Whole-patient, community-based care recognizes the critical role that integrated pharmacists and access to affordable medication play in the promotion and protection of health. Those with chronic conditions make up 91% of those who get prescriptions filled, according to the CDC. If there is a way to minimize the number and get more individuals to improve their health ,it's with the help of a pharmacist and access to affordable medication.
Under the Federal 340B Program, Covered Entities can acquire drugs from manufacturers at extreme discounts from what is normally available. In turn, Covered Entities "pass on" those savings to their patients through lower costs for medications, or, as contemplated by 340B itself, Covered Entities can seek reimbursement for 340B drugs in the normal course and use those greater profit margins to subsidize other unfunded areas of their operations. As articulated by Congress itself, the 340BProgram's purpose is to enable covered entities to stretch scarce Federal resources as far as possible, reaching more eligible patients and providing more comprehensive services. By offering an alternative to asking taxpayers to cover the cost of uncompensated care, the 340B Program provides for the pharmaceutical industry's contribution of its share in addressing the problem of uncompensated patient care.
Pharmacy Benefit Managers (PBMs), insurance intermediaries adding to the cost and administration of healthcare, however, are capturing the very benefit intended for patients and communities in need. Congress never intended the 340B program to benefit insurance intermediaries that provide little, if any, direct patient care for vulnerable populations. Among other predatory and self-serving business practices, PBMs siphon money from the 340Bdrug program by paying pharmacies substantially less for 340B claims for no reason other than to retain profits which is money intended for the underserved.
Our #ProtectKyPatientsNotPBMs campaign seeks lasting protection of the 340B program. Without action by Kentucky's General Assembly, PBMs will continue to profit from the funding intended to benefit Kentucky's most vulnerable patients and their communities. Through PBM reform, Kentucky can support patient care rather than adding to the profits of insurance companies. As our state elected officials prepare for the 2024 Regular Session commencing early January, the KPCA is committed to continued advocacy for PBM reform in Kentucky. We are working across party lines to garner bipartisan support and grateful for the Members' time, attention, and concern about an issue critical to our shared mission of improving health access and health equity for all Kentuckians. Thank you to the Patients Not PBMs Workgroup, Legislative & Advocacy Committee, and health center advocates for your contributions to the #ProtectKyPatientsNotPBMs campaign.
Please continue your advocacy and raise your voice this December. Thanks to the effort and expertise of @Melissa Mather at Family Health Centers, we are making advocacy easy. Please copy, paste, post and share these messages on your social media through December. We have prepared graphics, hashtags, and social media handles for the elected officials. Please download the material by clicking the button below.
The health center with the most engaged audience in the month of December will will receive an award and recognition during the next Advocacy Coordinators call.
If you have any questions please reach out to @Paula Straub; @Chuck O'Neal; @Ashley Gibson
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Drilon Gojani
Senior Director of Member Services
dgojani@kypca.net859-797-6134
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