For patients in Michigan living with a complex or chronic condition, home infusion therapy is a safe, comfortable and cost-effective way to receive essential treatments.
As someone who works closely with providers who deliver infusions to Michiganians, I see every day how much stability it gives people who would otherwise face repeated and costly hospital visits or prolonged stays.
Access to infusion therapies for conditions such as Crohn’s disease, multiple sclerosis, rheumatoid arthritis and other serious illnesses depends on a system that keeps care affordable and available in the settings where patients do best.
The 340B Drug Pricing Program exists to support that goal by helping low-income and uninsured patients access their medications.
As a federal program, 340B allows eligible hospitals and clinics to purchase medications at steep discounts. The expectation is that savings from 340B drug discounts will help vulnerable patients who otherwise cannot afford essential medications to treat complex conditions, many of whom need infusion therapies.
However, over time, large 340B hospitals and clinics have turned the program into a major source of revenue. They purchase drugs at the 340B discount, bill insurers and patients full price or more, and pocket the difference. In 2024, 340B hospitals and clinics purchased $81.4 billion in discounted drugs.
And because there is no requirement for 340B hospitals and clinics to report on how they use profits from drug discounts, there is virtually no way of knowing if patients are benefiting.
We do know that 340B hospitals in the state provide comparatively lower levels of charity care. In fact, Michigan hospitals participating in 340B provide less charity care than non-participating hospitals and are also more likely to pursue aggressive medical debt practices against patients. According to data from the National Consumers League, 75% of 340B hospitals allow legal action against patients, such as lawsuits, wage garnishment, liens and credit reporting, compared with 62% of non-340B hospitals.
340B abuse has also fueled consolidation that directly affects infusion treatment access. Large 340B hospitals can use the financial advantages of the program to make it more challenging for independent home-and community-based infusion providers that do not qualify for the program to remain sustainable. Ultimately, the result of such consolidation is that patients who would benefit most from infusion care at home or in their community lose access to appropriate care at a significant burden to the overall healthcare system.
Even more concerning, Michigan legislators are considering House Bill 4878, which would allow this broken 340B program to expand without much-needed guardrails.
Michigan cannot afford to let a federal program that already lacks transparency to expand in ways that further limit access to the most appropriate site of care for patients.
The 340B program’s core mission of expanding medication access for vulnerable patients remains as important as ever. Yet a lack of oversight and accountability has allowed the program to drift far from that purpose, often at the expense of the very people it was designed to help.
340B must be fixed by Congress. Michigan legislators should not push an already flawed program even further off course by passing a bill that fails to ensure patients benefit.
Michiganians, including those who rely on infusion therapies to manage serious and chronic conditions, deserve a 340B program that works as intended by helping them access and afford the medications they need to stay healthy.
Barbara Petroff is a Livonia resident and Chair of the Sterile Compounding Practice Committee for the National Home Infusion Association.
This article originally appeared on The Detroit News: 340B drug pricing program is failing Michigan patients | Opinion
Reporting by Barbara Petroff / The Detroit News
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