If you or a family member receives care at a hemophilia treatment center (HTC), you may have heard the term “340B,” but you may not know a lot about what it means.
The federal 340B Drug Pricing Program is a key reason for why HTCs are able to provide such high-quality, comprehensive care to patients and families, says Jeff Blake, president and CEO of Hemophilia Alliance, which is a national membership organization of HTCs that participate in the 340B Drug Pricing Program.
“I always say that if an HTC is strong, it’s because the patients are supporting the HTC's pharmacy program,” Blake says.
Read on to learn more about how the 340B Drug Pricing Program works, and why it’s integral to the sustainability of an HTC.
What Is the 340B Drug Pricing Program?
The 340B Drug Pricing Program is a federal initiative created in 1992 that allows eligible hospitals and clinics, known as “covered entities,” to purchase certain outpatient drugs at reduced prices and then reinvest those savings into staffing, education, outreach, and other services for the patients they serve.
Today, roughly 120 of the 140 HTCs across the country participate in the 340B Drug Pricing Program. To qualify, an HTC has to go through a federal grant process overseen by the Health Resources and Services Administration (HRSA). Eight regional core centers review applications and determine which clinics meet the requirements to become HRSA-funded HTCs that can then participate in a 340B Drug Pricing Program.
How 340B Pharmacy Revenue Benefits Hemophilia Treatment Centers
Once an HTC qualifies as a covered entity, it can create its own pharmacy program and ask patients to consider using the pharmacy for their bleeding disorders medications.
The revenue that comes from the program is tightly regulated, Blake says. “An HTC has to
use any revenue they make under the 340B program to provide it back to patient care services, programs, and education,” Blake explains.
“Each year an HTC has to show their regional core center the revenue they made, the expenses they allocated, and the programs and services they funded with that money,” he says. “There are strict reporting requirements — they can’t just decide to spend it on something unrelated like a parking garage.”
Other Ways Patients Can Receive Medications
Even when an HTC has a 340B pharmacy, not everyone who receives care at the HTC can receive their medications there. This is because some health insurance plans contract with specific specialty pharmacies, which can narrow the choices available to families.
“There can be times when a patient says, ‘I want to use your hemophilia treatment center pharmacy,’ but when the HTC pharmacy does a verification of benefits and tries to get a prior authorization to dispense, the patient will learn that they have to use a specialty pharmacy instead,” Blake says.
In those situations, the HTC team — in some cases with the help of Hemophilia Alliance — may step in to talk with the health plan or employer about whether allowing the HTC pharmacy to dispense could be a cost-effective option that keeps medication and specialized care closely connected.
How Support for 340B Programs Helps Keep HTC Care Strong
By supporting HTCs, 340B pharmacy programs ultimately benefit patients and families, Blake says.
“Nationally, HTCs provide the most comprehensive and high-quality care, and to continue to provide that high-quality care and comprehensive services, HTCs need to have strong 340B pharmacy programs that generate the revenue to pay the salaries of the staff and to pay for those programs and services.”
Revenue from 340B programs helps support meaningful services that families rely on, including care from nurse coordinators, social workers, physical therapists, and other specialists.
That revenue also helps fund outreach clinics — where HTC teams travel to different parts of a state to provide care to patients who are unable to travel long distances — as well as telehealth visits that make it easier for families in rural or underserved areas to stay connected to expert care.
Blake says that when he talks with the bleeding disorders community about 340B programs, it all comes back to the same core message: “Patient support of the 340B program is critical for the sustainability of hemophilia treatment centers and the care they provide.”