Letter to the editor: 340b is essential program for ND



Drive any stretch of highway in North Dakota, and one is struck by the beauty of this state. Still, the freedom we feel when we travel our endless prairies reveals a stark truth: North Dakota has a health care access problem.

It’s certainly no secret that we live in a rural state – the miles between our rural cities add up quickly in North Dakota, and those communities have serious health care concerns which we must not ignore.

It’s the reason that I’m writing about a federal program that has helped many communities maintain access to critical health care.

That program is known as 340b.

At its heart, the 340b program is a drug discount program. In return for the access to sell drugs to Medicaid patients, drug companies agree to provide outpatient medications at a reduced price to safety net providers, which includes most of North Dakota.

Created by Congress in 1992, 340b was given the specific mission to enable health care providers “to stretch scarce Federal resources as far as possible, reaching more eligible patients and providing more comprehensive services.”

One would be hard pressed to find a piece of federal legislation which has fulfilled its mission better than 340b.

Across the United States, safety net hospitals provide health care to the poor and vulnerable. The savings from the 340b program are used in many ways to help these providers continue to offer care in their communities.

Drug savings may be passed directly on to patients, as many 340b facilities have programs by which the poorest patients can receive low- or no-cost medications.

340b reduces gaps in care by allowing facilities to continue to provide services which may be underfunded by the federal government.

Indeed, many hospital services operate at a loss – outpatient infusion, delivery services, hospice and home health often fit this description. Most Americans or their loved ones have been touched in some way by these programs.

Hospitals today are under incredible financial pressure. Reimbursement rates continue to decline; drug costs continue to rise and there are still millions of underinsured or uninsured patients. Rarely are hospitals reimbursed for the true cost of caring for these patients, which threatens the viability of the facility in general.

In rural North Dakota, our facilities must remain viable so that they can continue to provide critical ambulance and emergency department services, among others.

340b is more than access to less expensive medications – it’s an essential program. In some cases, it is no exaggeration that the health of entire communities depends on 340b savings.

Congress must understand these realities. I encourage Sens. John Hoeven and Heidi Heitkamp, as well as Rep. Kevin Cramer, to work to preserve and strengthen the 340b program.

Rue is a pharmacist.