What Is the 340B Program?
The 340B Drug Pricing Program (“340B Program”) is a federal drug discount program that Congress passed into law in 1992. The 340B Program requires drug manufacturers to provide drugs at discounted prices to hospitals that provide a disproportionate share of uncompensated care to patients who are unwilling or unable to pay.
Hospitals that qualify for the 340B Program are nonprofit or government entities that provide a substantial amount of care to Medicaid and low-income Medicare patients. The 340B Program benefit compensates hospitals for uncompensated care and helps “stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services.” (Source: Health Resources and Services Administration [HRSA], Office of Pharmacy Affairs [OPA] Website, 340B Drug Pricing Program.)
Serving the People of Utah Through the 340B Program
At University of Utah Health, we are dedicated to serving people throughout the Mountain West by continually improving individual and community health and quality of life. We achieve this through excellence in patient care, education, and research; each is vital to our mission, and each makes the others stronger.
The 340B prescription drug program provides critical funding to support our mission of providing compassionate, patient-centered care. This program makes it possible for us to expand our reach to under-resourced and uninsured patients and enhance our services, ensuring comprehensive and equitable care to communities throughout the region. Our goal is to enrich the lives of all our patients, address their unique needs, and foster their overall well-being. Serving all of our diverse communities is foundational to our mission of advancing health.
We invite you to explore the profound impact this essential program has on our organization. Even more importantly, we urge you to understand the incredible difference it makes in the lives of the communities and patients we serve. The 340B program opens doors to initiatives and resources that would otherwise be unavailable, ensuring those in need receive the support and care they deserve.
Dan K. Lundergan, MHA
Charlton Park, MBA, MHSM
About University of Utah Health
University of Utah Health (U of U Health) is the only academic health system in the Mountain West region. We serve patients in Utah and five surrounding states, servicing an area that comprises 10 percent of the geographic United States. Our mission is to improve health and quality of life through excellence in patient care, education, and research. As a Disproportionate Share Hospital (DSH) and safety net provider, U of U Health serves a large proportion of low-income and uninsured patients. Many of the services we provide are under- or unreimbursed, qualifying U of U Health for the 340B Program. U of U Health is committed to 340B Program compliance. We invest in the necessary resources and infrastructure to ensure we continue to meet the 340B Program rules and provide uncompensated care to those who need it.
How the 340B Program Benefits Our Community
U of U Health has participated in the 340B Program for more than 25 years. In FY 2018, we spent more than $256 million on medications. Without the 340B Program, our medication spend would have been more than $405 million. The savings generated from the 340B Program allow us to improve patient outcomes in our community and provide critical services to patients who would otherwise lack access to care.
In line with the original intent of the 340B Program, U of U Health has used its 340B savings well to reach a larger number of eligible patients and improve access to care.
We use our 340B savings to improve access to care by:
- Providing clinical care to patients who are unable to pay for services. Uncompensated or charity care is provided to our patients for free or at a discounted rate.
- Providing patients access to medications through our Medication Support Services (MSS) program. Patients who qualify for the MSS program receive their medications free of charge from U of U Health pharmacies. Since November 2018, the MSS program has provided free medications to more than 11,000 patients.
- Helping patients to access medications through our Pharmacy Assistance Program (PAP) and Huntsman Medication Access Coordination (MAC) programs. Our PAP and MAC teams connect patients with federal, state, or private resources that provide coupons, grants, and free or discounted drugs. In 2022:
- The PAP Program helped more than 3,600 patients access medications through foundations or other programs.
- The MAC program helped more than 1,800 patients access medications free of charge.
- Patients who may not qualify for the MSS program may qualify for assistance through U of U Health's case management service. More than 200 patients per year receive free medications, supplies, and courier services.
- Subsidizing health care services that operate at a loss, including mental health, substance abuse, psychiatry, crisis intervention, primary care, HIV, air ambulance, and other outpatient specialty services. We are projected to spend more than $25 million on these services in 2023.
- Providing free or discounted clinical services to the public, including skin cancer screenings, physical exams, diabetes screenings, and mental health assessments.
- Investing in a robust telehealth and education program that connects providers to patients living in rural areas. Our TeleStroke and TeleBurn programs connect primary care providers serving rural communities with specialists that triage and develop care plans for complex patient care.
- Providing certified translators in more than 90 languages for patients who do not speak English as their primary language. Robust and extensive translation services break down the language barriers and help our clinical teams better communicate and connect with our non-English speaking patients in their native tongue. In addition, University of Utah Health donates 10 medical translation certification courses per year to nonprofit agencies that serve our refugee population.
In addition to expanding access to care, our 340B savings helps us provide value-added services that improve patient outcomes.
We use our 340B savings to invest in programs that improve patient outcomes, including:
- Treating patients with chronic conditions in the ambulatory or same-day care setting when possible and preventing hospital admissions. (U of U Health ranked #1 according to Vizient Ambulatory Quality and Accountability Performance Score Card.)
- Providing bins for patients to safely dispose of unused narcotics in our community pharmacies. Removing unneeded opioids from the community helps decrease opioid misuse, abuse, and overdose.
- Deploying Mobile Crisis Outreach Teams (MCOT) that perform crisis interventions and aim to stabilize patients in the community and prevent emergency department or inpatient admissions. MCOT has been able to handle 93 percent of cases in the community setting, thereby diverting trips to the emergency room and decreasing unnecessary high-risk and more expensive care.
- Developing and supporting the SafeUT app, which is the official crisis and suicide prevention line for children and young adults in the state of Utah. U of U Health clinicians respond to phone calls and chats in real-time and counsel clients on drug and alcohol abuse, depression, loss, grief, and a variety of other issues.
- Preventing hospital readmissions and medication-related issues through a transitions of care program. Pharmacists review medication histories and clinical notes for high-risk patients discharged from the hospital. The pharmacists answer any follow-up questions or concerns and ensure the patients are able to pick up their medications.
- Preventing the spread of HIV infection through a free HIV prevention clinic. The clinic provides free sexual health counseling, STD and HIV testing, and HIV Pre-Exposure Prophylaxis (PrEP). Since its opening in March 2018, more than 500 patients have enrolled in the program, which continues to expand in 2023.
In addition to improving outcomes and expanding access to care, our 340B savings provide:
- More comprehensive care
- Increased patient access to care
- Free or reduced-cost medications to patients
- Improved patient experience and outcomes
- Enhanced community outreach and screenings
- Better community health as a whole
Without the 340B savings, our health system could not reach as many patients or provide as much comprehensive and free care without additional taxpayer funding.
If we lost access to the 340B program, we would have to stop providing certain services and programs and could not continue expanding services for our patients. The 340B program is vital to Utahns receiving the health care they need
University of Utah is committed to program integrity, dedicating more than 16 FTEs to ensure compliance with the regulations of the 340B program. These FTEs include pharmacy technicians, pharmacists, auditors, legal counsel, billing and compliance, revenue cycle integrity, informatics, hospital executives (e.g., Chief Financial Officer, Chief Pharmacy Officer), compliance, and other support staff.