Boston Medical Center, Boston
Thanks to 340B savings, the hospital’s Specialty Pharmacy Program has more than doubled the percentage of patients with cancer, HIV, and other diseases who have medications reliably in hand, versus the communitywide average. The program also has dramatically reduced wait times for cancer drugs and improved medication adherence among oncology and HIV patients to 90 percent, compared with historical rates of 50 to 70 percent. Hepatitis C therapy compliance—the key to full recovery—is at 99 percent compared with 60 percent communitywide.
East Alabama Medical Center (EAMC), Opelika, Ala.
At EAMC, a patient mix that includes a high number of uninsured and Medicaid patients contributed to $50 million in uncompensated care costs in 2016. Although falling well short of covering this gap, the 340B savings the hospital achieved—$10 million that same year—helped EAMC make cancer treatment available to indigent, uninsured, and underinsured patients.
Hennepin County Medical Center (HCMC), Minneapolis
HCMC admitted a homeless, uninsured man nine times over four months at a cost of $225,000, or more than $56,000 a month. Pharmacists in a hospital medication therapy management program made possible by 340B savings taught the man how and when to take his medications. After regular clinic visits and improved care management, his medical expenses dropped to $36,000—$4,000 a month—in just nine months.
UK HealthCare, Lexington, Ky.
UK HealthCare’s 340B savings allow the health system to maintain dedicated pharmacy staff to help indigent, self-pay, and underinsured patients receive needed medications through copayment assistance and other financial support programs. The system, which lacks its own home-infusion pharmacy, extends care through a contract home-infusion pharmacy with the help of the 340B program.
Erlanger Health System, Chattanooga, Tenn.
Without its 340B savings—$9 million in 2014, or about a tenth of its $92 million in uncompensated care costs—Erlanger could not provide some trauma, oncology, and stroke services programs to underserved patients. The health system’s 340B savings also fully fund a pharmacy at its Dodson Avenue Community Health Center, which offers face-to-face counseling on medication therapy, adherence, and chronic disease management.
University of Utah Health Care, Salt Lake City
With its 340B savings, University of Utah Health Care provides an AIDS drug assistance program in which patients receive drugs at cost plus a minor fee. It also partners with rural hospitals to help them successfully care for patients with peripherally inserted central catheter lines or with high-risk pregnancies, increasing capacity for emergency and critical care and improving operating room procedures. This keeps patients in their communities and avoids costly transfers to other hospitals.
University of Virginia (UVA) Health System, Charlottesville, Va.
UVA Health System has one of the highest case mixes in the United States—evidence that it cares for many of the sickest patients. It also provides more than $250 million in uncompensated care annually. The health system’s 340B savings are vital to maintaining specialty services, such as home health and dialysis, and access to specialized pharmacy services for patients at high risk of readmission.
VCU Health, Richmond, Va.
Savings from the 340B program made possible the VCU Health Virginia Coordinated Care Program, which contracts with primary care providers to offer a medical home for 23,000 low-income, uninsured people. The program has lowered emergency department use and costs and made medications available to the 80 percent of outpatients who otherwise lack prescription drug coverage.
Arrowhead Regional Medical Center, Colton, Calif.
More than half of patients at this San Bernardino County hospital are indigent and most have no insurance or depend on Medicaid. The savings Arrowhead achieves through the 340B program help it treat as outpatients many people who otherwise would be admitted, saving taxpayer dollars.
Broadlawns Medical Center, Des Moines, Iowa
Money saved through 340B discounts allows Broadlawns to fill a coverage gap for patients in the state’s public health insurance program, IowaCare, which does not cover outpatient medication. The 340B program helps ensure chronically ill IowaCare patients—low-income residents without Medicaid or other coverage—can adhere to medication regimens.
Grady Health System, Atlanta
With more than 620,000 patient visits annually, Grady is Georgia’s largest hospital and largest safety-net provider. About 44 percent of the hospital’s outpatients lack insurance, and, overall, 30 percent of the hospital’s patients are uninsured. Grady fills more than 800,000 outpatient prescriptions annually, most going to uninsured patients whose out-of-pocket costs are $5 or less thanks to the 340B program.
Greenville Health System (GHS), Greenville, S.C.
With 340B savings, GHS established its Upstate MAP (Medication Assistance Program) in 2016 to make free and low-cost drugs available to the state’s neediest patients. The program has saved 2,500 patients more than $6 million in medication costs, including an arthritis patient who fell short of meeting manufacturer assistance criteria and a man whose copayment for an anticoagulant fell from $465 to $1 with MAP assistance.
LAC+USC Medical Center, Los Angeles
LAC+USC uses the money it saves by purchasing drugs through the 340B program to sustain clinics across Los Angeles County that serve uninsured, low-income patients. The savings also enable the hospital to expand therapy for, and make costly brand-name drugs available to, diabetes patients.
Riverside University Health System (RUHS), Moreno Valley, Calif.
Since 2012, RUHS has used its 340B savings to help nearly 900 patients and families affected by sexual assault. The hospital’s Sexual Assault Response Team (SART) program provides 24-hour comprehensive, coordinated forensic and medical services, including advocacy and social worker consultations, sexually transmitted infection treatment, and follow-up care. RUHS provides these and other SART services at no cost to patients.
Tampa General Hospital, Tampa, Florida.
The 340B program was lifesaving for a 56-year-old man who came to Tampa General after passing out at a picnic and learning, at another hospital, that he had brain lesions. He was diagnosed with a malignant brain tumor and began treatment with Lomustine, a chemotherapy drug. The monthly dosage of Lomustine retails for more than $3,300, which far exceeded the man’s insurance coverage. But with 340B, he paid just $21 a month for the vital drug.
University of Illinois (UI) Health, Chicago
At UI Health, 340B savings free up resources the hospital plows back into population health improvement programs, including Better Health Through Housing. This initiative provides subsidized housing and care managers for chronically homeless emergency department users. Preliminary data suggest health care costs for the first 15 patients housed fell by 42 percent.
UI Health also uses money saved through 340B for:
- PRONTO (Pilot PROgram for Non-emergency TranspOrtation), which provides rides home for discharged patients who live in Chicago; and
- telemedicine to manage health care for Illinois Department of Corrections inmates with HIV and hepatitis C, saving taxpayers $11 million in fiscal year 2016.
Of course, 340B makes prescription drugs affordable for many vulnerable UI Health patients. It came to the rescue when the family of a 9-year-old girl with a brain tumor could not afford the $330 out-of-pocket cost for a drug in her chemotherapy regimen. 340B lowered from $2,000 to $200 the cost of an immunosuppressant drug that a kidney transplant patient needed and that Medicare would not cover. Employed, but uninsured, patients at UI Health rely on 340B, including a man who could not afford the $300 monthly cost of diabetes and hypertension medications (340B lowered that to $50) and a glaucoma patient who received needed eye drops for $14 a month versus $130 without 340B.
UW Medicine, Seattle
UW Medicine uses its 340B savings to offset the cost of a variety of programs that help vulnerable people and meet its broader mission to prepare for emergencies and reach outside its walls to improve population health. Examples include:
- long-term housing services for recovering patients and families;
- programs to support rural primary care providers, such as Project ECHO and the Telepain opioid addiction program; and
- the Stop the Bleed campaign, which trains the public to control bleeding for victims of mass casualty events and other violence until emergency responders arrive.