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Although section 340B of the Public Health Service Act may be effective in other areas, this study shows that it does not seem to limit health disparities among certain populations of patients with asthma.

In the United States, patients from many walks of life can have difficulties paying for medical care and medications that are crucial to managing or treating their diseases. Section 340B of the Public Health Service Act, which was established in 1992, provides resources to low-income and uninsured patients that allow them to gain access to more comprehensive healthcare services. This includes discounts on outpatient drugs as well as access to safety-net providers, known as 340B-covered entities. This study, published in the journal Health Services Insights, provides an analysis of how these discounts impact patients who were initially Medicare-diagnosed with moderate to severe chronic asthma. The study was restricted to Medicare Fee-For-Service (FFS) beneficiaries and relied on data from 2017 to 2019. 

Common Disparities Among Patients With Asthma

Patients with asthma exhibit a variety of disparities in both treatment and outcomes among vulnerable populations, which have been well documented in past studies. In some cases, these disparities can be very large. One study showed that Hispanic patients with asthma had 43% lower odds of receiving a maintenance drug compared to their non-Hispanic White counterparts. Vulnerable populations with asthma also exhibit a greater risk of adverse outcomes, such as hospitalizations. 

Hospital systems that participate in the 340B program may be able to reduce health disparities if providers use their savings from 340B discounts on covered outpatient drugs, which can help improve the quality of care available to patients with limited resources. This study estimated rates for various outcome measures in both 340B and non-340B hospital systems separately. These estimations included various factors, such as clinical risk factors, age, and gender. Data were taken from a total of 45,175 beneficiaries. More than 70% of the sample was female, and the average age was under 70 years old. Non-White beneficiaries treated at 340B hospitals were less likely to receive maintenance drugs or novel therapy drugs compared to their White beneficiaries and also exhibited higher rates of adverse outcomes.

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The 340B Program Does Not Reduce Disparities 

The results presented in this study show that there is some evidence that disparities persist in drug treatment and health outcomes for Medicare FFS beneficiaries with asthma. These disparities are primarily based on race, dual eligibility status, and socioeconomic status. Importantly, 340B hospitals, which receive discounts on drugs, did not exhibit decreased disparities despite these discounts. This study raises questions about the efficacy of the resources provided to 340B hospital systems, although the possibility remains that disparities are reduced among other patient populations.

Source:

Tripp, A. S., Marrufo, G., Kornfield, T., Morley, M., Nichols, D., & Yeh, A. (2023). The 340B Program and Health Disparities Among Medicare Beneficiaries With Chronic Asthma. Health Services Insights, 16, 117863292311692. https://doi.org/10.1177/11786329231169257