Patient Perspective: Legislators should oppose Pharma’s efforts to cut drug discount program

By Monique McCollum

When I adopted my special needs children, whose lives had been forever impacted from the start by parental substance abuse or domestic violence, they also came to me with Medicaid.

Medicaid has been the vital lifeline for children with substantial, lifelong medical needs. Without it, there would be no care. But that doesn’t mean it was an easy street for us. Kids with Medicaid and their parents or guardians still must fight or beg for care. At times, I had to push for access to a clinic or physician. I had to argue against a discharge from in-patient care too soon, or we struggled through senseless bureaucratic changes that could have led to my kids losing access to their essential, stabilizing medicines.

So, imagine my exhaustion and despair now as the federal government in Washington threatens to cut Medicaid benefits, and here in Colorado, the state legislature considers a bill that would allow big pharmaceutical companies to continue cutting a program that expands access to Medicaid services.

My kids’ health care — and that of thousands of others — may soon become a casualty of greed.

More than 30 years ago, Congress created the 340B program to support those hospitals and clinics that provide the most Medicaid and charity care. Facilities have to qualify for the program – either by being located in a rural area or by providing significantly more uncompensated care than others. Pharma benefits from the program too – in exchange for providing discounts to qualifying providers, pharma companies get to participate in Medicaid and sell their drugs in far larger numbers.

Hospitals and clinics use their 340B savings to support important medical services like cancer screenings, substance abuse treatments and maternal health, while expanding their charity care – all at no additional cost to taxpayers.

But now the pharmaceutical industry – Big Pharma — is trying to weaken 340B and restrict these discounts by limiting the number of pharmacies in the program. Those restrictions will limit the ability of thousands of patients statewide – people like my kids – to acquire the medications we need or receive the health care we rely on — all in the name of increased profits for Big Pharma.

The Big Pharma plan to cut 340B also would financially hit the very hospitals we rely on – 90 percent of the 68 Colorado hospitals that participate in the 340B program operate at unsustainably narrow or negative margins, far smaller than the large, double-digit margins Big Pharma enjoys.

Right now, Colorado legislators are considering two 340B bills. One, Senate Bill 25-071, is supported by health care providers and seeks to force Big Pharma to stop their cuts and restrictions on 340B discounts. This bill does not expand 340B, it just sustains the program and adds transparency requirements to ensure the savings go to support patients and charity care.

The other bill, Senate Bill 25-124, is Big Pharma’s bill to further restrict the program. Clouded in “transparency” language, this bill would undermine 340B by placing onerous, unworkable tracking and reporting requirements on every discounted medicine dispensed by a pharmacy. Hospitals and providers would be forced to hire more people just to administer these reporting requirements, driving up expenses and health care costs in Colorado.

So, state legislators face a crucial choice right now. Protect the 340B drug pricing program in Colorado and the benefits it provides to those of us who rely upon it by passing SB 71, or pass the bill Big Pharma drafted, SB 124, which will increase profits of pharmaceutical companies at the expense of Colorado hospitals and patients.

There’s simply no upside to weakening the 340B program through unnecessary restrictions that create barriers for low-income and vulnerable patients – one in 10 who have serious mental illness — in the name of increased Big Pharma profits. Colorado legislators must reject SB25-124 and pass SB25-071 to stabilize this important health care program. My kids can’t afford for them to do otherwise.

Author bio: Monique McCollum is a family advocate in the Denver metro area.