Hospitals, health clinics, and pharmacies in Maine are urging state lawmakers to support a bill that protects access to a program that they say serves as a lifeline.
The 340B program was created by Congress more than 30 years ago. It allows rural health providers to purchase drugs at a discount to stretch scarce resources and reach more patients. And Lori Dwyer, president and CEO of Penobscot Community Health Care, said that's exactly how they use the program.
"340B is critical to our mission," Dwyer told lawmakers on the Health Coverage, Insurance and Financial Services Committee Wednesday.
She said that the center has used savings from the program to increase access to low cost medications, expand recovery programs, and to start a statewide program to address over-prescribing of controlled substances.
But Dwyer said for the past several years, pharmaceutical companies have placed restrictions on 340B. As a result, the center lost $5 million in one year and had to cut some of its services.
"These attacks on rural healthcare providers by some of the largest corporations in the world serve their profit motive at the expense of Maine's safety net," she said.
Hospitals in the program have also lost millions, said Jeff Austin of the Maine Hospital Association.
"And the last five years, losing that has been really detrimental," Austin said. "It's not the only cause of our problems, but it is a significant portion of the challenges that we face."
Austin said pharmaceutical companies are trying to shrink use of 340B in several ways, including by limiting the number of pharmacies providers can partner with to dispense drugs. A bipartisan-sponsored bill, LD 1018, would prohibit drug manufacturers from placing such restrictions on the program.
But PhRMA spokesperson Rachel Cottle Latham said 340B has seen staggering growth and is not being used appropriately.
"What we do not support is the ongoing misuse of a program that was intended to serve patients but is now being leveraged as an unchecked revenue stream for large hospitals and for profit entities," she said.
Some research has found that it's providers who benefit the most from savings under 340B, and it's unclear whether the program actually results in better health care access for under-served patients.
That's why several consumer advocates told lawmakers that more transparency is needed before enacting a law. Meg Garratt-Reed is the executive director of Maine's Office of Affordable Health Care.
"The most important point I'd like to make in my testimony today is that this issue is not as simple as a choice between health care providers and pharmaceutical manufacturers," she told the committee.
Trevor Putnoky of the Healthcare Purchaser Alliance of Maine said Federally Qualified Health Centers, such as Penobscot Community Health Care, are subject to more transparency requirements, and they appear to be using the program as intended by offsetting costs for patients. But he said it's less clear how other providers are using the savings.
"I would ask, if all this money is justifiably being used to lower the cost of care, then why can't we have more transparency in the program?" Putnoky said.
Putnoky told the committee, you can't fix what you can't measure.
