New Analysis Shows Contract Pharmacies Financially Gain From 340B Program With No Clear Benefit to Patients

New Analysis Shows Contract Pharmacies Financially Gain From 340B Program With No Clear Benefit to Patients

PR Newswire

WASHINGTON, Oct. 8, 2020

WASHINGTON, Oct. 8, 2020 /PRNewswire/ — Today, the Berkeley Research Group (BRG) published an analysis of historical trends in 340B contract pharmacy arrangements. The findings conclude that the growth in the number of these arrangements is fueling explosive growth in the program at large and driving the 340B program farther and farther away from its original intended goal of providing discounted medicines to safety-net entities treating uninsured and vulnerable patients. 

New Analysis Shows Contract Pharmacies Financially Gain From 340B Program With No Clear Benefit to Patients
New Analysis Shows Contract Pharmacies Financially Gain From 340B Program With No Clear Benefit to Patients

Congress created the 340B program to help safety-net providers, including certain qualifying hospitals and federally-funded clinics, access discounts on prescription medicines for low-income or uninsured patients. In 2010, a Health Resources and Services Administration (HRSA) policy opened the door to allow all 340B entities to contract with an unlimited number of for-profit retail pharmacies (e.g., CVS, Walgreens) to dispense 340B medicines. While this policy may have been intended to improve patient access to needed medications, it had the misguided effect of creating an opening that allowed for-profit vendors, pharmacies and pharmacy benefit managers to exploit the program and make a profit on 340B sales – sales intended to benefit low-income and vulnerable patients.

“It is clear that contract pharmacies have leveraged market power to drive unprecedented program growth and siphon money out of the program and away from vulnerable patients,” said Stephen J. Ubl, president and chief executive officer of the Pharmaceutical Research and Manufacturers of America (PhRMA). “I urge lawmakers to consider the results of this analysis and pursue policies that ensure the 340B program benefits vulnerable patients rather than just line the pockets of for-profit corporations.”

Key findings from the analysis show that many retail pharmacies and other third parties have taken advantage of and financially benefited from the 340B program’s contract pharmacy arrangements:

  • 340B covered entities and their contract pharmacies generated an estimated $13 billion in gross profits on 340B purchased medicines in 2018, which represents more than 25% of pharmacies’ and providers’ total profits from dispensing or administering brand medicines.

  • Following HRSA’s expansion of the contract pharmacy program in March 2010, contract pharmacy participation grew a staggering 4,228% between April 2010 and April 2020.

  • While over 27,000 distinct pharmacies participate in the 340B program today, over half of the 340B profits retained by contract pharmacies are concentrated in just four pharmacy chains – Walgreens, Walmart, CVS Health and Cigna’s Accredo specialty pharmacy.

Analysis after analysis shows there is explosive growth in the program, but there is little to no clear evidence that this growth has benefited low-income and vulnerable patients. Even the New England Journal of Medicine found no evidence that expansion of the 340B program has resulted in improved care or lower mortality among low-income patients.

These new findings build upon a mounting body of evidence from the Government Accountability Office

13-year-old holds exercise class to benefit kids’ mental health

As 13-year-old Sadie Feingold prepared for her bat mitzvah project this year, she had one goal in mind: to stop the stigma.

The eighth-grader from Port Washington knew she wanted to focus on mental health for her community service project ahead of her bat mitzvah, or Jewish coming-of-age ceremony. She wanted to encourage kids and teens to talk about mental health struggles and help normalize it.

She said she was inspired to focus on this topic because of her own previous struggles with mental health.

“The whole point was to raise awareness to it and normalize it,” Sadie said.

So after doing some research with her mom about the connection between exercise and children’s mental health, they came up with a plan: She would host an exercise class at their synagogue for local teens and families, and raise money to support the North Shore Child and Family Guidance Center in Roslyn Heights, a mental health agency that treats children and families.

The Guidance Center said her efforts have raised nearly $2,000.

“People don’t really talk about mental health as they do with physical health,” Sadie said. ”I think that some people feel like it’s not important, and I want people to feel like they should be able to talk about their emotions, as they would talk about like how they feel physically.”

The idea originated back in the winter — before the pandemic took hold. She and her mom read a piece in The New York Times that reported how even a moderate amount of exercise in adolescents can raise their endorphin levels, and in turn, help improve their mental health. Endorphins are hormones that promote feelings of natural well-being.

Sadie continued doing research on the topic, and once restrictions lifted and they could congregate outside, her class came together.

They invited family, friends and others to congregate in the parking lot of The Community Synagogue in Port Washington, and on Sept. 13, about 35 kids, teens and adults participated in the 45-minute class of individual exercises, led by a fitness instructor they knew.

They took donations at the class to support the Guidance Center — and encouraged those who couldn’t attend to donate as well. Sadie also gave out T-shirts with “#StopTheStigma” printed on them.

“I think it’s important … that kids feel comfortable, and so they’re not alone in dealing with these issues,” Sadie’s mom Jessica Feingold said. “It’s just something that tons of people deal with now more than ever, and I think it’s important to get that message out there.”

Sadie’s bat mitzvah had been originally scheduled for June, and was postponed to Sept. 26 because of the pandemic. But her mitzvah project only grew in relevance during this period.

Regina Barros-Rivera, associate executive director at the Guidance Center, said their work at the center has become

New possible health care benefit rule roils theater world

The U.S. labor union that represents more than 51,000 theater actors and stage managers is blasting a proposal that would raise eligibility requirements for members to receive health care

“We all understand that there is no escaping the devastating loss of months of employer contributions nationwide, and no alternative aside from making adjustments to the plan. But I believe that the fund had both the obligation and the financial reserves to take the time to make better choices,” said Kate Shindle, president of Actors’ Equity Association.

Many actors and stage managers have been unable to qualify for the necessary weeks of work for eligibility since theaters went dark in March. Equity represents actors and stage managers across the nation.

In a statement, the fund said: “The past six months have been among the most difficult any of us has ever faced. We recognize the emotional and financial burdens you are facing.” It added: “After looking at many different approaches, the Trustees have developed a solution that balances meaningful coverage with the long-term sustainability of the fund.”

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Mark Kennedy is at http://twitter.com/KennedyTwits

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New Possible Health Care Benefit Rule Roils Theater World | Entertainment News

By MARK KENNEDY, AP Entertainment Writer

NEW YORK (AP) — The U.S. labor union that represents more than 51,000 theater actors and stage managers is blasting a proposal that would raise eligibility requirements for members to receive health care during the pandemic.

The Equity-League Pension Health Fund on Thursday proposed hiking the number of weeks of employment needed to qualify for six months of health care coverage from 11 weeks to 16 weeks. The proposal would start on Jan. 1, 2021. Individuals who work at least 12 weeks will qualify for low-tier plans with higher co-payments and additional restrictions.

The proposal has angered Actors’ Equity Association, which has been lobbying for more access to health care for its members, especially during the pandemic when members are out of work. The Equity-League Benefit Funds is a separate organization.

“We all understand that there is no escaping the devastating loss of months of employer contributions nationwide, and no alternative aside from making adjustments to the plan. But I believe that the fund had both the obligation and the financial reserves to take the time to make better choices,” said Kate Shindle, president of Actors’ Equity Association.

Many actors and stage managers have been unable to qualify for the necessary weeks of work for eligibility since theaters went dark in March. Equity represents actors and stage managers across the nation.

The Equity-League Health Fund is governed by a board of trustees, with half appointed by Equity and the other half by the Broadway League, which represents producers. It provides health, pension and 401(k) benefits. In August, it hiked up quarterly premiums for health care and prescription drug plan coverage to $300 from $100.

In a statement, the fund said: “The past six months have been among the most difficult any of us has ever faced. We recognize the emotional and financial burdens you are facing.” It added: “After looking at many different approaches, the Trustees have developed a solution that balances meaningful coverage with the long-term sustainability of the fund.”

Mark Kennedy is at http://twitter.com/KennedyTwits

Copyright 2020 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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Trump-touted hydroxychloroquine shows no benefit in COVID-19 prevention: study

(Reuters) – A malaria drug taken by U.S. President Donald Trump to prevent COVID-19 did not show any benefit versus placebo in reducing coronavirus infection among healthcare workers, according to clinical trial results published on Wednesday.

The study largely confirms results from a clinical trial in June that showed hydroxychloroquine was ineffective in preventing infection among people exposed to the new coronavirus.

Trump began backing hydroxychloroquine early in the pandemic and told reporters in May he started taking the drug after two White House staffers tested positive for COVID-19. Studies have found the drug to offer little benefit as a treatment.

In the study of 125 participants, four who had taken hydroxychloroquine as a preventative treatment for eight weeks contracted COVID-19, and four on placebo tested positive for the virus.

All eight were either asymptomatic or had mild symptoms that did not require hospitalization, according to the results published in the JAMA Internal Medicine journal.

The research shows that routine use of the drug cannot be recommended among healthcare workers to prevent COVID-19, researchers from the University of Pennsylvania said.

The study authors said it was possible that a trial conducted in a community with higher prevalence of the disease could allow detection of a greater benefit from the drug.

In the latest trial, which was terminated before it could reach its enrollment target of 200 participants, mild side effects such as diarrhea were more common in participants taking the malaria drug compared to placebo.

(Reporting by Manas Mishra in Bengaluru; Editing by Shinjini Ganguli)

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Higher ‘Time in Range’ May Benefit Type 2 Diabetes Patients

Patients with type 2 or type 1 diabetes who stay in a blood glucose range of 70-180 mg/dL at least 70% of the time have the lowest rates of major adverse coronary events, severe hypoglycemic episodes, and microvascular events, according to a post hoc analysis of data collected from 5,774 patients with type 2 diabetes.

Data collected by the DEVOTE trial showed that every additional 10% of the time that a patient with type 2 diabetes (T2D) spent in their target range for blood glucose linked with a significant 6% reduced rate for developing a major adverse cardiovascular event (MACE), Richard M. Bergenstal, MD, said at the virtual annual meeting of the European Association for the Study of Diabetes.

For every 10% increase in time in range (TIR), patients showed an average 10% drop in their incidence of severe hypoglycemic episodes.

Increasing Evidence From Post Hoc Analyses

These findings confirmed a prior post hoc analysis of data collected in the DCCT trial (NCT00360815), which were published in the New England Journal of Medicine, although those results showed significant relationships between increased TIR and decreased rates of retinopathy and microalbuminuria. For every 10% drop in TIR, retinopathy rose by 64% and microalbuminuria increased by 40%, according to a post hoc analysis of the DCCT data that Dr. Bergenstal helped run and was published in Diabetes Care.

“It’s becoming clear that time in range is an important metric for diabetes management, and our new findings and those previously reported with the DCCT data make it look like time in range is becoming a good marker for clinical outcomes as well,” said Dr. Bergenstal, an endocrinologist at the Park Nicollet Clinic in Minneapolis.

“It’s a new concept, getting time-in-range data,” said Dr. Bergenstal, who was a coauthor of recommendations from Diabetes Care that were made in 2019 by an expert panel organized by the Advanced Technologies & Treatments for Diabetes Congress. “We think this will be a good marker to keep glycemia in a safe range, and the results look positive.” Patients who stay in the blood glucose range of 70-180 mg/dL (3.9-10.0 mmol/L) at least 70% of the time generally have a hemoglobin A1c of about 7%, which is what makes it a good target for patients and clinicians to focus on. Patients with a 50% TIR rate generally have an HbA1c of about 8%.

But a TIR assessment can be more informative than HbA1c, said the 2019 recommendations document. It called TIR assessments “appropriate and useful as clinical targets and outcome measurements that complement A1c for a wide range of people with diabetes.”

Data Mining From DEVOTE

The analysis run by Dr. Bergenstal and his associates used data from 5,774 of the 7,637 patients enrolled in the DEVOTE trial, for whom adequate longitudinal blood glucose data were available to derive and track TIR. DEVOTE had the primary aim of comparing two different types of insulin in patients with T2D, according to its explanation in the New England