340B Health Releases New Report on Impact of Medicare Part D and Most-Favored Patient Assistance Programs
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Medicare Part D and the Changing Landscape
for Patient Assistance Programs
Executive Summary
This report presents the results of a survey of 340B Health members. The survey gathered information about 340B Health member experience with drug manufacturer-sponsored patient assistance programs (PAPs) and the Medicare Part D drug benefit. The new Medicare drug benefit provides insurance coverage for pharmaceuticals to many who had previously relied on charity care from 340B Health members or PAPs, but the new legal and regulatory landscape created by the Part D benefit resulted in restructuring of manufacturer assistance programs. In addition to gathering general information about members’ experience with Part D and PAPs, the survey explored changes in PAP use after Part D was implemented.
Many safety net pharmacies facilitate enrollment in “individual” PAPs that provide free drugs directly to patients and/or administer “institutional” PAPs that distribute drugs to eligible patients from bulk donations. With Part D came additional requirements from PAP sponsors designed to ensure that donated drugs are not improperly provided to patients who receive the Medicare benefit. The report identifies pharmaceutical manufacturer PAP programs that hospitals find to be the most beneficial based on cost avoidance and efficiency.
While many respondents reported positive experiences with Part D, other hospitals are struggling with the consequences of the new drug benefit. Forty percent of respondents reported that Part D had a positive financial impact on their institution and more than half of respondents reported a decrease in reliance on charity care because of Part D. However, almost a third of respondents reported a negative impact from Part D.
Some hospitals have been able to take advantage of Part D partly due to the availability of reimbursement for pharmaceuticals they previously provided for free. However, in addition to these positive effects, the survey also found some unintended consequences of Part D deserving of further research and attention. For example, since Part D was implemented, the administrative burden on 340B Health members increased for both institutional PAPs and individual PAPs. In addition, some hospitals reported that Part D patients were only using their pharmacy when the patient had reached the “donut hole” where Medicare does not provide drug coverage.
The report is a free publication for 340B Health member hospitals and corporate partners. If you are not a 340B Health member or corporate partner, you can order an electronic copy for $100 or a hard copy for $150. If you are a 340B Health member and wish to order an additional hard copy, there is a $50 fee.
To order a copy of this report, please contact 340B Health’s Mike Hess at 202-552-5869 or mike.hess@340bhealth.org.
340B Health Members: An electronic copy of this report can be found on the Members Only page of this Web site under the Medicare Part D section.
Corporate Partners: An electronic copy of this report has been sent to you. Please contact Mike Hess at 202-552-5869 or mike.hess@340bhealth.org if you did not receive it.