艾昆纬-患者是否在合同药房柜台获得340B药品折扣？（英）

White PaperDo Patients Receive 340B Drug Discounts at the Contract Pharmacy Counter?RORY MARTIN, PHD, Sr. Principal, IQVIA Market Access Technology & SolutionsWILLIAM SARRAILLE, JD, Professor of Practice, University of Maryland Francis King Carey School of LawKEPLER ILLICH, PHD, Consultant, IQVIA Market Access Technology & SolutionsTable of contentsAbstract 1Introduction 2340B drug discount cards 4Methods 4Data 4Identification of 340B discount sharing mechanisms 4Percentage of claims using a 340B card 5Limitations 6Findings 6Discussion 8Conclusion 9References 10About the authors 12Acknowledgements 12 iqvia.com | 1AbstractThe question of whether patients of hospitals and clinics participating in the 340B Drug Pricing Program (“340B program”) receive financial assistance when filling prescriptions has become central to 340B policy debates and litigation. Against a backdrop framed by the rapid increase in 340B revenue generated using contract pharmacies, advocates and critics of the program offer sharply different perspectives on whether 340B discounted prices are shared with patients filling prescriptions at those pharmacies.To address that question, this study used a national sample of branded, self-administered drugs to examine 340B patient discount sharing at contract pharmacies between July 2020 and June 2024, completed as a follow-up to an earlier study performed by our group three years ago. We found that 340B drug discount cards continued to be the dominant mechanism used for sharing 340B discounts with patients, when assistance was provided, and that 340B discount cards were used in approximately 0.17% of all branded prescriptions at contract pharmacies, whether 340B or not. In Q3 2020, when the first manufacturer introduced a contract pharmacy policy designed to limit the use of those pharmacies, 340B cards were used on 3.0% of all branded 340B prescriptions. In Q2 2024, by which time approximately three dozen manufacturers had introduced contract pharmacy policies, 340B cards were used on 4.7% of branded 340B prescriptions filled at those pharmacies. Despite 340B advocates’ assertions to the contrary, these data do not support the notion that manufacturer contract pharmacy policies reduced patient assistance using 340B discount cards.Although 340B card usage was not adversely affected by manufacturer contract pharmacy policies, patient assistance using 340B cards, both before and after manufacturer policies were implemented, was well below the 32% of U.S. adults who were uninsured or under-insured at the time of the study. Disproportionate share hospitals — which receive the vast majority of all revenue generated by the 340B program — were substantially less likely than health center grantees to provide financial assistance to their patients.2 | Do Patients Receive 340B Drug Discounts at the Contract Pharmacy Counter?IntroductionThe 340B Drug Pricing Program (“340B program”) is a federal program in which manufacturers provide heavily