vulnerable

Why 340B

Without the 340B program, the hospital’s Joshua Max Simon Primary Care Center would not be able to provide its patients the prescription medications they need at a cost they can afford.

“Because of 340B, we are able to help many patients with chronic health conditions who might go untreated and risk their long-term health if they had to pay retail prices,” said Wendy LeMasters, PharmD, director of ambulatory pharmacy services at St. Vincent Hospital. “Medication plus pharmacist education has really made a difference for the patients we treat.”