Advocacy in Action

10/26/20 • 22 min

In this episode, we speak with Julie Clements, Director of Health and Clinical Affairs at the University of California Office of Federal Government Relations. Clements details why advocating for 340B is critical, how health care professionals can engage in advocacy, and how advocacy has changed during the COVID-19 pandemic.

The Importance of Health Care Professionals Advocating For 340B: Clements discusses how important it is for those who work with the 340B program every day, such as pharmacists and other health care professionals, to provide their first-hand experiences to policymakers on how beneficial 340B is to patients. She and her government relations colleagues partner with health care providers and other health system colleagues, such as communications professionals, to share how University of California is a good steward of the program. Health care providers advocating directly about the program to policymakers is the best way for them to understand how the 340B program works.

Educating Policymakers on 340B: Julie discusses how one of the greatest advocacy challenges is helping policymakers understand how 340B works. A couple of years ago, University of California had one of its chief pharmacists testify on Capitol Hill to educate policymakers about the program and answer their questions. The chief pharmacist discussed how safety-net hospitals rely on 340B and how they use their program savings. Julie heard positive feedback about the testimony the chief pharmacist provided and how it helped members of Congress understand 340B better.

Workarounds During COVID-19: Advocacy days also have been productive opportunities to share information to policymakers in D.C. The temporary halt to in-person events drastically altered how advocacy is done. Clements shares that one upside is the ease of setting up virtual meetings to allow for quick one-on-one conversations with members of Congress and their staff rather than long trips to and from Washington D.C. Virtual meetings also provide more opportunities for C-suite executives to participate.

Drug Manufacturers Refuse to Provide 340B Discounts: One of the biggest challenges 340B currently faces is drug manufacturers refusing or threatening to refuse 340B discounts when drugs are dispensed at community pharmacies. Julie said that the timing of the drug manufacturers’ actions is unconscionable considering the ongoing COVID-19 pandemic. The University of California is responding to these actions by continuing to demonstrate to policymakers how the health system is using 340B as Congress intended.

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Episode Resources

Episode Resources

Previous Episode

Researching 340B’s Value to Medication Therapy Management

In this episode, we spoke with Dr. Jessica Tilton, the clinical coordinator for the University of Illinois Health Medication Therapy Management Clinic and a clinical assistant professor in the Department of Pharmacy Practice at the University of Illinois at Chicago College of Pharmacy. Jessica discusses the research she and her colleagues have conducted that demonstrates how the clinic is measurably improving patient health outcomes. Prior to the interview, we provide news updates on additional drug manufacturers refusing to provide 340B discounts and the Centers for Medicare and Medicaid Services reviewing comment letters regarding its proposals to make deep Medicare Part B cuts in 2021.

Improving Medication Adherence: The majority of the MTM clinic’s patients are on more than 10 medications and struggle with medication adherence. Jessica and her colleagues spend 60 minutes the first time a patient comes to the clinic evaluating the medications the patient has at home and comparing this to the medications the patient has been prescribed and indicates they are taking. Following the appointment, patients can pick up their medications all at once since the clinic is embedded within the pharmacy.

Disease State Management: Once a patient’s medication adherence challenges are addressed, the clinic’s pharmacists are working with patients on disease state management, primarily for diabetes, hypertension, and asthma. For instance, a patient with blood pressure of 200/150 can be managed weekly in the clinic until their blood pressure is under control, rather than through the emergency department.

340B Savings Create a Robust Clinic: Jessica says that 340B savings enable the Medication Therapy Management clinic to care for many more patients than it otherwise could without this financial support.

Conducting 340B Research: The Medication Therapy Management clinic partnered with the Department of Health Systems, Outcomes, and Policies to conduct its own 340B research to measure how much patients’ health outcomes were improving. The research focused on patients with diabetes and hypertension. The research found that the MTM clinic reduces A1C hemoglobin levels by an average of 0.63% and systolic blood pressure by 8.2 ml. Using modeling, the research also found the decrease in blood pressure reduced cardiovascular events by 10 and increased life years for the cohort of 200 patients by 4.5 life years. Costs to insurers were reduced by $500,000.

Episode Resources:

340B Health Celebrates American Pharmacists Month

Next Episode

Celebrating National Rural Health Day

For this episode of 340B Insight we speak with Alan Morgan, CEO of the National Rural Health Association. Alan previews National Rural Health Day on November 19, discusses how rural hospitals are faring during the COVID-19 pandemic, the future of rural hospitals, the role of 340B to help hospitals stay afloat, and why drug manufacturers attacks on contract pharmacies are detrimental to rural hospitals and their patients. In our news segment prior to the interview, we recap how Novartis has become the fourth drug manufacturer to block 340B discounts when drugs are dispensed at some contract pharmacies. We also celebrate the 340B program’s anniversary.

National Rural Health Day National Rural Health Day is November 19. On this day, the rural health community comes together to celebrate the importance of rural health. It is a great reminder of what’s working in health care for these communities. NRHA asks folks to promote the positive stories on social media and other digital platforms.

340B Keeps Rural Hospitals Afloat With 48% of rural hospitals operating at a loss back in the first week of April, many of these health care providers were struggling to stay afloat. Recent research from 340B Health found that more than 75% of rural hospitals depend on 340B savings to keep their doors open.

Rural Hospitals During the Pandemic A rise in COVID-19 cases has forced hospitals to stop scheduling elective and other non-emergency procedures, which account for 70-75% of revenue for rural hospitals. As a result, many of these facilities do not have the capacity or resources to manage the new surge of cases sweeping the nation. However, these hospitals have responded by collaborating and networking with peer hospitals to share supplies and efficiently transfer patients to facilities with additional resources.

Innovations That Have Helped Rural Hospitals Alan touches on the benefits and advances in telehealth, which have been critical and will continue even after the pandemic ends. He discusses the positive effects of rural hospitals and their CEOs reaching out to and communicating with their communities about the pandemic and public health.

Drug Manufacturers’ Attacks on Contract Pharmacies Affect Rural Hospitals and their Patients Drug manufacturers are refusing to provide discounts to 340B hospitals when drugs are dispensed at contract pharmacies. Alan says this is terrible for rural hospitals and their patients. In many communities, rural patients rely on contract pharmacies to receive their medications and other pharmacy services. The drug manufacturers’ actions put this at risk as well as the ability for rural hospitals to access their 340B savings. As a result of the pandemic, many people are moving to more rural areas and need access to care in these communities. This is why NRHA is advocating for rural hospitals to provide outpatient services, keep open a 24/7 emergency department, and use telehealth, while eliminating the requirement for inpatient beds.

Episode Resources:

1.340B Health Statement Regarding Novartis Cutting Off Access to 340B Pricing Through Community-based Pharmacies

2. Letter to HHS Secretary Alex Azar from More than 60 Advocacy Organizations for Patients and Social Justice

3. 340B Health President and CEO Maureen Testoni’s 340B Anniversary Video Message

4. National Rural Health Day

5. 340B Health Webinar: What the 2020 Election Means for 340B