Senator Murray Calls for Strengthening Drug Discount Program Undermined by President Trump

Senate HELP Committee held second hearing on the 340B program that helps make drugs more affordable for safety net care providers

President Trump delayed a rule to prevent drug companies from overcharging 340B care providers and withdrew guidance that aimed to provide clarity on program rules.

The Trump Administration has cut Medicare payments to 340B care providers by nearly 30 percent

Murray: Given President Trump’s record on 340B, recent promises to lower drug prices “not going to have a lot of credibility”

(Washington, D.C.) – Today, Senator Patty Murray (D-WA), Ranking Member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, delivered opening remarks at the Committee’s second hearing about the 340B program, which provides safety net care providers with drugs at a discounted rate to help them stretch their resources farther to serve vulnerable populations.

In her remarks, Senator Murray shared stories from Washington state about hospitals and patients that have benefited from the program. She discussed the importance of providing accountability and transparency to keep the program strong, and criticized President Trump’s steps to undermine the 340B program and delay progress toward accountability.

Key excerpts of Senator Murray’s remarks:

“Olympic Medical Center uses 340B savings in Sequim, Washington to fund the only full-service cancer center on the Olympic Peninsula—allowing patients to access treatment close to home—and provide treatment regardless of whether patients are able to pay. Without 340B, the Center would operate at a loss and would have to cut back these programs. At Evergreen Health in Monroe, Washington, they use 340B savings to fund a program for pregnant women struggling with substance use, a primary care center in rural Sultan, and discounted care for those who need it. Without 340B, Evergreen would operate at a loss. It would also have to cut programs. On the east side of the state, Kootenai Health uses 340B to serve rural communities in Washington, Idaho, and Montana. Kootenai’s 340B savings support a level 3 NICU that helps babies born prematurely and facing health challenges, an E-R that sees over 50,000 visitors a year, no cost behavioral health services, and financial support for cancer patients. It’s clear 340B has helped care providers that are so essential to their communities stretch their resources farther than they could otherwise.”

“We should strengthen the 340B program and have more accountability and transparency for everyone in our drug system. We should be confident entities are using their 340B savings appropriately, and pharmaceutical manufacturers are providing 340B discounts fairly. If there is misuse or abuse in the system—we should hold those actors accountable.”

“… unfortunately President Trump seems entirely uninterested in actual oversight or program integrity. For example, he has continued to sabotage efforts to make sure drug companies play by the rules. The Affordable Care Act gave the Health Resources and Services Administration, or HRSA, new authorities to keep the 340B program accountable. And after the inspector general for the Department of Health and Human Services found many drug companies were overcharging, HRSA drafted a rule to make sure companies were giving the discounts required by the 340B program. The Obama Administration finalized that rule, but the Trump Administration has delayed its implementation over and over. The most recent delay came last week—the same week he gave a speech claiming he was getting tough on drug companies. And when HRSA attempted to provide more clarity for the program through its so-called ‘mega-guidance,’ instead of improving that draft and working with stakeholders to develop a path forward, the Trump Administration took a giant step back and withdrew the guidance—abandoning the effort completely.”

“President Trump can talk and tweet about lowering drug prices all he wants, but when his only concrete steps are to hold back rules that would provide accountability and prevent drug companies from overcharging, roll back guidance to clarify how the 340B discount program works, and cut resources for providers who are caring for the patients and families least able to otherwise afford care, he's not going to have a lot of credibility—and his promises aren’t going to come true.”

“Even if President Trump doesn’t appreciate the value of the 340B program, the many hospitals across the country—and the many patients they help—do. Like a retired social worker in Centralia, Washington who has been fighting melanoma for seven years. Thanks to the 340B program, her medication costs $45 a month—without the program it would cost several hundred dollars. Like a man in Olympia, Washington who lost his health insurance while fighting an aggressive cancer. Thanks to 340B he could afford to continue his chemotherapy. Like many patients in struggling communities across the country who feared care might be out of their reach or out of their budget, but who learned a health provider was able to use 340B savings to stretch its resources far enough to cover them.”

Full text below of Sen. Murray’s remarks:

“Thank you Mr. Chairman.

“I’m glad we’re able to continue our discussion about the 340B program with witnesses from the Government Accountability Office, and the Department of Health and Human Services’ Office of the Inspector General. I’m interested to hear more about how this program helps so many hospitals and health centers stretch their resources and serve their communities, and how we can strengthen and preserve it.

“340B is critical for safety net providers that care for patients and families with the greatest needs and fewest resources. The program works by requiring pharmaceutical companies to sell drugs at a lower price to health providers who take on a larger burden by serving vulnerable populations, and low-income patients. The congressional intent of the program is to help providers ‘stretch scarce federal resources’ and ‘provide more comprehensive services.’

“And in Washington state, they are using their 340B savings to do just that.

“Olympic Medical Center uses 340B savings in Sequim, Washington to fund the only full-service cancer center on the Olympic Peninsula—allowing patients to access treatment close to home—and provide treatment regardless of whether patients are able to pay. Without 340B, the Center would operate at a loss and would have to cut back these programs.

“At Evergreen Health in Monroe, Washington, they use 340B savings to fund a program for pregnant women struggling with substance use, a primary care center in rural Sultan, and discounted care for those who need it. Without 340B, Evergreen would operate at a loss. It would also have to cut programs.

“On the east side of the state, Kootenai Health uses 340B to serve rural communities in Washington, Idaho, and Montana. Kootenai’s 340B savings support a level 3 NICU that helps babies born prematurely and facing health challenges, an E-R that sees over 50,000 visitors a year, no cost behavioral health services, and financial support for cancer patients.

“It’s clear 340B has helped care providers that are so essential to their communities stretch their resources farther than they could otherwise.

“But that doesn’t mean we can’t also have more clarity in the 340B program. We should strengthen the 340B program and have more accountability and transparency for everyone in our drug system. We should be confident entities are using their 340B savings appropriately, and pharmaceutical manufacturers are providing 340B discounts fairly. If there is misuse or abuse in the system—we should hold those actors accountable.

“And there have been opportunities to provide that accountability—but unfortunately President Trump seems entirely uninterested in actual oversight or program integrity. For example, he has continued to sabotage efforts to make sure drug companies play by the rules.

“The Affordable Care Act gave the Health Resources and Services Administration, or HRSA, new authorities to keep the 340B program accountable. And after the inspector general for the Department of Health and Human Services found many drug companies were overcharging HRSA drafted a rule to make sure companies were giving the discounts required by the 340B program.

“The Obama Administration finalized that rule, but the Trump Administration has delayed its implementation over and over. The most recent delay came last week—the same week he gave a speech claiming he was getting tough on drug companies.

“And when HRSA attempted to provide more clarity for the program through its so-called ‘mega-guidance,’ instead of improving that draft and working with stakeholders to develop a path forward, the Trump Administration took a giant step back and withdrew the guidance—abandoning the effort completely.

“And they haven’t just backed away from accountability and clarity for the 340B program—they have tried to cut it as well. 340B-eligible providers have traditionally been reimbursed by Medicare at the same rate as everyone else. But this year, the Trump Administration announced they would unnecessarily and dramatically cut the program and reimburse 340B hospitals for drugs at a rate nearly 30% lower than all other hospitals.

“President Trump can talk and tweet about lowering drug prices all he wants, but when his only concrete steps are to hold back rules that would provide accountability and prevent drug companies from overcharging, roll back guidance to clarify how the 340B discount program works, and cut resources for providers who are caring for the patients and families least able to otherwise afford care, he's not going to have a lot of credibility—and his promises aren’t going to come true.

“Even if President Trump doesn’t appreciate the value of the 340B program, the many hospitals across the country—and the many patients they help—do.

“Like a retired social worker in Centralia, Washington who has been fighting melanoma for seven years. Thanks to the 340B program, her medication costs $45 a month—without the program it would cost several hundred dollars.

“Like a man in Olympia, Washington who lost his health insurance while fighting an aggressive cancer. Thanks to 340B he could afford to continue his chemotherapy.

“Like many patients in struggling communities across the country who feared care might be out of their reach or out of their budget, but who learned a health provider was able to use 340B savings to stretch its resources far enough to cover them.

“There are many stories—from Washington state and across the country—about how this program is so important. So I’m glad we have this opportunity to discuss how we make sure 340B remains accountable enough to fulfill its intent, and strong enough to continue serving our communities for generations to come.

“I look forward to hearing what our witness have to say about this. Thank you Mr. Chairman.”

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