Drug discount program saves lives

Scaling back a prescription drug discounting program means those in the greatest need will lose key services.

It's our mission to take care of whomever walks through our doors. Whether critically ill, poor or in decent health, it doesn't matter: At Bon Secours Hospital in Baltimore, we help all of our patients get the care and medicine they need to get better and remain healthy — including our community's most vulnerable patients. These are the men, women and children who would otherwise not be able to afford health care when they need it most.

Providing excellent care to the poor is a tall order, but a little-known federal program lends a helping hand. Established in 1992, the "340B" program requires pharmaceutical companies to give discounts on drugs to nonprofit and public health systems that treat high numbers of low-income patients. Because the program is funded entirely by the discounts hospitals like ours receive from drug companies, it doesn't cost taxpayers a cent. In fact, the program helps taxpayers save money by helping hospitals keep their patients healthy and out of the emergency room.

In the 14 years we have been involved in this program, we have been able to reinvest the savings back into the community we serve. With the help of 340B, we provide free or discounted prescriptions to qualifying patients who would otherwise not be able to afford the prescriptions they need to stay healthy. Without access to these medications, we would see more and more patients being readmitted to the emergency room, incurring preventable costs and health consequences. The 340B program helps with more than just discounted drugs for patients, though; the savings it generates enable us to reinvest additional resources into our other community outreach programs.

Our hospital is not only dedicated to the total care of each patient we see, but the health of the community at large. The 340B program aids us in our goal of increasing outpatient services and reaching the community outside of the walls of the hospital. We are able to provide health fairs and screenings to West Baltimore residents, educating them about their current health issues and providing information on the best ways to stay healthy. Screenings identify possible health issues in community members that may not have the time or the resources to dedicate a visit to the doctor's office. In the future, we hope to expand on these services and add nutritionists and pharmacists to our staff that help patients adhere to their medication regimens and continue to improve their health after they leave the hospital.

Unfortunately, some in the pharmaceutical industry are pressuring Congress and agencies of government to change the 340B program to scale it back, even though the program represents about 2 percent of U.S. drug revenues, which amounted to $374 billion in 2014, according to a report by IMS Health.

The federal Health Resources and Services Administration is currently considering proposed guidelines for 340B — expected to be published this year — which would limit patient eligibility and block major sources of 340B savings. Prescriptions given to patients after discharge would be ineligible for discounts under the new guidelines, dramatically reducing the program's ability to reduce hospital readmissions and encourage drug adherence. Many low-income patients would be forced to pay full price for drugs, and the cycle of high-cost readmissions would continue. Up to a third of hospitals have indicated they would consider dropping out of the program if these changes went into effect, lessening 340B's overall effectiveness for communities in Baltimore and nationwide.

Over 80 percent of the patients we see at Bon Secours are covered by Medicare or Medicaid, or they are uninsured. To provide the medical attention our patients need, we deliver a great deal of uncompensated care, which 340B helps us sustain.

We appreciate that our representatives in Congress understand our need to provide a strong safety net for people in our region. We are happy to do it. Without this program, though, those with the greatest need in Baltimore could lose critical services, and our efforts to serve all of our patients with the best care possible would be compromised.

Esther Alabi (esther_alabi@bshsi.org) is the director of pharmacy services at Bon Secours. Shelly Buck (shelly_buck@bshsi.org) is the chief nursing officer and chief nurse executive at Bon Secours.

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