Earlier today, the bipartisan leadership of the U.S. Congress received a letter signed by CEOs representing more than 700 hospitals and health systems that participate in the 340B drug pricing program urging lawmakers to protect 340B from legislative or regulatory efforts that would harm its effectiveness. The letter highlights the overwhelming support 340B has among safety-net hospital leaders and demonstrates that our members are united in their goal to make sure 340B continues to support care to the patients who need it the most.


In a demonstration of national unity, hospital and health system leaders from all 50 states and the District of Columbia added their signatures to the letter. They include major nonprofit systems, large community-based hospitals, and small rural facilities. In their letter to House Speaker Paul Ryan, House Minority Leader Nancy Pelosi, Senate Majority Leader Mitch McConnell, and Senate Minority Leader Chuck Schumer the CEOs said, in part:


“Americans are right to be upset with the high prices being charged for new and existing drugs, and cutting back the 340B program would make these problems much worse. We are concerned about recent regulatory actions that have reduced the reach of this vital program and by legislative proposals that would undo more than two decades of bipartisan work to preserve the health care safety net.”


The letter comes at a time when Congress and the Trump administration have been closely examining 340B. Since the beginning of the 115th Congress, congressional committees have held six hearings on 340B, and more than a dozen legislative proposals have been introduced or circulated for discussion. While some of these proposals would strengthen the program, others would either cut it back or impose reporting requirements that could paint an incomplete picture of the value 340B brings to patients and communities. Meanwhile, the administration has proposed rules to continue the deep reductions in Medicare Part B drug reimbursements to 340B hospitals and delayed enforcement of rules requiring transparency and accountability for drug manufacturers. At the 340B Coalition summer conference in July, Secretary of Health and Human Services Alex Azar said the 340B program needs two kinds of reform: “greater transparency surrounding how these discounts are being used, and reforms to reduce the gap between discounted prices and the reimbursement provided, particularly by government programs.”


Executives at hospitals and systems represented on the letter strongly agree on the need to protect the 340B program.


“As the largest non-profit health system in the nation, our Mission calls upon us to provide compassionate, personalized care to all persons, with special attention to those most in need,” says the Rev. Dennis H. Holtschneider, CM, EdD, Executive Vice President & COO of Ascension Health, based in St. Louis, Mo. “The 340B drug pricing program is crucially important to many organizations, including ours, for serving the health needs of low-income, rural, and inner-city patients nationwide. Ascension devotes all the savings we receive from the program to stretch finite resources in support of services for those most vulnerable, including operating charity pharmacies and clinics, and prescription drug assistance programs. We also use the savings to invest in collaborative disease prevention programs and partnerships in the communities we serve. We urge Congress to preserve the 340B program and take steps to make prescription drugs affordable.”


“Twenty-two of our 28 hospitals in six states participate in 340B, so we know very well how important it is to protect this assistance for our patients,” says Peter Fine, President & CEO of Banner Health, based in Phoenix, Ariz. “In our larger disproportionate share hospitals, the program enables us to provide a wider range of comprehensive services to people who are uninsured and traditionally underserved – services that would need to be scaled back along with any 340B reductions. For our more rural critical access hospitals, cuts to 340B would threaten the only places for people in the communities to get their care in the first place.”


John Couris, CEO of Tampa General Hospital in Florida, says, “We use 340B to help provide comprehensive health services regardless of patients’ ability to pay. This is critical for Tampa General Hospital, which provides 21 percent of the charity care cost in the greater Tampa Bay market. Our savings go directly toward patient care, including free or discounted medications at our top-ranked organ transplant center and discharge prescriptions that keep patients healthy after they leave the hospital. Those are critical benefits to TGH from a program that doesn’t cost the taxpayers anything.”


“Congress must protect 340B,” says Joseph Smith, CEO of Boone County Hospital, located in Boone, Iowa. “Savings from the program are what allow a small, rural hospital such as ours to provide critical services – hyperbaric wound care, outpatient infusion therapies, baby delivery – to some of the most vulnerable patients in central Iowa. We also can provide tens of millions of dollars in care every year that is not compensated. Without this resource, patients would need to drive long distances to receive services from the next available facility, and we worry that many of them would not obtain that care at all.”


“The health care leaders whose voices are heard through this effort represent many different hospitals but share a unified mission to serve the best interests of patients who traditionally have been underserved,” says 340B Health Interim President and CEO Maureen Testoni. “340B is a vital resource to further that mission. 340B savings might allow a major nonprofit system to implement a comprehensive cancer, HIV/AIDS, or opioid addiction treatment program, or they might prevent a small, rural facility from shutting down. In both cases, rolling back the program would weaken the safety net and harm patient access to needed care.”


The letter to Congress is part of a broad advocacy campaign by members of 340B Health to demonstrate the value of 340B in the face of an ongoing, multi-million-dollar campaign to weaken it by the pharmaceutical industry. Hospital leaders have met with their elected representatives in Washington and in their home districts, written to lawmakers asking them to protect 340B, and penned op-ed columns and letters to the editors of their local news outlets. All of these actions are key to success. If your institution would like to become more involved in these efforts, please contact David Glendinning (david.glendinning@340bhealth.org or 202-536-2289) in our communications department or Amanda Smith (amanda.smith@340bhealth.org or 202-552-5861) in our government relations department.

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