Protecting the True Nature of 340B

The 340B program was implemented to provide certain hospitals and clinics with drugs at significant discounts since they provided care to a disproportionate share of low-income patients. However, since its inception, the 340B program has drifted heavily from its mission. With the passage of the Affordable Care Act (ACA), there has been a significant increase in the number of institutions eligible to receive 340B discounts. The number of contract pharmacies affiliated with such covered entities has also increased since 2010, when the Health Resources and Services Administration (HRSA) allowed an unlimited number of contract pharmacies to serve eligible institutions.

However,  it is unclear whether the proliferation of contract pharmacies is consistent with the 340B mission of serving uninsured and low-income communities. For example, a study in the Journal of Medical Association concluded that 340B contract pharmacy growth was concentrated in high-income neighborhoods, compared to low-income communities where the number of contract pharmacies declined. The tool developed by Pioneer Institute identifies the number and physical location of contract pharmacies for all 340B eligible entities. Pioneer Institute has built this website so that users may observe contract pharmacy trends from a national and local perspective. The goal is to quantify and depict the volume and geographic distribution of contract pharmacies for each 340B eligible entity throughout the U.S. The tool is designed to contextualize the 340B policy solutions under consideration at the federal and state levels.

Location of 340B-eligible Contract Pharmacies

This project was developed, in part, thanks to a grant from Pfizer Inc.  Pioneer’s Life Sciences also receives generous support from other corporations, foundations, and individuals.

Get Updates On Our Life Sciences Work!

Other Life Sciences Resources

First-of-Its-Kind Interactive Mapping Tool Reveals Extent of For-Profit Entities Benefitting from the 340B Drug Pricing Program

Today, Pioneer Institute released a first-of-its-kind, 50-state mapping tool and database highlighting the troubling way in which hospitals and covered entities leverage unlimited pharmacy contracts under the 340B Drug Pricing Program.

Is CHIA’s Drug Cost Data Reliable?

Earlier this year, the Center for Health Information and Analysis (CHIA) released its Annual Report on the Performance of the Massachusetts Health Care System for 2020.  The Massachusetts Legislature relies on CHIA data when considering bills to regulate drug costs and prices. The advocacy group Health Care for All reported that CHIA data showed prescription drug spending grew by 7.7 percent in 2020, more than twice the benchmark - but the most reliable data on prescription drugs indicates that spending in 2020 was essentially flat. 

Is this PBM tactic blocking healthcare access?

Utilization Management (UM) was originally a strategy designed to improve the safety, quality, and cost-effectiveness of physician prescribing. However, UM has grown exponentially over the last decade, becoming more a tactic for Pharmacy Benefit Managers (PBMs) to manage costs to benefit their bottom line.

The Realities Behind US Healthcare Spending

Healthcare policy is an all-encompassing term. It plays a role in every individual’s life; how it is curated, developed, and maintained has a significant long-term impact on the quality of life of any given community. It is critical that policymakers consistently adapt and amend healthcare policies in the ever-changing global pricing and affordability environment while providing funding support for optimal quality of care.

Cures for Patients, Not Health Plan Profits, Make Drugs Valuable

To the astonishment of many observers, the Institute for Clinical and Economic Review (ICER) recently concluded that a $2.1 million gene therapy for a life-threatening blood disorder called beta thalassemia, is priced cost-effectively. The surprise was especially pleasant, given that ICER’s methodology had, in the past, displayed bias against rare disease treatments and undervalued the lives of people living with disabilities.

Massachusetts Hospitals Pull Back on Charity Care as Revenue from Federal 340B Drug Discount Program Explodes

Over the past decade, the revenue for hospitals generated by the federal 340B drug discount program, initially intended to serve low-income, uninsured populations, has exploded even while a number of important Massachusetts hospitals have reduced the level of charity care they provide, according to a new study published by Pioneer Institute. The Pioneer Institute study, “340B Drug Discounts: An Increasingly Dysfunctional Program,” notes that nationwide, 340B drug sales rose from $9 billion in 2014 to $38 billion in 2020.

The Promise and Challenges of Rare Cancer Treatments

Dr. William Smith, Pioneer Institute's Visiting Fellow in Life Sciences, spoke about the challenges and opportunities for rare cancer treatments, in a video interview produced by Rare Cancers, a patient group based in Australia, for the November 26th CAN Forum. 

Study: Decline in Cardiovascular Health Screenings During COVID-19 Pandemic Poses New Public Health Threat

Pioneer Institute today released a new analysis focused on cardiovascular disease, An “Impending Tsunami” in Mortality from Traditional Diseases?, that examines how the COVID-19 pandemic has created another unrelated public health crisis. The Pioneer analysis examines how a single-minded public health focus on COVID-19, social distancing, and lockdowns drove reductions in screenings, diagnoses, and early treatment for complex conditions such as heart disease.

New Analysis: ICER Framework Ignores Patient Preferences, Innovation & Societal Benefits in Evaluating Cost-Effectiveness of New Cancer Treatments

Pioneer Institute today released a new analysis, The QALY and Cancer Treatments: An Ill-Advised Match, that examines the alarming methodological and contextual shortcomings of the Quality Adjusted Life Years (QALY)-based methodology in evaluating new cancer therapies. The Pioneer Institute analysis reveals five specific problems with ICER’s evaluation of cancer treatments and demonstrates the urgent need to prohibit the use of the QALY amid trends in rapid cancer innovations and personalized medicine.

Study: Growth of Antibiotic-Resistant Infections Could Have Massive Human, Financial Costs

The world was blindsided by COVID-19, but a new Pioneer Institute study finds that even as we continue to wrestle with the pandemic, another threat looms that scientists have long known about but the nation has thus far failed to address: the growth of antibiotic-resistant infections. “Market dysfunction and perverse Medicare reimbursement rates have led to a growth in infections that resist antibiotics,” said Gunnar Esiason, author of “Antimicrobial Resistance: Learning from the current global health crisis to prevent another one.”  If we don’t solve this problem, the human and economic costs are likely to be astronomical.”