title: The 340B discount program: outpatient prescription dispensing patterns through contract pharmacies in 2012.
abstract: Section 340B of the Public Health Service Act provides qualified organizations serving vulnerable populations with deep discounts for some outpatient medications. A 2010 regulatory change widely expanded the 340B program's reach, allowing these organizations to contract with retail pharmacies to dispense medications for eligible patients. Little is known about which medications are dispensed by contract pharmacies under the expanded program. We provide the first comparison of 340B prescriptions and all prescriptions dispensed in contract pharmacies. We used 2012 data from Walgreens, the national leader in 340B contract pharmacies. Medications used to treat chronic conditions such as diabetes, high cholesterol levels, asthma, and depression accounted for an overwhelming majority of all prescriptions dispensed at Walgreens as part of the 340B program. A higher percentage of antiretrovirals used to treat HIV/AIDS were dispensed through 340B prescriptions than through all prescriptions dispensed at Walgreens. The majority of 340B prescriptions dispensed at Walgreens originated at tuberculosis clinics, consolidated health centers, disproportionate-share hospitals, and Ryan White clinics. Our results suggest that 340B contract pharmacies dispense medications used to treat Americans' chronic disease burden and disproportionately dispense medications used by key vulnerable populations targeted by the program.
authors.affiliation: Bobby L. Clark (bobby.clark@walgreens.com) is senior director of outcomes and health services research at Walgreens, in Deerfield, Illinois.
authors.forename: Bobby L
authors.initials: BL
authors.lastname: Clark
authors.affiliation: John Hou is manager of outcomes and health services research at Walgreens.
authors.forename: John
authors.initials: J
authors.lastname: Hou
authors.affiliation: Chia-Hung Chou is a research assistant professor of medicine at the University of Chicago, in Illinois.
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Chou
authors.affiliation: Elbert S. Huang is an associate professor of medicine at the University of Chicago.
authors.forename: Elbert S
authors.initials: ES
authors.lastname: Huang
authors.affiliation: Rena Conti is an assistant professor of pediatrics and health studies at the University of Chicago.
authors.forename: Rena
authors.initials: R
authors.lastname: Conti
mesh_terms: D016527:Drug Costs / Q000331:legislation & jurisprudence*; D004608:Eligibility Determination; D006801:Humans; D017057:Medically Uninsured / Q000331:legislation & jurisprudence; D006278:Medicare / Q000191:economics / Q000331:legislation & jurisprudence; D055553:Prescription Drugs / Q000191:economics*; D012111:Residence Characteristics / Q000706:statistics & numerical data; D064876:Safety-net Providers / Q000191:economics / Q000331:legislation & jurisprudence; D012959:Socioeconomic Factors; D014481:United States; D014488:United States Health Resources and Services Administration / Q000331:legislation & jurisprudence; D035862:Vulnerable Populations
chemical_list: D055553:Prescription Drugs
keywords: Access To Care; Pharmaceuticals; Safety-Net Systems; Special Populations