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http://dx.doi.org/10.1056/NEJMc1802999DOI Listing

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Cancer treatment has become increasingly expensive, partially due to the use of specialty drugs. The costs of these drugs are often passed down to patients, who may face the consequences of paying for more than they can afford, leading to financial toxicity. The 340B drug pricing program is a health care policy that may provide an opportunity to mitigate the financial consequences of cancer care.

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: The 340B Drug Pricing Program provides discounted drug prices to safety-net entities which help stretch scarce resources to expand comprehensive services and treat more vulnerable patients. The program has received criticism questioning whether the original intentions are being accomplished. : This qualitative study aimed to understand lived experiences of patients accessing high-cost injectable diabetes medication(s) through a 340B Prescription Cash Discount Program (PCDP) provided at a community health center.

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Article Synopsis
  • The 340B Drug Pricing Program significantly impacts the US healthcare system, accounting for about 1% of total spending, and decisions made about it affect safety net services nationwide.
  • A scoping review of existing literature reveals that nonprofit hospitals involved in the program may prioritize financial margins, though evidence of increased community engagement is weak and varies by hospital type.
  • The review encompasses 44 peer-reviewed studies, highlighting common research questions and categorizing the literature based on the motivation behind 340B use and the types of healthcare entities involved.
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Importance: Previous studies have found that hospitals participating in the 340B Drug Pricing Program have higher Medicare Part B spending and expansion into affluent neighborhoods. Less is known about the association of 340B participation with spending by commercial insurance, where reimbursements are higher than Medicare.

Objective: To use the Affordable Care Act expansion of eligibility for the 340B Drug Pricing Program to study the association between participation and spending on outpatient-administered oncological drugs for commercially insured patients.

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