To:         Interested Parties
From:   Consumer Action for a Strong Economy
Re:         PA voters express concerns with abuses to 340B program
Date:     June 2024

 

For most Americans, including Pennsylvanians, the economy is the #1 issue in this election. Part and parcel with economic concerns is the cost of prescription drug prices.

The 340B Drug Pricing Program was designed to help patients access and afford medicines at certain hospitals and clinics that serve low-income and underserved patients. However, there is ample evidence that many patients are not fully benefiting from the program as intended. Since its inception in 1992, the 340B program has been weakened by the lack of government oversight and lax federal guidance, opening the door for abuse and fraud.

There are some solutions to reform the program and make it operate as intended, including the recently introduced 340B Affording Care for Communities and Ensuring a Strong Safety-net, or 340B ACCESS Act, bill in the U.S. House of Representatives. Among other things, the 340B ACCESS Act would require that hospitals and grantees use 340B profit to directly lower the cost of medicines for our nation’s most vulnerable patients and increase levels of charity care offered by 340B-eligible hospitals.

The following are some of the findings related to the 340B program in our poll in the 2024 battleground state of Pennsylvania:

1. When Pennsylvania voters learn more about the 340B program and how it has drifted from its original purpose, the more they express concern with a broken program in need of oversight and reform.
2. In a rare show of unity, Democrats and Republicans expressed concern over the current state of the 340B program.
3. Notably, but perhaps not surprisingly, women and seniors expressed serious concern when they learned more about the abuses within the current 340B program.

 

Key takeaways from the Pennsylvania poll:

• More Education Is Needed About 340B: Very few people have heard of the 340B program. In Pennsylvania, only 13% say they definitely have heard of the program while a strong 64% majority say they have never heard of it.
• Pennsylvania Voters Express Concern Over Program’s Performance: As Pennsylvania voters learn more about the 340B program’s performance, they become increasingly concerned that the program is failing to deliver for underserved communities. Here are a few examples:
  • 98% of patients are not receiving any benefit from the 340B program[i]. In fact, data show patients at 340B hospitals are paying 150% more for their prescriptions than patients at non-340B hospitals.[ii]
    [80% in PA find it extremely or very concerning]
  • Some hospitals are abusing the 340B program by issuing more prescriptions and prescribing more expensive drugs in order to access additional funding. A recent report showed that Medicare beneficiaries paid 48% more for some prescriptions at 340B hospitals.[iii]
    [78% in PA find it extremely or very concerning]
  • Hospitals are not required to report to the federal government basic information about their involvement in the 340B program including how or whether they reinvest 340B revenue into care for vulnerable patients, opening the door for significant fraud and abuse.
    [70% in PA find it extremely or very concerning]
  • Hospitals participating in the 340B program made $44 billion in profits in 2023 but only spent $18 billion on charity care. And more than two-thirds of 340B hospitals provide less charity care than the national average for all hospitals.[iv]
    [66% in PA find it extremely or very concerning]
• Rare Bipartisan Agreement:  For the most part, there were few differences in message resonance by party. Regardless of the overall level of concern, there was agreement that the messages detailed in the previous bullets were the MOST concerning. The only distinct partisan difference was that Republicans were much more concerned about how the 340B program has ballooned into the 2nd largest government pharmaceutical program.
• 76% of Pennsylvania Voters Agree the Program Needs to Work for Those in Need:  More than 3 out of 4 Pennsylvania voters said they agreed with the statement that while well-intentioned when it was created, the 340B program today is broken. It lacks proper oversight and accountability, leading to higher profits for hospitals and their contracted pharmacies while failing to lower prices for rural and lower income patients in need. It’s crucial the program ensures the discounts pharmaceutical companies provide are passed on to patients who need them.

 

Poll methodology: The online poll of 400 registered voters in Pennsylvania was conducted May 1-4, 2024, with a margin of error of +/- 5%.

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[i] https://phrma.org/-/media/Project/PhRMA/PhRMA-Org/PhRMA-Refresh/Report-PDFs/D-F/Fact-Sheet—By-the-Numbers-340B-is-Driving-Up-Health-Care-Costs—March-2024_v2.pdf
[ii] Milliman, “Analysis of 2020 commercial outpatient drug spend at 340B participating hospitals,” September 2022
[iii] Medicare Payment Advisory Commission, “Initial findings from analysis of the Medicare Part B payment rates and 340B ceiling prices,” April 12, 2024.
[iv] AIR340B Coalition, “Charity Care at 340B Hospitals is on a Downward Trend,” October 2023