Basia Jenkins, an anesthesiologist and founding partner of Health Professionals for Equality and Community (HPEC), expressed concerns regarding the profits from 340B-discounted drugs. She said that these profits are not clearly reducing patients' costs and called for reforms to address potential abuses. This statement was made on the social media platform X.
"There is no clear evidence that 340B hospitals and their contract pharmacies use 340B profits to help lower costs for patients," said Jenkins, Founder Partner. "contract pharmacies and hospitals generate profits sometimes by charging vulnerable patients the full non-340B price for their prescriptions."
According to a report by the U.S. Government Accountability Office (GAO), the oversight of 340B contract pharmacies by the Health Resources and Services Administration (HRSA) requires improvement. The GAO noted risks associated with pharmacies dispensing 340B drugs to ineligible patients and highlighted that covered entities might generate revenue by being reimbursed at non-discounted rates for drugs acquired at 340B prices. The GAO recommended clearer guidance and stronger audits to ensure that discounts benefit eligible patients rather than contributing to profit margins.
A New England Journal of Medicine (NEJM) analysis of Blue Cross Blue Shield claims from 2020–2021, involving over 404,000 patients and 4.7 million infusion visits, reported significant hospital markups for physician-administered drugs. It found that hospitals eligible for the 340B program retained a larger share of private-insurer drug spending compared to others—64.3% at 340B-eligible hospitals versus 44.8% at non-340B hospitals and 19.1% at independent practices—indicating a weak pass-through of savings to patients.
Meanwhile, an interim staff report by the Federal Trade Commission (FTC) dated July 9, 2024, finds that the six largest Pharmacy Benefit Managers (PBMs), which are vertically integrated with major insurers, manage approximately 95% of U.S. prescriptions. The report details how PBMs can influence patient choices towards affiliated pharmacies, set contract terms that under-reimburse independent pharmacies, and use rebates, fees, and formularies in ways that may increase costs for patients and plans. The FTC urges greater transparency, data access, and potential policy action.
Jenkins is recognized as a physician anesthesiologist with a long clinical career and active involvement in physician advocacy and health policy discussions. She is publicly known as "@Docbasia" across various platforms where she uses her professional expertise to comment on issues related to patient affordability and system reform.
