Since I started my column earlier this year, I have written a number of pieces on the unprecedented attention that the 340B program is facing in state capitols. One of the more exciting developments is the growing interest among states to partner with 340B covered entities to lower costs and improve health outcomes for incarcerated populations.
Correctional partnerships reduce costs and improve care
State policymakers have focused a great deal of attention on figuring out ways to leverage the 340B program to improve care and lower drug costs for state prison populations. The National Governors Association and Pew Charitable Trusts have both recently published reports encouraging states to explore these partnerships. At least 17 state correctional facilities currently partner with 340B providers for purchasing and providing care to inmates. The states have generally restricted use to individuals with highly complex and expensive therapies, such as those who have contracted HIV/AIDS, the Hepatitis C virus (HCV), or hemophilia. However, there is a growing interest in expanding this care model to other inmates.
Texas, one of the forerunners in 340B collaboration, has reduced drug costs by 60 percent over the past five years, according to Pew. The state credits its 340B partnership with UTMB Galveston, a teaching hospital, for keeping drug spending on the incarcerated at levels significantly below national averages. At the same time, the state has met or exceeded the chronic disease quality measures used by health insurers.
North Carolina takes legislative action on 340B
This summer, North Carolina enacted bipartisan legislation that puts the state at the forefront of tackling not only HIV and HCV but also other expensive diseases, including cancer, cardiovascular disease, COPD, epilepsy, mental health, multiple sclerosis and rheumatology.
On July 19, Governor Roy Cooper signed the Inmate Health Care and 340B Program (H106) into law. The bill, which received strong support from both the Republican-controlled legislature and the Democratic governor and lawmakers, has three components:
Strong momentum for collaboration
Although there have been some objections over the years from the pharmaceutical industry to apply 340B discounts to the incarcerated, the public health and cost benefits of these arrangements are taking precedence. As state and local governments grapple with providing high-quality care at a low cost, expect to see more of these partnerships. As long as they are carefully structured to abide by the law and are developed in a way that is a win-win for all parties, these opportunities are worth exploring for other states and covered entities, as well.
AIR340B Quietly Steps Up Advocacy Efforts – October 2019
Recent 340B Developments of Interest – September 2019
Key Takeaways from the 340B Coalition Summer Conference – August 2019
Clearing Off the Desk – Part 2 – June 2019
A Welcome Addition to the 340B Debate – May 2019
Clearing Off the Desk – April 2019
Be Vigilant on State 340B Activity – March 2019