Iowa Lutheran Hospital and the 340B Program
What is the 340B Prescription Drug Program?
The 340B program requires drug manufacturers to sell outpatient drugs at a discount to safety-net hospitals serving high numbers of low-income Medicare, Medicaid and Supplemental Social Security Insurance Patients. Congress created the program to enable these providers to "stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services." Savings from the program help fund free and low-cost medications as well as HIV/AIDS, diabetes, cancer, dental and primary care clinics that serve our most vulnerable citizens.
The 340B prescription drug program is a vital lifeline for safety-net hospitals, supporting vital health care services in our communities.
Eligible Covered Entities for the 340B Program
For a hospital or other entity to be eligible for the 340B program they must register and be enrolled with the program and comply with all program requirements. Some entities include children's hospitals, rural referral centers, disproportionate share hospitals (like Iowa Lutheran Hospital), federally-qualified health centers and State HIV/AIDS drug assistance programs.
Patients who are eligible for this drug benefit include those who receive outpatient services, such as same day surgery, emergency room visits without admission, and infusion services.
Our 340B Story
Iowa Lutheran (ILH) uses 340B savings to enhance provision of care, reach more patients and provide more comprehensive services. Examples of activities we have been able to provide as a result of the 340B program and the value it has had to our patients include:
- Expanded infusion center space to allow more patients access to care ($25,000 lease space);
- Administrative support for additional patient assistance programs, including a Medication Advocate and legal clinic/legal resource for patients;
- Additional charity care (medication charge write-off) for patients ($167,000 minimum); and
- Medication therapy management - reconciliation and appropriate medication histories maintained.
Infusion centers are vital access points for patients. There are numerous examples of patients in the Des Moines metro area not having to travel 2-3 hours away (one way) for service. Their physician refers them to our center at ILH for IV infusion therapy.
A recent example includes a patient who was traveling to Memphis, TN to receive infusion therapy. The medication advocate, which is a position funded by the 340B program, was able to arrange for treatment at ILH saving the patient and caregiver a 20-hour round trip bus ride for therapy.
340B by the Numbers
The total savings from the 340B program since mid-2009 to now is estimated at $11.9 million, which averages to about $1.7 million per year. By paying less for medications, the amount of uncompensated care goes down and the revenue from the 340B contract pharmacy helps contribute to reducing the expense.
Since the start in 2009, 10,000 patients, on average, have been provided with clinical services annually as a result of 340B savings (a $250,000 related cost to ILH) in the infusion centers that may have not had access to care or may have had to travel hours away from home to get their care.