Welch introduces 340B PATIENTS Act to lower prescription drug costs for health care providers

Serving America’s Most Vulnerable, Rural, and Low-Income Patients 

Vermont Business Magazine U.S. Senator Peter Welch (D-Vermont) today introduced the bicameral 340B Pharmaceutical Access To Invest in Essential, Needed Treatments & Support (PATIENTS) Act, legislation that would protect the 340B drug pricing program and ensure patients—especially those in lower income and rural communities—can continue care with providers who utilize the program. 

For over 30 years, the 340B program has helped safety-net providers like rural community hospitals, critical access hospitals, and community health centers purchase outpatient prescription drugs at reduced prices from drug manufacturers at no cost to the taxpayer. Savings from the 340B program help providers expand critical services such as mental health care, substance-use disorder treatments, and emergency services, to support the most vulnerable patients in their community without the need for additional federal funding.  

During the COVID-19 pandemic, pharmaceutical manufacturers began announcing restrictions on the 340B program by limiting the number of pharmacies 340B providers can use to dispense the medications to patients. These restrictions disproportionately impact rural states, which are struggling with a decline in pharmacies. Representative Doris Matsui (D-CA-07) introduced companion legislation in the House of Representatives earlier this year. 

“Across the country, rural health systems are facing affordability and sustainability issues. Programs like 340B, which allow health care providers to purchase prescription drugs at discounted prices, help ensure rural communities can access important medical and social services. But right now, the 340B program is under attack from Big Pharma, endangering care for patients who rely on small rural health care providers for their health care needs. We’ve seen it here in Vermont and across the country,” said Senator Welch. “Our bill safeguards providers’ access to this crucial funding stream that provides a lifeline for rural health systems and protects access to discounted prescription drugs for patients.” 

“For more than 30 years, the 340B program has been a lifeline for our nation’s most vulnerable patients – providing free or discounted prescription drugs and important safety-net services at no cost to taxpayers,” said Congresswoman Matsui. “Unfortunately, Big Pharma is directly undercutting this mission. More and more pharmaceutical companies are denying access to 340B pricing for drugs that are dispensed through community or specialty pharmacies. For underserved populations and low-income Americans relying on the services provided by the 340B program – this loss of access is devastating. The 340B Patients Act sets clear ground rules to prevent manufacturers from continuing these practices and strengthen the 340B program for years to come.” 

The 340B Pharmaceutical Access To Invest in Essential, Needed Treatments & Support (PATIENTS) Act would: 

  • Clarify that manufacturers are required to offer 340B discount prices to covered entities regardless of the manner or location in which a drug is dispensed, including if a covered entity uses a contract pharmacy to dispense 340B drugs to the entity’s patients. 
  • Ensure that manufacturers cannot place conditions on the ability of a covered entity to purchase and use 340B drugs, regardless of the manner or location in which the drug is dispensed, including through contract pharmacies. 
  • Impose civil monetary penalties on manufacturers that violate these statutory requirements and prohibition. 

 

The 340B PATIENTS Act is endorsed by 340B Health, Advocates for Community Health, AIDS Healthcare Foundation, America's Essential Hospitals (AEH), American Hospital Association (AHA), American Society of Health-System Pharmacists (ASHP), Association of American Medical Colleges (AAMC), Bi-State Primary Care Association, Catholic Health Association of the United States, Children's Hospital Association (CHA), Community Health Centers of Burlington, National Rural Health Association (NRHA), Ryan White Clinics for 340B Access, and the Vermont Association for Hospitals and Health Systems (VAHHS). 

“The safety-net hospitals participating in the 340B drug pricing program applaud Senator Welch for his unwavering dedication to the millions of patients who rely on the essential services and support these hospitals provide. 340B enables hospitals to provide vital care to those most in need, including low-income patients and residents of rural areas of Vermont and across the nation. This proposed legislation would significantly enhance patient care by stopping harmful restrictions imposed by pharmaceutical companies on 340B access. It would end the losses of billions of dollars in 340B savings that should be going to safety-net providers but instead are padding already massive drugmaker profits,” said Maureen Testoni, 340B Health President and CEO. “This bill makes it unequivocally clear that the pharmaceutical industry must honor its commitment to the health care safety net. We call on the Senate to support this legislation.” 

“The 340B Program is an essential source of discounted outpatient drugs for many rural providers serving vulnerable populations. The National Rural Health Association (NRHA) is proud to support Senator Welch’s introduction of the 340B PATIENTS Act, which seeks to protect rural covered entities’ contract pharmacy arrangements and stop the erosion of 340B savings. For rural safety-net providers operating on thin financial margins, the funds saved through the 340B program help them continue to offer critical services, sustain key service lines, and keep doors open. NRHA applauds Senator Welch for his leadership on this important legislation,” said Alan Morgan, Chief Executive Officer, National Rural Health Association. 

“The AHA thanks Senator Welch for his longstanding leadership of protecting the 340B drug pricing program and the patients and communities that benefit from it. This important bill would put an end to pervasive drug company restrictions on the use of contract or community pharmacy arrangements in 340B, which make it harder for many underserved patients to get vital medicines,” said Aimee Kuhlman, AHA’s Vice President of Advocacy and Grassroots. “While we believe that the existing 340B statute already makes these drug company restrictions unlawful, this new bill which the AHA strongly supports makes it even clearer.” 

“We thank Sen. Welch for his leadership to protect the 340B program, a vital part of the patchwork support essential hospitals rely on to meet their safety net mission,” said Bruce Siegel, MD, MPH, President and CEO of America’s Essential Hospitals. “The pharmaceutical industry’s illegal and unconscionable actions to restrict access to 340B savings must end. Contract pharmacies are vital to the ability of our hospitals to reach patients where they are with affordable, lifesaving medications. This bill would help them do that and improve access to care for disadvantaged patients.” 

“On behalf of all of Vermont’s hospitals, the Vermont Association of Hospitals and Health Systems extends its thanks and strong support to Sen. Welch for his introduction of the 340B PATIENTS Act of 2024. This legislation clarifies that the intent of the 340B program is to stretch scarce federal resources for hospitals serving vulnerable communities and will allow Vermont’s hospitals to keep their doors open. The 340B PATIENTS Act of 2024 is crucial to the survival of rural hospitals and primary care,” said Devon Green, Vice President Government Relations VAHHS. 

“The 340B PATIENTS Act will help ensure patients have access to high-quality, comprehensive care from their provider or pharmacy of choice by enforcing manufacturer compliance with the 340B Drug Pricing Program,” said ASHP CEO Paul W. Abramowitz, PharmD, ScD (Hon), FASHP. “ASHP is proud to support the 340B PATIENTS Act.” 

“AIDS Healthcare Foundation (AFH) applauds U.S. Senator Peter Welch (D-VT) for introducing legislation that takes on drug companies for their illegal contract pharmacy restrictions. The 340B PATIENTS Act codifies contract pharmacy use for 340B covered entities, prohibiting gamesmanship by drug makers that place profits over the health outcomes of vulnerable Americans. As a 340B provider, AHF understands how contract pharmacy restrictions not only deny nonprofits vital savings but interfere with their successful models of care. Drug companies have done everything possible to reduce the number of prescriptions available at 340B prices. For-profit interests have exploited ambiguity in the 340B statute to limit where medically underserved patients fill prescriptions. The 340B Drug Pricing Program finds itself at the mercy of drug makers bent on unraveling a critical component of the healthcare safety net,” said John Hassell, National Director of Advocacy, AHF. The 340B PATIENTS Act provides legal certainty for contract pharmacy use by covered entities, helping 340B function as intended. The legislation will also deter drug companies from future attempts to restrict pharmacy access. For years, drug makers have lobbied Congress to layer burdensome compliance standards onto healthcare nonprofits for nonexistent problems. Provisions in the legislation ensure drug makers will now face heavy fines for noncompliance. AHF urges the Senate to pass Senator Welch’s legislation and support 340B providers in their mission to care for Americans most in need.” 

“By introducing the 340B PATIENTS Act of 2024, Senator Welch has demonstrated yet again his steadfast commitment to improving access to care for Vermonters and Americans across the country. The 340B program plays a critical role in supporting the mission of primary care providers, such as Federally Qualified Health Centers, and other essential covered entities, to minimize barriers to care, address prescription drug affordability, and increase use of high-quality preventive and primary care. It does this by allowing FQHCs to stretch scarce federal dollars to deliver discounts on prescription drugs and other critical services to their patients,” said Tess Stack Kuenning, President & CEO, Bi-State Primary Care Association. 

“RWC-340B wholeheartedly supports Senator Welch's PATIENTS Act, which aims to prevent drug manufacturers from unlawfully preventing the delivery of 340B drugs to contract pharmacies and imposing unfair restrictions on safety net providers,” said Shannon Burger, President of Ryan White Clinics for 340B Access (RWC-340B) and CEO of Cempa Community Care in Chattanooga, Tennessee. “By safeguarding Ryan White clinics’ access to 340B discounts through contract pharmacy arrangements, this bill protects the integrity of the 340B program, allowing us to effectively serve our patients and communities and work towards ending the transmission of HIV among low-income and vulnerable populations.” 

“On behalf of our member community health centers, we applaud Senator Welch for sponsoring this important piece of legislation to protect and strengthen the 340B program by codifying 340B providers’ ability to use contract pharmacies to dispense 340B discounted drugs. This legislation would ensure that health centers can have their patients pick up their prescriptions at a local pharmacy and that community health centers can continue providing expanded medical and social services to their communities using their 340B savings,” said Amanda Pears Kelly, Chief Executive Officer of Advocates for Community Health. 

Learn more about the 340B PATIENTS Act

Read the full text of the bill. 

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