Hospitals participating in the 340B drug pricing program report new data on how they use their savings from prescription drug price discounts to maintain or expand patient care, to support uncompensated care for patients living with low incomes, and in the case of rural hospitals, to keep their doors open in an era of frequent closures.

A survey of nearly 500 hospitals participating in 340B found that their annual program savings vary based on hospital size. For small, rural hospitals, median savings were $564,000, while disproportionate share (DSH) hospitals had median savings of $8.9 million. The largest savings were reported by a relatively small number of children’s hospitals, with a median of $12.6 million.

Hospitals that qualify for 340B status can obtain discounts on many outpatient prescription drugs to treat their patients with cancer, heart disease, diabetes, and other conditions. These hospitals use those savings to stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services. The program, created in 1992, uses no tax dollars to support the care being provided. Savings come from discounts provided by pharmaceutical manufacturers.

“Congress created 340B for a specific reason, to make sure safety-net hospitals, health centers, and clinics are there to care for patients who cannot afford their care,” said Maureen Testoni, president and CEO of 340B Health, which conducted the survey. “340B hospitals are on the front lines of caring for people in need, whether in the face of global pandemic or chronic disease, so that patients can live fuller lives.”

Hospitals also report that they use 340B savings to dispense free or low-cost drugs, combat the opioid epidemic, and improve health outcomes for their patients, including though improved medication adherence, increased access to care, and reduced readmissions.

340B is particularly critical to rural hospitals. According to the U.S. Census Bureau, one in five Americans live in rural areas, many of which are sparsely populated and far from urban centers. Over the past decade, more than 120 rural hospitals have closed. Nearly three-quarters of small critical access hospitals (CAHs) report that 340B savings are a key element to maintaining their operations. More than a third of CAHs reported using their 340B benefits to support telemedicine programs. More than half (57%) of rural hospital respondents reported that a loss of 340B savings could force them to close.

More broadly, hospitals reported that a loss of some or all of their 340B savings would force them to reduce their provision of uncompensated care, including the free or low-cost drugs they offer to patients who can’t otherwise afford them. Hospitals also indicated that they likely would have to cut back certain clinical areas, including treatment for cancer, diabetes, mental health and substance abuse, and HIV/AIDS, if their 340B savings were scaled back.

“This report provides more clear evidence of the critical role 340B savings play in providing care for patients in need. Hospitals are fulfilling the mission set out by the enactment of the 340B statute in documented ways that contribute to the continuing, broad, bipartisan support for the program,” Testoni said.

Read the report and see our infographic summarizing the key findings.

St. Luke’s Miners Campus Hospital in Coaldale, Pennsylvania is one of the few hospitals with a Primary Stroke Center, Accredited Chest Pain Center, Level IV Trauma Center, and CMS 4 star rated hospital, in Schuylkill County, Pennsylvania. In partnership with ARC and the Federal Highway Administration, the Pennsylvania Department of Community & Economic Development (PA DCED), and the Northeastern Pennsylvania Alliance (NEPA), St. Luke’s Miners Campus Hospital will foresee construction to improve access to the building including narrowing and repaving connecting roadways to reduce speeds, building a pedestrian walking route and installing a transit bus shelter. In addition to making the hospital easier and safer to access, the project will prepare 15 acres of adjoining, undeveloped land for the construction of two new buildings for medical offices and clinical services. These improvements are projected to create and/or retain nearly 400 jobs.

“We are growing and are excited to work with Coaldale Borough, NEPA and the Appalachian Regional Commission to improve access to our small rural hospital. This project is so important as more people are coming from all over northeastern Pennsylvania for St. Luke’s Miners Campus’ nationally recognized care and highly engaged clinical teams,” said Wendy Lazo President of St. Luke’s Miners Campus.

Pennsylvania Governor Tom Wolf signed his 11th renewal of his January 2018 opioid disaster declaration to help the state fight the then-burgeoning opioid and heroin epidemic. The declaration allows the state to loosen regulations and work outside of typical procedures to expedite aid and initiatives to help those suffering from opioid use disorder and those who work to prevent and treat this medical condition.

“In the midst of the COVID-19 pandemic, the commonwealth’s Opioid Command Center continues its work to fight another health crisis – the opioid epidemic,” Gov. Wolf said. “The work that is enabled by this declaration is vital to saving the lives of so many Pennsylvanians, providing education and treatment, and advancing initiatives across the state to continue to battle this epidemic. This work is no less important during COVID and I am grateful for all those dedicated professionals who continue the drumbeat of compassionate care and work toward ending this crisis.”

The declaration allows for the redirection and reorganization of commonwealth resources to align programs from multiple agencies to work together to mitigate the opioid crisis, its causes and its effects. Because of the magnitude and complexity of the opioid crisis, additional resources may be needed to fully contend with the severity of this continuing and expanding disaster emergency.

“As the commonwealth continues to grapple with the COVID-19 pandemic, continuing our fight against the opioid epidemic has never been more important,” said DDAP Secretary Jennifer Smith. “Governor Wolf’s 11th renewal of the disaster declaration shows his unwavering commitment to support individuals suffering from substance use disorder and focusing resources to support the drug and alcohol community.”

Yesterday, Secretary of Health Dr. Rachel Levine signed an updated naloxone standing order permitting community-based organizations to provide naloxone by mail. This will assist organizations with distributing naloxone to Pennsylvanians in-need while reducing the risk of COVID-19 transmission. All Pennsylvanians can continue to obtain naloxone at a pharmacy under a previous standing order issued by Dr. Levine in 2018.

“The opioid crisis continues for those with the disease of addiction, our communities and our state,” Secretary of Health Dr. Rachel Levine said. “Renewing the disaster declaration allows us to continue our efforts to ensure that we are helping those in need. Recovery works, and treatment is possible for those with this disease.”

Work to address the opioid crisis focuses on three areas: prevention, rescue and treatment. Efforts over the past several years, working with state agencies, local, regional and federal officials, have resulted in significant action to address the opioid crisis:

• The Prescription Drug Monitoring Program has reduced opioid prescriptions by 34 percent and has virtually eliminated doctor shopping.
• The number of people receiving high dosages of opioids (defined as greater than 90 morphine milligram equivalents per day) has dropped 53 percent since the PDMP launched in August 2016.
• The Opioid Data Dashboard and Data Dashboard 2.0 has provided public-facing data regarding prevention, rescue and treatment.
• 11 Pennsylvania Coordinated Medication Assisted Treatment (PacMAT) programs are serving as part of a hub-and-spoke model to provide evidence-based treatment to people where they live, with just under $26 million dedicated into the centers.
• More than 45 Centers of Excellence, administered by the Department of Human Services, provide coordinated, evidence-based treatment to people with an opioid use disorder covered by Medicaid. The COEs have treated more than 32,500 people since first launching in 2016.
• The waiver of birth certificate fees for those with opioid use disorder has helped close to4,800 people, enabling easier entry into recovery programs.
• A standing order signed by Dr. Rachel Levine in 2018 allowed EMS to leave behind more than 2,400 doses of naloxone.
• Education has been provided to more than 6,600 prescribers through either online or face-to-face education.
• 882 drug take-back boxes help Pennsylvanians properly dispose of unwanted drugs, including 178,540 pounds of unwanted drugs in 2019.
• The Get Help Now Hotline received close to 38,700 calls, with nearly half of all callers connected directly to a treatment provider.
• The state prison system has expanded their Medication Assisted Treatment (MAT) program which is viewed as a model program for other states.
• A body scanner pilot project was successful in reducing overdoses and violent crime in a number of facilities. Body scanners are in place in more than 30 locations and are currently being expanded to additional facilities.
• Several agencies have worked together to collaborate on the seizure and destruction of illicit opioids across Pennsylvania.
• Education and training on opioids have been provided to schools. Future plans are in place to make opioid education a standard component of their school-based training.
• The coordination with seven major commercial providers has expand access to naloxone and mental health care, while also working to make it more affordable.
• Naloxone has been made available to first responders through the Commission on Crime and Delinquency, with more than 63,400 kits made available and close to 12,700 saves through that program. More than half of those saves, 6,633, occurred in 2019.
• EMS have administered more than 40,600 doses of naloxone and more than 10,000 doses were made available to members of the public during the state’s naloxone distribution last year.

For more information on Pennsylvania’s response to the opioid crisis visit www.pa.gov/opioids.

The Office of the National Drug Control Policy announced $15.9 million in discretionary funding for its HIDTA Program, adding to the $266 million in baseline funding released earlier this year. Combined, this represents the highest award level ever for the HIDTA program. This new allocation of discretionary funds expands the HIDTA Overdose Response Strategy (ORS) — a public health and public safety partnership designed to reduce overdoses and save lives — to all 50 states.

Read the full ONDCP press release HERE

The Pennsylvania Department of Drug and Alcohol Programs is providing the opportunity for public comment on its annual Pennsylvania Substance Abuse Prevention and Treatment Block Grant (SABG) Submission. This submission will occur in three parts:

1. The Substance Abuse Prevention and Treatment (SAPT) Plan which will be submitted to SAMHSA by October 1 and is currently available in draft and available for review by September 30;
2. The SAPT Report which will be available in November for comment prior to submission on December 1st, and;
3. The Annual Synar Report which will also be made available in December for comment prior to submission on December 31st.

These documents can be accessed at bgas.samhsa.govOpens In A New Window utilizing “citizenpa” as your login and “citizen” as your password.

Please submit all comments to ra-dabaps@pa.gov by timeframes indicated.